title: Integrating transition theory and bioecological theory: a theoretical perspective for nurses supporting the transition to adulthood for young people with medical complexity.
abstract: OBJECTIVE
  To present a discussion of a theoretical perspective developed through integrating Meleis' Transition Theory and Bronfenbrenner's Bioecological Theory of Human Development to inform nursing and advanced nursing practice supporting the transition to adulthood for young people with medical complexity.
  
  
  BACKGROUND
  Theoretical perspectives to inform nursing practice in supporting successful transition are limited, yet nurses frequently encounter young people with medical complexity during the transition to adulthood.
  
  
  METHODS
  Discussion paper.
  
  
  METHODS
  A literature search of CINAHL and Medline was conducted in 2014 and included articles from 2003-2014; informal discussions with families; the author's experiences in a transition program.
  
  
  CONCLUSIONS
  The integrated theoretical perspective described in this paper can inform nurses and advanced practice nurses on contextual influences, program and intervention development across spheres of influence and outcomes for the transition to adulthood for young people with medical complexity. Young people and their families require effective reciprocal interactions with individuals and services across sectors to successfully transition to adulthood and become situated in the adult world. Intervention must also extend beyond the young person to include providers, services and health and social policy.
  
  
  CONCLUSIONS
  Nurses can take a leadership role in supporting the transition to adulthood for young people with medical complexity through direct care, case management, education and research. It is integral that nurses holistically consider developmental processes, complexity and contextual conditions that promote positive outcomes during and beyond the transition to adulthood.
authors.affiliation: School of Nursing, University of Victoria, British Columbia, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Joly
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D007857:Leadership; D024802:Nurse's Role; D060305:Transition to Adult Care; D055815:Young Adult
keywords: Ecological Theory; Transition Theory; adolescent; advanced nursing practice; framework; medically fragile; transition to adulthood; young adult