title: The presence and meaning of chronic sorrow in patients with multiple sclerosis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Health Sciences, University of Orebro, Sweden. ann-kristin.isaksson@hi.oru.se
authors.forename: Ann-Kristin
authors.initials: AK
authors.lastname: Isaksson
authors.forename: Lars-Gunnar
authors.initials: LG
authors.lastname: Gunnarsson
authors.forename: Gerd
authors.initials: G
authors.lastname: Ahlström
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000145:classification / Q000209:etiology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000145:classification / Q000523:psychology* / Q000628:therapy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013548:Sweden