Question

AFAF IBRAHIM MELEIS: TRANSITIONS THEORY

Sue Kim, 49 years of age, emigrated from South Korea to the United States 6 years ago. Her family came to the US to educate their children and moved in with family members in Los Angeles.

Sue and her husband graduated from a top-ranked university in South Korea, and her husband also had a master’s degree in business. However, their English skills were not adequate for them to get jobs in the United States. Instead, they opened a Korean grocery store with the money they brought from South Korea, and they managed to settle down in Los Angeles, where a number of Koreans are living.

They have two children: Mina, a 25-year-old daughter who is now the manager of a local shop, and Yujun, a 21-year-old son who is a college student. Both children were born in South Korea and moved to United States with Sue. The children had a hard time, especially Mina, who came to the United States in her senior year of high school. However, the children finally adapted to their new environment. Now, Mina is living alone in one-bedroom apartment near downtown, and Yujun is living in a university dormitory.

The Kim’s are a religious family and attend their community’s protestant church regularly. They are involved in many church activities. Sue and her husband have been too busy to have regular annual checkups for the past 6 years.

About 1 year ago, Sue began to have serious indigestion, nausea, vomiting, and upper abdominal pain; she took some over-the-counter medicine and tried to tolerate the pain. Last month, her symptoms became more serious; she visited a local clinic and was referred to a larger hospital. Recently, she was diagnosed with stomach cancer after a series of diagnostics tests and had surgery; she is now is undergoing chemotherapy.

You are the nurse who is taking care of Sue during this hospitalization. Sue is very polite and modest whenever you approach her. Sue is very quiet and never complains about any symptoms or pain. However, on several occasions, you think that Sue is in serious pain, when considering her facial expressions and sweating forehead. You think that Sue’s English skills may not allow her to adequately communicate with health care providers. Also, you find that Sue does not have many visitors -only her husband and two children.

You frequently find Sue praying while listening to some previous songs. You also find her sobbing silently. About 2 weeks are left until Sue finishes chemotherapy. You think that you should do something for Sue so she will not suffer through pain and symptoms that could be easily controlled with existing pain-management strategies. Now, you begin some preliminary planning.

QUESTIONS:

1. Consider the patterns of response that Sue is showing. What are the indicators of healthy transition(s)? What are the indicators of unhealthy transition(s)?

2. Reflect on how Transitions Theory helped your assessment and nursing care for Sue.

3. If you were Sue’s nurse, what would be your first action/interaction with her? Describe a plan of nursing care for Sue.

Answer 1

Transition theory is based on transition from one situation to other.

1. H illness transition is one person's change from health to illness.The person may show sentiments and behaviour related to disease.Here Sue is very polite and modest.Her facial expressions indicate pain.But she doesn't tell anything related to this.Her prayers is also help her to adjust with this.

Sue doesn't have adequate skill to speak with nurse,thi t is a unhealthy transition.

2. Transition theory help to know the changes occur in people.Here nurse identified the changes in Sue.It helped nurse to make correct care.

3. I would first make interaction with Sue.I give counsilling to the patient

encourage the client to express her feelings.

Be polite and helpful and friendly

Give correct medication if she has pain

Understand the relatives about her condition

Understand them to communicate with her and to give positive energy.