Middle-range theory of chronic sorrow.

PURPOSE To introduce a middle-range nursing theory of chronic sorrow that presents this sorrow as a normal response to ongoing disparity due to loss. Chronic sorrow is the periodic recurrence of permanent, pervasive sadness or other grief related feelings associated with a significant loss. The theory provides a framework for understanding and working with people following a single or ongoing loss. ORGANIZING FRAMEWORK The model of chronic sorrow includes antecedents, trigger events, and internal and external management methods. SCOPE 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. SOURCES The theory was developed using concept analysis, critical review of research, and validation in 10 qualitative studies of various loss situations. CONCLUSIONS Chronic sorrow has been shown to explain the experience of people across the lifespan who encounter ongoing disparity because of significant loss. 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.