In 1999, the Boston-Based Adaptation in Nursing Research Society associates published their analysis of Roy adaptation model—based research. This earlier analysis supported the model's conceptual framework, its adaptive processes, and the influences that effect human responses. The purpose of this article is to describe more recent research within the context of the Roy adaptation model's structural framework, and ongoing developments that include expanded research programs, middle-range theory construction, and research that is related to the philosophic assumptions. An additional aim is to present an expanded worldview or an integrated paradigm that includes both sets of the Roy adaptation model's assumptions (scientific and philosophic), as well as a holistic-adaptation inquiry that could be used to derive Roy adaptation model-based nursing knowledge in future research investigations.

Nurses and health care increasingly are embracing and guided by achievements and challenges of evidence-based practice and reflective practice. Nursing science advances have positioned nurses to move forward in the development of science. New directions for nursing knowledge need to emerge in several ways including the development of interdisciplinary knowledge, emphasis on the nursing care process, creation of new work-force patterns, and development of economic theories of nursing practice.