00137 Chronic Affliction

Domain 9: coping/stress tolerance
Class 2: coping responses
Diagnostic Code: 00137
Nanda label: chronic affliction
Diagnostic focus: affliction
approved 1998 • Revised 2017

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « chronic affliction ” is defined as: cyclical, recurrent and potentially progressive pattern of generalized, experienced sadness (by a parent, caregiver, person with a chronic disease or disability) In response to continuous loss, in the course of a disease or disability.

Definite characteristics

  • Express feeling that interferes with well -being
  • Overns negative feelings
  • Sadness

Related factors

  • Crisis in disability management
  • Crisis in condition management
  • Lost milestones
  • Lost opportunities

Risk population

  • People who experience development crisis
  • People who experience loss of significant people
  • People who work in the role of caregivers for prolonged periods of time

Associated problems

  • Chronic disability
  • Chronic disease

Suggestions of use

compared to the normal suffering that occurs in response to a loss, chronic affliction diagnosis does not decrease over time, partly because the loss continues present (as occurs in the case of chronic disability) and the condition is a Constant loss reminder. Chronic affliction implies a more effective coping than the one presented in the case of complicated grief.
Many of the defining characteristics of chronic affliction are, for themselves, nursing diagnoses. When more than one of the following diagnoses occurs: fear, hopelessness, loneliness, low chronic self -esteem and impotence, chronic affliction is more useful.

Suggested alternative diagnostics

NOC Results

  • acceptance : Health state: reconciliation with a relevant health change
  • psychosocial adjustment : Change of life: psychosocial response of adaptation of a person to an important change of life
  • depression self -control : personal actions to reduce melancholy and maintain interest in life events
  • emotional balance : appropriate adjustment of the predominant emotional tone in response to circumstances
  • Esperanza : Optimism that is personally satisfactory and promoter of life
  • depression level : severity of melancholic mood and loss of interest in life events
  • duel resolution : adaptation to a real or imminent loss

Evaluation objectives and criteria

  • Demonstrates duel resolution, as manifested by the following indicators (specify from 1 to 5: never, sometimes, sometimes, often or usually):
    • Verbally express the acceptance of the loss
    • Participate in the planning of the funeral
    • refers to reduction of concern for loss
    • Share the loss with your loved ones
    • Progress through the duel stages
    • Keep hygiene and personal toilet
  • Other examples

    • The patient will be able to:
      • Express feelings of guilt, anger or suffering
      • Identify and use effective coping strategies
      • Verbally express the impact of the loss (s)
      • Find information about disease and treatment
      • Identify and use the available social support, including loved ones
      • Work to accept the loss (s)
      • Lean at spiritual beliefs to console
      • Report adequate sleep and food

    NIC Interventions

    • spiritual support : Help the patient to feel in balance and in communion with a superior power
    • facilitation of the expression of the duel : Help with the resolution of an important loss
    • facilitation of the expression of the duel : perinatal death: help with the resolution of a perinatal loss
    • inspiration of hope : Facilitation of the development of an optimistic perspective in a certain situation
    • mood management : provision of security, stability, recovery and maintenance, to a patient who abnormally experiences a depressed or elevated mood
    • coping improvement : Help to patient to adapt to stressful factors, changes or perceived threats, which interfere with the satisfaction of the demands and the roles of life

    Nursing Activities

    • See nursing activities for duel and complicated duel.
    • See also the nursing activities corresponding to spiritual suffering.
    • For patients whose diagnosis is an etiology, see nursing activities corresponding to the diagnosis of fear.
    • For patients whose diagnosis of low chronic self -esteem is an etiology, seeing nursing activities corresponding to low chronic self -esteem.
    • For patients whose diagnosis of hopelessness is an etiology, seeing nursing activities of despair diagnoses and disposition to improve hope.
    • For patients whose impotence diagnosis is an etiology, see nursing activities for impotence.


    • Value and document the presence and origin of the patient’s affliction
      Patient and family education
    • Comment on the characteristics of a normal affliction and an abnormal
    • Provide the patient and family information about community and hospital resources, as well as self -help groups

    Collaboration activities

    • Organize a meeting on patient care to review their needs and those of family members regarding the stage of grief in which they are, and to establish a care plan


    • Recognize the patient and family’s grief reactions while the necessary care activities continue to be carried out
    • Comment with the patient and relatives the impact of loss on the family and its operation
    • Establish a contact schedule with the patient
    • Establish a relationship of trust with the patient and relatives
    • Provide a safe and private environment to facilitate the patient and family grieving process
    • Recognize and reinforce the strengths of each family member
    • (NIC) Facilitation of the expression of the duel:
      • Help the patient identify the nature of attachment with the lost object or person
      • Include close people in debates and decisions, as required
      • Encourage the patient to establish cultural, religious and social rites, related to loss
      • Encourage the patient to express their feelings regarding the loss

    Notes to apply in the nursing diagnosis


    • (NIC) Facilitation of the expression of the duel:
      • Answer the questions of children related to loss
      • Help the child clarify erroneous ideas