Theory of Chronic Sorrow

  • Theory of chronic sorrow was developed by Georgene Gaskill  Eakes, Mary Lermann Burke and Margaret A. Hainsworth in 1998.
  • Other related theories - Kubler-Ross (1969), Bowlby (1980)
  • Theory of chronic sorrow is considered as a a middle-range nursing theory.
  • Theory explains the ongoing feelings of loss that arise from illness, debilitation, or death.
  • This theory provides a framework to describe the reaction of parents to the ongoing losses associated with caring for a child with chronic illness or disability (Scornaienchi JM, 2003).
  • Nurses caring for families need to be aware of the high potential for chronic sorrow to occur in persons with chronic conditions, their family caregivers, and bereaved persons.(Eakes GG, 1999).
  • Major concepts
    • chronic sorrow
    • disparity
    • loss
    • antecedents
    • trigger events, and
    • internal and external management methods.
  • Chronic sorrow is the periodic recurrence of permanent, pervasive sadness or other grief related feelings associated with a significant loss. (Eakes GG, 1998).
  • Disparity refers to the difference between the ideal and the real situation due to some type of loss.
  • Loss - a significant loss that may be ongoing or a single event.
  • The model explains two antecedents: (Gorden J, 2009)
    • First antecedent is initiated when a single event of a living loss is experienced e.g. onset or time of diagnosis of chronic illness
    • Second antecedent to chronic sorrow is unresolved disparity resulting from the loss.
  • Triggers are events which prompt the recognition of a negative disparity in the disabled loved one or loss which brings out sadness again.
  • Internal management methods consist of individualized coping interventions initiated by the person experiencing chronic sorrow (Gordon J, 2009).
  • External management methods of coping consist of interventions provided by medical professionals to aid in effective coping (Gordon J, 2009).
  • Examples of external management methods (Gordon J, 2009) are
    • professional counseling,
    • pharmaceutical interventions to treat symptoms of insomnia or anxiety if necessary,
    • pastoral care or spiritual support to assist with grieving,
    • use of therapeutic communication, and
    • referral services
  • Other concepts related to the framework are:
    • Coping - “Facing difficulties and acting to overcome them”.
    • Parents - “A mother or father who nurtures and raises a child”.
    • Child - “A son or daughter, an offspring”.
  • The theory provides a framework for understanding and working with people following a single or ongoing loss (Eakes GG, 1998).
  • Theory is useful for analyzing individual responses of people experiencing ongoing disparity due to chronic illness, caregiving responsibilities, loss of the "perfect" child, or bereavement (Eakes GG, 1998).
  • Nurses need to view chronic sorrow as a normal response to loss and, when it is triggered, provide support by fostering positive coping strategies and assuming roles that increase comfort (Eakes GG, 1998)
  • With an understanding of chronic sorrow, nurses can plan interventions that recognize it as a normal reaction, promote healthy adaptation, and provide empathetic support.
  1. Eakes, G.G., Burke, M.L., & Hainsworth, M.A. (1998). Middle range theory of chronic sorrow. Image: Journal of Nursing Scholarship, 30(2), 179-183.
  2. Eakes, G.G., Burke, M.L., & Hainsworth, M.A. 1999) Milestones of Chronic Sorrow: Perspectives of Chronically Ill and Bereaved Persons
    and Family Caregivers. Journal of Family Nursing, 5(4), 374-38
  3. Scornaienchi JM (2003) . Chronic sorrow: one mother's experience with two children with lissencephaly. J Pediatr Health Care. Nov Dec;17(6):290-4.
  4. Gordon J ( 2009). An evidence-based approach for supporting


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