Nurse's Pocket Guide

chronic SORROW
Expresses feelings of sadness (e.g., periodic, recurrent)
Expresses feelings that interfere with ability to reach highest
level of personal/social well-being
Desired Outcomes/Evaluation
Criteria—Client Will:
• Acknowledge presence/impact of sorrow.
• Demonstrate progress in dealing with grief.
• Participate in work and/or self-care ADLs as able.
• Verbalize a sense of progress toward resolution of sorrow and
hope for the future.
Actions/Interventions
NURSING PRIORITY NO.1.To assess causative/contributing factors:
• Determine current/recent events or conditions contributing
to client’s state of mind, as listed in Related Factors
(e.g., death of loved one, chronic physical or mental illness,
disability).
• Look for cues of sadness (e.g., sighing, faraway look, unkempt
appearance, inattention to conversation, refusing food, etc.).
Chronic sorrow has a cyclical effect, ranging from times of
deepening sorrow to times of feeling somewhat better.
• Determine level of functioning, ability to care for self.
• Note avoidance behaviors (e.g., anger, withdrawal, denial).
• Identify cultural factors/religious conflicts. Family may experience
conflict between the feelings of sorrow and anger
because of change in expectation that has occurred (e.g.,
newborn with a disability when the expectation was for a
perfect child, while religious belief is that all children are
gifts from God and that the individual/parent is never
“given” more than he or she can handle).
• Ascertain response of family/SO(s) to client’s situation. Assess
needs of family/SO. Family may have difficulty dealing with
child/ill person because of their own feelings of sorrow/loss
and will do better when their needs are met.
• Refer to dysfunctional Grieving; Caregiver Role Strain; ineffective
Coping, as appropriate.
NURSING PRIORITY NO.2.To assist client to move through sorrow:
• Encourage verbalization about situation (helpful in beginning
resolution and acceptance). Active-listen feelings and be
available for support/assistance.
• Encourage expression of anger/fear/anxiety. Refer to appropriate
NDs.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
644 Cultural Collaborative Community/Home Care