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Transgenerationality refers to the psychological and behavioral elements transmitted across generations. It is intrinsically linked to unelaborated content—such as trauma, grief, secrets, conflicts, and shame—operating through implicit and partially unconscious pathways that manifest in individual behavior. In the context of nursing, transgenerationality explores how nursing care is influenced by these dynamics and how the concept can be utilized to achieve superior health-related outcomes, such as facilitating more effective healthcare transitions. Specifically, it examines how experiences, vulnerabilities, resilience factors, and health-related patterns transmitted across generations affect overall health. As a humanistic profession rooted in person-centered care, nursing must remain cognizant of the impact of this concept on healthcare. This is particularly relevant in clinical settings where nurses are pivotal practitioners, such as mental health, health literacy, chronic disease management, and healthcare transitions. Healthcare transitions represent critical periods in a person’s life, and nurses are present across all contexts to facilitate these shifts. A primary example is the transition from hospital to home, which illustrates the importance of understanding transgenerationality within the roles of both patients and caregivers. Understanding how this concept impacts healthcare allows for the perception of transition as a holistic process. Awareness of these transgenerational operations leads to more personalized care, fostering healthier and more seamless healthcare transitions. The general purpose of this paper is to define and operationalize the concept of transgenerationality within nursing care, emphasizing its critical role in achieving better health outcomes, particularly during hospital-to-home transitions.
- continuity of care
- family/informal caregiver
- hospital-to-home transition
- nursing
- person-centered care
- transgenerationality
Transgenerationality in nursing care is a new perspective of care within real caring situations, such as hospital-to-home transitions. In order to understand this, it is fundamental to understand first the philosophical roots of nursing itself and how these rooting perspectives are deeply connected with transgenerationality itself.
1.1. Nursing as Humanistic Profession
Nursing has been connected, since its very beginnings, to the concept of caring for others, which constitutes its genesis and its highest mission. “Caring” appears to be far more comprehensive and broader than “curing,” as it is a concept that moves away from the biological domain of disease and encompasses knowledge of the other through careful observation of individual meanings and subjective lived experiences. It also examines how individuals adapt based on those meanings and experiences during their life transitions [1][2].
The foundation of the nursing profession and the essence of caring, as a concept, is the valuing of human beings [3]. This means recognizing each person as a unique and special individual with the right to self-determination, and working collaboratively with them to deliver the best possible healthcare—in other words, humanistic care.
Humanism is a broad philosophical concept that frames a perspective based on the human being and their potentialities. It can be described as “a democratic and ethical life stance, which affirms that human beings have the right and responsibility to give meaning and shape to their own lives” [4]. In this sense, humanistic care is grounded in experiences related to health and suffering in which participants “are and become” through their human potential [5].
Humanistic care has been extensively studied from a wide range of perspectives, including theoretical approaches and practical experiences that support its development [4]. The nursing profession itself has evolved around this concept and is currently conceptualized through an honest human relationship with others, based on the possibility of continuous human growth and development [6].
In its evolution as a caring profession, nursing has undergone a transition that involved moving beyond “doing for” toward “being with,” integrating technical competence with relational, ethical, and reflective practice, placing the person—rather than the task or disease—at the center of care.
This shift, which has led nursing to adopt the concept of humanistic care as the core of its perspective, defines it through the following attributes [7]: excellence in clinical literacy; creation of a healing environment; a comprehensive and unique viewpoint; contribution to the client’s adaptation and flourishing of talents; unconditional regard and affection; preservation of human dignity; real presence; constructive dynamic interaction; and nurses’ self-care.
Nowadays, one of the most influential contemporary nursing theories is the Person-centered Nursing Framework by McCormack and McCance [8], which perfectly encompasses this humanistic care perspective. It defines person-centered nursing as a practice that is respectful of values and beliefs, engages the person in decision-making, and is underpinned by therapeutic relationships.
Person-centered humanistic care highlights the relevance of understanding an individual’s past in the provision of nursing care, particularly how interaction and socialization across previous generations generate behaviors and may compromise each individual’s potential to seek health [9].
It is this humanistic approach, which guides nursing as a profession, that enables it to observe individuals across all their dimensions. This perspective facilitates an understanding of the human nuances arising from social interactions, particularly those within family structures. Furthermore, it is through this lens that nurses are able to identify transgenerationality as a pivotal concept in healthcare delivery.
1.2. Trangenerationality, Socialization and Attachment
Prior to defining transgenerationality, it is essential to clarify that this concept is distinct from intergenerationality, despite their frequent conflation. Operationally, both terms refer to transmission processes across generations; however, they are not equivalent. Intergenerationality pertains to that which circulates between generations in direct interaction (e.g., parent-child or grandparent-grandchild), primarily through socialization, learning, and modeling. It often assumes a relatively explicit and consciously recognizable character, even if not formally taught.
Conversely, transgenerationality refers to that which is transmitted across generations, potentially “skipping” a generation. It tends to be linked to unelaborated content—such as trauma, grief, secrets, conflicts, and shame—operating through implicit and partially unconscious pathways. In these instances, one inherits “without knowing”: that which has not been symbolized reappears over time in the form of relational patterns, family silences, or symptoms, reinscribing into the present that which remained unelaborated [10][11].
Inheritance includes characteristics such as height, sex, eye color, and potential intelligence; while some are wholly genetic, others are inherited as ranges of possibility dependent on the environment [12]. It is to this second category of characteristics that the concept of transgenerationality is deeply connected. The way we experience and regulate emotions results from the interaction between lived experience and inherited psychic legacies, partially inscribed in the individual and family unconscious [13]. The infant enters this world as a biological organism concerned with its own physical comfort, but soon becomes a human being endowed with a set of attitudes, values, preferences, aversions, goals, and purposes, alongside an enduring conception of its own identity [14].
This concept is deeply rooted in sociology, particularly in the field of socialization. Socialization can be defined as an active process of learning and social development that occurs as individuals interact with one another and become familiar with the social world in which they live, forming ideas about who they are and making decisions about their goals and behaviors [14]. This learning occurs primarily in an unconscious manner. For Pierre Bourdieu, one of the most influential sociologists of the second half of the 20th century, socialization is the process through which social structures are incorporated into individuals in the form of habitus, shaping perceptions, practices, and actions in a largely unconscious manner [14]. This type of process leads individuals to internalize attitudes and patterns of behavior from previous generations, giving rise to conditioned responses to similar events. That is, the response to an adverse event is strongly shaped not only by one’s own lived experience, but also by the experiences of preceding generations.
This concept is also directly linked to psychological theory, particularly Attachment Theory. Bowlby’s classical attachment theory explains how early emotional bonds between infants and primary caregivers shape patterns of emotional regulation, security, and relationships throughout the lifespan. According to Bowlby [15], consistent and sensitive caregiving enables the child to develop secure attachment, fostering trust, autonomy, and the capacity to seek support in times of distress. In contrast, inconsistent, unavailable, or frightening caregiving may lead to insecure attachment patterns, which can influence how individuals respond to stress, illness, and dependency later in life.
Intergenerational transmission may manifest in the reproduction or interruption of legacies, rituals, legends, and customs, occurring through implicit pathways—such as micro-regulations of the body and voice or patterns of attachment—and through narrative pathways, such as stories that are told and omissions, often sustained by pacts of silence and invisible loyalties [16]. Transgenerationality manifests itself not through conscious and open practices passed from one generation to another, but through what was never verbalized and remains hidden among unspoken family secrets [17]. Several studies use this theory to explain the reproduction of psychopathological behaviors derived from previous generations, which manifest as mental disorders without the individual being aware that they are reproducing behaviors that are not originally their own [18]. In other words, this illustrates the practical impact of transgenerationality.
When parents are unable to elaborate specific affects or traumas, these contents may be implicitly transmitted to the child, who incorporates them as if they were their own [11]. Such a process compromises the child’s capacity to understand and manage their own suffering, interfering with the construction of internal resources for emotional regulation [19][20]. This “undigested” emotional burden can thus disrupt the recognition, naming, and regulation of affects, with repercussions for the development of reflective function and mentalization [21][22].
When a child begins to assume symbolic roles of caregiving or emotional organization within the family—for instance, when the eldest child attempts to “substitute” for the parents—a role reversal (parentification) may emerge. This imposes premature maturity and can compromise spontaneous psychic development [23][24]. Family relational patterns may transform throughout the life cycle as new relationships and sociocultural contexts introduce influences that create conditions for either continuity or rupture. Nevertheless, the persistence of these patterns is frequently sustained by childhood experiences, which structure expectations, meanings, and internal working models of relationships [25].
This kind of unspoken transmission of behavioral patterns within families on this transgenerationality surpasses the abstract field of philosophical concepts and it is observed in practice, particularly in healthcare settings, being an important part of the contexts where nursing care is delivered.
This entry is adapted from the peer-reviewed paper 10.3390/encyclopedia6050100
References
- Meleis, A.I.; Sawyer, L.M.; Im, E.O.; Messias, D.K.H.; Schumacher, K. Experiencing transitions: An emerging middle-range theory. Adv. Nurs. Sci. 2000, 23, 12–28.
- Kokorelias, K.M.; Valentine, D.; Eaton, A.D.; Munce, S.E.P.; Sheppard, C.L.; Hitzig, S.L.; Wasilewski, M.B.; Zhabokritsky, A.; Abdelhalim, R.; Jamieson, L.; et al. Lived Experiences of Social Isolation and Meaningful Relationships Among Older Adults Living with HIV with a Concurrent Mental Health Diagnosis: A Heideggerian Phenomenological Approach. Healthcare 2026, 14, 257.
- Taghinezhad, F.; Mohammadi, E.; Khademi, M.; Kazemnejad, A. Humanistic care in nursing: Concept analysis using Rodgers’ evolutionary approach. Iran. J. Nurs. Midwifery Res. 2022, 27, 83–91.
- Copson, A.; Grayling, A.C. (Eds.) The Wiley Blackwell Handbook of Humanism; John Wiley & Sons: Chichester, UK, 2015; p. 6.
- Paterson, J.G.; Zderad, L.T. Humanistic Nursing; National League for Nursing: New York, NY, USA, 1988.
- Létourneau, D.; Goudreau, J.; Cara, C. Humanistic caring, a nursing competency: Modelling a meta-morphosis from students to accomplished nurses. Scand. J. Caring Sci. 2021, 35, 196–207.
- Cara, C.; Gauvin-Lepage, J.; Lefebvre, H.; Létourneau, D.; Alderson, M.; Larue, C.; Beauchamp, J.; Gagnon, L.; Casimir, M.; Girard, F.; et al. Le modèle humaniste des soins infirmiers—UdeM: Perspective novatrice et pragmatique. Rech. Soins Infirm. 2016, 125, 20.
- McCance, T.; McCormack, B. The person-centred nursing framework: A mid-range theory for nursing practice. J. Res. Nurs. 2025, 30, 47–60.
- Oetting, E.R.; Donnermeyer, J.F. Primary socialization theory: The etiology of drug use and deviance. I. Subst. Use Misuse 1998, 33, 995–1026.
- Trachtenberg, A.R.C. Transgeracionalidade: Sobre silêncios, criptas, fantasmas e outros destinos. Rev. Psicol. 2017, 51, 77–89.
- Švorcová, J. Transgenerational epigenetic inheritance of traumatic experience in mammals. Genes 2023, 14, 120.
- Lieberman, S. A transgenerational theory. J. Fam. Ther. 1979, 1, 347–360.
- Kaës, R. Le Groupe et le Sujet du Groupe; Dunod: Paris, France, 1993.
- Horton, P.; Hunt, C. Sociology; McGraw-Hill: New York, NY, USA, 1981.
- Bowlby, J. Attachment and Loss: Vol 1. Attachment; Basic Books: New York, NY, USA, 1969.
- Coakley, J.J. Sport in Society; McGraw-Hill/Irwin: Boston, MA, USA, 1998.
- Bourdieu, P. Distinction: A Social Critique of the Judgement of Taste; Harvard University Press: Cambridge, MA, USA, 1984.
- Fonagy, P. Attachment, the development of the self, and its pathology in personality disorders. In Treatment of Personality Disorders; Springer: Boston, MA, USA, 1999; pp. 53–68.
- Abraham, N.; Torok, M. The Shell and the Kernel: Renewals of Psychoanalysis; University of Chicago Press: Chicago, IL, USA, 1994; Volume 1.
- Fraiberg, S.; Adelson, E.; Shapiro, V. Ghosts in the nursery: A psychoanalytic approach to the problems of impaired infant–mother relationships. J. Am. Acad. Child Psychiatry 1975, 14, 387–421.
- Fonagy, P.; Gergely, G.; Jurist, E.L.; Target, M. Affect Regulation, Mentalization, and the Development of the Self; Other Press: New York, NY, USA, 2002.
- Saramago, F.M.; Abrantes, M.J.; Madureira, I.L.; Alexandre, A.; Lencastre, M.P.A. Mantendo vivo o que já está morto: A transgeracionalidade psíquica do trauma. Rev. Port. Psicanal. 2020, 40, a4.
- Byng-Hall, J. Rewriting Family Scripts: Improvisation and Systems Change; Guilford Press: New York, NY, USA, 1995.
- McGoldrick, M.; Gerson, R.; Petry, S. Genograms: Assessment and Intervention, 3rd ed.; W. W. Norton: New York, NY, USA, 2008.
- Kerr, D.C.R.; Capaldi, D.M. Intergenerational transmission of parenting. In Handbook of Parenting, 3rd ed.; Bornstein, M.H., Ed.; Routledge: New York, NY, USA, 2019; pp. 443–481.
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