- Trajectory Model is a nursing model particularly applicable in situations of people
with chronical diseases developed by Anselm L. Straus, medical sociologist and Juliet Corbin, a nurse theorist.
- This model is also called “Corbin-Strauss-Model” and is recognised as a middlerange explanatory nursing theory (Corbin & Straus, 1991)
- This model was developed following over 30 years of
interdisciplinary research on a variety of chronic
- -“a course of
illness over time plus the actions taken by patients,
families and health professionals to manage or shape
- The term “trajectory” refers to the course of a chronical disease in its different
stages and phases.
- Chronical illnesses are serious diseases which could last the whole life of the concerned
person affecting the person’s mental, emotional and social well-being.
McCorkle & Pasacreta, 2001- explains eight phases of chronic illness trajectory
- Initial or pretrajectory phase - occurs before any signs and symptoms are present.
- Trajectory onset phase- occurs with the first onset of signs and symptoms and includes the diagnostic period.
- The crisis phase -is when a potentially life-threatening situation arises
- The acute phase- follows the crisis phase and refers to the period when the patient's symptoms can be controlled by a prescribed regimen.
- Stable phase - this phase starts once symptoms are controlled.
- Unstable phase - when the patient's symptoms are uncontrolled by the previously adopted regimen
- Downward phase - characterized by progressive deterioration in mental and physical status
- Dying phase - refers to a period of weeks, days, or hours preceding death .
The Corbin and Strauss Chronic Illness Trajectory
Framework consists of six steps:
- Identifying the trajectory phase.
- Identifying problems and establishing goals.
- Establishing plans to meet goals.
- Identifying factors that facilitate or hinder attainment of goals.
- Implementing interventions.
- Evaluating the effectiveness of interventions.
- Trajectory model can be used as a management instrument for the professional care.
- It helps the
nursing person to get familiar with the patient’s perspective.
- Trajectory model has been applied in conditions like cancer, cardiovascular diseases, HIV, Aids, diabetes mellitus and multiple sclerosis..
- Corbin J., and Strauss A. A Nursing
Model for Chronic Illness Management Based
upon the Trajectory framework. Scholarly
Inquiry for Nursing Practice, 1991, 5, 155-174.
- Smeltzer SC. Use of the Trajectory Model of nursing in multiple sclerosi. Sch Inq Nurs Pract. 1991 Fall;5(3):219-34.
- McCorkle R, Pasacreta JV.
Enhancing caregiver outcomes in palliative care. Cancer Control. 2001 Jan-Feb;8(1):36-45.
at http://www.moffitt.org/CCJRoot/v8n1/pdf/36.pdf . Accessed on 31/1/2011.
- Kabinga M,
Banda SS. A 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,2008; 35:3.