Afaf Meleis’ Transitions Theory in Nursing


To encourage the active recovery of a patient, a nurse must create a platform for changes in the former’s life. The identified step also implies that a patient‘s family members must accept and embrace the change that is required for the promotion of a patient’s well-being. However, the specified transition often turns out to be rather difficult to ensure because of the incongruence of the family members’ actions. Without an intervention that encourages family members to support a patient actively, the success of the recovery may be questioned. Herein lies the importance of using an appropriate theory for enhancing learning among family members.

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In the case under analysis, a 48-year-old woman suffers from Diabetes Mellitus Type II (DM II). Because of the high level of sugar in her blood and the lack of insulin, the patient needs a massive change in her dieting habits and the choice of meals. However, she believes that the change will be impossible since her family members will not approve of it. Particularly, the woman presumes that her husband and two sons will refuse to eat the food that will represent an adjusted menu for the patient.

The case is a clear representation of the lack of awareness among family members and the following absence of support from them. While further analysis of the relationships between the woman and her husband, as well as her children, is needed to have an in-depth perception of the issue, the current problem stems from miscommunication between the patient and her family. Therefore, an intervention involving all family members is required.


Afaf Meleis’ Transitions Theory introduces order into the complicated framework of helping patients transfer from one environment to another safely and securely. According to Meleis, the specified theory helps to perform a transition successfully by identifying its enhancers and inhibitors, as well as determining the nature of a transition in question (Joly, 2016). As a result, possible patterns of stakeholders’ response toward a change in the setting can be located, and crucial obstacles in instilling change can be identified. The theory also offers a rather elaborate typology of the variables listed above, such as types, patterns, and properties that characterize the nature of a transition; personal, community-based, or societal factors; and process- and outcome-focused responses produced by patients (Fegran, Hall, Uhrenfeldt, Aagaard, & Ludvigsen, 2014). Thus, a vast range of variations in a specific scenario can be identified and used to select the best set of strategies for health management.

The focus on both personal and societal factors that may inhibit or enhance the promotion of recovery in patients doubtlessly is an advantage of Meleis’ Transitions Theory. A profound examination of societal and community-related issues that may hinder the recovery increases the chances of a positive outcome. In addition, the theory can become the tool for creating a setting in which a patient can develop the required healthy habits and adopt the behavior suggested by a healthcare provider (Bohner, 2017). The active promotion of healthy behaviors through bonding between a patient and their family becomes possible because of the interpretation of awareness as a combination of “perception, knowledge, and recognition of a transition experience” (Ramsay, Huby, Thompson, & Walsh, 2014, p. 610). Therefore, the framework is especially important in the scenarios in which family relationships are among the factors that define a patient’s ability to recover.

Theory Application

Since the case under analysis shows a drastic lack of understanding between the patient and her family members, adopting Meleis’ Transitions Theory is crucial to ensuring a positive outcome. Since DM II is a chronic disorder that cannot currently be cured completely, it will be necessary to sustain the patient’s health by helping her follow the prescribed diet. Handling her fear of changing the family menu will require establishing better communication between the woman, her husband, and her son. The next step of the intervention will require reassessing and resetting the family’s priorities and values. Specifically, a nurse will launch the process of preparation and knowledge to create the platform for the husband and sons to realize the gravity of the situation. As a result, their general level of awareness will increase, and they will recognize the need to change the family menu in order to support the patient and help prevent her health from further deterioration, including nerve damage, blood flow issues, and vision conditions (Lotfy, Adeghate, Kalasz, Singh, & Adeghate, 2017). Thus, the health threat will be prevented successfully.

However, in the case under analysis, it is not the possibility of the husband and son being against the new diet but the patient’s attitude toward the suggested change that raises the greatest concerns. Normally, it is expected that close family members should support a patient when the need to manage a disorder a serious as DM II arises. However, the patient is entirely sure that neither her husband nor her children will support her and, instead, expects them to be frustrated and have little to no compassion or understanding of her condition. Thus, it will also be necessary to use Meleis’ theory to change the dynamics of interactions within the family. Particularly, it will be required to ensure that all of its members are willing to recognize each other’s needs. Therefore, the patterns of the transition can also be described as multiple and simultaneous, thus, involving the change in the patient’s perception of her relationships with her family, possible alterations in the latter’s perspective of family needs, and the resulting shift in the family values toward well-being and safety of its members.

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Meleis’ Transitions Theory seems to be extraordinarily helpful for patients that experience difficulties changing the family dynamics to promote the health and support of the family members. The framework is impeccable for addressing the case described above, yet it can also be applied to manage other health issues, such as the management of patients’ needs in the context of a hostile social environment. The identified approach is especially important for vulnerable groups that experience social contempt, such as people with HIV/AIDS and people with sexually transmitted infections (STIs) (Rosenberg et al., 2016). Since the Transitions Theory provides the platform for an in-depth analysis of external factors affecting patients and the subsequent opportunities for the latter to either change these conditions or adapts to them, it can be applied to any case involving a social conflict between a patient and a specific group of people (Barimani, Vikström, Rosander, Frykedal, & Berlin, 2017). Therefore, the theory should be regarded as a crucial constituent of successful healthcare practice. Because of the clever typology of factors affecting a patient’s health and the ways of performing the transition, Meleis’ theory deserves to be listed among the essential frameworks for promoting health within the global community.


Barimani, M., Vikström, A., Rosander, M., Frykedal, K. F., & Berlin, A. (2017). Facilitating and inhibiting factors in transition to parenthood–ways in which health professionals can support parents. Scandinavian Journal of Caring Sciences, 31(3), 537-546. Web.

Bohner, K. (2017). Theory description, critical reflection, and theory evaluation of the transitions theory of Meleis et al according to Chinn and Kramer (2011). Advances in Nursing Science, 40(3), E1-E19. Web.

Fegran, L., Hall, E. O., Uhrenfeldt, L., Aagaard, H., & Ludvigsen, M. S. (2014). Adolescents’ and young adults’ transition experiences when transferring from paediatric to adult care: a qualitative metasynthesis. International Journal of Nursing Studies, 51(1), 123-135. Web.

Joly, E. (2016). Integrating transition theory and bioecological theory: A theoretical perspective for nurses supporting the transition to adulthood for young people with medical complexity. Journal of Advanced Nursing, 72(6), 1251-1262. Web.

Lotfy, M., Adeghate, J., Kalasz, H., Singh, J., & Adeghate, E. (2017). Chronic complications of diabetes mellitus: A mini review. Current Diabetes Reviews, 13(1), 3-10. Web.

Ramsay, P., Huby, G., Thompson, A., & Walsh, T. (2014). Intensive care survivors’ experiences of ward based care: Meleis’ theory of nursing transitions and role development among critical care outreach services. Journal of Clinical Nursing, 23(5-6), 605–615. Web.

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Rosenberg, N. E., Stanley, C., Rutstein, S. E., Bonongwe, N., Kamanga, G., Pettifor, A.,… Miller, W. C. (2016). Recruiting the social contacts of STI patients for HIV screening in Lilongwe, Malawi: Process evaluation and assessment of acceptability. Sexually Transmitted Infections, 92(8): 587–592. Web.

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