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618 UNIT V Middle Range Nursing Theories

LIFE-SPAN
Chronic sorrow
Loss experience Pervasive
Ongoing Disparity Permanent
Single event Periodic
Potentially progressive
Trigger
events
Management
methods

Internal External

Ineffective Effective

Discomfort Increased
comfort

FIGURE 31-1 Theoretical Model of Chronic Sorrow. (From Eakes, G. G., Burke, M. L., & Hainsworth, M. A.
[1998]. Middle-range theory of chronic sorrow. Image: The Journal of Nursing Scholarship, 30[2], 180.)

versus external management and ineffective versus Accessibility
effective management, it is clear what type of assess- As is characteristic of middle-range theory, the limited
ment and at what point appropriate intervention scope readily allows researchers to study clinical phe-
by nurses and other health care providers would be best nomenon. With a limited number of variables and
to prevent chronic sorrow from becoming progressive. defined relationships among the variables, researchers
With a limited number of defined variables, the theory are able to generate hypotheses to study nursing inter-
is succinct and readily understood. As a middle-range ventions that promote effective management strategies
theory, it is useful for research design and practice for chronic sorrow. These outcome studies provide
guidance. and add to the foundation of evidence-based practice.
Because the theory was derived from empirical
Generality evidence, it has clear utility for further research. The
The concept of chronic sorrow began with the study clear definition of chronic sorrow allows the study of
of parents of children with a physical or cognitive individuals with a variety of losses and loss situations
defect. The NCRCS theorists, through empirical that commonly result in chronic sorrow. In their
evidence, expanded the theory to include a variety of study of bereaved individuals, Eakes and colleagues
loss experiences. The theory clearly applies to a (1999) identified symptoms of chronic sorrow in
wide range of losses and is applicable to the affected most subjects.
individual as well as to the caregivers and the be-
reaved. In addition, the theory is useful to a variety of Importance
health care practitioners. With these concepts, the As a consequence of the rich body of research
unique nature of the experience is captured with surrounding this theory, chronic sorrow is a widely
the broadness of the concepts such as triggers. The accepted phenomenon. This is evident by its inclusion
triggers and the management strategies are unique in NANDA-I diagnoses. Nurses and other health care
to the individual situation and thus allow application professionals found validity for their experiences with
to a wide variety of situations. loss in the clinical arena. Subsequently, health care