Conceptual-Theoretical-Empirical Structure Evaluation

Connecting theory and practice is an essential task in nursing since this endeavor causes a nurse to address the needs of patients more effectively while managing cases that involve handling the health issues of diverse patients. The theory to be evaluated is known as the Middle-Range Theory of Chronic Sorrow (TCS). The tenets of the theory posit that sorrow is a normal response to emotionally devastating situations and that this phenomenon is healthy in moderation. Therefore, instead of seeking a means of mitigating sorrow, a nurse should develop strategies that will help in overcoming it.

Theory Application and Examples

Patients who face an unexpected and emotionally exhausting health concern tend to respond not only negatively but also with a pronounced sense of loss and confusion. The inability to grasp a problem immediately is natural, yet if this state of mind is prolonged, such a reaction may make patients extremely vulnerable to external factors. For example, it may be difficult for the vulnerable demographic to acquire necessary behaviors and habits aimed at inhibiting the further progress of disease (Nikfarid, Rassouli, Borimnejad, & Alavimajd, 2015). One possible solution is to combine therapy with patient education and help to build awareness.

CTE Linkages Evaluation

In applying the CTE principles to the TCS, it becomes evident that the framework in question makes an efficient transition from exploring the tenets of a grand nursing theory to managing a practical issue. Specifically, direct connections link the conceptual model of TCS, the theory of nursing that embraces the notion of patient safety and education, and empirical indications of positive patient outcomes (Burke et al., 2015). The conceptual model of TCS is based on the idea of deconstructing the concept of grief as a response to health concerns.

The theoretical tenets that provide a foundation for the analysis of grief, in turn, offer a platform for constructing a model aimed at managing the needs of patients who may be experiencing significant emotional distress. The same concept applies to the guardians of patients, thus helping to build an efficient support system for the vulnerable demographic (Wright, Limbo, & Black, 2015). As a result, this theory of nursing, which explains the relationships between the key variables, is designed to reveal how grief can be transformed, encouraging patient education and building awareness (Guzman, 2018). Afterward, the theory can be used to address a particular instance of patient grief, thus locating empirical indications of the framework’s effects.

Theory Evaluation

From the CTE perspective, the TCS is a legitimate theoretical framework. The theory serves as a means of channeling patients’ grief into a process where they develop awareness and behaviors that will enhance the recovery process or, at the very least, improve the quality of the patients’ lives. The theory introduces a framework for grief counseling, thus helping patients to reconcile with their feelings and proceed to fulfilling prescriptions as instructed by their healthcare practitioners. In particular, it deconstructs grief as a concept, allowing patients to reconcile with their emotions and move on to healing. Thus, the conceptual aspect of the TCS meets the set standards.

Similarly, the basic tenets of the theory align with the requirements established by the CTE model due to a smooth transition from creating a conceptual framework to developing crucial theoretical postulates. For example, the deconstruction of grief and emotional vulnerability leads to the development of an in-depth understanding of how grief can be approached and managed. In addition, the assumptions that the specified theory promulgates are easily translated into the management of practical issues (Overton & Cottone, 2016). Specifically, the tenets of the TCS posit that grief needs to be recognized, reconciled with, and then transformed, resulting in an observable improvement in patient outcomes (Gross, 2015). Finally, the empirical implications indicate that the theory helps to extensively boost recovery rates among patients. Specifically, a recent study involving the management of a kidney disease case has proved that the use of the TCS improves the quality of care by enhancing the process of patient education (Widyawati, Nursalam, Kusnanto, Hargono, & Hsieh, 2018).

Empirical Indicators Evaluation

The existing empirical evidence of TCS application shows that the framework has a significant impact on the well-being of patients (Graffigna & Barello, 2018). However, to prove that the proposed approach can be applied in any scenario, it is necessary to consider some of the empirical indicators that support the use of the TCS as a platform to address the emotional issues faced by patients and their guardians. The propensity among patients to return to experiences that have led to the development of negative emotions such as grief are primary empirical indicators that can be used to measure the efficacy of the proposed theory (Klass, 2014). Such data would provide a valuable tool for establishing proof that enhancing patient education through the inclusion of grief therapy has a direct positive impact on the vulnerable population.

Evaluation of Research Findings

Although the TCS has not been widely discussed in contemporary scholarly studies, its significance remains high in the nursing setting. On a related note, existing studies have recognized the clearly harmful effects that result from focusing on eradicating negative emotions in patients without allowing the latter to acknowledge and reconcile with their feelings (Coombs, Mitchell, James, & Wetzig, 2017). The extensive research that has been conducted to prove their legitimacy adds weight to these findings. While the research findings under consideration can be seen as requiring further generalization since, in most cases, they are based on an analysis of very specific cases, most seem to agree that the use of the TCS approach has a positive effect on patients’ ability to cope with grief. A profound analysis of the problem shows that the TCS framework helps patients develop an insightful understanding of their condition along with building a dialogue between patient and nurse. In this way, the process of patient education continues and leads to further improvement.

Utility and Soundness of the Practice Evaluation

The practice theory evaluation appears to be reasonable since it is based on an objective assessment of the instances associated with a rise in patient recovery rates. However, the assessment of the practical use of the theory might be somewhat biased; the transition from theory to practice is inherently problematic due to the presence of patient- and environment-specific issues. In short, as a broad generalization that should, later on, be narrowed down to a particular case, the TCS provides a set of guidelines rather than an ultimate solution to any health concern involving grief. Therefore, biases associated with the process of transforming theoretical principles into strategies for managing specific cases are inevitable. Nevertheless, the theory is useful and has proved sound for managing the needs of patients who may be in the throes of severe emotional distress since it aims to help them develop emotional intelligence and engage in metacognition, thus understanding their own needs better.


Grief is a frequent occurrence in many patients who face significant health problems, a fact that makes TCS an important part of the contemporary nursing system. Complying with the essential principles of the CTE framework, TCS offers a set of standards for managing both theoretical and empirical issues related to grief among patients or their guardians. The theory represents a platform for enhancing patient education and provides a chance to transfer from the theoretical aspect of handling an issue to real-life, practical application. Thus, the TCS framework needs to be incorporated into the present-day nursing setting to improve the rates of patient recovery.


Burke, L. A., Clark, K. A., Ali, K. S., Gibson, B. W., Smigelsky, M. A., & Neimeyer, R. A. (2015). Risk factors for anticipatory grief in family members of terminally ill veterans receiving palliative care services. Journal of Social Work in End-of-Life & Palliative Care, 11(3-4), 244-266. Web.

Coombs, M., Mitchell, M., James, S., & Wetzig, K. (2017). Intensive care bereavement practices across New Zealand and Australian intensive care units: A qualitative content analysis. Journal of Clinical Nursing, 26(19-20), 2944-2952. Web.

Graffigna, G., & Barello, S. (2018). Spotlight on the Patient Health Engagement model (PHE model): A psychosocial theory to understand people’s meaningful engagement in their own health care. Patient Preference and Adherence, 12, 1261-1271. Web.

Gross, R. (2015). Understanding grief: An introduction. New York, NY: Routledge.

Guzman, R. R. (2018). Caring for the bereaved mother. South Orange, NJ: Seton Hall University.

Klass, D. (2014). Grief, consolation, and religions: A conceptual framework. OMEGA-Journal of Death and Dying, 69(1), 1-18. Web.

Nikfarid, L., Rassouli, M., Borimnejad, L., & Alavimajd, H. (2015). Chronic sorrow in mothers of children with cancer. Journal of Pediatric Oncology Nursing, 32(5), 314-319. Web.

Overton, B. L., & Cottone, R. R. (2016). Anticipatory grief: A family systems approach. The Family Journal, 24(4), 430–432. Web.

Widyawati, I. Y., Nursalam, N., Kusnanto, K., Hargono, R., & Hsieh, P. L. (2018). Grieving as an internal factor of nurse-patient interaction in a dialysis unit. Journal of Nursing, 13(1), 64-71. Web.

Wright, P. M., Limbo, R., & Black, B. P. (2015). Perinatal and pediatric bereavement in nursing and other health professions. New York, NY: Springer Publishing Company.