Self-Transcendence Theory: Pamela G. Reed Chapter 25 Overview of Self-Transcendence Theory: Three Central Concepts Self-transcendence: capacity to expand self-boundaries intrapersonally, interpersonally, temporally, and transpersonally Well-being: feeling whole and healthy, according to one’s own criteria for wholeness and health Vulnerability: awareness of personal mortality and the likelihood of experiencing difficult life situations Moderating-mediating factors are personal and contextual variables such as age, gender, life experiences, and social environment that influence the relationships between vulnerability and self-transcendence and between self-transcendence and well-being Nursing activities that facilitate self-transcendence are points of intervention Major Concepts of Nursing Based on Reed’s Self-Transcendence Theory Person: human beings developing over the lifespan in interaction with other persons and within an environment Environment: composed of family, social networks, physical surroundings, and community resources Major Concepts of Nursing Based on Reed’s Self-Transcendence Theory Health: well-being is a sense of feeling whole and healthy, according to one’s own criteria for wholeness and health Nursing: role of nursing activity is to assist persons through interpersonal processes and therapeutic management of their environment to promote health and well-being Assumptions of the Self-Transcendence Theory Focus of the discipline of nursing should be on building and engaging knowledge to promote health processes Persons are open systems who impose conceptual boundaries upon themselves to define their reality and to provide a sense of wholeness and connectedness within themselves and their environment Assumptions of the Self-Transcendence Theory Self-imposed conceptual boundaries fluctuate across the life span and are associated with health and development Self-transcendence is a developmental imperative that must be expressed for a person to realize a sense of wholeness and connectedness Propositions of the Self-Transcendence Theory Self-transcendence is greater in persons facing end-of-own-life issues than in persons not facing these issues Conceptual boundaries are related to well-being Increased vulnerability is related to increased self-transcendence Propositions of the Self-Transcendence Theory Self-transcendence is positively related to well-being Personal and contextual factors influence the relationship between vulnerability and self-transcendence Personal and contextual factors influence the relationship between self-transcendence and well-being Brief Critique of the Self-Transcendence Theory Derived using deductive reformulation Easy to understand with terms used consistently Number of concepts and relationships is minimal, yet still meaningful and fairly comprehensive Can be applied to a wide variety of situations Concepts are broad and abstract but empirical indicators have been iden.

1. Self-Transcendence Theory:
Pamela G. Reed
Chapter 25
Overview of Self-Transcendence Theory: Three Central
Concepts
Self-transcendence: capacity to expand self-boundaries
intrapersonally, interpersonally, temporally, and transpersonally
Well-being: feeling whole and healthy, according to one’s own
criteria for wholeness and health
Vulnerability: awareness of personal mortality and the
likelihood of experiencing difficult life situations
Moderating-mediating factors are personal and contextual
variables such as age, gender, life experiences, and social
environment that influence the relationships between
vulnerability and self-transcendence and between self-
transcendence and well-being
Nursing activities that facilitate self-transcendence are points of
intervention
Major Concepts of Nursing Based on Reed’s Self-
Transcendence Theory
Person: human beings developing over the lifespan in
interaction with other persons and within an environment
Environment: composed of family, social networks, physical

2. surroundings, and community resources
Major Concepts of Nursing Based on Reed’s Self-
Transcendence Theory
Health: well-being is a sense of feeling whole and healthy,
according to one’s own criteria for wholeness and health
Nursing: role of nursing activity is to assist persons through
interpersonal processes and therapeutic management of their
environment to promote health and well-being
Assumptions of the Self-Transcendence Theory
Focus of the discipline of nursing should be on building and
engaging knowledge to promote health processes
Persons are open systems who impose conceptual boundaries
upon themselves to define their reality and to provide a sense of
wholeness and connectedness within themselves and their
environment
Assumptions of the Self-Transcendence Theory
Self-imposed conceptual boundaries fluctuate across the life
span and are associated with health and development
Self-transcendence is a developmental imperative that must be
expressed for a person to realize a sense of wholeness and
connectedness
Propositions of the Self-Transcendence Theory
Self-transcendence is greater in persons facing end-of-own-life
issues than in persons not facing these issues
Conceptual boundaries are related to well-being
Increased vulnerability is related to increased self-

3. transcendence
Propositions of the Self-Transcendence Theory
Self-transcendence is positively related to well-being
Personal and contextual factors influence the relationship
between vulnerability and self-transcendence
Personal and contextual factors influence the relationship
between self-transcendence and well-being
Brief Critique of the Self-Transcendence Theory
Derived using deductive reformulation
Easy to understand with terms used consistently
Number of concepts and relationships is minimal, yet still
meaningful and fairly comprehensive
Can be applied to a wide variety of situations
Concepts are broad and abstract but empirical indicators have
been identified and scales developed for research and theory
development
The Self-Transcendence Theory as a Framework for Nursing
Care
Assessment and Planning: nurse assesses indicators of self-
transcendence, well-being, vulnerability, and moderating–
mediating factors that influence relationships between
vulnerability and self-transcendence and between self-
transcendence and well-being
The Self-Transcendence Theory as a Framework for Nursing
Care

4. Implementation: actions may focus directly on person’s inner
resources for self-transcendence or indirectly on personal and
contextual factors that affect relationship between vulnerability
and self-transcendence and relationship between self-
transcendence and well-being
Evaluation: based on effectiveness of activities to facilitate
self-transcendence and well-being
Theory of Chronic Sorrow: Georgene Gaskill Eakes,
Mary Lerman Burke, and Margaret A. Hainsworth
Chapter 26
Overview of the Theory of
Chronic Sorrow
Chronic sorrow is the periodic recurrence of permanent,
pervasive sadness or other grief-related feelings associated with
ongoing disparity resulting from a loss experience
Chronic sorrow is viewed as normal response to a void created
by ongoing disparity or loss; normalization of the experience
does not diminish the validity or intensity of feelings
Overview of the Theory of
Chronic Sorrow
Trigger events are those situations or circumstances that bring
the disparity created by the loss into focus and trigger the grief-
related feelings associated with chronic sorrow
Management methods within the theory refer to coping
strategies used by persons during the chronic sorrow experience
and supportive interventions provided by professionals

5. Major Concepts of Nursing Based on the Theory of Chronic
Sorrow
Person: human beings with an idealized perception of life
processes and health who compare their experiences both with
the ideal and with others around them
Environment: interactions that occur within the social context,
including family, social, work, and healthcare environments
Major Concepts of Nursing Based on the Theory of Chronic
Sorrow
Health: a normality of functioning, with a person’s health
dependent upon adaptation to disparities associated with loss
Nursing: primary roles of nurses include empathetic presence,
teacher-expert, and caring and competent caregiver
Assumptions of the Theory
of Chronic Sorrow
Chronic sorrow is a normal human response related to ongoing
disparity created by a loss situation
Chronic sorrow is cyclic in nature
Predictable internal and external triggers of heightened grief
can be categorized and anticipated
Assumptions of the Theory
of Chronic Sorrow
A human who experiences either a single loss or an ongoing
loss will perceive a disparity between the ideal and reality
Disparity between the real and the ideal leads to feelings of
pervasive sadness and grief

6. Propositions of the Theory
of Chronic Sorrow
Humans have inherent and learned coping strategies that may or
may not be effective in regaining normal equilibrium when they
are experiencing chronic sorrow
Health professionals’ interventions may or may not be effective
in assisting the person to regain equilibrium
Brief Critique of the Theory
of Chronic Sorrow
Inductively derived and evaluated from review of literature and
qualitative research data
Key concepts are consistently defined
Proposed relationships between concepts are clear and logical
Introduced with focus on specific population, but has been
shown to be applicable to a wide variety of loss situations
The Theory of Chronic Sorrow as a Framework for Nursing
Practice
Assessment: The Chronic Sorrow Questionnaire or interview to
identify the indicators of chronic sorrow; should also include
assessment for presence and effectiveness of internal
management strategies already being used
Planning: matching the internal and external management
strategies that should be the most beneficial based on specific
loss situation
The Theory of Chronic Sorrow as a Framework for Nursing
Practice

7. Implementation: provide anticipatory guidance regarding the
situations and circumstances that are likely to trigger episodes
of chronic sorrow; support and strengthen personal coping
mechanisms
Evaluation: based on whether the management methods were
ineffective or effective in decreasing discomfort