1. Running head: A Look At Transition Theory Through The Eyes of Afaf Ibrahim Meleis 1
A Look At Transition Theory Through The Eyes of
Afaf Ibrahim Meleis
Pamela N. Davis
October 13, 2013

2. A Look At Transition Theory Through The Eyes of Afaf Ibrahim Meleis 2
Transition Theory
Alaf Ibrahim Meleis
Introduction
. The daughter of a nurse whom is considered the “Florence Nightingale of the Middle
East” (Elsevier, 416), Alaf Meleis noted that transitions, or “passages from one life phase,
condition or status to another” (Meleis, 11) is experienced by individuals and groups from all
walks of life on a continuous basis. Influenced by the social inequities noted in her home land
and her mother’s work, she began her career in Alexandria Egypt where she became the first
Egyptian nurse to obtain an advanced degree.
Holding multiple degrees including an MS in Nursing, an MA in Sociology and a PhD in
Medical and Social Psychology, she first began developing her Transition Theory in the 1960’s
at the University of California at San Francisco. Her earliest work was developed after noting
unhealthy or ineffective transitions in relation to role insufficiency. She drew from the
theoretical sources of nursing, sociology, symbolic interactionism, role theory and an extensive
literature review to assist in developing her concepts. (Elsevier, 2013)
Currently the Dean of Nursing at the University of Pennsylvania School of Nursing,
Professor of Nursing and Sociology, and Director of the School’s WHO Collaborating Center for
Nursing and Midwifery Leadership, and holding multiple accolades, Dr. Meleis continues to
refine her theory by focusing on global health, women’s health, and immigrant and international
health as well as the theoretical development of nursing. (Pennsylvania, 2013)

3. A Look At Transition Theory Through The Eyes of Afaf Ibrahim Meleis 3
Purpose
Theoretically, Meleis’ middle-range Transition Theory, while recognizing that transition
is ongoing because individuals are in continuous states of transition that are complex and “may
occur simultaneously during a given period of time” (Schumacher, 121), would successfully end
once an individual has developed the skills necessary to make a healthy transition. Transitions
encompasses all life spans, affecting individuals as well as organizations. Meleis notes that
“transitions are both a result of and result in change in lives, health, relationships, and
environments”. (Meleis, 13) One must also consider that completion of transition implies that
an individual has grown by reaching stability and has come to a less disruptive time in their lives
compared to prior experiences. (Meleis, 1994)
The ultimate goal of a successful transition would be for individuals or organizations to
develop a new awareness, knowledge, skills, and comfort level in relation to the role changes
associated with the transition. (Schumacher, 1994) As primary caregivers for indivduals
experiencing transition, nurses have the unique opportunity to positively influence the transition
experiences of their patients by helping them develop new skills.
While working on her PhD Meleis began researching planned pregnancies and spousal
communication as it releated to planning the number of children a family chose to have. She
noted that her assumptions may have been incomplete because she failed to take note of the
transitions that were involved. She began transitioning her research to look at individuals who
were ineffective in their transitions which eventually developed into her Role Insufficency
Theory. Out of this research, she began looking at ways that individuals could make healthy
transitions and the role that nurses played in these positive outcomes.

4. A Look At Transition Theory Through The Eyes of Afaf Ibrahim Meleis 4
Transition framework has been utilized to look at various transitions that cause
vulnerability including immigrant populations, lifecyle transitions in women which include
parenting, mothering and menopause, cargiving, family, educational and professional transitions,
transitions involving changes within levels of care within a healthcare system, transition through
disease processes, and organizational transitions. (Schumacher, 1994)
Assumptions
Role Supplementation and middle-range theory were utilized in the development by
Meleis and Schumacher for the theoretical framework for Transition Theory. Assumptions
inferred are both implicit and explicit in that transtions are multidimentional with patterns of
complexity and multiplicity, and there is potential for multiple transitions to occur concurrently.
Transitions involve changes in life patterns that transform over time with changes noted in
behavioral patterns, abilities, roles, and relationships. (Elsevier, 2013)
Change and difference are not the same as transition, however both result in transition.
Individuals lives are affected by the meaning behind, conditions of, nature and processes of their
transiton experience. These same experiences and conditions potentially lead to individual
damage, problems or recovery issues, or inability to cope in a healthy manner. (Chick, 2013)
For individuals and families experiencing transition, nurses are the primary caregivers.
(Elsevier, 2013) In this role, nurses have the opportunity to assist in preparing and facilitating
individuals and their families to learn new skills by attending to the changes and demands that
result from transition.

5. A Look At Transition Theory Through The Eyes of Afaf Ibrahim Meleis 5
Concepts
Multiple concepts are introduced in Meleis’ Transition Theory, the first being Role in
which an individual’s interactions with others leads to a discovery, creation, modification and
definition of each other’s role. As a result of transition, role insufficency occurs. (Meleis, 1994)
Meleis outlines three natures of transitions. Types of transitions that individuals can
experience include Developmental, Situational, Health/illness and Organizational. Patterns
describe how transition occurs; Single, Multiple, Sequential, Simultaneous, Related and
Unrelated. Awareness, Engagement, Change and Difference, Time Span, and Critical Points and
Events describe the Properties of Transition. (Meleis, 2000)
Transition Conditions describe the Personal Conditions that either smooth the progress of
or encumber progress towards a healthy transition. These conditions can be influenced by or
influence transition and include personal Meanings, Cultural beliefs and attitudes,
Socioeconomic status and Preparation and knowledge. Likewise, Community conditions and
Societal conditions can facilitate or inhibit a healthy transition. (Meleis, 2000)
Finally, transitions are influence by Patterns of Response which include Process
Indicators and Outcome Indicators. Identifying Process Indicators that help move patients in
one direction or the other on the transition continum can facilitate beneficial outcomes.
Indicators include feelings of connectedness, interfacing, located and being situated, and
developing confidence and coping. Indicators that predict completion of a transition are Mastery
and Fluid integrative identities. (Meleis, 2000)
Definitions
Meleis defines transition as “passage from one life phase, condition or status to another”
(Chick, 239) and is defined by process, time span and perception. Transition is a process

6. A Look At Transition Theory Through The Eyes of Afaf Ibrahim Meleis 6
involving a beginning and an ending. The length of transition can vary from short to long. It is
fluid where the ending can or can not resemble the beginning. The intensity and affect on an
individuals life can vary as well. (Chick, 1986)
A common theme noted in the importance to health is connectedness. Disconnectedness
therefore is defined as an interruption in the connections with feelings of security that individuals
have. Disconnectedness is considered one of the most persistent characteristics of transition.
(Chick, 1986)
Perception varies among transitional situations resulting in varied outcomes. Because
perception influences responses and reactions, it makes it difficult to predict transition outcomes.
As a result of transition being a very personal issue, it requires a redefinition of “self and
situation” (Chick, 241). To be in transition however, individuals must have an awareness of the
situation. Until an individual becomes aware of the situation they are in preawareness. It is
during this time that the nurse plays a crucial role in eliminating barriers to awareness. (Chick,
1986)
Patterns of response are both observable and nonobservable and are considered to be
nonrandom regardless of how dysfunctional they may appear. They range from happiness and
excitement to confusion and difficulty. (Chick, 1986)
Relationships/Structure
Transition theory is easily understood and relatively simple. The framework provides for
a well rounded understanding of the intricacies of transition. The concepts wrap together the
three distinct phases; entry, passage and exit. They acknowledge the lack of variance in the
sequance of the phases, recognizing that the duration of the phases and disruption to the phases
can occur any time or place along the process. Sometimes, the phases can merge. Armed with

7. A Look At Transition Theory Through The Eyes of Afaf Ibrahim Meleis 7
knowledge of the general patterns of the phases of transition, the nurse can plan and implement
tools to assist individuals in making a healthy transition.
Conclusion
Meleis’ transition theory conciously connects the concepts of transition outlining it’s
usefulness for a multitude of disciplines, not just nursing. Her development of this theory has
spanned over fifty years of research in which she had tested it in a variety of transitional
situations from preparenthood through the aging process. It ties together three logical qualities
of transition (types, patterns and properties), recognizing the fluidity and movement of the
process while conceding that transitional conditions are influenced by both community and
society and are personalized, heavily influenced by a variety of individual factors. She rounds
out the theory by including indicators that indicate the successfulness of mastering the
transitional process in a healthy manner.
Reflecting back on nursing through many years of practice, this theory has probably been
utilized by individuals throughout their careers without them even being aware of it. All nurses
experience transition in their careers beginning with nursing school. Due to the stressors of
going to school, it is suspected that patterns of multiplicity were experienced as they transitioned
through the schooling process into their careers. Their personal backgrounds heavily influenced
their success or failure in the process. Successful integration into the nursing field indicated
mastery of the transition of becoming a nurse.
Coming to familiarize myself with and understand Meleis’s transition theory I found it
very easy to understand, especially as I saw her work mature over the years. When I think of
nursing and personal experiences, I found the theory to be very accurate and surprised myself by
recognizing that I had been practicing a theory for many years without even knowing it.

8. A Look At Transition Theory Through The Eyes of Afaf Ibrahim Meleis 8
Tra
l
Transition
Properties
Awareness
Engagement
Change & Difference
Transition Time Span
Critical Points and Events
Types
Developmental
Situational
Health/Illness
Organizational
Patterns
Single
Multiple
Sequential
Simultaneous
Related
Unrelated
Unrelated
Process Indicators
Connectedness
Interacting
Location and Being
Situated
Developing
Confidence and
Coping
Personal
Meanings
Cultural beliefs & Attitudes
Socioeconomic status
Preparation & Knowledge
Outcome Indicators
Mastery
Fluid Integrative
Identities
Community
Society
Transition
Conditions
Nature of
Transitions
Patterns of
Response
N
U
R
S
I
N
G
T
H
E
R
A
P
U
T
I
C
S
Transition Theory

9. A Look At Transition Theory Through The Eyes of Afaf Ibrahim Meleis 9
Bibliography
Chick, N. & Meleis, A. I. (1986). Transitions: A Nursing Concern, 237-257. Retrieved from
University of Pennsylvania:
http://repository.upenn.edu/cgi/viewcontent.cgi?article=1008&context=nrs&sei-
redir=1&referer=http%3A%2F%2Fscholar.google.com%2Fscholar_url%3Fhl%3Den%2
6q%3Dhttp%3A%2F%2Frepository.upenn.edu%2Fcgi%2Fviewcontent.cgi%253Farticle
%253D1008%2526context%253Dnrs%2
Elsevier. Elsevier Health.com. Chapter 20 Afaf Ibraheim Meleis, Transition Theory. 416-433.
Retrieved from
http://elsevierhealth.com/media/us/samplechapters/9780323056410/Chapter%2020.pdf
Meleis, A. I. (2010). Transitions Theory Middle Range and Situational Specific Theories of
Nursing Research and Practice. New York : Springer Publishing, LLC.
Meleis, A. S. (2000). Experiencing Transitions: An Emerging Middle-Range Theory. Advances
in Nursing Science, 12-27.
Meleis, A. T. (1994). Facilitating Transition: Redefinition of the Nursing Mission. Nursing
Outlook, 42(6), 255-259.
Pennsylvania, U. o. (2013, September). Faculty Profile. Alaf I Meleis, PhD, DrPS (hon), FAAN:
Retrieved from www.nursing.upen.edu/faculty/profile.asp?pid=853
Schumacher, K. M. (1994). Transitions: A Central Concept in Nursing. Nursing Outlook, 119-
127.