Academic journal article Scholarly Inquiry for Nursing Practice

The Concept of Adaptation: Examining Alternatives for the Study of Nursing Phenomena

Academic journal article Scholarly Inquiry for Nursing Practice

The Concept of Adaptation: Examining Alternatives for the Study of Nursing Phenomena

Article excerpt

Clients' adaptation frequently is studied in nursing and used to guide nursing practice. Many nurse authors have suggested that adaptation may be a unique conceptual framework for nursing. Other nurse authors have suggested, however, that in focusing on adaptation, nursing limits its focus to changing clients to fit the environment and neglects to change the social system or environment to meet clients' needs. The purpose of this article is to argue that adaptation theory limits the range of clients' acceptable responses to change. Adaptation theory assumes clients are responsible for adjusting to the norms or standards established by a relatively immutable environment. An alternate set of assumptions broadens the range of acceptable responses by clients and targets the environment for change. On the basis of these assumptions, directives are given for nursing research aimed at studying clients' responses to change.

The concept of adaptation is used continually in health care as a benchmark of health. In research, practice, and education, adaptation is the measure that distinguishes health from illness. Health is defined as successful human adaptation to particular environmental circumstances (Moore, Van Arsdale, Glittenberg, & Aldrich, 1980) and change (Wilson & Kneisl, 1983), in order to promote individual integrity and wholeness (Roy, 1984).

Nursing has accepted adaptation as a valid measure of health. The literature abounds with articles that discuss the adaptation of clients, students, and nurses. According to Hall (1981), adaptation is becoming ubiquitous and reified in nursing. Gooshen and Bush (1979) suggest that emphasis on assisting the client to adapt may be unique to nursing. In a recent review of nursing textbooks on families, Allen (1986) found the family's homeostatic or adaptive capacity to be a major focus. Adaptation or adjustment to chronic illness, death, divorce, and other crises are familiar topics in nursing research.

The centrality of the concept of adaptation in nursing has developed with almost no critical examination of its definitions, parameters, and meanings. Broad definitions relating to homeostasis or equilibrium have been borrowed from the biological sciences and applied unaltered to the psychological and social sciences. Because a concern with physiological, psychological and social phenomena is inherent in nursing, nurses should be concerned about the use of the concept of adaptation; however, the nursing literature lacks clear, conceptual definitions.

The purposes of this article are to examine the concept of adaptation and to describe its limitations as a measure of health in nursing research. The argument will be made that adaptation measures a person's conformity to prevailing societal norms. According to adaptation theory, it is the individual who is responsible for making the adjustments necessary to achieve a balance with the environment. This theory neglects to address the role of the environment in establishing the person-environment fit. Consequently, the person often is encouraged to change when it is the system that needs changing.

Nurse researchers must question the assumptions inherent in a theory before testing that theory in research. Without this ciritcal examination of existing theories, the nurse researcher will perpetuate the status quo. This critical examination of the concept of adaptation will begin with a historical overview of its development.

DEFINITIONS OF ADAPTATION

Webster's New Collegiate Dictionary defines adaptation as the "adjustment to environmental conditions: as modification of an organism or its parts that makes it more fit for existence under the conditions of its environment." The outcome of adaptation is to fit: "to be suitable for or to be in agreement or accord with; to cause to conform to or suit something." This definition describes a person-environment relationship with specific characteristics that describe the two phases of adaptation: the process and the outcome. …

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