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The presence and meaning of chronic sorrow in patients with multiple sclerosis
Örebro University, Department of Health Sciences.
Örebro University, Department of Health Sciences.
2007 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 11C, 315-324 p.Article in journal (Refereed) Published
Abstract [en]

AIM AND OBJECTIVES: 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). BACKGROUND: 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. METHOD: 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. RESULTS: 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. CONCLUSION: 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. RELEVANCE TO CLINICAL PRACTICE: 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.

Place, publisher, year, edition, pages
Oxford: Blackwell , 2007. Vol. 16, no 11C, 315-324 p.
National Category
Nursing Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-11559DOI: 10.1111/j.1365-2702.2007.01995.xPubMedID: 17608632OAI: oai:DiVA.org:oru-11559DiVA: diva2:343247
Available from: 2010-08-12 Created: 2010-08-12 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Chronic sorrow and quality of life in patients with multiple sclerosis
Open this publication in new window or tab >>Chronic sorrow and quality of life in patients with multiple sclerosis
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to increase our understanding and knowledge of patients’ experiences of living with multiple sclerosis (MS). A mixed-method design was used, including both qualitative and quantitative methods. Thirty-one immunologically treated MS patients were randomly selected and matched with patients without immunological treatment. Matching criteria were gender, impairment, time since diagnosis and age. One patient dropped out and therefore the final sample consisted of 61 patients. All 61 were interviewed (Studies I, III and IV) and completed the 36-item Short Form health survey questionnaire (SF-36), the Subjective estimation of Quality of Life questionnaire (SQoL), the Self-reported Impairment Check-list (SIC) (Study II) and the Montgomery–Asberg Depression Rating Scale questionnaire (MADRS) (Study III). The interviews were subjected to content analysis.

Initial symptoms and being diagnosed with MS were described in terms of becoming vulnerable and remaining in that vulnerability long after the diagnosis. Eventually the patients were able to manage this emotional distress and acquired strength in their illness situation (Study I). In the matched analysis, 29 pairs of patients were included after internal drop-out. There were no statistically significant differences between the treatment and control groups. Concerning the total group of 61 patients, the self-reported impairment check-list showed that they had various problems of impairment, most evident in balance and walking. The score on health-related quality of life (SF-36) was reduced, disclosing a negative influence on vitality, physical role and function. However, subjective quality of life (SQoL) was not reduced, showing that the patients estimated their well-being to be quite unaffected (Study II). Thirty-eight of the 61 patients (62%) experienced chronic sorrow (Study III). The group were not depressed in general, only four having mild symptoms of depression, revealing that chronic sorrow is a particular form of emotional distress in MS. Chronic sorrow was experienced in terms of loss of hope, loss of control over the body and loss of integrity and dignity. When the patients could not adequately manage their sorrow and lacked support, they were struggling with their vulnerability. In the successful management of MS, losses and emotional distress are managed in such a way as to enhance personal growth, appreciation and trust in life. The theoretical model of chronic sorrow facilitated the sorting of the empirical data and the linking of these data to theory, showing the usefulness of the model (Study IV).

Place, publisher, year, edition, pages
Örebro: Örebro universitetsbibliotek, 2007. 84 p.
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 12
Keyword
Multiple sclerosis, illness experience, diagnosis experience, impairment, health-related quality of life, subjective quality of life, immunological treatment, chronic sorrow, depression, managing chronic illness, content analysis, well-being
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-846 (URN)91-7668-521-7 (ISBN)
Public defence
2007-02-09, Aulan, Universitetsbiblioteket, Fakultetsgatan 1, Örebro, 13:00
Opponent
Supervisors
Available from: 2007-01-19 Created: 2007-01-19 Last updated: 2017-10-18Bibliographically approved

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Isaksson, Ann-KristinAhlström, Gerd

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