Nursing knowledge development through research: using the Roy adaptation model

Almost half of the ancillary propositions tested in the metaparadigm category were related to the concept of person, and 94% were supported. Theoretically and empirically, there is support for Roy's conceptualization of the person as an adaptive system. Almost 25% of the ancillary propositions tested were related to the concept of health, of which the great majority were supported. Theoretically and empirically, there is support for Roy's conceptualization of health as an outcome of adaptation. Approximately 75% of the ancillary propositions tested were related to the concept of person or health. Of these, only 5 out of 55 ancillary propositions were not supported, or less than 10%. Less than 13% of the ancillary propositions that were tested focused on the metaparadigm concepts of environment or nursing. Of these, 15% were not supported. These findings are not surprising, because conceptual clarity is the foundation of practice theory. The hierarchy of research, according to the classic work by Dickoff and James (1968), progresses from understanding and describing phenomena to situation-producing theory. Nursing models are relatively young. Research is required to validate the concepts within the models. Situation-producing theory, based on the concepts, guides nursing actions and is necessary for a practice discipline to maintain its status as a profession. Based on the findings of the integrative research review, adequate research has provided support for Roy's conceptualization of the metaparadigm concepts of person and health. Future research needs to be directed toward testing propositions derived from the RAM concepts of environment and nursing. Intervention studies need to be designed based on concepts that have been supported. Knowledge development through research and testing of propositions based on the RAM continues to contribute to nursing science. Future directions for RAM research are clear.