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.