School essay: outsourcing some brain work

I’m currently writing an essay for one of my classes, ‘Theoretical Foundations of Nursing.’ I’m about the most ‘gong-si’ class I’ve ever taken. (That is a Chinese term for ‘shit talking,’ which is my boyfriend’s favourite term for any field that gets into arguments over definitions, has concepts that don’t correspond to any empirical phenomena, is based on ideology, etc.)

The essay involves analyzing a clinical situation (in this case a 55-year-old recently divorced, recently unemployed man, admitted to the psychiatric ward with major depression and suicidal ideation) using a theory (in this case, Roy’s Adaptation Model). Done. The next step involves finding criticisms with the model...and despite the fact that I’ve been complaining about this class and its non-empirical nature all semester, I seem unable to come up with specific criticisms of what this nursing theory is missing.

Which is what I need your help for, because LessWrong is the best community ever when it comes to specific criticisms.

Here is a very brief overview of Roy’s Adaptation Theory:

  • Defines ‘health’ as ‘state or process of becoming integrated with the environment, in the domains of survival, growth, reproduction, mastery, and personal/​environmental transformation.’

  • Defines a ‘person’ as an ‘adaptive system with coping processes.’ Goes on to subdivide this a bit: there are ‘regulator mechanisms’ (i.e. innate, not consciously controlled) and ‘cognitive mechanisms’ of adaptation within four different modes: physiological, role function, interdependence, and self-concept.

  • Defines environment as ‘all conditions, circumstances, and influences that affect the development and behavior of individuals and groups.’ Further subdivides environmental stimuli into focal (which demand the person to immediately adapt), contextual (which affect how they adapt), and residual (i.e. attitudes, beliefs).

  • The nurse’s goal is to manipulate stimuli to improve the person’s level of adaptation, as well as teaching more effective coping methods.

  • The steps in the process of creating a care plan are: assessment of behavior, assessment of stimuli, choosing a nursing diagnosis from this huge lookup table, setting a goal, choosing an intervention, and evaluation the results.


Now my question is, what is a specific criticism I can make of this particular theory in general...not “your definitions aren’t specific enough” or “the whole field of nursing theory isn’t reductionist enough”, but something that this kind of theory should have but doesn’t. Any ideas?