According to the Roy Adaptation Model (Boston Based
Adaptation Research in Nursing Society, 1999; Roy &
Andrews, 1991), people are adaptive systems with the
capacity to adjust to stressors that may originate internally
(e.g., physiologic changes or perceptions) or externally (e.g.,
environmental). Men, women, and children are complex
biopsychosocial spiritual beings. Although Roy acknowledged
the need to view each patient holistically, she advocated
the examination of different systems or functions to better understand
the overall wellness of the patient. As such, adaptive
modes or the way in which one adjusts to stressors may be
physiologic or psychosocial in nature.
Roy identified four domains of adaptation, or adaptive
modes: physical, self-concept, role function, and interdependence.
Specific behaviors, actions, or interventions can be
classified within one of the four modes. Modes are behaviors
(physical or psychosocial) that are used to maintain positive
responses, or adjustment, to a constantly changing environment.
Behaviors are aimed at achieving adaptation through
physical regulator (i.e., neural, chemical, or endocrine systems
or cognatur (i.e., perceptual and information processing,
learning, judgment, and emotion) mechanisms (Roy & Andrews,
1999). When modes are not used or used unsuccessfully,
ineffectual coping behavior occurs. Ineffectual behavior
previously was referred to as “maladaptive” in earlier
explanations of the Roy Adaptation Model (Roy, 1975).
When caring for patients, nurses identify and enhance positive
behaviors in direct response to specific stressors. Given
an abnormality, such as bone metastasis, stressors vary. Nursing
interventions are developed based on a comprehensive assessment
of each individual, abnormality, and existing environmental
conditions. Before the identification of effective
physiologic behaviors related to bone metastasis can begin,
one must understand normal and pathologic physiology and
psychosocial behaviors