Reed's Process Model For Clinical Mental Health Nursing Practice

Reed’s process model for clinical specialty education and psychiatric mental health nursing practice articulates relationships among the metaparadigm constructs of health, persons and their environments, and nursing activity (Smith & Liehr, 2014). Self-transcendence theory delineates specific concepts from Reed’s process model: constructs of health (i.e., well-being), a person (i.e., self-transcendence), and environment (i.e., vulnerability), and it proposes relationships among these concepts to direct nursing activities (1986, 1987). Reed (1991) and Coward and Reed (1996) have suggested nursing activities that facilitate the expansion of self-conceptual boundaries journaling, art activities, meditation, life review, and religious expression,

Nurse activities that promote the activities of self-reflection, hope, and faith in vulnerable persons are associated with an increased sense of well-being (Smith & Liehr, 2014). Others suggested similar strategies to facilitate well-being in caregivers of persons with dementia (Smith & Liehr, 2014). Applications of creative-bonding art activities to promote self-transcendence were used in studies with nursing students and older adults (Chen & Walsh, 2009; Walsh, Chen, Hacker, et al., 2008) and in late-stage Alzheimer’s disease (Walsh, Lamet, Lindgren, et al., 2011). McGee (2000) suggested that recovery in alcoholism involves self-transcendence, facilitated by a nurse-designed environment that supports the 12 steps and 12 traditions of Alcoholics

Other scholars broadened the theory to include younger adults with life-limiting conditions that may make them vulnerable to spiritual disequilibrium and depression (Haugan & Innstrand, 2012). Recent studies by Reed and others have extended the scope of the theory to include additional populations of adolescent and adult age groups, patients and nonpatients, who may have increased awareness of personal mortality (Palmer, Griffin, Reed & Fitzpatrick, 2010). Examples are Japanese hospitalized older adults (Hoshi & Reed, 2011), Korean older adults and their family caregivers (Kim, Reed, Hayward, et al., 2014), Amish adults in rural Ohio (Sharpnack, Quinn-Griffin, Benders, et al., 2010, 2011), caregivers of older adults with dementia (Kidd, Zauszniewski, Morris, et al., 2011), low-income older adults (McCarthy, 2011), older adults patients in Norwegian nursing homes (Haugan, Rannestad, Garåsen, Hammervold, et al., 2013), Taiwanese nursing students (Chen & Walsh, 2009). Furthermore, Reed received funding to study self-transcendence as it relates to end-of-life decisions and well-being in patients and their family caregivers (Teixeira, 2008). People facing the end of life represent some of the most vulnerable individuals to whom nurses may