Change Readiness: A Construct to Explain Health and Life Transitions

Article excerpt

Abstract: Change is a ubiquitous phenomenon. Both nurses and their clients must learn to cultivate change readiness. This article presents two related, but distinct views of change readiness. Readiness to change (a motivational construct) describes how people initiate and maintain self-change needed to promote health or reduce risk. Readiness for change (a developmental construct) denotes how people manage, endure, or cope with life and health transitions over which they have little or no control. 1 heoreticalpropositions are offered concerning the latter kind of change readiness. Aging among baby boomers is examined as a prototype of readiness for change.

Key Words: Aging, Baby boomers, Change theory, Human development, Motivation

Nurses are familiar with change. The health care delivery systems in which they work are in constant flux, and people who nurses encounter as patients commonly face challenging health and life transitions (Chin Chou, Chan, & Tang, 2004; Hall, 2003; Lee & Bakk, 2001; Teichler, 2001, Walker, 2002; Wiseman, 2003). Even so, Chinn (1992) concedes that nurses "think of change as something 'out there' noticeable only when they see dramatic changes in edifice, structure, or effect (p. 102). Chinn goes on to say that genuine and significant changes only begin with the willingness to boldly experiment with and cultivate change readiness.

Although change readiness has keen treated heretofore as a unitary concept, this article presents change readiness as two related, but distinguishable constructs. Both the motivational construct: readiness to change (Prochaska, 1991) and a developmental construct: readiness for change (Walker, 2000) will be considered. Aging among baby boomers will be presented as a prototype for the second kind of change readiness. Before turning to discussions of these two aspects of change readiness, however, "readiness" as a concept will be described.


When theorizing about change, nurses often focus on achieving stability or equilibrium in unwelcomed or tragic circumstances (Hall, 1983). Change is less frequently appreciated for its capacity to empower people. Change readiness is an idea with precedent in the literature of cognitive science, educational psychology, human development, and commercial marketing. As a developmental and motivational concept, "readiness" has origins dating back to the 1930s.

Origins of Readiness

During the 1930s, psychologists and educators became convinced that children can learn only after attaining a specified level of "readiness," which generally meant the physical maturity and neurological development sufficient to negotiate an unfamiliar situation or learn a new task (Gesell, 1928; Dennis, 1972, 1973). A child s behavior would unfold m a particular way and at a particular time no matter what parents did. Parents were advised to assume the role of interested spectators. From the mid-1950s onward, however, this view was widely rejected. Parents were urged to do everything possible to accelerate children's physical and intellectual development (Doman, 1964). If parents stimulated their children to master physical and mental skills early in life, the children would he more capable and competent later in life.

Research About Readiness

During the 1960s, developmental psychologists and educators developed research-based practices consistent with the readiness concept. Heller (1972), one of the leading proponents of early educational intervention for disadvantagcd children and chief researcher in the Head Start program, identified the leverage that a) human motivation, b) interpersonal relationships and c) cognitive style have on readiness. Beller (1972) argued that apprehension, a common reaction to new and strange situations, produces an inhibiting effect upon readiness.

According to Beller (1972), readiness is more than physical maturity. Instead readiness is a combination of emotional and cognitive forces that mediate learning environments and result in the mastery of new operations. …