Transitions theory as a framework for rehabilitation nursing for people with tracheostomy during ventilatory weaning in intensive care

Introduction: Ventilatory weaning involves moving from invasive mechanical ventilation to spontaneous ventilation. In people with tracheostomies, this process causes physical vulnerabilities (reduced respiratory function, risk of infections), psychological vulnerabilities (anxiety due to the inability to vocalize) and social vulnerabilities (isolation in the ICU, interruption of roles). Objective: To analyze the role of rehabilitation nursing care in promoting ventilatory weaning in tracheostomized individuals, through the lens of Meleis’ Transitions Theory. Methods: Theoretical review based on Meleis' Transitions Theory and recent studies, integrating evidence on the vulnerability of the person with a tracheostomy, in the process of weaning, respiratory rehabilitation strategies, mobilization, emotional support and health education. Results: The Transitions Theory guides the rehabilitation nurse towards a personalized assessment of the physical, cognitive, social and cultural conditions of the person with a tracheostomy; education adapted to the level of literacy, with respiratory exercise training; early mobilization and functional training to reduce atrophy and strengthen respiratory muscles; psychosocial and family support, promoting adequate communication, the presence of family members and coping strategies; monitoring of transition indicators, allowing dynamic adjustments to the rehabilitation nursing care plan. Conclusions: The application of the Transitions Theory enables rehabilitation nurses to plan and implement interventions centered on the person with a tracheostomy and their family, valuing vulnerability as an expression of quality of life. By monitoring process and outcome indicators, nurses anticipate barriers, strengthen trust and promote coping strategies, helping to make ventilator weaning a healthy and transformative transition.