The Role Of The Nurse Practitioner In Support Of Families Experiencing Chronic Sorrow

Chronic sorrow is the periodic recurrence of permanent, pervasive sadness or other grief-related feelings associated with ongoing disparity resulting from a loss experience (Eakes, 2004). As a concept, chronic sorrow speaks to the emotional strain in the lived experiences of caregivers of the chronically ill and disabled. The term chronic sorrow was first used by Olshansky (1962) to describe the grief and sadness that parents felt when their child was first diagnosed as being mentally retarded. Research on chronic sorrow has proven its presence not only in parents, but in other family members, caregivers, and those with an illness or disability. Furthermore, chronic sorrow as a phenomenon has also been recorded in caregivers of the physically ill, mentally ill, and those disabled. Healthcare providers across all disciplines are in constant contact with individuals who are dealing with hopeless situations and many of them are experiencing chronic sorrow. It is inconceivable that with modem medicine and technological advancements, the majority of healthcare providers are at a loss in dealing with those caregivers who suffer. Therefore, this author has chosen to look at the progress made since the original usage by Olshansky. To this end, a systematic integrated review of the literature using computer searches of CINAHN, MEDLINE, the Cochrane Library, and electronic media was done in an effort to identify the current level of healthcare knowledge regarding the role of the nurse practitioner in providing support to families experiencing chronic sorrow. These searches produced a limited number of articles regarding support by any healthcare professional and none that referenced nurse practitioners. However, the literature was rich with progressive information and noted enormous gains in understanding of this phenomenon over the past two decades. Of particular importance was information about the instigation of the Nursing Consortium for Chronic Sorrow, the development of the Chronic Sorrow Questionnaire, and the ongoing work to further develop the middle range nursing theory of chronic sorrow. The Uncertainty in Chronic Illness Model developed by Merle Mishel was used as the theoretical foundation for this review. This model is used to describe and to establish an understanding of the uncertainty or unpredictability and lack of consistency that is ever present in chronic illness (Mishel, 1990). Within this review the theoretical and operational definitions of chronic sorrow, nurse practitioner, healthcare provider, and family support were explored. From this review, it is evident that there is a need for further considerations regarding the role o f the nurse practitioner in support of families experiencing chronic sorrow. Further evidenced is the need to fill the void in education of advanced practice nurses as it relates to this phenomenon. Within this review, implications for nursing theory, nursing research, advanced nursing practice, nurse practitioner education, and health policy are provided as they emerge from the concepts explored