Definitions of the Corbin and Strauss Chronic Illness Trajectory Model phasing16
Phase | Goal of definition | Goal of management |
---|---|---|
Pretrajectory | Genetic factors or lifestyle behaviours that place an individual or community at risk for the development of a chronic condition | Prevent onset of chronic illness |
Trajectory onset | Appearance of noticeable symptoms, includes periods of diagnostic workup and announcement by biographical limbo as person begins to discover and cope with implications of diagnosis | Form appropriate trajectory projection and scheme |
Stable | Illness course and symptoms are under control. Biography and everyday life activities are being managed within limitations of illness. Illness management centres in the home | Maintain stability of illness, biography and everyday activities |
Unstable | Periods of inability to keep symptoms under control or reactivation of illness. Biographical disruption and difficulty in carrying out everyday life activities. Adjustments being made in regime with care usually taking place at home | Return to stability |
Acute | Severe and unrelieved symptoms or development of illness complications necessitating hospitalisation or bed rest to bring course under control. Biography and everyday life activities temporarily placed on hold or drastically cut back | Bring illness under control and resume normal biography and everyday life |
Crisis | Critical or life-threatening situation requiring emergency treatment or care. Biography and everyday life activities suspended until crisis passes | Removal of threat |
Comeback | A gradual return to an acceptable way of life within the limits imposed by disability or illness. Involves physical healing, limitations stretched through rehabilitative procedures, psychosocial coming to terms, and biographical re-engagement and adjustment in everyday life | Set in motion and keep going the trajectory projection and scheme |
Downward | Illness course characterised by rapid or gradual physical decline accompanied by increasing disability or difficulty in controlling symptoms. Requires biographical readjustment and alterations in everyday life with each major downward step | To adapt to increasing disability with each major downward turn |
Dying | Final days before death. Characterised by gradual or rapid shutting down of bodily processes, biographical disengagement and relinquishment of everyday life and activities | To bring closure, let go and die peacefully |