Adaptation to chronic illness: a program of research for testing nursing theory.

The adaptation to chronic illness framework, an elaboration of the Roy adaptation model for chronic illness, provided direction for a program of nursing research. The purposes of investigations within the program were (a) to identify predictors of adaptation to chronic illnesses and (b) to determine whether the relationships between the variables differed by diagnostic group. A total of 597 adults, representing various chronic illness groups, participated in longitudinal studies during a seven-year period. Health-related hardiness and engagement in health promotion activities consistently predicted both physiological and psychosocial adaptation in all chronic illness groups. In addition, the individual's perception of the degree of disability caused by the illness was related to psychosocial functioning. Comparison of adaptive responses between the groups revealed significant differences in physiological adaptation but no significant differences in psychosocial adaptation. Results clarify relationships posited using the theoretical framework and support the value of using nursing models to guide nursing research.