RESUMEN

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.

Asunto(s)

RESUMEN

PURPOSE: Opportunities for family interaction with comatose patients are often strictly limited. Some studies have indicated that family visits to the ICU have detrimental effects on physiologic parameters such as blood pressure and heart rate. This study was undertaken to investigate the effects of taped messages by a family member on key measures of physiological functioning in comatose head-injured patients in intensive care units. METHODS: A convenience sample of 10 comatose patients was used. Paired t-tests were performed to determine changes in physiologic measures with the introduction of family member taped messages. FINDINGS: None of the subjects exhibited any statistically significant variables in physiologic criteria after introduction of the tapes. CONCLUSIONS: Research to date represents conflicting results. This study demonstrated no untoward effects with exposure to taped familial messages, including no changes in intracranial pressure (ICP), blood pressure, pulse, respiratory rate, mean arterial pressure, oxygen saturation level, or level of restlessness. The findings support allowing family interactions with comatose head-injured patients in the ICU.

Asunto(s)

RESUMEN

This article describes the initiation and evolution of the support group component of a cardiac rehabilitation pilot program. It also outlines how the group was initiated and discusses the group's development during the 20 weeks of its existence. The description of this nurse-facilitated support group provides a model for clinicians interested in integrating such an approach into their own cardiac rehabilitation programs.

Asunto(s)

RESUMEN

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.

Asunto(s)

RESUMEN

PROBLEM: Noting that many nurses tend to hold a narrow view of the term "psychosomatic," the authors explored the meanings assigned to the term psychosomatic among registered nurses (N = 189) employed in a variety of settings. METHODS: The Psychosomatic Attitude Scale (PAS) was used to categorize the meaning of psychosomatic as either imaginary, functional, structural, or holistic. FINDINGS: Although nurses theoretically espouse a holistic approach to client care, only 46% of the nurses sampled gave a holistic interpretation of the term psychosomatic. A holistic interpretation was more common among nurses who had an internal health locus of control and who were extroverted and intuitive in their personality profile. Further, nurses with a higher level of education and who practiced in maternity or psychiatric settings were more holistic in their understanding of the term psychosomatic. CONCLUSIONS: The authors advocate further study of how beliefs, values, and personality traits interact to influence the nurse's interpretation of the term "psychosomatic."

Asunto(s)

Asunto(s)

RESUMEN

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.

Asunto(s)

RESUMEN

This study investigated the occurrence of chronic sorrow in individuals diagnosed with cancer and explored factors perceived as helpful to those experiencing grief-related feelings. Using the Burke/NCRCS Chronic Sorrow Questionnaire (Affected Individual Version), interviews were conducted with 10 individuals with cancer at least one year postdiagnosis. Interviews were transcribed and coding categories were developed. Data then were sorted into categories and recurring themes were identified. Nine of the subjects demonstrated evidence of chronic sorrow. Subjects most often used cognitive or action-oriented coping strategies to deal with their grief-related feelings. Nursing roles identified as particularly helpful to subjects experiencing chronic sorrow were providing an empathetic presence and being a teacher/expert. Nurses need to be aware that individuals living with cancer may experience chronic sorrow, and they need to be prepared to intervene in ways deemed helpful.

Asunto(s)

RESUMEN

Multiple sclerosis, one of the most common chronic disabilities among young adults, may potentiate the occurrence of chronic sorrow. Chronic sorrow differs from acute grief because it is permanent, periodic, and progressive in nature; it may be a normal component of chronic illness and disability. This study describes one woman's experience with multiple sclerosis, her chronic sorrow about the trajectory of her disability, her progressive loss of bodily function, and the stigma of chronic illness. It also reports some of the feelings experienced by her husband, the primary caregiver.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Losses are an integral part of chronic illness and disability. The term chronic sorrow, has been used to describe the long-term periodic sadness the chronically ill and their caregivers experience in reaction to continual losses. In this conceptual analysis of chronic sorrow, identified critical attributes are: cyclic sadness over time in a situation with no predictable end; external and internal stimuli triggering the feelings of loss, disappointment, and fear; and, progression and intensification of the sadness or sorrow years after the initial disappointment or loss. Model, borderline, related, contrary, and illegitimate cases illustrate what the concept is and what it is not. The meaning of chronic sorrow is compared to the meaning of unresolvable grief and depression. Chronic sorrow in various stages of life is illustrated in descriptions of: the situation and feelings of parents of handicapped children; multiple sclerosis patients in the middle, productive years; and elderly caregivers of spouses with dementia. Implications for research include the need to study the concept in various populations to determine its prevalence and operation. Through research, the meaning of the concept can be further clarified. This is a beginning step toward developing nursing theory that will give direction for providing care to persons encountering sadness over long periods of time.

Asunto(s)

RESUMEN

A total of 40 baccalaureate nursing students were assigned to write a paper that expressed their opinions about providing care to patients with acquired immunodeficiency syndrome (AIDS) and to give the rationale used to support their views. Although 75% of the students believed that nurses should provide care to patients with AIDS, 25% expressed either negative or ambivalent feelings about providing such care. Moreover, many of the same rationales were offered to substantiate all three attitudes, emphasizing the need for definitive guidelines for decision making.

Asunto(s)

RESUMEN

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.

Asunto(s)

RESUMEN

Although there is a considerable amount of literature available on grief and grief resolution, the relevance of this information has not been adequately applied to the arena of nursing. A few studies have examined various issues impacting on nurses involved in caring for dying patients, and some have offered recommendations to facilitate grief resolution in nurses. However, these studies have primarily focused on single aspects of the nurse's involvement with dying patients/families (i.e., the nurse-patient relationship), with recommendations for strategies to facilitate grief resolution often emanating from the researchers rather than the nurses themselves. This study explored grief resolution strategies employed by hospice nurses who effectively cope with the deaths of patients. The recurring themes that emerged from the interviews with these nurses can be brought together to form a framework for better understanding of grief resolution among this unique group of individuals. Viewing these strategies in concert with one another provides a more comprehensive, holistic perspective on methods that assist nurses to effectively resolve the deaths of their patients.

Asunto(s)

Asunto(s)

RESUMEN

Numerous advantages are anticipated with the implementation of the school-based referral system as a method of providing outpatient clinical experiences for a group of Psychiatric/Mental Health Nursing students. The school setting, when used as a clinical site, can provide valuable learning experiences where the student can apply the nursing process with individuals, families and groups. This multi-dimensional involvement reinforces family systems theory as well as group concepts. The nature of the students' experiences through the school-based referral system gives them the opportunity to increase their knowledge and understanding of the three levels of prevention: primary, secondary, and tertiary. The referrals generally constitute secondary intervention, with early recognition/intervention being the focus. Students are also encouraged to assess for factors that would place a child at risk for the development of other problems. With the identification of such factors, primary intervention strategies can be structured and implemented to reduce the child's risk. In some cases, students are involved in tertiary prevention, with a rehabilitative approach employed to assist individuals/families cope with a long-term problem situation. This expanded clinical experience facilitates the application of leadership concepts and reinforces the collaborative role of the nurse in the multidisciplinary provision of client services. Since the Psychiatric/Mental Health component of the curriculum is in the senior year, involvement in such a clinical experience also provides the students with a positive stimulus for the assumption of their professional roles and an opportunity to synthesize all previous learning.

Asunto(s)

Asunto(s)

RESUMEN

The purpose of this study was to investigate the relationship between death anxiety and attitudes toward the elderly among nursing staff in nursing homes. Questionnaires were distributed to all 310 full-time nursing staff members in six nursing homes; 159 usable questionnaires (51 percent) were returned. The self-administered packet consisted of Templer's Death Anxiety Scale to determine high and low death anxiety groups. Palmore's Facts on Aging Quiz to identify positive or negative attitudes toward the elderly, and a self-developed demographic data questionnaire. A t-test was used to compare the mean attitude toward the elderly scores of the high and low death anxiety groups. Nursing staff with high levels of death anxiety had significantly more negative attitudes toward the elderly than nursing staff with low levels of death anxiety (t = 2.52; p. less than .01). A correlation coefficient was also used to analyze the relationship between death anxiety and attitudes toward the elderly for the entire study sample. The relationship was significant (r = -.21; p less than .007). Findings indicated no significant differences in death anxiety or attitudes toward the elderly when compared with various demographic variables.

Asunto(s)

Asunto(s)