Health Transitions Their Types and Uses

Types and Uses of Health Transitions

What is Transition,What are Transitions In Health,Transition in Healthcare Systems and Their Properties,Responses to Transitions,Transitional Theories,Nursing Concerns and Human Experience 

What is Transition

      Transition is defined as a passage between two relatively stable periods of time. In this passage the individual moves from one life phase, situation, or status to another.

    Transitions often are conceptualized in terms of stages in order to capture their movement and direction as they evolve over time. A classic description of transition stages is found in Bridge's (1991) work. He identified three stages: 

(a) a period of ending or disconnectedness from what had been before

(b) a neutral period characterized by a sense of disruption and disorientation as well as discovery

(c) a period of new beginnings in which the individual finds new meanings and a sense of control and challenge. 

    Transitions also can be conceptualized in terms of critical points. Critical points are turning points that can lead to either healthy or unhealthy outcomes. 

    The identification of stages, critical points, and strategies for coping during the transition experience provides the basis for nursing therapeutics to support healthy transitions processes and outcomes and to prevent unhealthy transitions.

What are Transitions In Health 

    Nurses provide care to patients and families who are experiencing many kinds of transitions. Developmental transitions (pregnancy, birth, parenthood), situational transitions (immigration, widowhood, relocation), and health/illness transitions (diagnosis of a chronic disease, recovery from surgery, rehabilitation) are examples of the many types of transitions encountered in clinical practice . 

    Transitions also occur in the work setting of nurses and can be classified as organizational transitions. Examples include changes in leadership, new staffing patterns, implementation of new models for nursing care, and structural reorganization. 

    A focus on transitions is so central to nursing practice that it has been argued that the mission of nursing is to facilitate transitions ( Meleis &Trangenstein , 1994).

Transition in Healthcare Systems and Their Properties 

    When using a transition framework in clinical practice or research, several universal properties of transitions must be taken into account. First, transitions are precipitated by significant marker events or turning points that require new patterns of response. These markers prompt the recognition that new strategies are needed to handle familiar daily life experiences. 

    Second, transitions are processes that occur over time. Transition processes encompass the period of time from the first anticipation of a transition until a new identity is formed at the completion of the transition. During this process the context, history, and future of the person are important. 

    A sense of disconnectedness from one's familiar world is another universal property of transition. There is often a sense of loss or alienation from what had been familiar and valued. 

    Another property is that transitions involve fundamental changes in one's view of oneself and the world. During transitions, changes in identity, roles, and patterns of behavior occur. New skills, new relationships, and new coping strategies must be developed.

Responses to Transitions 

    Persons in transition experience a wide range of responses. They may experience losses or gains, suffer from physical debilitation, have lower or higher immune responses, feel an emergence or loss of spirituality, discover new meanings, or experience traumatic stress symptoms. 

    Indicators of a healthy transition include a sense of well-being, the development of a new identity, mastery of new roles, well-being in relationships, harmony with the environment, renewed energy, and positive quality of life. Indicators of unhealthy transitions may be protracted transitional periods or the continuation of responses, such as role insufficiency or isolation, during the transition period. 

    Previous life patterns may be maintained that are incongruent with the demand for new identities and life patterns. Goals for knowledge development about transitions include increased understanding of the following: 

(a) the processes and experiences of human beings who are in transition

(b) the nature of life patterns and new identities that emerge during transitions

(c) the processes or conditions that promote healthy transition outcomes

(d) environments that constrain, support, or promote healthy transitions

(e) the structure and components of nursing therapeutics that deal with transitions ( Meleis , 1993). 

Transitional Theories 

    Numerous theories of family, ecology, problem solving, and self-care can be used to facilitate such knowledge development.Research has begun to contribute to the development of knowledge about transitions.     

Transition frameworks have been used in research to uncover the experiences of persons living with chronic illness, new mothers, patients recovering from surgery, and persons taking on the care giving role.     

Nursing therapeutics tested in research include debriefing, transition services, and role supplementation. Further research is needed to identify the types and dimensions of transitions and the consequences of transition for individuals, families, and communities. Because transitions are processes, appropriate research methods include qualitative and longitudinal approaches.

Nursing Concerns and Human Experience 

    As a discipline, nursing is concerned with the process and the experiences of human beings undergoing transitions where health and perceived well-being are the outcomes ( Meleis &Trangenstein , 1994).     

    The concept of transition was developed as a framework particularly appropriate for viewing nursing phenomena from the perspective of a human science and a practice-oriented discipline. A transition framework provides a way of understanding human responses to events that affect growth and development, health, and person/environment interaction. 

    A transition framework also provides a focus for understanding the content and timing of nursing interventions. From a transition perspective, both the timing and the duration of nursing interventions are of utmost importance. Further, a transition perspective is focused on clients and nurses as dynamic, changing beings evolving within the context of an environment that may be healthy or unhealthy. 

    During the process of transition, clients experience losses and gains. They need new skills to develop new lifestyles or modify lifestyles, prevent illness or live with illness, and enhance or maintain well-being. Nurses and nurses' actions are instrumental in the of developing these skills process.

    In summary, the use of transition as a framework facilitates the development of knowledge related to changes in persons, health, and environment. Within this framework, the scholarship should focus on uncovering and explaining patterns of responses and critical points in transitions that require nursing interventions.