The family, crisis and chronic illness: an evolutionary model


Maureen C Shaw Clinical Nurse Specialist The Arthritis Society (BC and Yukon Division), 895 West 10th Avenue, Vancouver, British Columbia V5Z IL7, Canada


While chronic illness has a profound impact upon the individual, an immense burden is imposed upon the family When the competing demands of an illness and the family escalate exponentially, there may be a crisis Traditionally, crisis theory has been applied to acute care contexts such as emergency, intensive care and mental health nursing Yet, clinical experience with families and chronic illness supports the notion of periodic crises from the prediagnostic phase to the long-haul of the illness Moreover, the authors hypothesize that the family's perception of the event determines whether the crisis is perceived as a threat or a challenge This paper thus addresses the perception of crisis within the framework of chronic illness from a biological and family systems nursing perspective First, the theory of Humberto Maturana, a Chilean biologist, is explored and applied to clinical observations regarding family, crisis and chronic illness Second, an evolutionary model for conceptualizing crisis and chronic illness is presented Third, the role of beliefs in the family perceptions of crisis and chronic illness is discussed