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Background of Theories of Chronic Sorrow and Cerebral Palsy

Background of Theories of Chronic Sorrow and Cerebral Palsy

Georgene Eakes et al. established the chronic sorrow theory in the 1960s to elucidate the causal factors of chronic grief and how to deal with it (Wijaya et al., 2022). According to the notion, sorrow is a natural response to grief, which might be abrupt or chronic. It has significantly contributed to dispelling myths about sadness and establishing methods for recognizing and regulating the illness. Despite its flaws, the idea is critical for nurses working with patients suffering from chronic sadness. After a continuous or single loss, the idea gives a foundation for comprehending and dealing with people. Chronic sadness has been found to demonstrate the feeling of persons of all ages who face enduring inequity as a result of substantial loss (Fernandes et al., 2021). Nurses ought to identify chronic grief/sorrow as an ordinary reaction to losses and, whenever the occasion happens, propose assistance by inspiring good coping skills and assuming responsibilities that improve comfort.

Analysis of the Underpinning of the Chronic Sorrow Theory

According to the hypothesis, chronic sorrow refers to a natural and predicted humankind response to a big loss. According to the concept, prolonged grief necessitates an antecedent: which is an occurrence or condition that causes sadness as a reflex. Loss is the most common cause of chronic sadness. An abrupt loss, like the death of a loved one, or a long-term loss, such as a deteriorating physical condition, are both examples of loss (Boss et al., 2022). The disparity can also be a forerunner to persistent grief, in which a person who has experienced or is experiencing loss is presented with a reality that differs from the one they had imagined. People who have lost loved ones struggle to reconcile this gap, which causes them to be sad for a long time. Because of the situations that remind us of the unresolved difference, we suffer loss in parts and pieces, which can return over time. These events are known as trigger events and vary depending on the type of loss (Fernandes et al., 2021). According to this view, chronic grief can be addressed through internal and external methods, acknowledging that chronic sorrow is natural.

Before the creation of the theory, the nursing profession and society saw chronic sadness as a disease. Furthermore, parents of disabled children (e.g., children with cerebral palsy) and adults with impairments were the only ones who experienced long-term grief. Individuals who had long-term grief due to unexpected losses were not deemed at-risk patients, which impacted their overall health management (Boss et al., 2022).

Olshansky proposed persistent grief as a reasonable reaction to disruptions of assumed regularity in 1962. According to an additional study, parents of disabled children and persons with disorders suffer from long-term grief. Hainsworth and her colleagues used these studies to develop the chronic sorrow hypothesis, which addressed the nursing culture’s and society’s preconceptions regarding grief (Wijaya et al., 2022). To construct the chronic grief hypothesis, the theorists employed interviews with 196 people and a literature study of prior theories on the subject—the notion of chronic sorrow aided in the development of methods for recognizing and treating chronic sadness. The hypothesis eliminated myths about those at risk of chronic sadness, resulting in a shift in how nurses and society view the disease. The idea has been useful in identifying and treating chronic sadness in cancer patients. Furthermore, the idea has acted as a conceptual framework for developing interventions that parents and nurses can employ to manage chronic grief among the affected people in their care. The hypothesis has also been used as a preliminary step for investigating the differences in coping techniques between mothers and fathers of impaired children experiencing persistent sadness (Wijaya et al., 2022). The development of ways to diagnose and regulate chronic grief has been aided by studies based on the idea of chronic sorrow.

There are several key concepts in the chronic sadness theory. The definition of antecedent events is the first notion that generates the definition. There exist two main issues when it comes to antecedent occurrences. The antecedent occurrence is the incident that happens before the onset of chronic grief, and two distinct antecedent occurrences exist. The loss suffered is an example of an “antecedent” occurrence. A big loss represents a loss that has occurred. It might be a one-time occurrence or a series of events. A single incident, for instance, can be the loss of loved ones or close acquaintances (Coughlin et al., 2017). The one-time event takes place at a fixed moment in time. The occurrence ends, although the individual must now deal with the ramifications.

The testability of a hypothesis determines its strength and reliability. Examining the persons at risk of suffering from chronic sorrow is one technique to investigate the notion of chronic sorrow. The Burke Chronic Sorrow Questionnaire is a quantitative tool that consists of an interview that can be used to investigate various aspects of chronic sadness (Fernandes et al., 2021). Giving the questionnaire to at-risk persons identified by the notion of constant sorrow could be one way to apply it to the theory. The questionnaire can be used both before and after chronic grief treatment. The findings will reveal whether at-risk persons, as described by the theory, suffer from chronic sadness and whether the theory’s suggested management approaches are beneficial to the afflicted.

Understanding the causes of chronic grief requires knowledge of the chronic sorrow hypothesis. The hypothesis, however, is incomplete since it ignores the various types of losses and the cultural influences on loss interpretation. One of the hypothesis’s assumptions is that the only significant losses are limited to continuing and restricted losses. On the other hand, the significant loss might be subjective, based on an individual’s personality and societal and cultural influences (Boss et al., 2022). Nonetheless, the hypothesis’s hypotheses about dealing with chronic sadness are informative.

Applications of the Theory of Chronic Sorrow

Since it normalizes parental experience, the conceptual model of chronic grief theory might be a beneficial environment to comprehend the caregivers’ perspectives of children who have cerebral palsy. Although the chronic grief theory has already been discovered to effectively explain the feelings of caregivers of kids with other diseases, such as neural tube and epilepsy defects, recent findings are scarce. Grief-related feelings resurface when provoking events to close the gap between actual and ideal into focus, as per the chronic sorrow hypothesis. The repetitive grieving cycle is healthy and normal, and many parents show resilience by establishing various effective coping mechanisms known as internal management systems (Prigerson et al., 2021). A case manager must ensure the victim of sorrow is coping well with the event they are experiencing. In chronic grief theory, parents can also seek help and interventions from healthcare workers, referred to as external management approaches. An antecedent, trigger occasions, and external and internal management approaches are all included in the chronic grief paradigm and can help in the planning of care for a child with cerebral palsy and offer resources available to the family (Fernandes et al., 2021). Individual responses to continuous discrepancy owing to chronic diseases, caregiving obligations, the grief of the “ideal” kid, or mourning can be studied using this theory. Case managers must recognize enduring grief/sorrow as a natural rejoinder to death and, whenever it surfaces, render support by encouraging good coping skills and assuming responsibilities that improve comfort. Case managers can also create interventions which classify persistent sorrow as a natural response, facilitate healthy adjustment, and provide sympathetic support if they understand it.

Implication to Practice

The hypothesis can be used in a variety of clinical settings. It can be utilized by patients to react to sickness and client events in order to forecast how they will react and assist patients in coping with various experiences and traumas. When patients get diagnosed to have a chronic disease, lose a loved one, and so on, a study has demonstrated that healthcare professionals who understand chronic sorrow are better able to predict different phases and help individuals adapt to their triggers and when to seek help and maximize their spiritual and psychiatric wellness (McLaughlin, 2017). Prospective nurses will benefit from the clarification that chronic sorrow is a natural emotion of loss because it encourages them to be empathetic, which is an important part of nursing. The hypothesis will be essential in my nursing profession since it will influence my nursing skills, particularly when dealing with convalescing parents, disordered patients, and people who have recently lost a loved one. Just like case managers, nurses must recognize chronic grief as a natural reaction to bereavement and, whenever it occurs, offer assistance by encouraging good coping skills and taking on responsibilities that improve comfort.


A thorough comprehension of the concept of chronic sadness and its accompanying idea requires an examination of its concepts and essential principles, the sorts of individuals it serves, and its clinical and research applications. The chronic sorrow theory is useful for understanding nurses’ psychiatric wellness, psychological well-being, and clients’ well-being. It considers the onset of grief and its long-term consequences from the perspective of the preceding event, the antecedents, the diagnosis of chronic sadness, and how it can be controlled. It is arguably a notion with a rare combination of implications, and the reality that it benefits providers and patients makes it a particularly valuable hypothesis in current scientific research.


Boss, P., Roos, S., & Harris, D. L. (2021). Grief in the midst of ambiguity and uncertainty: An exploration of ambiguous loss and chronic sorrow. In Grief and bereavement in contemporary society (pp. 163-175). Routledge.

Coughlin, M. B., & Sethares, K. A. (2017). Chronic sorrow in parents of children with a chronic illness or disability: An integrative literature review. Journal of Pediatric Nursing, 37, 108-116.

Fernandes, M. A., Nóbrega, M. M. L. D., Zaccara, A. A. L., Freire, M. E. M., Andrade, F. F. D., & Costa, S. F. G. D. (2021). Fawcett’s analysis and evaluation model applied to the theory of chronic sorrow. Texto & Contexto-Enfermagem, 30.

McLaughlin, V. G. H. (2017). Chronic sorrow in family members of addicts: An investigation of partners of addicts and divorcees to explore chronic sorrow as a theoretical understanding of the experiences of family members of addicts. The College of William and Mary.

Prigerson, H. G., Kakarala, S., Gang, J., & Maciejewski, P. K. (2021). History and status of prolonged grief disorder as a psychiatric diagnosis. Annual Review of Clinical Psychology, 17(1), 109-126.

Wijaya, Y. A., Yudhawati, N. L. P. S., Andriana, K. R. F., & Ilmy, S. K. (2022). Middle Range Theory: Understanding Perspective Theory Of Chronic Sorrow Nursing Presented By Georgene Gaskill Eakes.


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The purpose of this assignment is to explain how the Theory of Chronic Sorrow can be used as a framework for planning care and identifying resources in the following case:

Background of Theories of Chronic Sorrow and Cerebral Palsy

Background of Theories of Chronic Sorrow and Cerebral Palsy

You are a case manager for a family with a young child diagnosed with cerebral palsy. Explain how the Theory of Chronic Sorrow can be used as a framework for planning care and identifying resources for this family.

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