Eakes, G.G., Burke, M.L., & Hainsworth, M.A. (1998)
- Theory of chronic sorrow was developed by Georgene Gaskill Eakes, Mary Lermann Burke and Margaret A. Hainsworth in 1998.
- Other related theories - Kubler-Ross (1969), Bowlby (1980)
- Theory of chronic sorrow is considered as a a middle-range nursing theory.
- Theory explains the ongoing feelings of loss that arise from illness, debilitation, or death.
- This theory provides a framework to describe the reaction of parents to the ongoing losses associated with caring for a child with chronic illness or disability (Scornaienchi JM, 2003).
- Nurses caring for families need to be
aware of the high potential for chronic sorrow to occur in persons
with chronic conditions, their family caregivers, and bereaved persons.(Eakes GG, 1999).
- Major concepts
- chronic sorrow
- trigger events, and
- internal and external management methods.
- Chronic sorrow is the periodic recurrence of permanent, pervasive sadness or other grief related feelings associated with a significant loss. (Eakes GG, 1998).
- Disparity refers to the difference between the ideal and the real situation due to some type of
- Loss - a significant loss that may be ongoing or a single event.
- The model explains two antecedents:
(Gorden J, 2009)
- First antecedent is initiated when a single event of a living loss is experienced e.g. onset or time of diagnosis of chronic illness
- Second antecedent to chronic sorrow is unresolved disparity resulting from the loss.
- Triggers are events which prompt the recognition of a negative disparity in the disabled loved one or loss which brings out sadness again.
- Internal management methods consist of individualized coping interventions initiated by the person experiencing chronic sorrow (Gordon J, 2009).
- External management methods of coping consist of interventions provided by medical professionals to aid in effective coping (Gordon J, 2009).
- Examples of external management methods (Gordon J, 2009) are
- professional counseling,
- pharmaceutical interventions to treat symptoms of insomnia or anxiety if necessary,
- pastoral care or spiritual support to assist with grieving,
- use of therapeutic communication, and
- referral services
- Other concepts related to the framework are:
- Coping - “Facing difficulties and acting to overcome them”.
- Parents - “A mother or father who nurtures and raises a child”.
- Child - “A son or daughter, an offspring”.
- The theory provides a framework for understanding and working with people following a single or ongoing loss (Eakes GG, 1998).
- Theory is useful for analyzing individual responses of people experiencing ongoing disparity due to chronic illness, caregiving responsibilities, loss of the "perfect" child, or bereavement (Eakes GG, 1998).
- Nurses need to view chronic sorrow as a normal response to loss and, when it is triggered, provide support by fostering positive coping strategies and assuming roles that increase comfort (Eakes GG, 1998)
- With an understanding of chronic sorrow, nurses can plan interventions that recognize it as a normal reaction, promote healthy adaptation, and provide empathetic support.
- Eakes, G.G., Burke, M.L., & Hainsworth, M.A. (1998). Middle range theory of chronic sorrow. Image: Journal of Nursing Scholarship, 30(2), 179-183.
- Eakes, G.G., Burke, M.L., & Hainsworth, M.A. 1999) Milestones of Chronic Sorrow: Perspectives
of Chronically Ill and Bereaved Persons
and Family Caregivers.
Journal of Family Nursing, 5(4), 374-38
- Scornaienchi JM (2003) . Chronic sorrow: one mother's experience with two children with lissencephaly. J Pediatr Health Care. Nov Dec;17(6):290-4.
- Gordon J ( 2009). An evidence-based approach for supporting parents experiencing chronic sorrow. Pediatr Nurs.35(2):115-119.