Meleis's theory of nursing transitions and relatives’ experiences of nursing home entry

Abstract

This paper explores the extent to which Meleis's mid-range theory of nursing transitions is supported by the findings of a study exploring relatives' experiences of the move to a nursing home. Mid-range nursing theories are useful tools in helping to understand the scope of nursing practice in a range of contexts and situations. However, as yet, many formal mid-range theories have not been adequately tested. Findings from a constructivist study of relatives' experiences of nursing home entry were re-analysed in relation to the extent to which they reflected the domains of the theory of nursing transitions. Data for the original study were generated during 37 qualitative interviews involving 48 close family members of older people who had recently moved to a nursing home, and in observational case studies in three nursing homes. All domains of the theory of nursing transition were supported by the data generated within the study. However, the model failed to represent adequately the interactive and dynamic nature of relationships between formal and informal caregivers in the nursing home context. The theory of nursing transitions has the potential to assist nurses in identifying appropriate strategies for supporting relatives throughout the period of an older person's relocation to a nursing home. However, in order to reflect fully the experiences of relatives at this time, the theory requires adjustment to recognize the contribution made by relatives themselves to positive outcomes. This therefore raises questions as to whether the relative absence of this reciprocal and interactive dimension is an element of Meleis's theory that requires further exploration in relation to other forms of transition.