by Sharon Curran, RN, #facingtheissues
Over the years, at times it’s been hard to think about that year without feeling anxious and sad.
Ten years ago this week on the eve of Thanksgiving, my then 20 year old was diagnosed with cancer. We set up the Christmas tree and spent time with family and friends in between consults with oncologists. By Christmas, my son’s physical pain was peaking and his breathing was strained. Thankfully chemotherapy began just after the New Year when an infection cleared. After three surgeries, an inpatient stay for another infection, four months of chemotherapy and a month of radiation, he was cancer free. Since its Thanksgiving, I want to express how grateful I am for my son’s recovery.
I do recall how difficult that year was for my family and I, especially for my son. Over the years, at times it’s been hard to think about that year without feeling anxious and sad. Admittedly, I am filled with gratitude for the positive outcome that my son and our family had related to his cancer experience. I reflect on how fortunate we were with some degree of survivor’s guilt, understanding the losses that others experience due their cancer diagnosis is far greater.
During my nursing graduate school studies, I learned of the “Theory of Chronic Sorrow” which was developed and published in 1998 by three nurses, M. L. Burkes, G. G. Eakes, M. A. Hainsworth.
The theory provides a framework for understanding and working with people following a single or ongoing loss (Eakes GG, 1998). The 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.
I wanted to share this information with anyone reading the UCF website as I believe there are many cancer survivors and cancer caregivers who might relate to this experience. I hope some of you will comment describing your story, hoping that in sharing, it may help you or other’s cope with periodic sadness, grief, or anxiety that you experience.
Theory of Chronic Sorrow
Eakes, G.G.,Burke, M.L., & Hainsworth, M.A. (1998). Date of last revision September 19, 2013.
- 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 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).
- Chronic Sorrow: The periodic recurrence of permanent, pervasive sadness or other grief related feeling 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.
- 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.
- Tiggers: Events which prompt the recognition of a negative disparity in the disabled loved one or loss which brings out sadness again.
- Internal Management Methods: Individualized coping interventions initiated by the person experiencing chronic sorrow (Gordon J, 2009).
- External Management Methods: Interventions provided by medical professionals to aid in effective coping (Gordon J, 2009). Examples include – Professional counseling, Pharmaceutical Interventions, Pastoral Care or Spiritual Support, Therapeutic Communication, and Referral Services.
- 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.
- 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.
- 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
- Scornaienchi JM (2003) . Chronic sorrow: one mother’s experience with two children with lissencephaly. J Pediatr Health Care. Nov Dec;17(6):290-4.
- Gordon J ( 2009). An evidence-based approach for supporting parents experiencing chronic sorrow. Pediatr Nurs.35(2):115-119.