untitled

The critical analysis involved evaluating each
study according to predetermined criteria for the
quality of the research and for the linkages of the re-
search to the model. The studies that met the estab-
lished criteria for adequacy of the quality of the
research and links to the model were used to test
propositions derived from the model. They were
based on 12 generic propositions from Roy’s pub-
lished work. As the studies were analyzed, the find-
ings were used to state ancillary and practice
propositions. (“Ancillary propositions” are special
instances of the general propositions and some-
times are stated in terms directly relevant to practice
and thus are referred to as “practice propositions.”)
Significant research support for the ancillary propo-
sitions lent support to the theoretical statements of
the generic propositions. This process is demon-
strated in the exemplar study reported here.
The BBARNS reviewers also examined the ap-
plication of findings to nursing practice. They used
three categories to assess the potential of research
findings for use in practice: Category 1—high po-
tential for implementation based on positive find-
ings with methodologic adequacy and without risk
to patients; Category 2—need further clinical eval-
uation before implementation (for example, by
teams of advanced practice nurses in the practice
area to evaluate potential effectiveness relative to
risk); and Category 3—further research warranted
before implementation; designation used in cases
where findings were negative or equivocal or that
were promising but posed a risk to patients and
thus needed replication and clarification before
being recommended for practice. This review
showed the breadth and depth of the Roy model’s
use in nursing research in qualitative and quantita-
tive research and in instrument development stud-
ies, using populations of individuals and groups (of
all ages, both in health and in illness, and in all areas
of nursing practice). A review of the next five years
of research, including 57 identified studies, is un-
derway, along with a critique, examples, and rec-
ommendations for the use of instruments to
measure concepts of the Roy Adaptation Model
(visit the Roy Adaptation Association Web site at:
http://www2.bc.edu/~royca/htm/raa.htm)..)

COPING AND ADAPTATION PROCESSING

Two constructs of the model—coping and adapta-
tion processing and self-consistency—are discussed

in greater detail as a basis for applying the model in

the research exemplar with the elderly. The Roy

Adaptation Model focuses on enhancing the basic

The Roy Adaptation Model focuses on

enhancing the basic life processes of the

individual and group.

life processes of the individual and group. The cog-

nator and regulator of the individual, and the inno-

vator and stabilizer of the group, have basic abilities

to promote adaptation; that is, the process and out-

come whereby thinking and feeling are used in con-

scious awareness and choice to create human and

environmental integration (Roy & Andrews, 1999).

A major concentration of nursing activity is to as-

sist people in using their cognitive abilities to han-

dle their internal and external environment

effectively. Given the priority of this notion, Roy fo-

cused efforts on further conceptual and empirical

work to understand this human ability and nursing

practice based on that understanding.

Conceptual Development

The conceptual basis for coping and adaptation

processing lies in Roy’s work on understanding the

cognator and regulator as processors of adaptation

(Roy & Andrews, 1999), on the development of a

nursing model for cognitive processing (Roy,

1988a, 1988b), and on understanding of Das and

Luria’s model of simultaneous and successive infor-

mation processing (Das, 1984; Luria, 1980).

Drawing from knowledge in the neurosciences, her

early theory development and research on the

model, and her observations in neuroscience nurs-

ing practice, Roy proposed a nursing model for

cognitive processing (Roy, 1988b, 2001). Cognitive

processes in human adaptation are described as fol-

lows: input processes (arousal and attention, sensa-

tion and perception), central processes (coding,

concept formation, memory, language), output

processes (planning and motor responses), and

emotion. Through these cognitive processes, adap-

tive responses occur.

Taylor (1983), in a study of cancer patients, pro-

posed a related theory of cognitive adaptation.

According to Taylor, cognitive adaptation is cen-

tered on three themes: a search for a meaning in the

experience, an attempt to regain mastery over the

event, and an effort to restore self-esteem through

272 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration