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612 UNIT V Middle Range Nursing Theories

in 1974 and a doctoral degree in education adminis- at international, state, and regional conferences
tration from the University of Connecticut in 1986. and published 13 manuscripts. In 1999, they were
In 1988, she became board certified as a clinical awarded the Best of Image Award in Theory from
specialist in psychiatric and mental health nursing. Sigma Theta Tau International (M. Hainsworth,
Hainsworth was inducted into Sigma Theta Tau, personal communication, 2005).
Alpha Chi Chapter in 1978 and Delta Upsilon Chapter-
at-Large in 1989. In 1976, she received the outstanding
faculty award at Rhode Island College. In 1992, she was Theoretical Sources
selected and attended the Technical Assistance Work- The concept of chronic sorrow originated with
shop and Mentorship for Nurses in Implementation of the the work of Olshansky in 1962 (Lindgren, Burke,
National Plan for Research in Child and Adolescent Hainsworth, et al., 1992). The NCRCS (Eakes, Burke,
Mental Disorders,sponsored by the National Institutes & Hainsworth,1998) based their middle-range Theory
of Health. Hainsworth reviewed manuscripts for of Chronic Sorrow on the work of Olshansky (1962).
Qualitative Health Research, an Inter-disciplinary Journal, Lazarus and Folkman’s (1984) model of stress and
a Sage publication. In 1999, she was a visiting fellow on adaptation formed the foundation for their conceptu-
a faculty exchange program at the Royal Melbourne alization of how persons cope with chronic sorrow.
Institute of Technology in Melbourne, Australia. The NCRCS theorists cite Olshansky’s observations
Hainsworth’s nursing practice was in public health of parents with mentally retarded children that indi-
and psychiatric and mental health nursing. She became cated these parents experienced recurrent sadness and
a lecturer in the Department of Nursing at Rhode his coining the term chronic sorrow. This original
Island College in 1974 and full professor in 1992. concept was described as “a broad, simple description
Her major area of teaching was psychiatric care in the of psychological reaction to a tragic situation”
classroom and clinical. A course entitled “Death and (Lindgren, Burke, Hainsworth, et al., 1992, p. 30)
Dying” that she taught became an elective in the During the 1980s, other researchers began to
college’s general studies program. Hainsworth always examine the experience of parents of children
maintained her practice and was employed for 13 years who were either physically or mentally disabled.
as a consultant at the Visiting Nurse Association. She This work validated a recurrent sadness and never-
entered private practice at Bay Counseling Association ending grief the parents experienced. Grief was
in 1993 and maintained that practice for 5 years. previously conceptualized as a process that resolved
Her interest in chronic illness and its relationship over time, and if unresolved, was abnormal accord-
to sorrow began in her practice as a facilitator for a ing to Bowlby and Lindemann’s work (Lindgren,
support group for women with multiple sclerosis. This Burke, Hainsworth, et al., 1992). In contrast to
interest led to her dissertation work, An Ethnographic this time-bound conceptualization, chronic sorrow
Study of Women with Multiple Sclerosis Using a Symbolic researchers later described recurrent sadness as a
Interaction Approach. This research was accepted for a normal experience (Lindgren, Burke, Hainsworth,
presentation at the Sigma Theta Tau Research Congress et al., 1992). Burke, in her study of children with
in Taipei, Taiwan, in 1989, where she learned about spina bifida, had defined chronic sorrow as “perva-
Burke’s research on chronic sorrow after attending her sive sadness that is permanent, periodic and progres-
presentation. sive in nature” (as cited in Hainsworth, Eakes, &
Building on Burke’s work, the NCRCS was estab- Burke, 1994, p. 60).
lished in 1989 to expand the understanding of The NCRCS group focused on the response to
chronic sorrow. Hainsworth was one of the four grief and incorporated Lazarus and Folkman’s 1984
cofounders and remained an active member until work on stress and adaptation as a basis for manage-
1996. The NCRCS research began with four studies ment methods described in their work (Eakes, Burke,
focused on chronic sorrow in individuals in chronic & Hainsworth, 1998). Internal coping strategies
life situations, and members of the consortium ana- include action-oriented, cognitive reappraisal and
lyzed data collaboratively. During the 7 years she was interpersonal behaviors (Eakes, Burke, & Hainsworth,
a member, the consortium presented their findings 1998). Thus, the middle-range Theory of Chronic