Georgene G. Eakes

Current knowledge and research on chronic sorrow: A foundation for inquiry

Abstract Research on the phenomenon of chronic sorrow has been limited to samples of parents of children with disabilities. The Nursing Consortium for Research on Chronic Sorrow was formed to study this concept in individuals with chronic illness and their family caregivers across the life span. Although no research on this concept has focused on a life-span approach, the level and quantity of related research indicate that a qualitative method is most appropriate. A study of parents of children with spina bifida provided a usable instrument, the Chronic Sorrow Questionnaire. The purpose of additional study is to determine when chronic sorrow occurs and what characteristics it displays in a variety of populations across the life span, how groups suffering from chronic sorrow compare with parents of children with disabilities, whether chronic sorrow is an inherent phenomenon in chronic illness situations, and how the major subconcepts of chronic sorrow theory are linked.

Chronic sorrow: the lived experience of parents of chronically mentally ill individuals.

This study investigated the incidence of chronic sorrow in parents of chronically mentally ill children. A convenience sample of 10 parents (four couples and two mothers) of adult children diagnosed with either schizophrenia or bipolar disorders were interviewed using the Burke/NCRCS Chronic Sorrow questionnaire (Caregiver Version). Findings showed that 8 out of 10 parents experienced chronic sorrow. These grief-related feelings were most often triggered by the unending caregiving responsibilities parents described. Those who evidenced chronic sorrow indicated that healthcare professionals could assist them by providing information about their childs illness and by involving them in the treatment process.

Coping with Chronic Sorrow

This qualitative study was designed to examine the presence of chronic sorrow in diverse populations of individuals with chronic or life threatening conditions and to identify strategies for coping with feelings of chronic sorrow. Chronic sorrow was defined as a pervasive sadness that is permanent, periodic, and progressive in nature. The sample comprised 5 infertile couples, 10 individuals with long-term cancer, 10 individuals with multiple sclerosis, 6 individuals with Parkinsons disease, and 4 spouse caregivers. Data were collected through audiotaped face-to-face or telephone interviews using the Burke/NCRCS Chronic Sorrow Questionnaire. The audiotapes were transcribed, entered into a computer analysis program, and collaboratively analyzed by the researchers. The findings indicate that 83% of the subjects experienced chronic sorrow. The four coping strategies that were identified by the subjects as being helpful to their situation were categorized by the researchers as interpersonal, emotional, cognitive, and action.

Milestones of Chronic Sorrow: Perspectives of Chronically III and Bereaved Persons and Family Caregivers

Chronic sorrow is the presence of pervasive grief-related feelings that have been found to occur periodically throughout the lives of individuals with chronic health conditions, their family caregivers, and the bereaved. These feelings emerge in response to an ongoing disparity that results from the loss of the anticipated “normal” lifestyle of these persons. Circumstances and situations shown to trigger chronic sorrow in a variety of these populations are defined. Similarities and differences of the trigger events among groups and the implications for family nursing practice are discussed. Support that has been identified as helpful when life circumstances evoke chronic sorrow is described.

The relationship between death anxiety and attitudes toward the elderly among nursing staff.

The purpose of this study was to investigate the relationship between death anxiety and attitudes toward the elderly among nursing staff in nursing homes. Questionnaires were distributed to all 310 full-time nursing staff members in six nursing homes; 159 usable questionnaires (51 percent) were returned. The self-administered packet consisted of Templers Death Anxiety Scale to determine high and low death anxiety groups. Palmores Facts on Aging Quiz to identify positive or negative attitudes toward the elderly, and a self-developed demographic data questionnaire. A t-test was used to compare the mean attitude toward the elderly scores of the high and low death anxiety groups. Nursing staff with high levels of death anxiety had significantly more negative attitudes toward the elderly than nursing staff with low levels of death anxiety (t = 2.52; p. less than .01). A correlation coefficient was also used to analyze the relationship between death anxiety and attitudes toward the elderly for the entire study sample. The relationship was significant (r = -.21; p less than .007). Findings indicated no significant differences in death anxiety or attitudes toward the elderly when compared with various demographic variables.

Family Centred Brief Solution‐focused Therapy with Chronic Schizophrenia: a Pilot Study

The purpose of the study was to pilot a family centred brief solution-focused therapy model (BSFT) with families and clients diagnosed with schizophrenia. A control group of clients and their families received traditional outpatient therapy, while an experimental group of clients and their families were treated with a BSFT model. All participants were pre-tested and then post-tested with the Family Environment Scale after five therapy sessions over a ten-week period. Significant differences between the groups were found on expressiveness, active-recreational orientation, moral-religious emphasis and family incongruence. The participation of families and clients with schizophrenia in family centred brief solution-focused therapy produced encouraging results and demonstrated the need for expanded studies using BSFT with other chronically mentally ill clients and their families.

Chronic sorrow in multiple sclerosis. A case study.

Multiple sclerosis, one of the most common chronic disabilities among young adults, may potentiate the occurrence of chronic sorrow. Chronic sorrow differs from acute grief because it is permanent, periodic, and progressive in nature; it may be a normal component of chronic illness and disability. This study describes one womans experience with multiple sclerosis, her chronic sorrow about the trajectory of her disability, her progressive loss of bodily function, and the stigma of chronic illness. It also reports some of the feelings experienced by her husband, the primary caregiver.

Chronic Sorrow in Women With Chronically Mentally Disabled Husbands

BACKGROUND: Chronic sorrow was described by Olshansky (1962) to explain a perva sive, psychologic reaction that he observed in parents of mentally retarded children. He believed that the sorrow was a normal, not a neurotic, response to their situation and relatedly, thought clinicians would intervene differently with these parents if they held a similar belief. The Nursing Consortium for Research on Chronic Sorrow (NCRCS), of which the authors are members, has conducted multiple studies to ex pand the understanding of chronic sorrow as a normal state associated with chronic or life-threatening conditions, occurring both in the individual with the condition and in family members. These NCRCS investigators have provided evidence supporting the premise that chronic sorrow is likely to occur in various chronic situations. OBJECTIVES: This study explored whether women with chronically mentally disabled husbands experienced feelings of chronic sorrow in their lives. DESIGN: Using content analysis, the transcriptsfrom interviews with 11 women were coded using the Burke/NCRCS Chronic Sorrow Questionnaire (Caregiver version) as a guide. RESULTS: All 11 women experienced feelings of chronic sorrow. Feelings of chronic sor row occurred periodically over an extended time when some event reminded partici pants of their long-term situation. Subjects identified personal strategies for coping with feelings of chronic sorrow and nursing activities that had been helpful to them. CONCLUSIONS: The findings of this study are consistent with those of other studies on chronic sorrow. Subjects identified the role of the nurse as teacher/expert as most important for helping women with chronic sorrow, specifically by providing them with knowledge that is current and specific. From these findings, interventions can be developed to increase the psychologic comfort of these caregivers. (J AM PSYCHIATR NURSES Assoc [1995]. 1, 120-124)

Chronic Sorrow: The Experiences of Bereaved Individuals

This study investigated the occurrence of chronic sorrow among individuals who experienced the death of a loved one. In-depth interviews were conducted with fourteen parents who had experienced the death of a child, ten people who had suffered the death of their spouses, and ten individuals who had had a family member die. Interviews were transcribed and data were sorted into categories, with recurring themes identified. Thirty-three (97 percent) of those interviewed evidenced chronic sorrow. Confronting disparity with social norms and situations that brought memories to mind most frequently triggered recurrence of grief-related feelings. Subjects used action-oriented, cognitive, and interpersonal coping strategies to deal with these episodes of grief. These findings bring into question the expectation inherent in traditional grief theories that emotional closure is a necessary outcome of the grieving process.

The connotative meanings of the term “Psychosomatic”

The purpose of this study was to investigate the connotative meanings nurses attach to the term “psychosomatic.” The word psychosomatic was originally coined to represent the continuous and joint interaction of the mind and body. Unfortunately, the term, which was intended to convey an open-minded consideration of the whole person, has gradually acquired additional meanings that communicate disdain. A questionnaire designed to elicit information regarding the connotative meanings that nurses ascribe to the term psychosomatic was administered to 60 registered nurses. An open-ended format including four major questions was used. The participants were asked to define the term psychosomatic in their own words, to describe ideas and feelings that came to their minds when they heard the term psychosomatic, and to give an example of how psychosomatic would be used in their area of practice. Qualitative and quantitative analyses of the data were conducted. Findings showed that nurses expressed connotative meanings that contradicted the original meaning of the term and implied contempt for patients. Because it is accepted that attitudes and beliefs influenced actions, the way nurses use the term psychosomatic undoubtedly has important implications for the quality of care provided.