Nursing Theory Reflection 3

Chapter 26

Theory of Chronic

Chapter 26

Theory of Chronic Sorrow: Georgene

Gaskill Eakes, Mary Lerman Burke, Mary Lerman Burke,

and Margaret A. Hainsworth

Overview of the Theory of Chronic SorrowChronic Sorrow

• Chronic sorrow is the periodic recurrence of • Chronic sorrow is the periodic recurrence of permanent, pervasive sadness or other grief- related feelings associated with ongoing related feelings associated with ongoing disparity resulting from a loss experience

• Chronic sorrow is viewed as normal response to a void created by ongoing disparity or loss; normalization of the experience does not to a void created by ongoing disparity or loss; normalization of the experience does not diminish the validity or intensity of feelings

Overview of the Theory of Chronic SorrowChronic Sorrow

• Trigger events are those situations or circumstances that bring the disparity created circumstances that bring the disparity created by the loss into focus and trigger the grief- related feelings associated with chronic sorrowrelated feelings associated with chronic sorrow

• Management methods within the theory refer to coping strategies used by persons during the to coping strategies used by persons during the chronic sorrow experience and supportive interventions provided by professionalsinterventions provided by professionals

Major Concepts of Nursing Based on the Theory of Chronic Sorrowthe Theory of Chronic Sorrow

• Person: human beings with an idealized perception of life processes and health who perception of life processes and health who compare their experiences both with the ideal and with others around themand with others around them

• Environment: interactions that occur within the social context, including family, social, the social context, including family, social, work, and healthcare environments

Major Concepts of Nursing Based on the Theory of Chronic Sorrowthe Theory of Chronic Sorrow

• Health: a normality of functioning, with a person’s health dependent upon adaptation to person’s health dependent upon adaptation to disparities associated with loss

• Nursing: primary roles of nurses include • Nursing: primary roles of nurses include empathetic presence, teacher-expert, and caring and competent caregivercaring and competent caregiver

Assumptions of the Theory of Chronic Sorrowof Chronic Sorrow

Chronic sorrow is a normal human response • Chronic sorrow is a normal human response related to ongoing disparity created by a loss situationsituation

• Chronic sorrow is cyclic in nature• Chronic sorrow is cyclic in nature • Predictable internal and external triggers of

heightened grief can be categorized and heightened grief can be categorized and anticipated

Assumptions of the Theory of Chronic Sorrowof Chronic Sorrow

• A human who experiences either a single loss or an ongoing loss will perceive a disparity or an ongoing loss will perceive a disparity between the ideal and reality

• Disparity between the real and the ideal leads • Disparity between the real and the ideal leads to feelings of pervasive sadness and grief

Propositions of the Theory of Chronic Sorrowof Chronic Sorrow

• Humans have inherent and learned coping strategies that may or may not be effective in strategies that may or may not be effective in regaining normal equilibrium when they are experiencing chronic sorrowexperiencing chronic sorrow

• Health professionals’ interventions may or may not be effective in assisting the person to may not be effective in assisting the person to regain equilibrium

Brief Critique of the Theory of Chronic Sorrowof Chronic Sorrow

• Inductively derived and evaluated from review • Inductively derived and evaluated from review of literature and qualitative research data

• Key concepts are consistently defined• Key concepts are consistently defined • Proposed relationships between concepts are

clear and logicalclear and logical • Introduced with focus on specific population,

but has been shown to be applicable to a wide but has been shown to be applicable to a wide variety of loss situations

The Theory of Chronic Sorrow as a Framework for Nursing PracticeFramework for Nursing Practice

• Assessment: The Chronic Sorrow Questionnaire or interview to identify the indicators of chronic or interview to identify the indicators of chronic sorrow; should also include assessment for presence and effectiveness of internal presence and effectiveness of internal management strategies already being used

• Planning: matching the internal and external • Planning: matching the internal and external management strategies that should be the most beneficial based on specific loss situationbeneficial based on specific loss situation

The Theory of Chronic Sorrow as a Framework for Nursing PracticeFramework for Nursing Practice

Implementation: provide anticipatory guidance • Implementation: provide anticipatory guidance regarding the situations and circumstances that are likely to trigger episodes of chronic that are likely to trigger episodes of chronic sorrow; support and strengthen personal coping mechanismscoping mechanisms

• Evaluation: based on whether the • Evaluation: based on whether the management methods were ineffective or effective in decreasing discomforteffective in decreasing discomfort