Self Transcendence Middle Range Theory in Nursing Care

Nursing Care and Self  Transcendence Theory

Self Transcendence Middle Range Theory,Role in Nursing Care,Concepts In Theory,Use in Nursing Research,Use of Theory and Impact on Outcomes,Conclusion.

Self Transcendence Middle Range Theory

    The middle-range theory of self-transcendence was developed by Pamela G. Reed (1991, 1996, 2003) to provide an under- standing about enhancing well-being for any person in a life situation where there is an increase in the awareness of vulnerability and mortality. 

    The two assumptions underpinning the theory of self-transcendence are that human beings are integral with their environment and capable of an awareness that extends beyond temporal/spatial dimensions, and that self-transcendence is an innate human characteristic that necessitates expression and the realization of full potential (Reed, 2003).

Role in Nursing Care

    Reed (2003) makes the case that the theory is grounded in research and theories on post formal thinking, which is reasoning about life situations that is more pragmatic, spiritual, and tolerant of ambiguity. 

    When engaging in postformal thinking, a person integrates experience as an expanded awareness of the moral, social, and historical context of life. There is an enhanced appreciation of self and life.

Concepts In Theory

    There are three concepts that make up the theory. These concepts are self trancedance, well-being, and vulnerability. Self- transcendence, a major concept of the theory, is defined as the capacity to expand self-boundaries intra personally (toward greater awareness of one's philosophy, values, and dreams).

    Interpersonally (to relate to others and one's environment), temporally (to integrate one's past and future in a way that has meaning for the present), and trans personally (to connect with dimensions beyond the typically discernible world). (Reed, 2003, p. 147)

    Well-being is defined as a "sense of feeling whole and healthy, in accord with one's own criteria for wholeness and health" (Reed, p. 148). Vulnerability is defined as "awareness of personal mortality" (Reed, p. 149). 

    The relationship between self-transcendence and vulnerability is nonlinear in that very low and very high levels of vulnerability are unrelated to increased transcendence. The relationship between self-transcendence and well-being is direct and positive when the outcome indicator of well-being is positive.

Use in Nursing Research

    The Self-Transcendence Scale developed by Reed (1991) has been used in research related to the theory. Reed (2003) reports research focused on well elders, elders who were hospitalized for treatment of depression, the oldest old (80 to 100 years of age), healthy adults, and adults facing end-of-life experiences with advanced breast cancer and AIDS (Reed, 2003, pp. 152-156). 

    These studies demonstrated the consistent finding that transcendence was related to outcome indicators of well-being. In addition, Reed (2003) cites several dissertation studies on self-transcendence. It can be concluded that there is significant research providing support that self-transcendence is related to well-being across a diversity of human health experiences.

Use of Theory and Impact on Outcomes

    The theory has been used in nursing practice that aims to facilitate self-transcendence in bereavement, in caregivers of adults with dementia, sobriety, and in primary care situations (Reed, 2003, pp. 158-161). 

    Intrapersonal strategies, interpersonal strategies, and transpersonal strategies for enhancing self- esteem are proposed (Reed). Intrapersonal strategies include: meditation, prayer, visualization, life review, and journaling. It is believed that these strategies assist a person to look inward to clarify and expand an under- standing about self and the meaning of a situation. 

    Positive self-talk and involving oneself in challenging activities can help a person to heal, grow, and transcend beyond an illness experience (Reed). Interpersonal strategies include support groups, altruistic activities, and group psychotherapy. 

    Support groups enable people to connect with each other around a challenging life event and enhance self-transcendence through sharing experiences and reaching out to help and be helped by others. 

    Transpersonal strategies include facilitating the connection with a power greater than self (Reed). Providing an environment where a person can look beyond self toward a higher power for help can promote self-transcendence.

Conclusion

    Self-transcendence is a theory at the middle range of abstraction, appealing to nurses who are interested in a conceptual structure which will guide practice and research focusing on enhancing well-being. 

    This theory should be a part of the education of under- graduate and graduate students to enhance an awareness of self-transcendence. Teaching students to apply theory in practice will give direction to their care and advance their understanding of theory-based practice.