untitled

scientific developments by the theorist, have con-
tributed to model-based knowledge for nursing
practice. The purpose of this chapter is to describe
the use of the model in developing knowledge for
practice, with particular emphasis on research with
the elderly. A study of coping, adaptation, and self-
consistency in the elderly with hearing impairment
provides an example of some of the key concepts
of the model, as well as a research design to test
the relationships among the concepts. Specifically,
the study provides a test of a generic proposition
derived from the Roy Adaptation Model. But first,
a brief review of the Roy Adaptation Model is
provided, with emphasis on recent developments of
the theoretical work and its use in nursing research.
Then, the theoretical and empirical concepts of cop-
ing and adaptation processing and self-consistency
are described in greater detail.

Applications: Research

Framework

The Roy Adaptation Model (Roy, 1984, 1988a,
1988b; Roy & Andrews, 1991, 1999; Roy & Roberts,
1981) provides the framework for programs of
nursing research, particularly the constructs for the
research exemplar involving elderly patients with
hearing impairment.

ASSUMPTIONS

The model’s philosophical assumptions are rooted
in the general principles of humanism and in what
Roy has termed “veritivity and cosmic unity” (Roy
& Andrews, 1999). Scientific assumptions for the
model have been based on general systems theory
and adaptation-level theory (Roy & Corliss, 1993).
More recently, the assumptions have been extended
to include Roy’s redefinition of adaptation for the
twenty-first century (Roy & Andrews, 1999). The
cosmic unity stressed in Roy’s vision for the future
emphasizes the principle that people and the earth
have common patterns and integral relationships.
Rather than the system acting to maintain itself, the
emphasis shifts to the purposefulness of human
existence in a universe that is creative.

MAJOR CONCEPTS

People, both individually and in groups, are viewed
as holistic adaptive systems, with coping processes
acting to maintain adaptation and to promote per-

son and environment transformations. The coping

processes are broadly described within the regula-

tor and cognator subsystems for the individual and

within the stabilizer and innovator subsystems for

groups. Through coping processes, persons as ho-

listic adaptive systems interact with the internal

and external environment, transform the environ-

ment, and are transformed by it. A particular aspect

of the internal environment is the adaptation level.

This is the name given to the three possible condi-

tions of the life processes of the human adaptive

system: integrated, compensatory, and compro-

mised (Roy & Andrews, 1999). Processing of the in-

ternal and external environment by the coping

subsystems results in human behavior. Four

categories for assessing behaviors are termed

“adaptive modes.” Initially developed to describe

persons as individuals (Roy, 1971), the modes have

been expanded to include groups and are termed

physiologic-physical, self-concept-group identity,

role function, and interdependence (Roy &

Andrews, 1999). Central to Roy’s theoretical model

is the belief that adaptive responses support health,

Adaptive responses support health, which

is defined as a state and a process of being

and becoming integrated and whole.

which is defined as a state and a process of being

and becoming integrated and whole.

USES IN RESEARCH

Roy has described strategies for knowledge devel-

opment based on the model and a structure of

knowledge to guide research (Roy & Andrews,

1999). Knowledge-development strategies that she

has integrated through decades of work include

model construction; theory development (includ-

ing concept analysis, synthesis, and derivation of

propositional statements); philosophic explication;

and research, qualitative, quantitative, and instru-

ment development. The structure for knowledge

includes the broad categories of the basic and

clinical science of nursing.

Basic nursing science discovers knowledge about

persons and groups from a nursing perspective that

can provide understandings for practice. The clini-

cal science of nursing investigates specifically the

role of the nurse in promoting adaptation and

human and environment transformations. Within

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