Teoría de la transición afaf meleis

Transitions: A Central Concept in Nursing
Karen 1. Schumacher, Afaf lbrahim Meleis
Transition is a concept of interest to nurse researchers, clinicians, and theorists. This article builds on earlier theoretical work on transitions by providing evidence from the nursing literature. A review and synthesis of the nursing literature (1 986- 1992)supportsthe claim ofthe centrality oftransitions innursing. Universal properties of transitions are process, direction, and change in fundamental life patterns. At the individual and family levels, changes occurring in identities, roles, relationships, abilities, and patterns of behavior constitute transitions.At the organizational level, transitional change is that occurring in structure, function, or dynamics. Conditions that may influence thequality of the transition experience and the consequences of transitions are meanings, expectations, level of knowledge and skill, environment, level of planning, and emotional and physical well-being. Indicators ofsuccessful transitionsare subjective well-being, role mastery, and the well-being of relationships. Three types of nursing therapeutics are discussed. A framework for further work isdescribed. [Key words: transition; nursing theory; nursing model1

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1988; Shea, Adamzczak, & Flanagan, 1987), as well as in fulllength articles on practice, theory, or research. Entire issues of two journals have been devoted to exploring transitions (Fought, 1992; Murphy, 1990b), as have publications of major professional organizations (Ryan, 1988; Watson, 1988). Two instruments havebeen developed (Flandemeyer, Kenner, Spaite, & Hostiuck, 1992; Imle & Atwood, 1988). Such variety produced a wealth of ideas and reflects the interest in transitions. Although theory development was the stated intent of only a small subset of these publications, the descriptions of transitions and the many ideas about transitions discussed in the literature can be used as a basis for theorydevelopment. This review exemplifies an approach to theory development in which the nursing literature is used as “data” to address three questions: What are the types of transitions addressed in the nursing literature? What conditions influence transitions? What constitutes a healthy transition?

eleis (1975; 1985; 1986; 1991) has proposed that transition is one of the concepts central to thediscipline of nursing. Nurse-client encounters often occur during transitional periods of instability precipitated by developmental, situational, or health illness changes. Such changes may produce profound alterations in the lives of individuals and their significant others and have important implications for well-being and health. In an earlier paper, Chick and Meleis (1986), approached theorydevelopment for the concept of transition through concept analysis. They defined transition as a passage or movement from one state, condition, or place to another; they proposed an array of properties and dimensions of transition; and they examined its relationship to nursing therapeutics, environment, client, and health. In this article, we extend this work through a review of the nursing literaturepublished since 1986. Articles were identified through a MEDLINE search of the nursing literature from 1986 to 1992 using the key word transition. The search was limited to English language publications; 3 10 citations were identified. We then limited our review to publications in which the word transition appeared in the title to capture articles in which transition was a major focus. The initialoverview of this body of literature revealed that nurses have used a wide variety of publication modes to communicate their ideas about transitions. Transitions were addressed in an editorial (O’Brien, 1990), a letter to the editor (Schwartz, 1989), regular columns or features (Grady, 1992; Scherting, 1988), and accounts of personal experience (Rice,
Volume26, Number2,Summer1994

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