Changes in health and illness of individuals create a process of transition, and clients in transition tend to be more vulnerable to risks that may in turn affect their health. Uncovering these risks may be enhanced by understanding the transition process. As a central concept of nursing, transition has been analyzed, its components identified, and a framework to articulate and to reflect the relationship between these components has been defined. In this article, the previous conceptual analysis of transitions is extended and refined by drawing on the results of five different research studies that have examined transitions using an integrative approach to theory development. The emerging middle-range theory of transitions consists of types and patterns of transitions, properties of transition experiences, facilitating and inhibiting conditions, process indicators, outcome indicators, and nursing therapeutics. The diversity, complexity, and multiple dimensionality of transition experiences need to be further explored and incorporated in future research and nursing practice related to transitions.
Meleis: Professor, Department of Community Health Systems, School of Nursing, University of California, San Francisco, California; Sawyer: Assistant Clinical Professor, Department of Community Health Systems, School of Nursing, University of California, San Francisco, California; Im: Assistant Professor, School of Nursing, University of Wisconsin-Milwaukee, Wisconsin; Messias: Associate Professor, Women's Studies and Nursing, University of South Carolina, Columbia, South Carolina; Schumacher: Assistant Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.