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Middle Range Nursing Theories: The Self Transcendence Theory

Nurses experience broad instructions on practice hypothesis and are relied upon to comprehend an assortment of various speculations. This paper will discuss the self-transcedence theory, which form a part of middle range nursing theories. Middle age nursing theories are made up of a limited number of concepts and propositions that are written at a relatively concrete and specific level (Smith & Liehr, 2008).

Practicing and preparing nurses need to understand these concepts to use them as a basis for patient care and management. The paper will try to understand how the self-transcendence is known to contribute to the advancement of the nursing discipline, while explaining the general aspects of nursing practice, key elements for its development and knowledge (Maville & Huerta, 2013).

The middle range nursing theory has its foundations in one paradigmatic perspective. The philosophies guiding the abstract views of human beings, human–environment interaction, and health and caring are reflected in each of the paradigms. This influences the meaning of the middle range theory, and for this reason it is important that the theory has a philosophical link tothe paradigm clearly identified.

Middle range theories are more circumscribed, elaborating more
concrete concepts and relationships such as uncertainty, self-efficacy, meaning, and the others in this text. Middle range theory can be specifically derived from a grand theory or can be related directly to a paradigm. First, it presents the benefits of improving knowledge sustained by the
expression and practice using the models of: personal, nursing art or esthetical, ethical and nursing science or empirical (Smith & Liehr, 2008).

The Theory of Self-Transcendence, developed by Pamela Reed has its basis on the beliefs of Martha Roger’s science of ‘Unitary Beings’. It has a core philosophical belief in the enduring human potential for well-being thus developing an increased capacity for self-transcendence and its positive influence. The theory draws a link between human beings, nurses and the therapeutic environment presenting its nursing metaparadigm.

This proclaims that human beings are pan-dimensional and they often reach out to others, nature and God as a spiritual being. Self-transcendence can be defined as looking beyond the “now”, beyond barriers and
boundaries, looking beyond one’s own self and finding perspective and meaning that might otherwise be overlooked (Maville & Huerta, 2013).

Capitalizing on this ability to see beyond the boundaries of the self and the environment and using that ability during vulnerable moments to
see beyond the present limitations will lead to the well-being of the patient. At times, a patient finding himself/herself in a vulnerable situation will lead to self-transcendence and the eventual well being of the patient.

Vulnerability refers to a person’s awareness of their personal mortality or experience of difficult life events.  Reed theorized that self-transcendence as a developmental capacity (and perhaps a survival mechanism) occurs naturally in health experiences that confront a person with issues of mortality and immortality (Smith & Liehr, 2014). When people were faced in difficult life situations, this perception of mortality will be synergized and magnified.

Depending on how the person will respond to this; positively or negatively, will have an impact on his developmental progress and will either expand or crush his inner boundaries. This is where a person may benefit with his/her interaction with the nurse to help him explore and lead towards
the positive expansion of inner boundaries that will contribute to health and well-being

Studies on the effects of self transcendence and well being as a result of creative bonding interventions have been successful evident in 2011 when patients with late stage Alzheimer’s Disease. Nurses can help manage self-transcendence in patients by encouraging prayer sessions, sessions of meditation or encouraging reflection into their lives, marriages or careers. There can be support groups that are allowed to visit the clinics or simply group psychotherapy (Walsh etal, 2011).

The self-transcendence theory has a direct linkage to research and practice. This would include the research made that extends the current theory by examining the relationship of transcendence and other transcendence variables to depression in middle-age adults and which produced positive results. It may have been developed inductively through qualitative research and practice observations or deductively through logical analysis and synthesis.

It will however evolve through retroductive processes of rhythmic induction–deduction (Smith & Liehr, 2014). As scholarly work extends middle range theories, we can expect research and practice traditions
to continue developing. Therefore, self-transcendence theory is an essential conceptual model of interest in the nursing practice and can be used as appropriate guide to middle-range theories (Maville & Huerta, 2013).


According to the above findings, nurses are guided by the tenets of dedication, tranquility, autonomy, human dignity, confidentiality and care. Regardless of how the situation might be or look, nurses are required not to stop providing quality care to their patients. Tranquility helps in keeping avoiding burnout and stress which may deter the nurses from performing as required.

Keeping in mind the end goal to acquire and secure these humanistic philanthropic qualities, the nurses must show unending affection, benevolence, and mental mindfulness under all circumstances (Smith & Liehr, 2014). Autonomy and human dignity guides nurses in understanding the standards of human respect without considering the factors of age, sex, financial status, social or ethnic components,
political belief systems, religious alliance or criminal history.

Confidentiality is very vital in the health care industry. Nurses conform to confidentiality as a key guideline of moral practice that guides the nursing practice. In the whole, self-transcendence and wellbeing form the basis for the moral practices of sympathy, regard to duties and responsibility.


Maville, J. A., & Huerta, C. G. (2013). Health promotion in nursing. Clifton Park, NY: Delmar, Cengage Learning.
Walsh, S., Lamet, A., Lindgren, C., Rillstone, P., Little, D., Steffey, C., Rafalko, S., Sonshine, R. (2011). Art in Alzheimer's care:promoting well-being in people with late-stage Alzheimer'sdisease. Rehabilitation Nursing, 36(2), 66-72.
Smith, M., Liehr, P. (2008). Middle Range Theory for Nursing, 2ndEd. Springer Publishing Company LLC. New York, NY.
Smith, M. , & Liehr, P. (2014). Middle range theory for nursing. New York: Springer.

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