Historical Background of

Chronic Sorrow
 Presentation Outline

1
• Introduction

2
• History of theory

3
• Major Concepts

4
• Major parts of the Theory

5
• Symptoms

6
• Influencing Factors

7
• The Performance Outcomes

8
• Application in practice
 Theory of Unpleasant
Symptoms

When a relationship of attachment is

disrupted following an event that renders
a loved one forever changed from the
hoped‐for child or from the known
person, recurrent sadness, or chronic
sorrow, is a frequently encountered
response

Teel (1991)
 Introduction
• Theory of chronic sorrow is a middle range nursing theory
– provides a framework for understanding the reactions of individuals to various
loss situations and offers a new way of viewing the experience of bereavement

• It first appeared in a document authored by Eakes, Burke, and

Hainsworth in 1988 although the concept was introduced in
the 1960s
• Initial researches focused in chronic sorrow in the parents of
children with disabilities (Peterson & Bredow, 2020)
• This presentation focuses on the historical background of
chronic sorrow

Source: Peterson and Bredow (2020)

Definitions of Chronic Sorrow

• A condition characterized by intense feeling of grief that occur

periodically, especially among care givers and parents
• Periodic recurrence of permanent, pervasive sadness or other
grief-related feelings associated with ongoing disparity
resulting from a loss experience (Peterson & Bredow, 2020)
• A cyclic, recurring, and potentially progressive pattern of
pervasive sadness that is experienced by a parent or caregiver,
or individual with chronic illness or disability in response to
continual loss, throughout the trajectory of an illness of
disability (Farlex, 2009)
Source: Peterson and Bredow (2020)
 Major concepts of Chronic
Sorrow

• Pervasive
• Permanent
• Periodic
• Potentially progressive
Source: Peterson and Bredow (2020)
 History of Chronic Sorrow

• Appeared in medical literature in the

1960s
• Revealed in studies of parents of
children with disabilities
• Characterized by intense sadness
Source: Peterson and Bredow (2020)
 History of Chronic Sorrow

• Simon Olshansky authored the

first work on chronic sorrow in
1962
– Studied the recurring sadness in
parents of parents of children with
disabilities
Source: Peterson and Bredow (2020)
 History of Chronic Sorrow

• Other researchers that contributed to the

understanding of chronic sorrow concept
– resolution of grief was prevented by the never-ending
nature of the loss of the “perfect” child
– periodic episodes of re-grief labeled as chronic sorrow
resulted from the inability to bring closure to the loss
experience
• (Burke, 1989; Damrosh & Perry, 1989; Fraley, 1986; Kratochvil &
Devereux, 1988; Wikler, Wasow, & Hatfield, 1981)

Source: Peterson and Bredow (2020)

Theoretical model of
Chronic Sorrow

Source: Peterson and Bredow (2020)

 Theoretical model of
Chronic Sorrow
• Loss experience
• Trigger events
• Disparity
• Chronic sorrow
• Management methods

Source: Peterson and Bredow (2020)

 Triggers of Chronic Sorrow

In caregivers
• Crisis of managing illnesses of family members
• Recognizing that caregiving is an unending
activity
In parents
• In ability of child to achieve developmental
milestones
Source: Peterson and Bredow (2020)
 Summary

• Chronic loss is a debilitating emotional state

• Chronic loss is associated with the loss of a
valued or loved one
• Parents and caregivers can experience chronic
loss
• The historical development of this concept led to
the formulation of the nursing theory of chronic
sorrow

Source: Peterson and Bredow (2020)

 References

• Farlex (2009). Medical dictionary. Retrieved from

https://medical-dictionary.thefreedictionary.com/chronic+sorrow#:~:text=A%20cyclical
%2C%20recurring%2C%20and%20potentially,of%20an%20illness%20or%20disabilit
y
.

• Olshansky,S. (1962). Chronic sorrow: A response to having a mentally defective child.

Social Casework, 43, 191 – 193. https://doi.org/10.1177/104438946204300404.

• Peterson, S.J & Bredow, T.S. (2020). Middle Range Theories. Application to Nursing
Research and Practice (5th Edition). Wolters Kluwer. ISBN 9781975108311 Chapter
6, pp 96 – 107.

• Teel, C. S. (1991). Chronic sorrow: Analysis of the concept. Journal of Advanced

Nursing, 16(11), 1311-1319. https://doi.org/10.1111/j.1365-2648.1991.tb01559.x.