Chronic Illness Trajectory Framework, Essay Example

Introduction

The Trajectory Framework is a model within nursing that facilitates an approach to manage those with chronic illness.  It has also been termed the ‘Corbin Strauss Model’, named after a sociologist A.L. Straus and nursing theorist Juliet Corbin.  The model too in excess of 30 years to develop building upon the research of a wide range of chronic illnesses. “problems of chronic management, which will continue to grow as we move into the 21st Century” (Corbin J. 1998)

Use by the Advanced Practice Nurse

The method looks at the trajectory of a disease over a period of time. This enables the nurse to plan around the 8 stages of the illness regime.  This includes dealing with the patient, family and other health professionals.  Such illnesses termed ‘chronic’ suggest ultimate morbidity and as such may impact the patient’s mental and emotional wellbeing.  The nurse has to be prepared to deal with these issues through each of the 8 stages. “The trajectory framework developed by Strauss and associates provides a conceptual basis for developing a nursing model that gives direction for practice, teaching, and research in the area of chronic illness” (Corbin & Strauss, 1991)

In dealing with Chronic Pain the Nurse is able to follow the eight stages of the ‘Trajectory Framework’; that is structuring the work around the eight cycles as illustrated below. A predictable trajectory is one of cancer patients who are dying. This often involves control of pain in the closing cycles. The eight stages of the model enable the Nurse to better control these cycle of events particularly in the latter stages.

The Eight Stages in the Model

1. The initial phase – the stage preceding any signs or symptoms
2. Trajectory onset phase – The first signs within the diagnostic period
3. Crisis Phase – Where the potential life threatening situation is observed
4. Acute Phase – The phase where the patient’s condition is being controlled by a specific medical regime
5. Stable Phase – The phase these conditions are under control
6. Unstable Phase – Where the conditions of Stage 5 are failing
7. Downward Phase – Progressive deterioration in mental and physical health
8. Dying Phase – Refers to the period of time prior to death

The Nursing Process Within the Model

Essentially a 6 stage process that covers the following process:

1. The identification of the trajectory phase
2. Understanding the issues and developing goals
3. The construction of plans to meet the goals
4. Highlighting those issues that my hinder or impede goal attainment
5. The implementation of interventions
6. Evaluation of the interventions

Conclusion

This can be equally a very demanding role for the Advanced Practice Nurse and the framework is extremely useful in order to place actions into organized sequence of events. It has been widely adopted in African countries like Zambia in the treatment of HIV/AIDS. “ Chronic diseases are now a major cause of death and disability worldwide” (Banda, M.K. 2001).

References

Banda, M. K. (2001). Conceptual review of the demands of chronic care and the preparedness of nurses trained with the General Nursing Council of Zambia curriculum. Medical Journal of Zambia Vol 35(3), 105-109.

Corbin, J. (1998). The Corbin and Strauss Chronic Illness Trajectory Model: An update. Scholarly Inquiry for Nursing Practice, Vol 12(1, 33-41.

Corbin, J. M., & Strauss, A. (1991). A Nursing Model for Chronic Illness Management Based Upon the Trajectory Framework . Research and Theory for Nurses Practice Vol 5(3), 155-174.