Review of Roy Adaptation Model-Based Qualitative Research

Conceptualisation and measurement of adaptation within the Roy adaptation model in chronic care: a scoping review protocol

INTRODUCTION

The Roy adaptation model provides a basis for developing the science of nursing. Its theoretical assumptions have been tested in empirical studies. Although several works have historically reviewed the development of this model, a refinement of its key concepts is needed. The proposed scoping review aims to describe how the concept of adaptation was defined and measured in nursing studies related to chronic health conditions.

METHODS AND ANALYSIS

This scoping review will adopt the methodology proposed by Arksey and O'Malley. Several databases, including MEDLINE (OVID), CINAHL, EMBASE, PsycINFO, PubMed, Wan Fang, China National Knowledge Infrastructure and VIP net, will be selected and used to mine literature published in English and Chinese languages, up to December 2019. Key terms related to 'Roy adaptation model' will be identified and used for developing tailored search strategies for each database. Articles will be included in the analysis if they are primary research reports explaining the concept of adaptation within the field of chronic care. All screening and extraction of literature will be independently performed and checked by two authors, according to the guideline of Preferred Reporting Items for Systematic Review and Meta-Analysis-Extension for Scoping Reviews. The findings will be organised and summarised into narratives in line with the construction of conceptual-theoretical-empirical system of knowledge for further consultation and translation.

ETHICS AND DISSEMINATION

This scoping review does not require ethical approval. The findings are expected to be published in peer-reviewed English or Chinese journals as well as conference proceedings in the area of chronic care.

I Am As Normal As Everyone Now. . . : Examination of Experiences of Patients Undergoing Bariatric Surgery According to Roy's Adaptation Model: A Qualitative Study

The aim of this study is to examine experiences of patients undergoing bariatric surgery according to Roy's adaptation model (RAM). This is a qualitative study with a phenomenological design. The sample included patients undergoing bariatric surgery (N: 32). Of all the patients 84.37% were female and 59.38% were married. According to results of the content analysis, adaptive patient behavior was described by the themes "My life has changed", Everything is beautiful" "I can cope" and "Luckily, I have them" and their nonadaptive behavior was described by the themes "What if I cannot succeed", "Bad news" and "So many people, so many views". Patients having bariatric surgery experience various difficulties in adapting to their life and bodies, but the surgery leads to improvements in their body image, social life, personal relationships, and maintenance of roles. However, some patients can be afraid of postoperative complications and experience anxiety about regaining weight.

Understanding Experiences of Diabetes Medications Among African Americans Living With Type 2 Diabetes

African American (AA) adults are disproportionally affected by type 2 diabetes and are diagnosed at an earlier age, but are less adherent to diabetes medications compared with the general population. This qualitative study sought to describe the experiences of taking diabetes medications among midlife AA men and women with type 2 diabetes and to identify factors that influence these experiences. Fifteen AAs completed semistructured interviews. Using the Roy adaptation model, thematic analysis coded for both adaptive and ineffective experiences. Adaptive experiences included self-confidence in one's ability to control diabetes, a belief in the value of diabetes medication, assuming responsibility for one's health, developing a routine for taking medication, and positive relationships with the care team. Ineffective experiences for medication taking included: feeling powerless over diabetes, self-blame, and fear. One's self-concept as a person with diabetes, as well as assuming the role of "medication taker," were prominent themes.

Perceptions of Insulin Treatment Among African Americans With Uncontrolled Type 2 Diabetes

PURPOSE

Little is known regarding perception of insulin treatment among midlife and older African American (AA) adults with type 2 diabetes, or how perception affects self-management behaviors. Using the Roy adaptation model, this qualitative descriptive study explored the perception of insulin treatment in midlife and older AAs living with uncontrolled type 2 diabetes.

METHOD

Three 1-hour focus groups were conducted with a total of 13 participants. Thematic analysis of transcribed audio recordings used the constant comparative method.

RESULTS

Themes identified include (a) insulin as instigator of negative emotions, (b) adapting to a lifestyle with insulin, and (c) becoming an insulin user: a new identity.

CONCLUSION

Adapting to insulin is a psychosocial process that commonly results in negative emotions, identity conflict, and new roles.

IMPLICATIONS FOR PRACTICE

Further research is needed to understand how AA adults perceive insulin treatment, understand the role of perception in self-management behaviors, and determine whether interventions to change perceptions may be effective in improving adaptation to diabetes.

The effect of counselling on nausea and vomiting in pregnancy in Turkey

OBJECTIVES

The aim of this study was to assess the effects of follow-up counselling on the duration and severity of nausea and vomiting in pregnant women.

STUDY DESIGN

This study is quasi-experimental and included 62 pregnant women with nausea and vomiting. The group that received counselling was considered to be the experimental group, and the group that received a standard outpatient clinic service was the control group. Data were collected with a demographic data form, that is, the Nausea and Vomiting in Pregnancy Instrument and Pregnancy Unique Quantification of Emesis and Nausea. Significance tests of the differences between two mean values, the Mann-Whitney U test and survival analyses were used to test the hypotheses.

RESULTS

In pregnant women with mild or moderate nausea and vomiting, nausea and vomiting terminated in a significantly shorter time in the experimental group than in the control group (p <0.001), but this difference was not significant for pregnant women with severe nausea and vomiting (p > 0.05). In addition, the number of weekly telephone follow-ups in the experimental group was significantly smaller (p <0.001).

CONCLUSION

Counselling effectively reduced the duration and severity of mild or moderate nausea and vomiting during pregnancy. However, it did not affect the duration of severe nausea and vomiting during pregnancy.

The validation of the Coping and Adaptation Processing Scale based on the Roy adaptation model

BACKGROUND AND PURPOSE

To establish the psychometric soundness for Coping and Adaptation Processing Scale (CAPS) using the Roy adaptation model as theoretical framework.

METHOD

A descriptive, cross-sectional survey of a convenience sample of 199 nurses working in different acute health care facilities in California. The internal consistency of the multifactor CAPS questionnaire was explored using Cronbach's alpha coefficient. Factors correlation was examined using Pearson product moment correlation. The factor structure was studied using confirmatory factor analyses.

RESULTS

In the confirmatory factor analysis, the indices of fitness highly supported these results. The Cronbach's alpha coefficient for the total score was .81 and varied between .31 and .78 in the 5 domains. A positive and significant correlation emerged between CAPS factors and total scores (r = .91, p < .01) ranging from .17 to .81. CAPS showed acceptable validity and reliability for measuring the coping of nurses in acute setting. Future studies using the scale might lead to the improvement of the subscales measurement.

CONCLUSION

The psychometric data suggests that CAPS is a highly suitable instrument to measure coping processes.

Substantive review of the literature of medication treatment of chronic low back pain among adults

PURPOSE

Pain can be debilitating, and it is often inadequately treated, particularly among patients with chronic low back pain (CLBP). CLBP has a substantial economic impact, as it affects an individual's ability to perform activities of daily living and maintain employment. This study aims to review original studies related to the evidence-based management of patients with CLBP to develop an algorithm for prescribing medications and recommending other treatment modalities for patients with CLBP.

DATA SOURCES

An electronic search of PubMed, CINAHL, and the Cochrane Database was conducted to identify studies related to the evidence-based management of CLBP that were performed between 2003 and 2012. The following keywords were used: low back pain, back pain, chronic back pain, medication management, and adjunct therapy. The selected articles were specific to CLBP, medication-based management, and additional treatment options, such as adjunct therapies.

CONCLUSIONS

The collected data revealed that there are a number of approaches to the management of CLBP. Medication regimens are frequently used and widely available, but alternative treatment modalities can also be effective.

IMPLICATIONS FOR PRACTICE

Providers should encourage patients to explore a variety of treatment modalities that can provide pain relief and improve functionality and overall well-being.

Religious faith in coping with terminal cancer: what is the nursing experience?

This qualitative study describes nurses' reports on the role played by religious faith in the care of patients with terminal cancer. Using Gadamer's philosophical hermeneutics and C. Roy's adaptation model as a base, in-depth interviews were carried out with 23 nurses who had cared for patients with terminal cancer for at least 6 months. Three main themes emerged when a Gadamerian-based hermeneutic research method was applied: faith facilitates the coping process in cases of terminal cancer, faith hinders the coping process in cases of terminal cancer and terminal illness impacts faith. The lack of univocal results indicates that the role of faith in coping with death is essentially practical, individualised and changeable. The nurse-patient relationship can help to determine the spiritual needs of cancer patients at the end of life. This source of knowledge held by the nurse, together with the rest of the multidisciplinary team, can help to improve end-of-life care.

A Roy model study of adapting to being HIV positive

Roy's adaptation model outlines a generic process of adaptation useful to nurses in any situation where a patient is facing change. To advance nursing practice, nursing theories and frameworks must be constantly tested and developed through research. This article describes how the results of a qualitative grounded theory study have been used to test components of the Roy adaptation model. A framework for "negotiating uncertainty" was the result of a grounded theory study exploring adaptation to HIV. This framework has been compared to the Roy adaptation model, strengthening concepts such as focal and contextual stimuli, Roy's definition of adaptation and her description of adaptive modes, while suggesting areas for further development including the role of perception. The comparison described in this article demonstrates the usefulness of qualitative research in developing nursing models, specifically highlighting opportunities to continue refining Roy's work.

Effect of attachment styles of individuals discharged from an intensive care unit on intensive care experience

INTRODUCTION

The present study was conducted as a cross-sectional type to examine the effect of attachment styles of individuals discharged from an intensive care unit (ICU) on intensive care experience and health status.

METHODS

The population of the study included patients discharged from the ICU in a university hospital. The sample included 108 patients who were selected via simple random sampling method. Data were collected using a Demographic Information Questionnaire, Intensive Care Experience Questionnaire, the Relationship Scales Questionnaire, and Acute Physiology and Chronic Health Evaluation II system. In the analysis of data, frequency, percentage, mean, standard deviation, minimum and maximum values, and Mann-Whitney U, Kruskal-Wallis, Bonferroni-adjusted Mann-Whitney, and Spearman ρ correlation tests were used.

RESULTS

A significant difference in the awareness of surroundings subscale for attachment styles was noted (χ(2) = 10.820, P ≤ .01). Moreover, participants' attachment styles (fearful, preoccupied, and dismissing) and intensive care experience were significantly correlated. A significant correlation was found between participants' secure attachment style points and Acute Physiology and Chronic Health Evaluation II score during discharge from the ICU (r = 0.322, P = .001).

CONCLUSION

Individuals' attachment styles should be taken into consideration when planning and implementing the nursing care and treatment of individuals hospitalized in an ICU.

Attachment styles of nursing students: a cross-sectional and a longitudinal study

OBJECTIVE

This research included two consecutive studies, the first of which aimed to examine university nursing students' attachment styles and to study a set of variables that affect their attachment styles, while the second study aimed to identify the effect of nursing education on nursing students' attachment styles.

METHODS

This research was conducted as a cross-sectional survey with nursing students from a school of nursing in Turkey. The research also included a longitudinal follow-up of first year students, to evaluate the effect of nursing education on attachment styles. Data were collected by using a "Personal Information Form" and "Relationship Scales Questionnaire".

RESULTS

Nursing students' personal characteristics of age, longest place of residence, and economic status; family characteristics of number of siblings and families' longest place of residence; and romantic characteristics of any current romantic relationships and the number of past romantic relationships were found to be the factors that were influential in attachment styles. In addition, the nursing students had a statistically significant decrease in their insecure attachment style mean scores at the end of nursing education.

CONCLUSION

Assessing attachment styles may be a potentially useful way to understand and counsel nursing students.

A model of consensus formation for reconciling nursing's disciplinary matrix

With questions raised as to whether or not nursing knowledge should be developed from extant conceptual/theoretical models or from practice-based environments, this paper utilizes Kuhn's disciplinary matrix and Laudan's model of consensus formation to explore the changing nature of the discipline's structural matrix. Kuhn's notion that a discipline's structural matrix includes symbolic generalizations, models and exemplars, and Laudan's view that a maturing discipline embraces factual, methodological, and axiological (goals and aims) knowledge, and that context and discourse are also involved in advancing a discipline is described as a means for reconciling the source of nursing knowledge. This paper posits that shared axiological goals connect both theorists and practitioners, and resolve potential conflicts as to viable sources of nursing knowledge. Through shared goals that include humanization, meaning, quality of life, caring, consciousness, transcendence, and presence, which bridge both theoretical and practice approaches, nursing's charge to contribute to the good of society is fulfilled.