Transition Theory by Afaf Ibrahim Meleis

Transition Theory by Afaf Ibrahim Meleis

Transition Theory

Transition theory by Afaf Ibrahim Meleis gives a procedure in which the process of transition can be studied. From its definition, transitions are periods in which change in an environment which has some commonalities or individual is likely to take place. When transition theory is used in practice, it can provide a comprehensive perspective on transition experience while considering the contexts within which people are experiencing a transition (Meleis, 2010).

There are some traits that most transition theories are known to have in common, these include; disconnection from the past social connections and support, lack of known reference points, the inability to meet old needs in accustomed ways and/or the appearance of new needs and the incongruence between former sets of expectations and those that prevail in the current situation (Meleis, 2010). These traits may be summarized as process, disconnectedness, perception, and pattern of response. Other possible dimensions by which transitions can be described are as follows, they include magnitude, duration, reversibility, scope, effect, and the extent to which the transition is anticipated and voluntary and has clear boundaries.

Transition is in two levels, which are at the individual level/or and family level and the organizational level. In individual level the changes, which occur, are, usually on the abilities, identity, relationship, role and patterns of behavior. Whereas, organizational transition encompasses change in areas such as, in the organization's structure and function (Meleis, 2007).

In as much as the transition is concerned, there are those conditions that may affect the consequences and quality of the transition experience. These conditions are the likes of, the level of knowledge of the transition, expectation, meaning, skills, level of planning, physical well-being, environment and emotions. But in most cases transitions can be achieved fully when there is role mastery, well-being of relationships and subjective well-being (Kralik D, 2006).

The normal nursing -- client encounter usually takes place when transition is still in the process and, at this period, individuals are often unstable because of their change in health, situations which happen around them and development which takes place in them. This instability normally has some known effects on the client and those concerned with his/her care. This, therefore, brings us closer to the most crucial concepts of transition theory. These concepts are the likes of Developmental, situational and health illness transitions (Meleis, 2010).

Developmental transition is the most widely used transition concept. This stage usually occurs in parenthood especially during pregnancy and after birth towards the 18th month of the baby. How the mother / or both parents transit into parenthood after receiving the baby, is one of the core areas in development transition. Also, the life cycle i.e. adolescent to adulthood that the born child goes through is also part of the development transition, but in most researches done, this development transition has been addressed in relationships, for instance, the relation between a mother and a child and that between a mother and her family (Kralik D, 2006).

Situational transitions involve the addition or subtracting of a person in an already existing constellation of complements and roles. This is where somebody either dies or a child is born into a society where people have roles to play in it. When this happens it is required that for events to run as normal as they initially were, the responsibilities which were for the person who has passed on is given to someone else, whereas in the event that a new person is added into the society, role is reorganized and issued to everyone including the new person (Meleis, 2007).

Health illness transition involves a situation where there is a change in roles, especially when a person who used to bare those roles falls sick. In this transition, it can either take place suddenly or gradually from the person having adequate health at the time he/she falls ill. This role change can take a different direction, from wellness to sickness and vice versa (Kralik D, 2006).

In the transition theory, the major concepts derived from it, such as developmental transition, needs to be developed not only to cover some of the key issues such as a human being developmental stages but, also it should be broaden to find out the finer details concerning the relationship among them because, these relationship ties can either inhibit or foster the transition process in an individual (Meleis, 2010).

As a Molloy college masters prepared nurse, I would develop a program to assist African-American mothers who have lost their child/children to violence. This is can be implemented in a community setting where the affected mother reside while going through the transition of losing a loved one (Molloy College Division of Nursing, 2011). Nowadays, neighborhood violence has been on the rise and the trend is quite worrying, with even young children caught in the midst of this violence. From an inner view, this violence arises out of a search for dominance among the communities/neighborhood. Since our forefathers, there existed cartels, which gave rise to gang groups, which have taken, over most of our neighborhoods. Most of these gangs exist to cover up most illegal trade which exists within them, and when these trades go sour, the resulting effect is violence within individuals/groups involved. Boundary dispute between different gang groups is also one of the issues that cause this violence i.e when a member of one of the gangs happens to have had some business on another gang's territory, this leads to war between them (Deanne K. Hilfinger Messias, 1997).

Such violence and hatred among these different African-American groups have been deep rooted into the hearts and day-to-day activities of the young generation to the extent that extremely young children have been initiated into these activities by the older ones. Not knowing that those who suffer most are their mothers, because most of their children die at a unusually tender age. The affected mothers usually go through a transition period as they come to terms with their loss.

There are various conditions that these women go through and these conditions are dependent on the following variables. These variables are meaning, expectation, level of knowledge, environment, level of planning, emotional and physical well-being which entails socioeconomic planning, attitude towards health and illness, context, gender and interrelation among transition conditions. These variables are expounded as follows (Marriner-Tomey, 2006).

Meanings are the events that come out of a transition process. These outcomes may be harmful or beneficial depending on a persons' perception. Many of the mothers are normally occupied with grief of losing their children and in most cases; they feel that there is no meaning of anything they do and life itself. Most of them are seen secluded from the society, with some of their day-to-day activities being put to a halt. Therefore, with these perception or loss of meaning, they do not notice some of the stages of transition that they go through to, which is importance to their lives.

Cultural belief and attitude is also a vital transition condition, which will determine how well she will come out of the transition. In some African-American communities, they have made gangster hood and violence be part and parcel to them to the extent that the woman who has lost her child will not view it as tragic event but an unfortunate event (Deanne K. Hilfinger Messias, 1997). This is because she will have gotten used to the fact that it is normal to die while file fighting for your gang.

The level of knowledge among the affected mothers is also a significant factor in transition condition. African-American mothers with a high level of knowledge are less affected than those with low level of knowledge. This is because, those with prior experience of how it feels when a friend, relative or a neighbor who has lost a child, they usually have positive transition experiences than those who do not have any knowledge of losing a loved one due to violence and more so they develop strategies which will enable them manage the transition like seeking counseling (Meleis, 2010).

Those mothers with knowledge of the transition experience, normally have clear goals of how and what they should do to continue having a normal life even after the loss. These goals are the likes of, coming to terms with what has happened, going through the grief process, and planning a way forward. On the other hand, those women who were not prepared of such loss in their lives are normally shocked both physically and emotionally. To some extent this shock profoundly affects their health till they come to terms with what has befell them.

The environment at which they stay in is also determining the speed at which the affected mother will come out of the transition period. For example, mothers who still live in the same neighborhoods as the violence perpetrators tend to take more time in their transition than those who end up moving from the violence prone area. The environment tends to instill fear, and without proper management, this fear transforms to hatred to those who committed the offence which in turn gives the affected mother the strength to seek revenge (Deanne K. Hilfinger Messias, 1997).

So in order for them to recover from the transition of losing a loved one, they have to change the environment they live in, and this include all the activities that resulted to the death of their child/children. For the working women, they need a supportive work environment to help them through the transition period. The supportive work environment consists of having caring and respectful colleagues, colleagues respecting her life-work boundaries and more so, understanding what she is going through.

Economic security is also a contributing factor towards having a healthy transition. When a mother is economically stable, surplus resources, has a privately owned home and has low commitment (Marriner-Tomey, 2006). She is most likely to take a shorter time through the transition than a mother who dependent on the dead child. Maybe the child was caught in debt rows that led to his/her death thus leaving the mother to settle the debt. With a favourable economic security, this reduces the amount of issues to be worried about hence enabling the mother to focus towards coming out of the transition.

Another fundamental condition that determines how ease the transition will be is the health the person to go through the transition. A woman with good health is more likely to come out of the transition faster than one with poor health. It is also necessary for them to have some quality time on their own so as to initiate the transition. Most of them may try to occupy themselves with lots of irrelevant activities so as to shift their thoughts from the grief which they have to go though. Therefore, an enabling environment should be set for them, which will enable them to come to terms with the loss they are going through (Deanne K. Hilfinger Messias, 1997).

Also, adding on health is the community condition. Community resources have been found to either promote or inhibit transition. Some of the factors which facilitate transition include; support from partners and family members especially according to the African-American culture, from the woman's mother or any other influential person to her life. Other promoters are the relevancy of the information obtained concerning the transition, advice sought from a respected source and role models. On the other hand, some inhibitors include insufficient resources to take them through the transition, inadequate support and negative support among others.

Societal condition also has an influence on the transition process. For instance, the African-American society may not readily give the mother to the dead child time to go through the transition period. She will be expected to resume her normal day-to-day activities soon after burial as if nothing happened. Marginalization, as part of the societal condition, is also a factor that inhibits transition (Marriner-Tomey, 2006). This is because the African-Americans mothers are in the margin between the host societal and their own cultures, therefore, this makes them not to undergo the transition period fully as they understand or feel like.

On another dimension, there are properties that the affected mothers are known to go through during the transition experience. These include awareness, engagement, change and difference, timespan, critical points and events.

Some of the women normally do not have the knowledge, perception and recognition of some of the experiences they are going through. This degree of awareness is shown by the responses exhibited by the African-American mother who has lost a child. For example, a mother who is not aware of the transition experience may end up being part of the violence herself while she is trying to have revenge the death of her child. These women should be given some knowledge of the changes that take place during the transition phase. Though many may perceive that lack of awareness among the women who have lost their children to violence is a sign that they have not commenced the transition experience, this does not apply to all, some go through the transition experience without them being aware of what they are going through.

Another important property of transition is the level of engagement that the African-American woman portrays. This can be shown by the woman's eagerness to go through the transition successfully. The level of engagement goes hand in hand with the level of knowledge the woman has of what is expected of her. When the affected women are aware of the some of the changes which are to take place in her life i.e. emotional, physical, social/environmental changes, she will have fewer problems when it comes to tackling the transition changes. For example, a woman with knowledge of a looming violence in her community can avoid it by moving out of the neighborhood to other safer neighborhoods to avoid such violence in the future (Marriner-Tomey, 2006).

Change and difference are also essential properties of transition. All transition involves change and difference in the woman's life. The woman should start adapting with the loss of their children because this is the new change in their lives and it is irreversible. For a healthy transition to take place, the woman should know the reason that has led to the change.

All transitions are known to have a time span, but the time an affected woman takes to go through the transition varies from one woman to another. This transition period starts from the first signs of transition through to periods of instability, confusion, distress to an eventual ending of the transition experience. In as much as the time span varies so is the order of the stages which these women go through, therefore, when dealing taking these affected women through the transition theory it is essential for a nurse to consider the possibility of fluctuations and variability over time.