Page 633 - alligood 8th edition_Neat

614 UNIT V Middle Range Nursing Theories

grief feelings. These events were labeled chronic External management was described initially by
sorrow triggers (Eakes, Burke, Hainsworth, et al., Burke as interventions provided by health professionals
1993). The NCRCS compared and contrasted the (Eakes, Burke, & Hainsworth, 1998). Health care
triggers of chronic sorrow in individuals with chronic professionals assist affected populations to increase
conditions, family caregivers, and bereaved persons their comfort through roles of empathetic presence,
(Burke, Eakes, & Hainsworth, 1999). For all popula- teacher-expert, and caring and competent professional
tions, comparisons with norms and anniversaries (Eakes, 1993; Eakes, 1995; Eakes, Burke, Hainsworth,
were found to trigger chronic sorrow. Both family et al., 1993; Eakes, Burke, & Hainsworth, 1999;
caregivers and persons with chronic conditions Hainsworth, 1994; Hainsworth, 1995; Hainsworth,
experienced triggering with management crises. Busch, Eakes, et al., 1995; Lindgren, 1996).
One trigger unique for family caregivers was the In summary, an impressive total of 196 interviews
requirement of unending caregiving. The bereaved resulted in the middle-range Theory of Chronic
population reported that memories and role change Sorrow. The theorists summarized a decade of
were unique triggers. research with individuals with chronic sorrow and
found that this phenomenon frequently occurs in
Management Strategies persons with chronic conditions, in family caregivers,
The NCRCS posited that chronic sorrow is not and in the bereaved (Burke, Eakes, & Hainsworth,
debilitating when individuals effectively manage 1999; Eakes, Burke, & Hainsworth, 1998).
feelings. The management strategies were catego-
rized as internal or external. Self-care management Major Assumptions
strategies were designated as internal coping strate-
gies. The NCRCS designated internal coping strate- Nursing
gies as action, cognitive, interpersonal,and emotional. Diagnosing chronic sorrow and providing interven-
Action coping mechanisms were used across all tions are within the scope of nursing practice. Nurses
subjects—individuals with chronic conditions and can provide anticipatory guidance to individuals at
their caregivers (Eakes, 1993; Eakes, 1995; Eakes, risk. The primary roles of nurses include empathetic
Burke, & Hainsworth, 1999; Eakes Burke, Hainsworth, presence, teacher-expert, and caring and competent
et al., 1993; Hainsworth, 1994; Hainsworth, 1995; caregiver (Eakes, Burke, & Hainsworth, 1998).
Hainsworth, Busch, Eakes, et al., 1995; Lindgren,
1996). The examples provided are similar to distrac- Person
tion methods commonly used to cope with pain. For Humans have an idealized perception of life processes
instance, “keeping busy” and “doing something fun” and health. People compare their experiences both
are examples of action-oriented coping (Eakes, 1995; with the ideal and with others around them. Although
Lindgren, Burke, Hainsworth, et al., 1992). The each person’s experience with loss is unique, there are
NCRCS theorists found that cognitive coping was common and predictable features of the human loss
used frequently, and examples included “thinking experience (Eakes, Burke, & Hainsworth, 1998).
positively,” “making the most of it,” and “not trying to
fight it” (Eakes, 1995; Hainsworth, 1994; Lindgren, Health
1996). Interpersonal coping examples included “going There is a normality of functioning. A person’s health
to a psychiatrist,” “joined a support group,” and “talk- depends upon adaptation to disparities associated
ing to others” (Eakes et al., 1993; Hainsworth, 1994; with loss. Effective coping results in a normal response
1995). Emotional strategy examples included “having to life losses (Eakes, Burke, & Hainsworth, 1998).
a good cry” and expressing emotions (Eakes, Burke, &
Hainsworth, 1998; Hainsworth, Busch, Eakes, et al., Environment
1995). A management strategy was labeled effective Interactions occur within a social context, which
when a subject described it as helpful in decreasing includes family, social, work, and health care environ-
feelings of re-grief. ments. Individuals respond to their assessment of