the basic science, the investigator studies the person
or group as an adaptive system, including (1) the
adaptive processes; that is, cognator and regulator
activity, stabilizer and innovator activity, stability of
adaptation level patterns, and dynamics of evolving
adaptive patterns; (2) the adaptive modes; that is,
their development, interrelatedness, and cultural
and other influences; and (3) adaptation related to
health, particularly person and environment inter-
action and integration of the adaptive modes.
Topics for research in the clinical science of nurs-
ing include (1) changes in cognator-regulator or
stabilizer-innovator effectiveness; (2) changes
within and among the adaptive modes; and (3)
nursing care to promote adaptive processes, partic-
ularly in times of transition, during environmental
changes, and during acute and chronic illness,
injury, treatment, and technologic threats.
Roy has summarized her own research within
the structure of knowledge (Roy & Andrews, 1999).
In her early work, Roy used three methods to
explore how the cognator coping processes act
to promote adaptation and how they relate to the
adaptive modes. Two inductive processes involved
content analysis of patient interviews before diag-
nostic tests and recordings of the nursing process
done by students in 10 schools where the Roy
Adaptation Model was the basis of their curricula.
This data was used in the development of the
Coping and Adaptation Processing Scale (CAPS)
described below. The second major research effort,
again within the basic science of nursing, used a sys-
tematic controlled comparison of survey data col-
lected in six hospitals across the United States. One
purpose within the larger study aims was to exam-
ine levels of wellness in relation to levels of adapta-
tion. For the 208 patients of the sample, some of the
measures of physiologic adaptation were related to
levels of wellness, but no evidence was found of a
relationship between psychosocial adaptation and
measures of levels of wellness. There was, however,
such a relationship in the least acute care setting
and for patients with longer hospital stays. Thus, it
was suggested that adaptation is a process that takes
place over time. Further, Roy (1977) noted that the
measures of levels of wellness were limited and not
entirely consistent with the dynamic and holistic
concept of health as defined by the model.
Roy’s more recent research is related to clinical
nursing science. A model of cognitive information
processing was developed (Roy, 1988b, 2001), and a
program of research was initiated to contribute to
further understanding of cognitive processes; that
is, how people take in and process environmental
interactions and how nurses can help people use
these processes to positively affect their health sta-
tus. Cognitive recovery from head injury was the
focus of the research. The first study used a re-
peated measures design to describe changes in cog-
nitive performance over six months of recovery for
50 patients (Roy, 1985). Nursing intervention pro-
tocols were then developed for use during the first
month, which is considered the critical period for
recovery. The initial pilot study of nine matched
pairs shows some promising trends. Graphs of re-
covery curves on all nine measures showed earlier
improvement of performance in the treated group
as compared with the matched group that did not
receive the planned nursing interventions to pro-
mote cognitive recovery from head injury (Roy &
Hanna, 1999). The intervention has been extended
to involve family members as study partners with
the nurse to practice the information processing
protocol. Another funded research project in clini-
cal progress focuses on nurse coaching for symptom
management and recovery after same-day surgery.
The use of the Roy Adaptation Model for
nursing research is strikingly demonstrated by a
research synthesis project conducted by the
Boston-Based Adaptation Research Society in
Nursing (BBARSN). Roy worked with seven other
scholars for about four years to develop a method
to conduct a review and synthesis of research, based
on the Roy Adaptation Model, to identify and lo-
cate the literature from a 25-year period, to conduct
the critical analysis, and to present the findings in a
research monograph (Roy et al., 1999). From 1970
through 1994, a total of 163 studies met the inclu-
sion criteria. Only English-language publications
were included. The sample included 94 articles in
44 different research and specialty journals from
five continents. In addition, there were 77 disserta-
tions and theses from a total of 35 universities and
colleges in the United States and Canada that were
retrieved and included in the synthesis review. The
major concepts of the model were used to organize
the presentation of the review of this extensive use
of the Roy Adaptation Model in nursing research.
Although studies focused on more than one model
concept, it was possible to group the studies by
their major topic, as follows: multiple adaptive
modes and processes; physiologic, self-concept, role
function, and interdependence modes; stimuli; and
intervention.CHAPTER 17 Sister Callista Roy’s Adaptation Model and Its Applications 271