Adaptation in chronic illness: an eclectic model for nurses

Abstract

The growing prevalence of chronic illness is due, in large part, to the control and/or eradication of infectious diseases as well as, in North America, the increasingly aged population and overall lengthening life span. Although the trajectory of chronic illness is in a generally downward direction, the rate of progression may vary as plateaux an remissions occur. As these changes occur, the individual and his family move through a process of continual adjustment. This paper presents a conceptual model of the process of adaptation in chronic illness. The primary concept in the model is appraisal (Lazarus, 1966) and the thought that continuous appraisal/reappraisal of the individual's progress toward the goal of adaptation is required by the individual, his family, and the nurse. The focus of the model is the chronically ill individual and his family. The goal is movement toward adaptation to the illness and its ramifications. The process is caring, which facilitates movement towards the goal. The model and its interpretation are outlined in the paper. Finally, some strategies for nurses, and others, are suggested as ways in which the concepts may be applied and implemented in practice.