This theory was developed by Pamela Reed to explain the relationship between transcendence and well-being of individuals and to assist nurses in helping out patients achieve well-being. This essay will utilize the Chinn and Kramers 2011 model to critique this theory.
Description of the Theory
Chinn and Kramer use two different sections to evaluate the argument. The first one is the description of the theory divided into six sub-headings namely purpose, concept, definitions, relationships, structure, and function, (Chinn and Kramer, 2011).
Purpose and Concept
Self-transcendence theory provides comprehensive insight into the developmental nature of human being related to health situations relevant to nursing care (purpose), (Teixeira, 2008). This is achieved by following the model provided by the theory that provides the means to increase an individuals well-being through increased self-transcendence (concept). Reed believes that a patients well-being would be fastened by increased self-transcendence especially with the help of a nurse, (Reed, 2008).
Reed describes self-transcendence as the developmental process that is inherent, gradual and non-linear which leads to increased awareness of dimensions greater than oneself and results to expansions of personal boundaries within intrapersonal, interpersonal, transpersonal, and temporal domains, (McCarthy, Ling and Carini, 2013). The intrapersonal factor is the matter within oneself. This could be values, beliefs, philosophies, way of thinking, or how one views oneself and others. Interpersonal aspect is how an individual interacts with the environment outside the body, which is the world and the people around him. Transpersonal factor relates to the ability of a person to connect with dimensions beyond the typically discernible world. Nurses can utilize patients spiritual belief in assisting them enhance their recovery, (Kim and Reed, 2011). According to the theory, temporal domain relates to the ability of a person to hone through the passage of time continuum in the developmental process, and as a rational and intellectual being, the ability to merge past encounters and future outlook in life which results in a meaningful understanding of the present situation.
Relationship and Structure
The relationship in this theory is intrapersonal and interpersonal. Intrapersonal is between an individual and their inner self. This refers to the values one holds, the way of thinking and the manner in which one perceives life, himself and others. Interpersonal is the relationship between a person and the environment outside the body which is the world and the people around him. This, according to Reed, is highly influenced by the level of a persons self-transcendence and determines the developmental process. Increased self-transcendence leads to improved well-being and vice versa.
The theory is structured under three concepts which link vulnerability to well-being through self-transcendence, (Reed, 2008). Vulnerability is described as a persons awareness of personal mortality or an experience of challenging life events. The perception of mortality is synergized when people are faced with difficult situations. Depending on how an individual responds to such occurrences, either positively or negatively, will affect his developmental progress, expanding or crushing his inner boundaries. The assistance of a nurse is required at this point. Self-transcendence, as described earlier, is that inherent, gradual, non-linear developmental process that will result in the expansion of personal boundaries. Reed says that increased self-transcendence increases well-being. The concept of well-being is the sense of being whole and healthy by ones criteria for wholeness and health.
The theory is founded on two assumptions. One, human beings are integral to their environment. Reeds theory was influenced by Martha Rogers Science of Humanitary Human Beings which suggests that humans are one and co-existence with the environment. A person is more than, and different than the sum of its parts, and he has an on-going association with the surrounding exchanging energy (Rogers, 2011). Reed claims that in containing these innate characteristics, someone can expand current boundaries to help obtain optimum wellness, healthy state of mind and a good sense of well-being. The second assumption is that self-transcendence is a developmental imperative. The theory outlines the role of a person as a human resource and an integral component to well-being, as he can achieve development in which progress can be observed through outward expression. Reed says that it is of essence that the nurse recognizes this importance in successfully planning and executing nursing interventions.
The second section of the Chinn and Kramer model is critical reflection. This section has five sub-headings namely clarity, simplicity, generalizability, accessibility, and importance.
According to Chinn and Kramer (2011), clarity and consistency are key criteria in the description of and critical reflection on a theory. Reed describes the theoretical sources for the development of the theory in several of her publications. However, in an attempt to bring clarity to concepts of health and self-transcendence, she presents definitions that vary slightly and many examples that though theoretically consistent, are likely to confuse some readers. Concerning structural clarity, the relationships in the schematic model of the theory are more fully defined and described in her past and forthcoming writings. Structural consistency is okay because the identified relationships are logical and consistent.
The middle-range theory by Reed is strong in simplicity outlined in the three major concepts of vulnerability, self-transcendence, and well-being. However, the theory may increase in complexity since particular personal and environmental aspects and their association to the main concepts is found in clinical applications, (Chinn and Kramer, 2011). Still, the primary concepts and the number of relationships resulting from these ideas are few, remaining meaningful and relatively comprehensive.
Reeds theory offers a wide scope and purpose, thereby allowing the application to a broad spectrum of health events. The theory has the purpose of enhancing the understanding of nurses concerning well-being, (Reed, 2008). Reeds initial work focused on developmental resources in individuals facing challenges of later adulthood related to mental health, specifically clinical depression. She linked self-transcendence to mental health as an indicator of well-being, thereby expanding the scope of the theory to include persons other than old adults who faced end-of-own-life issues. Continued development and testing led to the specification of self-transcendence as a mediator between vulnerability and well-being and supported the direct relationship between self-transcendence and well-being. This broadening of the theory from mental health to well-being increased generality, resulting into a theory that is applicable in many situations of health.
The criterion of accessibility observes how well the concepts of the theory are linked to observable, empirical reality and nursing practice, (Chinn and Kramer, 2011). Although the concepts of vulnerability, self-transcendence, and well-being render the theory abstract, many researchers have identified and studied empirical indicators. Research findings supporting a strong relationship between self-transcendence and well-being as hypothesized by the theory attest to its empirical precision.
The theory has produced new nursing knowledge useful in practice like humans developmental nature that relates to health issues relevant to nursing care, (Masters, 2014). The nature of self-transcendence facilitates the development of numerous interventions possible for testing as strategies to enhance well-being in various encounters between patients and nurses.
Self-transcendence theory is imperative in the nursing education, practice, and research. The theory increases the nurses understanding that regardless of how desperate a health situation, patients have the capacity for personal development associated with feelings of well-being. Increased self-transcendence translates to improved well-being.
Alligood, M. R. (2014). Nursing theorists and their work. Elsevier Health Sciences.
Chinn, P. L., & Kramer, M. K. (2011). Integrated Theory and Knowledge Development in Nursing.
Kim, S. S., Reed, P. G., Hayward, R. D., & Koenig, H. G. (2011). Spirituality and psychological wellbeing: Testing a theory of family interdependence among family caregivers and their elders. Research in nursing & health, 34(2), 103-115.
Masters, K. (2014). Nursing theories: a framework for professional practice. Jones & Bartlett Publishers.
McCarthy, V. L., Ling, J., & Carini, R. M. (2013). The role of self-transcendence: a missing variable in the pursuit of successful aging?. Research in gerontological nursing, 6(3), 178-186.
Reed, P. G. (2008). Theory of self-transcendence. Middle range theory for nursing, 105-129.
Rogers, M. E. (2011). Science of Unitary Human Beings. Nursing Theories: The Base for Professional Nursing Practice, 6/e, 265.
Smith, M. J., & Liehr, P. R. (Eds.). (2013). Middle range theory for nursing. Springer Publishing Company.
Smith, M. C. (2008). Disciplinary perspectives linked to middle range theory. Middle range theory for nursing, 1-11.
Teixeira, M. E. (2008). SelfTranscendence: A Concept Analysis for Nursing Praxis. Holistic nursing practice, 22(1), 25-31.
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