No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Coping with Chronic Sorrow
Abstract
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 Parkinson's 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.
... Kronisk sorg är ett begrepp som är relativt okänt inom sjukvården vilket gör att patienter och livskamrater som lider av det inte får den hjälp de behöver (Hainsworth, Eakes & Burke, 1994). En studie visar att sjuksköterskor många gånger missbedömer vilka symtom patienterna upplever som svårast. ...
... Den kroniska sorgen kan också ge sig till känna då den drabbade inte längre kan leva upp till samhällets eller sina egna ideal samt även vid påminnelse av förlusten vid återkommande årsdagar (Burke, et al., 1999). Sorg är i vanliga fall en process som hjälper individen att gå vidare efter en förlust, men när förlusten ständigt gör sig påmind gång på gång avstannar sorgeprocessen och tillståndet övergår till kronisk sorg (Hainsworth, et al., 1994). Olshansky (1962) var den första att mynta begreppet kronisk sorg och upptäckte i sin studie att föräldrar med funktionshindrade barn sörjer att barnet inte är friskt vid födseln. ...
... Individen sörjer förlusten men ser sig själv fortfarande som värdefull (Worden, 2006). Hainsworth, et al. (1994) beskriver hur patienter och deras livskamrat med kronisk sorg orsakade av en kronisk sjukdom inte blir tillräckligt uppmärksammade inom sjukvården. Dessa patienter och livskamrater får själva hitta strategier för att hantera sorgen de upplever i samband med den kroniska sjukdomen. ...
... Atinge especialmente as mulheres numa faixa etária entre 30 e 60 anos, mas pode também aparecer em crianças e adolescentes (Feldman, 1999;Skare 1999;Lima & Carvalho, 2008). O nome fi bromialgia tem origem nos termos: fi bra do latim (tecido fi broso), mio do grego (referente aos músculos), e algia originário do grego (algos), que signifi ca dor (Goldenberg, 2006). É considera uma síndrome, porque inclui uma série de sintomas e sinais que não estão restritos a um órgão ou conjunto de órgãos pertencentes a um sistema do organismo. ...
... Essas dores físicas são agravadas por outra dor, a da incompreensão. De acordo com Goldenberg (2006), só de saber que se tem uma doença real, após anos de dúvida e sofrimento, na maioria dos casos, o paciente já apresenta uma melhora considerável no seu quadro. ...
... Já, Whitcomb (2007) afi rma haver um desalinhamento entre o forâmen magnun e a primeira vértebra da coluna cervical causando uma pressão nas meninges; a qual está ligada às raízes nervosas da coluna e do crânio, desencadeando estímulos indiscriminados dos impulsos nervosos, especialmente do Sistema Nervoso Simpático, resultando nos múltiplos sintomas da fi bromialgia. Goldenberg (2006) cogita que os agentes estressores na infância condicionam a resposta biológica pelos anos afora. E, Feldman (2004) afi rma existir uma predisposição genética e, também, que uma incapacidade em elaborar resposta adequada aos estímulos estressantes do ambiente resultaria em alterações na aquisição, percepção e interpretação da dor; fazendo com que o limiar de dor no fi bromiálgico seja muito baixo. ...
The fibromyalgia is a chronic syndrome, not inflammatory, characterized by the spread
of musculoskeletal pain and the presence of tender points in specific regions of the body. The
diagnosis is made by a clinical exam and there are no specific laboratory alterations. Therefore the
focus of this project was to understand the psychological suffering in a group of women, who have
fibromyalgia; describing the dimension of the symptoms produced by the syndrome, distinguishing
the psychological pain that permeates the process of accepting the illness. It’s about a qualitative
research, composed of a study group of 10 women diagnosed with fibromyalgia from 21 to 65 of
age. It became evident that the life path of a person with fibromyalgia is marked with a lot of pain;
physical and psychological, and in addition to medical treatment he needs psychological support
in order to develop his adaptive resources.
... The first was constructed by Burke (1989) and was also used by Mallow and Bechtel (1999). In addition, it was used by Hainsworth, Eakes and Burke (1994) in a study determining presence of chronic sorrow and coping for infertile couples, for individuals with long-term cancer, with Parkinson's disease, multiple sclerosis, and for spouses acting as caregivers. ...
... The study by Hainsworth, Eakes, & Burke (1994) used the BCSQ with validity and reliability having been established on the original questionnaire. "Face validity was provided by two experts in the field, and content validity was established by a panel of seven experts, three academicians, and four clinicians. ...
... Hainsworth and Lindgren, who wrote about chronic sorrow in several articles (Eakes, Burke, & Hainsworth, 1998;Hainsworth, 1996;Hainsworth, Busch, Eakes, & Burke, 1995;Hainsworth, Eakes, Burke, 1994;Lindgren, Connelly, & Gaspar, 1999). Realizing confusion existed in the definition of chronic sorrow as compared to other terms of pathological grief and depression, the authors compared these terms to chronic sorrow. ...
Chronic sorrow has been defined as a permanent and reoccurring experience of pervasive sadness and loss which underlies the life experience and which recurs over time for the parent of a child with developmental, medical, or behavior issues that prevent him from participating in society in a way previously anticipated by parents. The functional question asked of the mothers was: “Some parents have described a sadness that can occur when they think about their child with a disability. Parents can believe they are functioning well, but have times where they feel the loss for their child.” To date, little research has targeted chronic sorrow among parents of adult children who have a disability. Neither is it known how chronic sorrow exists and has changed over the years since the initial diagnosis for this specific sample. This exploratory, qualitative study focused specifically on mothers of adult children with cerebral palsy. Snowball sampling was utilized to recruit six mothers in northeastern Kansas who were primary caregivers to their adult children with CP. Data were gathered with face-to-face mixed self-report surveys, including the Kendall Questionnaire on Chronic Sorrow; two surveys which assessed demographic, potential complications from cerebral palsy, and available resources; and a standard schedule open-ended interview targeting: personal experiences of chronic sorrow, chronic sorrow triggers (developmental milestones), and losses (including support, roles and responsibilities, and quality of life). Two-coder analyses of interview responses were conducted within cases and comparisons were made across cases. Common themes identified in the narratives included sense of isolation, fear for the future, frustration, loss of hope, exhaustion, sadness, financial challenges, guilt, and anger. For example, isolation was another theme that changed over time depending on if the mothers were providing full-time care. Also, fear for the future was a universal theme when the children were much younger, but it changed into loss of hope for some of the mothers when the child was the age of an adult. The relevance of the findings was discussed, with particular focus being the subjective meanings of chronic sorrow for this sample. Recommendations for advancing research, practice, and policy are offered. Doctor of Philosophy Doctoral Department of Family Studies and Human Services Rick J. Scheidt
... Assim, a Teoria de Médio Alcance da Tristeza Crônica foi desenvolvida de forma indutiva, usando a análise de conceito, ampla revisão da literatura, revisão crítica da pesquisa e validação em estudos qualitativos e quantitativos de várias situações de perda. 10,15,16,[18][19][20][21] Quanto ao critério de consistência interna, o modelo de análise e avaliação sugere que, para que esse parâmetro seja mantido, é necessário analisar os aspectos semânticos e estruturais do contexto e do conteúdo da teoria. 11 Porém a Teoria da Tristeza Crônica atende ao critério de consistência interna. ...
... 10 Nessa perspectiva, a teoria influencia diversas intervenções de enfermagem e é amplamente utilizada. Uma série de estudos, que formam a base da Teoria de Médio Alcance da Tristeza Crônica, 10,15,16,[18][19][20][21][22][23][24] estão repletos de aplicações práticas. ...
Objective:
to analyze the Theory of Chronic Sorrow, following the model of analysis and evaluation of Nursing theories proposed by Jacqueline Fawcett.
Method:
a reflective study, developed through the investigation of the Theory of Chronic Sorrow and its application in the nursing practice. The sample consisted of eighteen studies that used the theory as a reference. A Model for Analysis and Evaluation of Nursing Theories was used, which involved, in the first stage, a detailed examination of the referred theory in terms of scope, context and content. In the second stage - evaluation - the criteria of clarity, significance, internal consistency, parsimony, testability, empirical adequacy and pragmatic adequacy were used.
Result:
This is a mid-range theory that is predictive in relation to the scope. As for the context, it is based on the stress and adaptation model. The content presents well-defined and interrelated concepts. The concepts of meta-paradigm have significance, internal consistency and are operable. It features a usable instrument: The Chronic Sorrow Questionnaire, reliable as a tracking tool to detect the presence of chronic sorrow. The theory is parsimonious, it can be used with chronic diseases and directed to people in the final phase of life and their family caregivers.
Conclusion:
this study may contribute to indicate the use of the Theory of Chronic Sorrow and support nursing care in promoting effective strategies and, consequently, improve the comfort of patients and their families in coping with chronic sorrow.
... Atinge especialmente as mulheres numa faixa etária entre 30 e 60 anos, mas pode também aparecer em crianças e adolescentes (Feldman, 1999;Skare 1999;Lima & Carvalho, 2008). O nome fi bromialgia tem origem nos termos: fi bra do latim (tecido fi broso), mio do grego (referente aos músculos), e algia originário do grego (algos), que signifi ca dor (Goldenberg, 2006). ...
... Essas dores físicas são agravadas por outra dor, a da incompreensão. De acordo com Goldenberg (2006), só de saber que se tem uma doença real, após anos de dúvida e sofrimento, na maioria dos casos, o paciente já apresenta uma melhora considerável no seu quadro. ...
... In small qualitative studies of multiple physical illnesses, the Nursing Consortium for Research on CS (Burke, Eakes, & Hainsworth, 1999;Eakes, 1993;Hainsworth, Eakes, & Burke, 1994) consistently found that patients with chronic physical illness fit the description of CS. More than 83% of those studied displayed CS. ...
... More than 83% of those studied displayed CS. The researchers concluded that CS might better explain the individuals' emotions and mood state rather than depressive illness (Hainsworth et al., 1994). ...
... Progressive functional impairment involves the loss of one important ability after another and demands renewed adaptation on the part of the person af icted. Knowledge of the greater vulnerability of people who have experienced repeated losses has an important role to play in the professional encounter with the patient in respect of care and rehabilitation (31)(32)(33). Staff need to encounter patients in a spirit of openness and with sensitivity, bearing in mind what it is like for them to live with newly occurring functional impairment (11,(31)(32)(33). They should give coping support to patients who express helplessness, hopelessness and anxious preoccupation with the problems, such states of mind having in an earlier study found to be related to a decline in quality of life (18). ...
... Knowledge of the greater vulnerability of people who have experienced repeated losses has an important role to play in the professional encounter with the patient in respect of care and rehabilitation (31)(32)(33). Staff need to encounter patients in a spirit of openness and with sensitivity, bearing in mind what it is like for them to live with newly occurring functional impairment (11,(31)(32)(33). They should give coping support to patients who express helplessness, hopelessness and anxious preoccupation with the problems, such states of mind having in an earlier study found to be related to a decline in quality of life (18). ...
... QoL has been linked with the notion of grief when speaking about parents' experiences of raising children. We speak of grief in terms of chronic sorrow as relating to the merciless sadness which seeps into every aspect of life and persists throughout life (Burke et al., 1999;Hainsworth et al., 1994;Harris & Winokuer, 2019;Lindgren et al., 1992;Olshansky, 1962). Chronic sorrow impacts the QoL of parents who have a child with disabilities (Burke et al., 1999;Hobdell, 2004;Liedstrom et al., 2008;Lindgren et al., 1992;Masterson, 2010;Northington, 2000;Olshansky, 1962). ...
Mothering a child who lives with a disability, or a congenital facial condition can impact quality of life. This appertains to relationships, isolation, and feelings exclusion, can result in ongoing vigilance, grief, and may be addressed via faith and future hope. In this IPA study we explore the lived experience of a non-facially disfigured mother mothering her child Living with Facial Eye Disfigurement (LwFED). Semi-structured interviews were used to collect rich data which were analysed to reveal emergent and overarching themes. We found that our participant is constantly vigilant in response to her son’s blindness and disfigurement. This impacts his schooling and her relationships. Isolation impacts all facets of the quality of life of our participant including seeking respite, exhaustion, and relationships. She acknowledges grief and chronic sorrow. As a mother, she encounters comments and stares from strangers in social situations. Our participant uses her strong faith to attempt to find balance in her life and to envisage a future for her son. We offer the narrative of one mother with a child LwFED. We do not draw generalisations but suggest resonances with the lived experiences of others. We recommend further research, advocacy and professional support for families and society to change culture.
... Literature also confirms that chronic diseases involve loss of independence [38,44]. Patients cannot live the life they lived before or the life they imagined living [38], often referred to as 'chronic sorrow' which reflects long-term periodic sadness in reaction to continuous personal and social losses that are part of chronic illness or disability [45,46]. Previous research demonstrated how dependency increases negative emotions as well as reducing self-efficacy, which is important in order to cope properly [47]. ...
Background
Little is known about how patients with low socioeconomic status (SES) experience their chronic disease, and how it impacts health-related quality of life (HRQoL). Compared to their more affluent counterparts, worse outcomes have been reported. A better understanding of the domains of HRQoL that are relevant to these specific populations is therefore needed. We explored the experiences of living with a chronic disease in low SES persons.
Methods
A qualitative interview study was performed in Flanders, Belgium. Semi-structured interviews were conducted in chronically ill patients, selected through purposive sampling. Interviews were audio-recorded and transcribed verbatim. Analysis followed an inductive and iterative approach.
Results
Fifteen patients were interviewed. Six major themes were identified: a heavy bag to carry, loss of autonomous life, inner and outer loneliness, emotional imbalance, unmet need for support, and coping strategies. Patients experienced their illness as an additional problem on top of all other problems (i.e. financial/social problems, traumatic life events). In general, the disease burden and non-disease burden were mutually reinforcing, resulting in greater dependency, greater risk of social isolation, greater psychological distress, and greater risk of impaired HRQoL.
Conclusions
This study is the first to provide detailed insight into the experiences of living with a chronic disease in low SES persons. A conceptual model is proposed that can be used in daily clinical practice to raise awareness among clinicians and health care providers that the patient’s needs go beyond the disease itself. Future research is needed to validate and test the model.
... A key finding in this literature is that the psycho-social losses are chronic, if episodic, throughout life (Hainsworth, Eakes, & Burke, 1994;Hewson, 1997;Hull, 1990;Moore, Constantino, & Allen, 2000;Murray, McKay, & Nieuwoudt, 2010). The onset of a visual impairment disrupts how a person feels about themselves and their ability to act within the world. ...
This study aimed to hear the voices of seven people living with Leber Hereditary Optic Neuropathy (LHON), to examine their lived experience. The participants were recruited through a website and social networking sites designed for this community; they discussed their experiences in semi-structured interviews. The analytical process was informed by Interpretive Phenomenological Analysis (IPA) principles. This process illustrated a lived experience that was initially consumed by psycho-social losses and conflicts around identity. However, through pragmatic and resilient attitudes, the participants developed practical methods and emotional coping mechanisms that permitted their adjustment to sight loss and progression in life. Consistent with other studies, the fundamental finding was that the associated feeling of loss and frustration are chronic if, episodic, throughout life.
... While there is disagreement over whether infertility is a disease, a disability or a condition which impairs life goals (Khetarpal and Singh, 2012), it can be understood as a form of disability which entails similar experi ences to chronic illness (Greil, 1991). The psychological distress that infertile patients may experience is also recognized within the mental health nursing literature (Hainsworth et al, 1994). ...
Couples may be reluctant to disclose they are experiencing infertility. Helen Allan and Ginny Mounce provide a discussion on the anxiety couples experience and how to care for these patients
... Coping can be categorized into problem-focused, cognitive reappraisal, emotionfocused, or avoidance coping (Hainsworth, Eakes, Burke, 1994). Cognitive coping strategies refer to the ways in which individual family members alter their perception of stressful situations (McCubbin et. ...
... One subject was clearly able to describe in his own words the chronic sorrow he felt, which was congruent with the theories of chronic sorrow within chronic illness stated earlier by Lindgren et al. 3,4 and Hainsworth et al., 6 thus suggesting that chronic sorrow within the type 1 diabetic population does, indeed, exist. This provides health professionals with an opportunity to understand the lived experience and to stimulate discussion in order to plan appropriate future care for people with diabetes, completing the aims of the study. ...
This qualitative study has been designed to examine chronic sorrow in a population of individuals with type 1 diabetes. Teel1 defines chronic sorrow as ‘a recurring sadness interwoven with periods of neutrality; satisfaction and happiness’. The sample chosen are five adult subjects with type 1 diabetes for an average of 22.4 years. Data was collected using audio taped, semi-structured, interviews. Tapes were transcribed and analysed. Four themes emerged; fear of the future, negative attitudes of others, regrets and difficulties in managing the condition. The study discusses the causes of sadness. Results are of relevance to people with diabetes, and those who care for them. Copyright © 2001 John Wiley & Sons, Ltd.
... Parents may not anticipate that they will have episodes of re-grief and may be unprepared for them. Particular times of difficulty appear to be associated with transitional milestones (e.g., loss of ambulation, adolescence, later stages of the disease), and providing them with support and guidance is necessary [18]. Some parents have a hard time modifying rigidly held expectations for how life should have been. ...
Receiving a diagnosis of Duchenne muscular dystrophy is a difficult process for any family. Multiple factors can contribute to how well a family adjusts to this new reality. While some of these are beyond the control of health professionals, there are strategies that can be implemented in the clinic that can facilitate the process and guide families toward a positive outcome of coping in spite of the diagnosis. Certain strategies may be particularly important at specific times of crisis, such as at diagnosis or during transitional phases, while others may be ongoing to meet recurrent or emerging needs. In our opinion, the factors and recommendations discussed in this article are just as important as the actual medical care that is delivered in the clinic. Neuromuscular clinics that give thought to these issues in advance and strive to have plans and structures in place for their patients will have the biggest impact on overall adjustment.
... However, this literature also points out that the uncertainty regarding the durability of current HIV medications can give this experience of renewal qualities similar to " Damocles Syndrome , " i.e., the fear of reoccurrence of cancer (Koocher and O'Malley, 1981; Brashers, Neidig, Cardillo and Dobbs, 1999). Cancer research has found that failure to manage uncertainty leads to " chronic sorrow, " pervasive sadness that is permanent and progressive in nature (Eakes, 1993; Hainsworth, Eakes and Burke, 1994). Charmaz (1994) provided data on the challenges that chronic illness presents to men in particular. ...
Based on qualitative data collected in 1999 in Dublin, Ireland and Providence, Rhode Island, this study examines psychosocial tasks for gay men with AIDS who are experiencing "Lazarus Phenomena," significant improvement in health and functioning as a result of current medication advances. The data showed a range of reactions, supportive of the literature on "uncertainty in illness," and suggesting that long term survival with AIDS requires an exceptional tolerance for ambiguity and an ability to reconstruct the future-skills which may co-vary with economic/career opportunities, social supports and individual resilience.
... Parents describe prolonged feelings of grief, disappointment, and fear in response to continual losses experienced over the trajectory of an illness or disability. Termed "chronic sorrow," this phenomenon has been described in adult patients (Hainsworth, Eakes, & Burke, 1994) as well as parents of children with mental handicaps (Krafft & Krafft, 1998;Wikler, Wasow, & Hatfield, 1981) and other chronic physical illness (cf. Northington, 2000). ...
To develop a measure of parent adjustment related to caring for a child with a chronic illness and to evaluate the reliability and validity of the measure with a group of parents of children with brain tumors.
One-hundred forty-nine parents of patients (age <1-17 years) diagnosed with a brain tumor were assessed using the 25-item self-report Parent Experience of Child Illness (PECI). Internal consistency, construct validity, and factor structure were assessed.
Exploratory factor analysis yielded four theoretically coherent factors including: Guilt and Worry, Emotional Resources, Unresolved Sorrow and Anger, and Long-term Uncertainty. Internal reliability for the PECI scales ranged from .72 to .89, suggesting acceptable reliability. As evidence of construct validity, the PECI scales show significant, positive correlations with scales from established measures of parent adjustment.
The PECI augments the current literature by providing a brief measure of parents' subjective distress and perceived Emotional Resources, domains that are critical but understudied in children with chronic illness and their caregivers.
... It could be a remembrance of a significant event in the course of the disease, such as it being a year to the day since the diagnosis was announced (Burke et al. 1999). It has been estimated that the occurrence of chronic sorrow in persons with chronic illness is around 80–90% (Hainsworth et al. 1994, Hainsworth 1994). This sorrow can afflict both the sick person and the person's next of kin (Hainsworth 1996, Lindgren 1996, Burke et al. 1999, Mayer 2001). ...
The aims of the present study were to describe losses narrated by persons afflicted with severe chronic physical illness and to identify the concomitant occurrence of chronic sorrow.
Reactions connected with repeated losses are referred to in the literature as chronic sorrow, which has recently been described in conjunction with chronic illness.
A qualitative study with an abductive approach of analysis, including both inductive and deductive interpretations.
The study is based on 30 persons of working age with average disease duration of 18 years. The average age was 51 years. All of the persons had personal assistance for at least three months because of considerable need for help in daily life due to physical disability. Each person was interviewed twice. There was also an independent assessment of the deductive results concerning chronic sorrow.
The inductive findings show that all persons had experienced repeated physical, emotional and social losses. Most common were 'Loss of bodily function', 'Loss of relationship', 'Loss of autonomous life' and 'Loss of the life imagined'. 'Loss of identity' included the loss of human worth, dignity and a changed self-image. In addition, the deductive findings suggest that chronic sorrow exists in the study population. Sixteen of 30 participating subjects were assessed by both assessors to be in a state of chronic sorrow and there was an especially high agreement with respect to one criterion of chronic sorrow 'Loss experience, ongoing or single event' (28 of 30 subjects).
This study shows that persons with severe chronic illness often experience recurring losses. These experiences are consistent with the phenomenon of chronic sorrow.
Knowledge of the existence of chronic sorrow in persons with chronic illness will enable nurses to support these persons in a more sensitive and appropriate way.
The following is how emotions are viewed within the nursing discipline. An exploration at the level of taxonomy, discipline, and nursing theories has been conducted. In addition, some articles are presented. It is also shown that emotions are part of the nursing discipline and that it would be relevant to explore the topic further.
PurposeThe purpose of this synthesis of qualitative studies is to explore manifestations of ambiguous loss within the lived experiences of family caregivers (FCG) of loved ones with cancer. Grief and loss are familiar companions to the family caregivers of loved ones with cancer. Anticipatory loss, pre-loss grief, complicated grief, and bereavement loss have been studied in this caregiver population. It is unknown if family caregivers also experience ambiguous loss while caring for their loved ones along the uncertain landscape of the cancer illness and survivorship trajectory.Methods
We conducted a four-step qualitative meta-synthesis of primary qualitative literature published in three databases between 2008 and 2021. Fourteen manuscripts were analyzed using a qualitative appraisal tool and interpreted through thematic synthesis and reciprocal translation.ResultsFive themes were derived, revealing FCGs appreciate change in their primary relationship with their loved ones with cancer, uncertainty reconciling losses, an existence that is static in time, living with paradox, and disenfranchised grief. The results of this synthesis of qualitative studies complement the descriptors of ambiguous loss presented in previous research.Conclusions
The
results of this synthesis of qualitative studies complement the
descriptors of ambiguous loss presented in previous theoretical and
clinical research. By understanding ambiguous loss as a complex and
normal human experience of cancer FCGs, oncology and palliative care
healthcare providers can introduce interventions and therapeutics to
facilitate caring-healing and resiliency.Implications
for Cancer SurvivorsUntreated
ambiguous loss can result in a decrease in wellbeing, loss of hope,
and loss of meaning in life. It is imperative that cancer FCGs
experiencing ambiguous loss are recognized and supported so that they
may live well in the family disease of cancer.
Purpose
The purpose of this study was to explore how adaptive patterns of religiousness/spirituality and hope predict adult life satisfaction in adults, even if they had childhood loss experiences.
Design and Methods
Using a cross-sectional survey design with132 adult participants (mean age 33.8 ± 15.2, 82% female, 78% Caucasian) we estimated two hierarchical regression models to examine how dimensions of religiousness/spirituality (Brief Multidimensional Measure of Religiousness/Spirituality) and hope (Herth Hope Index) predicted adult life satisfaction (Satisfaction with Life Scale) after controlling for effects of adverse childhood experiences (Adverse Childhood Experiences Study Questionnaire) or chronic sorrow from childhood loss (Kendall Chronic Sorrow Instrument).
Results
When effects of adverse childhood experiences (ACE) were controlled, higher levels of hope (β = .416, p < .001) and forgiveness (β = .273, p = .023) and lower levels of religious/spiritual values/beliefs (β = −.298, p = .014) predicted higher levels of adult life satisfaction. ACE remained a significant predictor of adult life satisfaction in the final model. When controlling for effects of chronic sorrow, higher life satisfaction was predicted only by forgiveness (β = .379, p = .003), values/beliefs (β = −.354, p = .007), and hope (β = .357, p < .001), with chronic sorrow not a significant predictor of adult life satisfaction in the final model.
Conclusion
Greater life satisfaction for adult survivors of childhood loss experiences could be promoted by interventions to enhance hope and foster forgiveness. These adult survivors may also need support as they engage with religious/spiritual struggle to reconcile their values and beliefs with childhood loss.
The purpose of this study was to assess the impact of chronic illness on patients in relation to its physical, psychological, and social effects, and its effects on activities of daily living. A structured questionnaire was used to interview I77 patients. Chronic illness had the greatest effect on psychological functioning, followed by physical and social functioning. The least affected aspects of a patient's, functioning were related to performing activities of daily living (ADLs). Results indicated that the diagnosis, duration of disease, and developmental stage of the patient S children were useful in predicting the impact of a chronic illness on a patient's physical functioning. Diagnosis, duration of disease, and economic status had a significant impact on a patient's psychological functioning. Diagnosis, duration of disease, age, sex, occupation, education, and marital and economic status were important factors relative to social functioning. Diagnosis, age, marital status, the developmental stage of the children, and the primary caregiver were the most important factors related to the effects of chronic illness on ADLs. The results of the study serve as a guide for a comprehensive assessment of chronically ill patients.
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 study concerns 77 adults with muscular dystrophy (mean age 49 years) in two counties in Sweden. The purpose was to investigate activities of daily living, quality of life and the relationship between these. Data collection was performed with "the Activity of Daily Living Staircase", "the Self-report Activity of Daily Living" and the Quality of Life Profile. The results indicated that over half of the subjects were dependent on others, chiefly in activities requiring mobility. Muscular dystrophy had mostly negative consequences, and nearly half stated that life would have offered more without it. Few significant diagnosis-related (no gender-related) differences emerged regarding activities of daily living and quality of life. Lower quality of life can only partly be explained by greater disability (r = 0.30-0.54). Therefore quality of life as a measurement of rehabilitation outcomes might be based both on physical status, disability and psychosocial factors in terms of positive and negative consequences.
Chronic diseases such as childhood diabetes mellitus (DM) constitute a challenge for both the affected children and their families. Childhood DM is characterized by complex therapeutic management and has a profound physical and psychological impact on the whole family and a number of losses for the parents. The parents of children with DM are reported to react to the diagnosis with anger, denial, frustration and depression, and the mothers differ from the fathers in their reactions. Adolescents with DM experience a very intense period, full of emotional distress and a varied range of extreme feelings, including anger, sorrow, fear and shame about their beliefs, attitudes and overall concept of their health status. It is, therefore, not unusual for a chronic disease diagnosed at this age to result in the adolescent having a negative perception of his or her body image and physical and mental abilities. For these reasons, studies in these fields should focus not only on the needs of the children/adolescents diagnosed with DM but also on the needs of their parents, so that with a global approach better control of DM and its complications may be achieved. It appears that, despite all the difficulties, the families of children with DM in general respond satisfactorily to the demands of the care of the children, and manage to deal effectively with the chronic disease.
This paper reviews the literature on the role of coping styles and strategies in psychosocial adaptation to a major threatening disability, namely heart disease. Following a general discussion of the concept of coping and its role within the context of coping with chronic illnesses and disabilities, the research literature on coping with cardiac disease is reviewed. The paper concludes with a summary of the findings on coping with the condition and offers rehabilitation-related clinical and research implications.
Abstract
Objectives: The aim of this study was to investigate psychometric characteristics of Persian version of Kendall Chronic Sorrow Instrument (KCSI) among a population of Iranian mothers of children with cancer. Method: The KCSI was translated using Wilde et al. method and its content and face validity were determined by 15 faculty members in different fields in nursing and psychology. Then, using convenience sampling method, 246 mothers of children with cancer referring to Medical Center for Children (Markaz-e-Tebbi-e-Koodakan), Mofid and Ali Asghar hospitals were selected and they filled out the Persian version of KCSI. Construct validity were assessed by exploratory factor analysis. For internal consistency Cronbach’s alpha coefficient and for reliability test-retest method was used for 20 participants within a two-week interval. Results: The factor analysis confirmed three factors explaining 49.9% of variance of total scores. The Cronbach's alpha for the whole instrument was 0.84 and Pearson's correlation coefficient within two times implementation was 0.86 (p<0.001). The participants’ KCSI mean score was 74.6 (SD=15.8). Conclusion: The KCSI could be used as a valid and reliable instrument for measuring chronic sorrow in mothers of children with cancer.
When physical therapists and physical therapist assistants think of loss and grief, they often think of death and dying. The concepts of loss and grief, however, are actually much broader. Patients and clients need to grieve and adjust to a variety of losses, such as strength, range of motion, balance, endurance, vital capacity, independence, employment, financial resources, relationships, dreams, and often their very freedom as individuals. The way that patients, clients, and rehabilitation professionals respond to loss is influenced by their perception of the loss and the meaning they have attached to what is being lost. By understanding that loss, grief, and adjustment are parts of a continuum rather than a linear progression with finite points, physical therapists and physical therapist assistants can provide sensitive care that incorporates the needs of the whole person, integrates the person's sources of support into the plan of care, and helps patients and clients develop a therapeutic response to loss and grief. 1,2 Part 1 of this continuing education (CE) article explores primary and secondary types of loss; factors that affect the outcome of, and adjustment to, the experience of loss; types of grief and grieving behavior; models of bereavement; and coping strategies for patients and clients.
Sixty-eight mothers and 64 fathers of children with a neural tube defect responded to a questionnaire about chronic sorrow. Mothers reported a mood state change in very intense category from more pessimistic at time of diagnosis to more optimistic at current time. Fathers, although indicating a mood change in the very intense category to more optimistic, also had more pessimistic responses. Parental similarities and differences were also reported in both times and events that triggered the sorrow response. Categories across times and events were primarily related to health care, school/development concerns and social significance. Clinical and research implications of these findings are discussed.
Approximately one fourth of the population is affected by chrome illness or disability (Schuster and Ashburn, 1992). It has been reported that caregivers of individuals with chronic illness or disability have feelings that were associated with their caregiving role. Olshansky (1962) described and termed these feelings "chronic sorrow." This study looked at the intensity of chronic sorrow in caregivers of adults with mental illness, geriatric and pediatric individuals with chronic illnesses. We also examined the possible relationship between the caregiver's roles and the intensity of chronic sorrow they experienced. The feelings of caregivers were analyzed at different stages during the caretaking period. Using quantitative measures this study determined that chronic sorrow can linger well past diagnosis and that there are trigger events that can increase chronic sorrow. Armed with this knowledge occupational therapists can make interventions that will more fully address the client and caregivers needs.
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.
Although qualitative researchers generally acknowledge that their theoretical location and methodological orientation will influence the findings of their inquiries, it has been less well understood how the body of knowledge within a substantive field might be shaped by these factors. In this article, the authors draw on insights obtained from their experiences attempting to synthesize qualitative research findings. From that reflective process, they raise questions about the manner in which qualitatively derived knowledge d from various orientations can be interpreted and understood.
Examined the relationship of coping style and illness uncertainty to psychological distress in individuals with Parkinson's disease (PD) and their primary caregivers. Design: Correlational methods, within-group theory-driven hierarchical regression analyses, and transactional analyses. Ss were 44 dyads composed of individuals with PD and their caregivers. Main Outcome Measures: Hoehn and Yahr Clinical Disability Rating Scale, Instrumental Activities of Daily Living Scale, Symptom Distress Checklist-90—Revised, Mischel Uncertainty in Illness Scale-Community Form, and Revised Ways of Coping Checklist. Results: Emotion-focused coping was associated with higher levels of distress for persons with PD, whereas both emotion-focused coping and perceived uncertainty were associated with distress for the caregivers. Transactional analyses between patients and caregivers indicated that higher levels of patient problem-focused coping and perceived uncertainty in illness were associated with increased problems in caregiver distress. Adjustment to PD is influenced by several patient and caregiver variables. The results warrant consideration of a variety of clinical interventions involving patient and caregiver education about the disease and methods for managing the associated symptoms. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study was a part of a larger qualitative descriptive study designed to explore chronic sorrow as a relapse trigger among female victims of child abuse who were currently enrolled in substance abuse treatment for relapse. The purpose of this study was to identify coping strategies and other factors these women perceived as helpful to their recovery. A purposive sample of twelve women participated in interviews using a semistructured interview schedule. The advice the participants offered to women in similar situations reflected interpersonal, cognitive and action-focused positive coping strategies. They encouraged clinicians in primary care facilities to approach persons suspected of substance abuse in a nonjudgmental manner. Healthcare professionals should be more assertive in recommending resources for substance abuse treatment.
IntroductionAim of the chapterIntended learning outcomesTheories of grief, loss and changeInitial impactType 1 diabetesImpact on parentsImpact on the child/young person with chronic illnessContinuing careImpact on siblingsCoping, adaptation and changeTheories of stress and copingCoping strategiesNormalisationConclusion
AcknowledgementUseful websitesRecommended readingReferences
The purpose of this qualitative study was to explore chronic sorrow as a relapse trigger among female victims of child abuse seeking treatment for substance abuse relapse. A purposive convenience sample of 12 women was interviewed using qualitative description to provide insight into their perceptions of relapse triggers. In addition to chronic sorrow, three common themes were interwoven in the narrative stories of these women: mothering loss, blocking feelings, and relapse triggers. Feelings described as relapse triggers included loneliness, sadness, anger, and frustration. The information gleaned from these women can be incorporated into the treatment of women and children in an effort to better prepare them for these recurrent feelings and triggers that could result in substance abuse and relapse.
The purpose of this study was to assess the impact of chronic illness on patients in relation to its physical, psychological, and social effects, and its effects on activities of daily living. A structured questionnaire was used to interview 177 patients. Chronic illness had the greatest effect on psychological functioning, followed by physical and social functioning. The least affected aspects of a patient's functioning were related to performing activities of daily living (ADLs). Results indicated that the diagnosis, duration of disease, and developmental stage of the patient's children were useful in predicting the impact of a chronic illness on a patient's physical functioning. Diagnosis, duration of disease, and economic status had a significant impact on a patient's psychological functioning. Diagnosis, duration of disease, age, sex, occupation, education, and marital and economic status were important factors relative to social functioning. Diagnosis, age, marital status, the developmental stage of the children, and the primary caregiver were the most important factors related to the effects of chronic illness on ADLs. The results of the study serve as a guide for a comprehensive assessment of chronically ill patients.
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 child's illness and by involving them in the treatment process.
Traditional grief models, which tend to prescribe "good grief" responses, are often applied to responses to loss of ability (loss of sensory, motor, intellectual or reproductive functioning). A brief review of relevant research concludes that the assumptions of grief models lack empirical support, both in the bereavement and the loss of ability contexts. It is argued that stress provides an appropriate framework for conceptualising loss of ability responses, especially the frequently observed recurrent pattern of stress (chronic sorrow). An Episodic Stress Response Model is proposed which avoids prescriptions and notions of pathology. It distinguishes between primary and secondary stress episodes and different types of stress demands (recognition, adjustment, comfort, and stress reduction).
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.
The model of chronic sorrow includes antecedents, trigger events, and internal and external management methods.
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.
The theory was developed using concept analysis, critical review of research, and validation in 10 qualitative studies of various loss situations.
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.
Chronic sorrow in parents of children with newly diagnosed diabetes: a review of the literature and discussion of the implications for nursing practice
Childhood (type 1) diabetes is a chronic, life-long condition, the diagnosis of which may represent multiple losses for parents. Their emotional responses to the diagnosis have been likened to the grief reactions experienced as a result of bereavement through death. The practice of health professionals who work with these families is informed by two contrasting theoretical views of the progress of grief reactions; the time bound and the chronic sorrow perspectives. This paper provides a critical appraisal of the evidence concerning grief reactions in parents of children with diabetes and evaluates the extent to which this supports the expectations of the time bound theorists, that parents normally reach an end stage of the grieving process, or those of the proponents of chronic sorrow, who anticipate lifelong, recurring sadness. It concludes with a discussion of the implications of the debate for nursing practice.
The present study investigates progressive muscular dystrophy over a five year period. The purpose is twofold: to describe changes over time and to investigate relations between disability, coping and quality of life.
The study group comprised 45 adults (16 men and 29 women), with an average age of 44 years. All were assessed in 1991 and 1996, with the following instruments: the ADL staircase, the Self-report ADL, the Mental Adjustment to Cancer scale, the Sickness Impact Profile and the Psychosocial well-being questionnaire (Kaasa).
Increasing disability was accompanied by an increase in dependence on others and a significant deterioration of health-related quality of life and with regard to 'Satisfaction'. The predominant type of coping was 'Fighting spirit', whilst 'Fatalism' showed the greatest decline over time. 'Ambulation' and the ADL staircase correlated with 'Physical index' on the SIP. Correlations between disability, coping and quality of life were moderate. The results can serve as a basis for planning and evaluation of recurring rehabilitation for persons with MD.
Chronic illness affects over 1 million children in the United States annually. One such illness prominent in the African-American population is sickle cell disease (SCD), which affects approximately 1 in 375 African Americans in the United States. This potentially life-threatening disease requires caregivers to carefully monitor and supervise children with SCD. Monitoring and caring for children with SCD places heavy burdens, demands, and responsibilities on these caregivers. The psychological stressors and unpredictable nature of the disease could cause caregivers to experience a variety of emotions, with one being chronic sorrow. The purposes of this study were to examine the process of chronic sorrow in caregivers of school age children with SCD, identify the characteristics of chronic sorrow, and generate a substantive theory of chronic sorrow. The methodology used was grounded theory, and data were generated through two interview sessions, a demographic questionnaire, field notes, and memos. Data analyses were performed following the principles of grounded theory. Data suggested these caregivers move through three overlapping stages: learning about and incorporating SCD into their daily lives; experiencing the sorrow; and doing what one has to do and moving on. The diagnosis was the initial trigger to evoke feelings, including sorrow. As time progressed, other internal and external triggers began to evoke feelings of sorrow that eventually became chronic. A process of repatterning began as caregivers learned to live with the unpredictable consequences of SCD, which produced the feelings of chronic sorrow. Repatterning behaviors enabled caregivers to "do what you have to do and move on."
Infertility affects 6 million American women and their partners, about 10% of the reproductive age population. Recent improvements in medication, microsurgery, and assisted reproductive technology (ART) make pregnancy possible for more than half the couples pursuing treatment, yet infertility is more than a medical condition. Infertility touches all aspects of a person's life. It affects how individuals feel about themselves, their relationships, and their life perspective. Stress is only one of a myriad of emotional realities that couples facing infertility deal with, often for extended periods of time. In addition to ongoing stress, infertility creates issues of guilt, anxiety, tension within the relationship, and feelings of depression and isolation. Treating couples and individuals who are involved in the journey of dealing with infertility is an opportunity for clinical specialists in psychiatric mental health nursing. The expertise of clinical specialists both in providing psychotherapy services as well as providing a bridge of understanding of sophisticated medical and surgical procedures places them in a unique position among the various disciplines offering mental health services. This paper provides an overview of the psychological issues that play a role in psychotherapy with this population and suggests specific clinical interventions and potential role expansion for psychiatric clinical specialists.
Epilepsy, a common problem in child neurology, affects the entire family. There is a potential for such psychosocial consequences as parental chronic sorrow and alterations in coping. In this study, 67 parents completed brief questionnaires about their sorrow and coping styles. Results demonstrated chronic sorrow as measured by the Adapted Burke Questionnaire (10.45 +/- 7.9). Interestingly, the total score was not significantly different between parents of children with refractory and nonrefractory epilepsy or parents of children with comorbid or without comorbid conditions. Selection of the individual item disbelief, however, was significantly increased in parents of children with nonrefractory epilepsy, and selection of the item anger was significantly increased in parents of children with comorbid conditions. Parental coping styles were similar to those reported in the normative data for the instrument used, the Coping Health Inventory for Parents (CHIP). The correlation between chronic sorrow and coping was significant between the grief component of sorrow and Coping Pattern II of the CHIP. Implications for practice include earlier identification of parental feelings of sorrow and coping styles, which may contribute to a positive outcome.
The aim of this study was to explore the presence and meaning of chronic sorrow and the presence of depression in a fairly large group of persons with multiple sclerosis (MS).
MS is a chronic and progressive neurological disease with a variety of symptoms. The patients have to live with losses of different kinds. A few earlier studies have used the concept of chronic sorrow to illustrate the emotional situation of such patients.
Sixty-one patients were interviewed about the occurrence of chronic sorrow and, thereafter, screened for depression. Thirty-eight (62%) of them fulfilled the criteria for chronic sorrow. The interviews were analysed with latent content analysis.
Seven themes describe the losses that caused sorrow: loss of hope, loss of control over the body, loss of integrity and dignity, loss of a healthy identity, loss of faith that life is just, loss of social relations and loss of freedom. The sorrow was constantly present or periodically overwhelming. Only four of the 38 patients with chronic sorrow had symptoms of being mildly depressed.
Chronic sorrow meant loss of hope, of control over the body, of integrity and of identity. The concept of chronic sorrow complements that of depression in providing important new knowledge relevant to understanding the consequences MS can have for the individual.
Knowledge of the meaning of chronic sorrow can contribute to the nurse's ability to give psychological support and promote a sense of hope and control in the MS patient.
245 males (mean age 46.8 yrs) and 248 females (mean age 44 yrs) were readministered the Social Readjustment Rating Scale, measures of personal functioning, and a social background index 12–15 mo after their initial assessment. There was some evidence for temporal consistency in the number and type of events Ss experienced as well as for a relationship between initial symptoms of depression (among males) and the more frequent occurrence of later events. After controlling for Ss' initial symptom levels and propensity to experience stressful events, an increase in negative events during the follow-up period was related to an increase in symptoms. Among several gender differences, negative events were found to have more impact on females than males. The confounding of the measurement of discrete stressful events and ongoing life strain is identified as potentially underlying the consistency of "events" as well as contributing to the difficulty in interpreting the relationship between "events" and functioning. (53 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Coping refers to behavior that protects people from being psychologically harmed by problematic social experience, a behavior that importantly mediates the impact that societies have on their members. The protective function of coping behavior can be exercised in 3 ways: by eliminating or modifying conditions giving rise to problems; by perceptually controlling the meaning of experience in a manner that neutralizes its problematic character; and by keeping the emotional consequences of problems within manageable bounds. The efficacy of a number of concrete coping behaviors representing these 3 functions was evaluated. Results indicate that individuals' coping interventions are most effective when dealing with problems within the close interpersonal role areas of marriage and child-rearing and least effective when dealing with the more impersonal problems found in occupation. The effective coping modes are unequally distributed in society, with men, the educated, and the affluent making greater use of the efficacious mechanisms.
In response to a questionnaire mailing, parents of mentally retarded children and social workers essentially agreed that such parents experience periodic crises during the child's development, rather than time-bound adjustment. Social workers tended to underestimate the impact on parents of later developmental periods. Clinical implications of the findings, which run counter to the prevalent professional view, are considered.
The relationship between premature children experiencing a stressor event and parents experiencing chronic sorrow was studied Data indicated that the subjects experienced feelings of loss/grief and fear when their premature child experienced the stressor events of illness, surgery, medical and behavioral problems, chronic illness, and day care, as well as when another child surpassed their child developmentally The subjects offered in-depth feedback directed to professionals to assist them in coping These data may help professionals to become aware of the emotional responses of parents of premature children and to assist them in copmg with their needs/concerns, preventing major adjustment and psychosocial problems for both the child and parents.
It is argued that the state of grief is a disease and that a program of research on it is indicated. From Psyc Abstracts 36:01:3JR18E. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
In-depth joint interviews of 25 infertile couples covering the full range of infertility etiologies and treatments were conducted in this qualitative study. Professional competency, sensitivity, and environmental comfort acted as mediators by increasing or decreasing treatment stress. In addition, couples individually or collectively developed action or mental strategies to mitigate stress. High stress, lack of hope, and frustration led to contemplation of terminating treatment.
With the increased emphasis on the generation of nursing knowledge through research, collaboration has been identified as an effective way of maximizing both personal and financial resources. There are few articles that specifically describe the process for initiating such a collaborative effort, especially when interested persons are far removed, geographically, from one another. This paper outlines the steps involved in establishing a research consortium and chronicles the development of the Nursing Consortium for Research on Chronic Sorrow. Lancaster's (1985) criteria for effective research collaboration are used to evaluate this developmental process.
Mothers and fathers of children with Down syndrome were surveyed on overall patterns of adjustment and on frequency of chronic sorrow and coping behaviors. Fathers overwhelmingly (83%) depicted their adjustment in terms of steady, gradual recovery, while the majority of mothers (68%) reported a peaks-and-valleys, periodic crises pattern; chi 2 = 8.64, p less than .01. Mothers also reported higher frequencies for chronic sorrow as well as for behaviors such as self-blame and expression of negative affect. Thus, mothers and fathers in the same family may experience distinct differences in adjustment and coping as parents of a handicapped child.
A causal model based on Lazarus' (1966) cognitively oriented theory of psychological stress and coping was tested in a functionally disabled population to determine the effects of social support variables, threat appraisal, and coping responses on coping effectiveness. Social support variables (perceived availability of social support, perceived effectiveness of social support, and personal constraints to the use of social support) were hypothesized to effect coping responses both directly and through the variable of threat appraisal. Coping responses (use of social support, cognitive reappraisal, emotion-focused coping, and problem-focused coping) were hypothesized to directly effect coping effectiveness and to mediate the effect of all other variables. Data from 50 functionally disabled, wheel-chair-bound individuals discharged within 3 years from two rehabilitation facilities were analyzed using path analysis. The model fit the data and accounted for 61% of the variance in coping effectiveness. Findings indicated that perceived availability of social support, but not the use of social support, was significantly and positively related to coping effectiveness through the mediating variables of problem- and emotion-focused coping. In contrast to the relationship of marital status to coping effectiveness usually found in the literature, nonmarried subjects coped more effectively and perceived less threat.
To explore relationships among treatment-related stressors, coping methods, and length of time on hemodialysis the Baldree, Murphy, and Powers (1982) study was replicated. Sixty-eight subjects completed the Hemodialysis Stressor Scale and the Jalowiec Coping Scale. Although Baldree et al. reported no significant difference in ratings of physiological and psychosocial stressors, results of this study showed that physiological stressors were more troublesome than psychosocial stressors, t = 10.85, p less than .0001. Subjects used problem-oriented coping more often than affective methods to handle stress, t = 10.93, p less than .0001, supporting the Baldree et al. findings. The results did not duplicate previous study findings of no significant relationships between stressor and coping scores. Total hemodialysis stressor scores were related to total coping scores, r = .43, and physiological stressors to affective coping, r = .38. However, psychosocial stressors were associated with affective-oriented, r = .43, and problem-oriented coping, r = .33. Length of time of hemodialysis was associated with problem-oriented coping, r = .26.
This study was conducted to determine the stability of conclusions derived from analyses of different ways of scoring coping responses in relation to the adjustment of subjects who had survived a burn injury. As part of a larger study of adjustment to burn injury, 260 adults who had sustained a burn injury over a 12-year period consented to complete the Billings and Moos Coping Responses Scale (CRS; Moos, Cronkite, Billings, & Finney, 1984) and the Psychosocial Adjustment to Illness Scale (PAIS; Deragotis & Lopez, 1983). A clinician made a global assessment of each subject's adjustment. Three ways of scoring the CRS were used for analyses: Method and Foci of coping (Indices of Coping Responses), as suggested by Moos et al. (1984), new factor analysis, and separate responses. Stepwise multiple regression analysis of each of these with three different outcomes of adjustment (PAIS, global clinical judgment scores, and the PAIS psychological distress component) gave consistent results. The more adjusted burn survivors used more problem-solving coping responses and fewer avoidance responses. The two responses in the individual multiple regression analysis gave a higher correlation than the factor or index descriptors. These two responses correlated well with all three adjustment outcomes, r = .49, .37, and .47. The relationship between coping behavior and adjustment to illness was not sensitive to the different ways of scoring the CRS.
Chronic sorrow in mothers of schoolage children with a myelomeningocele disability
- M L Burke
Attachment and loss: Vol 2. Separation, anxiety and anger. asic Books Inc
- J Bowlby
Stress, appraisal, and coping
- R S Lazarus
- S Follunan
The ethnograph: A program for the computer assisted analysis of text based data. Computer program
- J V Seidel
- R Kjolseth
- E Seymour
Born with loss: The first year of bereavement
- J Click
- R S Weiss
- C M Parkes
A secret stigma: The analogy between infertility and chronic illness and disability
- A L Griel