Obesity has reached epidemic levels in the United States, and bariatric surgery is becoming an increasingly prevalent intervention. Nurses play an integral role in the care of these patients before, during, and after surgery. Using theory in practice provides a systematic, organized space that promotes a comprehensive yet individualized approach to patient problems. Middle-range theories, such as the theory of experiencing transitions, can easily be used for research and practice development. The theory was described and evaluated for substantive foundations, structural integrity, and functional adequacy. The evaluation demonstrates the use of the theory in nursing practice and research with patients experiencing the transitions associated with bariatric surgery.
National Center for Health Statistics. Health, United States, 2007 with Chartbook on Trends in the Health in Americans. Hyattsvillle, MD: U.S. Government Printing Office;DHHS Publication No. 2007-1232, 2007; 40–41104.
3.
OgdenC, CarrollM, CurtinL, McDowellM, TabakC, FlegalK. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA, 2006; 295:1549.
4.
WangY, BeydounMA, LiangL, CaballeroB, KumanyikaSK. Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity, 2008; 16:2323–2330.
5.
MustA, SpadanoJ, CoakleyEH, FieldAE, ColditzG, DietzWH. The disease burden associated with overweight and obesity. JAMA, 1999; 282:1523–1529.
6.
ElixhauserA, SteinerC, HarrisDR, CoffeyRM. Comorbidity measures for use with administrative data. Med Care, 1998; 36:8–27.
7.
JiaH, LubetkinEI. The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxf), 2005; 27:156–164.
8.
TylerC, JohnstonCA, FullertonG, ForeytJP. Reduced quality of life in very overweight Mexican American adolescents. J Adolesc Health, 2007; 40:366–368.
9.
BachmanK, FriedmanKE, KunzRL, LatnerJ, RowenL, TylerR. Roundtable discussion: weight stigmatization and bias. Bariatric Nurs and Surg Patient Care, 2008; 3:7–15.
10.
MaggardM, ShugarmanLR, SuttorpMet al.Meta-analysis: surgical treatment of obesity. Ann Intern Med, 2005; 142:547–559.
11.
EncinosaWE, BernardDM, DuD, SteinerCA. Recent improvements in bariatric surgery outcomes. Med Care, 2009; 47:531–535.
12.
ColquittJ, CleggA, LovemanE, RoyleP, SidhuMK. Surgery for morbid obesity. Cochrane Database of Systematic Reviews, 2005Issue 4. Art No.: CD003641. DOI: 10.1002/14651858.CD003641.pub2.
13.
BuchwaldH, AvidorY, BraunwaldE, JensenM, PoriesWJ, SchollesK. Bariatric surgery: a systematic review and meta-analysis. JAMA, 2004; 292:1724.
14.
ApplegateKL, FriedmanKE. The impact of weight loss surgery on romantic relationships. Bariatric Nurs and Surg Patient Care, 2008; 3:135–141.
15.
AdamsTD, GressRE, SmithSCet al.Long-term mortality after gastric bypass surgery. N Engl J Med, 2007; 357:753–761.
16.
MeleisAI, SawyerLM, ImE, MessiasD, SchumacherK. Experiencing transitions: an emerging middle-range theory. ANS Adv Nurs Sci, 2000; 23:12–28.
17.
Van GennepA. The Rites of Passage. London: Routledge & Kegan Paul, 1965.
18.
ChickN, MeleisAI. Transitions: a nursing concern. ChinnPL. Nursing Research Methodology, first ed. Gaithersburg, MD:Aspen Publishers, 1986; 237.
19.
KarlssonJ, TaftC, RydénA, SjöströmL, SullivanM. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes (Lond), 2007; 31:1248–1261.
20.
SoggS, MoriDL. Psychosocial evaluation for bariatric surgery: the Boston interview and opportunities for intervention. Obes Surg, 2009; 19:369–377.
21.
SmithM. Evaluation of middle range theories for the discipline of nursing. SmithMJ, LierP. Middle Range Theory for Nursing, first ed. New York: Springer Publishing Company, 2003; 189.
22.
SchumacherKL, MeleisAI. Transitions: a central concept in nursing. Image J Nurs Sch, 1994; 26:119–127.
23.
KralikD, VisentinK, Van LoonA. Transition: a literature review. J Adv Nurs, 2006; 55:320–329.
24.
SkärsäterI, WillmanA. The recovery process in major depression: an analysis employing Meleis' transition framework for deeper understanding as a foundation for nursing interventions. ANS Adv Nurs Sci, 2006; 29:245–259.
25.
WeissME, PiacentineLB, LokkenLet al.Perceived readiness for hospital discharge in adult medical-surgical patients. Clin Nurs Spec, 2007; 21:31–42.
26.
WilkinsKL, WoodgateRL. Transition: a conceptual analysis in the context of siblings of children with cancer. J Pediatr Nurs, 2006; 21:256–265.
27.
DaviesS. Meleis's theory of nursing transitions and relatives' experiences of nursing home entry. J Adv Nurs, 2005; 52:658–671.
28.
RuschMD, AndrisD, WallaceJR. Reasons for failed weight loss surgery. Clin Nutr Insight, 2009; 35:1–4.
