model in a research exemplar with elderly pa-
tients. The exemplar research project served
to demonstrate support for a generic theoret-
ical proposition based on the model. Further,
the study illustrated how a hypothesis based
on the model, with adequate conceptual and
empirical development of the variables, can
be used to derive clinical knowledge for a
given patient population.References
Aldwin, C. M. (1994).Stress, coping, and development: An inte-
grative perspective.New York: The Guilford Press.
American Tinnitus Association. (1996).Information about tinni-
tus. Portland, OR: American Tinnitus Association.
Andrews, J. D. W. (1990). Interpersonal self-confirmation and
challenge in psychotherapy.Psychotherapy, 27(4), 485–504.
Atchley, R. C. (1988).Social forces and aging: An introduction to
social gerontology(5th ed.). Belmont, CA: Wadsworth.
Beck, T. (1976).Cognitive therapy and the emotional disorder.
New York: International Psychiatry.
Boston-Based Adaptation Research in Nursing Society. (1999).
The Roy Adaptation Model-Based Research: Twenty-Five Years
of Contributions to Nursing Science. Indianapolis, IN: Center
Nursing Press.
Carver, C. S., & Scheier, M. F. (1991). Self-regulation and the self.
In Strauss, J., & Goethals, G. R. (Eds.),The self: Interdisciplinary
approaches(pp. 172–207). New York: Springer-Verlag.
Chen, H. L. (1994). Relation of hearing loss, loneliness and self
esteem.Journal of Gerontological Nursing, 20(6), 22.
Coombs, A., & Snyggs, D. (1959).Individual behavior—A per-
ceptual approach to behavior. New York: Harper Brothers.
Das, J. P. (1984). Intelligence and information integration. In
Kirby, J. (Ed.),Cognitive strategies and educational perfor-
mance(pp. 13–31). New York: Academic Press.
Elliot, G. C. (1986). Self-esteem and self-consistency: A theoret-
ical and empirical link between two primary motivations.
Social Psychology Quarterly, 49(3), 207–218.
Elliot, G. C. (1988). Gender differences in self-consistency:
Evidence from an investigation of self-concept structure.
Journal of Youth and Adolescence, 17(1), 41–57.
Folkman, S., & Lazarus, R. (1988).Manual for the ways of
coping questionnaire. Palo Alto, CA: Consulting Psychologists
Press.
Goffman, E. (1959).The presentation of self in everyday life.New
Yo r k : A n c h o r.
Gove, W. R., Ortage, S. T., & Style, C. B. (1989). The maturation
and role perspective on aging and self through the adult years:
An empirical evaluation.American Journal of Sociology, 94,
1117–1145.
InterStudy Outcome Management System. (1991). The health
status questionnaire (SF–36).Interstudy Quality Edge, 1(1).
Kaufman, S. (1987).The ageless self.Madison: University of
Wisconsin Press.
Klarkowska, G. H., & Klarkowska, A. (1987). Perceived self-
concept discontinuity as a determinant of defensive informa-This study, though limited by the sample size
and representation, provided knowledge related to
the cognator conceptualization of the Roy Adapta-
tion Model. Maintenance of self-consistency is a
task that engages older persons. It can be achieved
through coping and adaptation processes and can
be influenced by multiple factors. It can be viewed
as a health indicator of how well a person copes
with stress in the aging process. Self-consistency is
a complex multidimensional construct. Mainte-
nance of self-consistency is not necessarily a rigid,
never-changing self-concept. Modifications of the
self-concept are expected. Maturation and social
learning provide the instance of a naturally chang-
ing self-concept. However, these changes need not
imply inconsistency of self (Elliot, 1986, 1988; Roy
& Andrews, 1999).
This empirical study provided support for the
Roy Adaptation Model and for the theoretical
proposition that cognitive processing brings about
adaptive responses such as the maintenance of self-
consistency. Coping and adaptation theory asserts
that cognitive processing is an essential feature of a
complete analysis of human responses to stressful
conditions of life (Roy, in review; Roy & Andrews,
1999; Taylor, 1983). Coping and adaptation pro-
cessing is not just information processing per se, al-
though it partakes of such a process. Rather, it is
largely evaluative, focusing on meaning and signif-
icance attached to each individual’s lived experi-
ence. Further, coping and adaptation processing
takes place continuously in the transaction between
the person and the environment.
This chapter focused on the Roy Adaptation
Model as a basis for developing knowledge
for clinical practice. There is extensive litera-
ture on both the theoretical development of
the model and the use of the model in re-
search. A brief review of the model focused
on recent developments in theory and re-
search. Two major constructs of the model
were elaborated: coping and adaptation pro-
cessing and self-consistency. The derived
middle-range theory of coping and adapta-
tion processing combined inferred coping
strategies with observed cognitive behavior
to provide the basis for an application of theCHAPTER 17 Sister Callista Roy’s Adaptation Model and Its Applications 279