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Chronic Sorrow In The Field Of Nursing: A Theoretical Investigation

1474 words - 6 pages

The theory of chronic sorrow is not a new one. It was introduced in the early sixties as a way of explaining the ongoing waves of grief experienced by parents of children with severe mental disabilities (Eakes, Burke, & Hainsworth, 1998). Since this early conceptualization, the theory has evolved significantly and has demonstrated important applications to nursing practice; by understanding how chronic sorrow affects patients, nurses are better equipped to guide them through this distinct and unique coping mechanism and ensure that they do not engage in pathological grief states such as depression (Gordon, 2009). In order to provide effective support to patients experiencing chronic sorrow, ...view middle of the document...

That chronic sorrow has been discovered to occur in infertile couples elucidates this fact by demonstrating that often, the loss of an idea or outcome can be more devastating than the physical loss of an individual who has died (Casale, 2009). This finding is echoed by the observation that 80% of next of kin participants in a study investigating response to the degenerative condition Multiple Sclerosis engaged in the chronic sorrow coping mechanism (Liedström, Isaksoon, & Ahlström, 2008). Similarly, family members of cancer patients have also been shown to engage in chronic sorrow that is only relieved when the affected individual dies (Eakes et al., 1998).
While it is clear that chronic sorrow can apply to many distinct types of loss, all of these observed emotional strains have several very specific traits that must be present in order to distinguish the experience of chronic sorrow from the normal experience of grief (Casale, 2009). The most important distinction between events that can elicit chronic sorrow versus grief is the subjective experience of a single, final loss versus a prolonged, ongoing loss (Eakes et al., 1998). In his study of chronic sorrow, Casale investigated the different coping mechanisms employed by couples that experienced perinatal loss, or miscarriage, with those exhibited by couples that desired children but were determined to be infertile, and aimed to demonstrate that while the grief experienced by victims of miscarriage and the chronic sorrow associated with infertility may be related, they are distinct loss mechanisms that should not be confounded (Casale, 2009). Casale defined grief as the “emotional response to the permanent loss of the fetus” and chronic sorrow as “a persistent and pervasive state of sadness associated with ongoing and resolved feeling of loss, unfulfilled life goals, self-role loss and unmet developmental milestones in relation to infertility” (Casale, 2009, p. 4). Though Casale’s prediction that grief and chronic sorrow would present as distinct responses to loss was not completely supported by his findings, it was discovered that chronic sorrow is a statistically significantly distinct subset of grief that requires unique clinical consideration (Casale, 2009).
Although chronic sorrow is certainly related to grief, it is crucial for healthcare providers to recognize and distinguish between the coping mechanisms and behaviors associated with the two constructs (Eakes et al., 1998). Bereavement associated with grief following the death of a loved one is an expected and normal reaction to loss that is often presented by intense emotional expression of sadness, crying, and a cascade of physical reactions including “wave-like sensations of somatic distress, a feeling of tightness in the throat, choking with shortness of breath, sighing, muscular weakness, and an empty feeling in the abdomen”, with associated guilt, anger, and relational tension (Teel, 1991, p. 1312). These symptoms can also...

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