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Purpose: To introduce a middle-range nursing theory of chronic sorrow that presents this sorrow as a normal response to ongoing disparity due to loss. Chronic sorrow is the periodic recurrence of permanent, pervasive sadness or other grief related feelings associated with a significant loss. The theory provides a framework for understanding and working with people following a single or ongoing loss.
Organizing framework: The model of chronic sorrow includes antecedents, trigger events, and internal and external management methods.
Scope: 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.
Sources: The theory was developed using concept analysis, critical review of research, and validation in 10 qualitative studies of various loss situations.
Conclusions: Chronic sorrow has been shown to explain the experience of people across the lifespan who encounter ongoing disparity because of significant loss. 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.
IMAGE: JOURNAL OF NURSING SCHOLARSHIP, 1 998; 30(2), 179-184. 1 998, SIGMA THETA TAU INTERNATIONAL [Key Words: grief/mourn; loss; chronic sorrow]
Chronic sorrow was introduced into the literature more than 30 years ago to characterize the recurring waves of grief observed in parents of children with mental deficiencies as they struggled to cope with the loss of a "perfect child" (Olshansky, 1962). The pervasive, recurrent sadness Olshansky characterized as chronic sorrow was viewed as a normal response to disruptions of anticipated normalcy.
Subsequent research validated the occurrence of chronic sorrow among parents of mentally or physically disabled young children and expanded the emotions commonly experienced to include not only sadness and sorrow, but also fear, helplessness, anger, frustration, and other feelings characteristic of grief (Burke, 1989; Damrosch & Perry, 1989; Fraley, 1986; Hummel & Eastman, 1991; Phillips, 1991; Seideman & Kleine, 1995; Wikler, Wasow, & Hatfield, 1981). Concluded in these studies was the idea that the never-ending nature of the loss of the "perfect" child prevented resolution of grief and precipitated periodic episodes of re-grief or chronic sorrow.
Research undertaken by the Nursing Consortium for Research on Chronic Sorrow (Eakes, Hainsworth, Lindgren, & Burke, 1991)...