Although research documenting the struggling response to chronic illness would assist nurses in understanding their patients and potentially in the assessment and support of struggling patients, such research is only in the infancy stage. The purpose of this research study was to address the rarity of literature describing and defining the concept of families struggling while managing chronic illness. Using Strauss and Corbin's paradigm model and grounded theory methodology, the researcher analyzed interviews with nine rural families managing chronic illness. The analysis revealed that families managing chronic illness struggled with everyday living, to obtain a diagnosis, with spiritual beliefs, and with cognitive and existential thoughts, encompassing mind, body and spirit struggles. Struggling occurred within and between individuals and groups. A thought process, more specifically, an awareness, interpretation, deciphering of meaning, or perception was a strong component of the struggling experience. The core phenomenon identified was struggling, which was preceded by the causal conditions perceiving uncertainty and/or vulnerability and ascribing negative meaning to illness management. Struggling occurred within the context of managing chronic illness. Intervening conditions for struggling were ineffective adapting and adapting. Action/ interaction strategies for struggling were denying, emphasizing loss, fostering independence, strengthening relationships, and turning to faith. Consequences of the action/interaction strategies were stagnating and reintegrating. In light of this study's findings, struggling while managing chronic illness is defined as the perception of a difficult process (e.g., a battle, conflict, strenuous effort, or task) while managing chronic illness. The perception of great difficulty is often preceded by perception of vulnerability or uncertainty and/or ascribing negative meaning to chronic illness management. The difficult process can occur within the body, mind, or spirit of a person or group of persons. The understanding of struggling as a perception makes it relatable to other literature exploring perceptions, representations, and ascribed meanings of not only illness experiences, but also other experiences, such as pain and treatments. Nurses can help those managing chronic illness identify its associated perceptions and representations, which in some cases is struggling.


Norma Krumwiede

Committee Member

Mary Bliesmer

Committee Member

Kelly Krumwiede

Date of Degree




Document Type



Master of Science in Nursing (MSN)


School of Nursing


Allied Health and Nursing

Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License



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