Theory of

Family Stress and Adaptation

Geri LoBiondo-Wood

Melissa Diebel
Ferris State University
diebelm1@ferris.edu

Objectives
Overview of the Theory of Family Stress and Adaptation
Metaparadigm concepts of the Family Stress and Adaptation

Analyze the Theory of Family Stress and Adaptation through:

o
o
o
o
o

Accuracy
Simplicity / complexity
Scope
Acceptance
Socio-cultural utility

Supportive research on Theory of Family Stress and Adaptation

Connecting Theory of Family Stress and Adaptation with research

Objectives

(continued)

Explain theory without theoretical framework

Describe how the Theory is used in my nursing practice
Understand how the theory connects with nursing practice

Overview
Theory of Family Stress and Adaptation
Middle range theory
As Smith and Liehr (2003), explains that Defining family for the purpose of
nursing research and practice is as complex as the range of families seen in society
today (p. 91).
o Interactive Integrative paradigm
o Grand theory
o Middle range theory
o Research tradition
o Practice tradition

This theory is complex, although the level of thinking is not at a clinical thinking
level. It is viewed on the lower end of thinking known as inductive and deductive
thinking. It is also complex based on the number of concepts involved with this
theory

Metaparadigm Concepts
Family Stress and Adaptation
Metaparadigm defined
o Fawcett (2005), Metaparadigm is explained, as the global
concepts that identify the phenomenon of central interest to a
discipline, the global propositions that the concepts, and the
global propositions that state the relations between or among
the concepts (p. 3).

This theory is complex because of the number of

concepts involved
Person is described as family, being the primary
focus of this Theory
Environment is the separation of families during
war and the stressor pile-up taking place affecting
each of the family members during this time. It is
also how the family adapts to the new environment
and how it effects there lives

Metaparadigm Concepts
Family Stress and Adaptation
(continued)

Health
o The crisis being the concern of a loved one dying at war and the resilience they may
have working through this individually (The Double ABCX Model)
o The child in need of a liver transplant and stressors involved

Nursing
o Interventions used to care for and provide education using existing and new resource
for the patient and their families throughout the liver transplant process

Abbreviated analysis
Family Stress and Adaptation.
Demonstrates the adjustment of family stress and the need to adapt
o Adjustment
o Adaptation
o Bonadaptation
o Maladaptation

Key concept is The Double ABCX model

o

The families are nonlinear as they do not move from crisis to adaption. A number
of steps are followed

Abbreviated analysis
Family Stress and Adaptation.
The double ABCX Theory evaluated families coping skills and adaption abilities with resilience
to stressor pile-up conditions
o Positive or negative impact
o Ability to adjust and adapt

Accuracy
o
o

This theory is relevant to nursing today. The interventions and caring strategies can be applied to educate and
support families throughout this long term process.
Accuracy would also express a world view. Any family would experience these common stressors and pile-up
demands.

Scope
o

This is a general theory of nursing that particularly focuses on family stress coping resiliency balance

Acceptance
o

Theory of Family Stress and Adaptation is accepted into the nursing practice.

Socio-Cultural Utility
o

This theory can be used with individuals, groups and communities as well as the global society. All people
experience stressors through environmental changes requiring coping and adaptation

Supportive Research on
Family Stress and Adaptation.
Research article chosen
The Double ABCX Model of Family Stress
and Adaptation: An Empirical Test by
Analysis of Structural Equations with
Latent Variables.
Yoav Lavee, Hamilton I. McCubbin and Joan M. Patterson,
National Council on Family Relations, Journal of Marriage and
Family, Vol. 47, No. 4 (Nov., 1985), p. 811-825

This research article studied the aspects

of the Double ABCX Model through using
a common stressor event on data collected
from Army families who have been
relocated overseas. The study compared
the pre-crisis and post-crisis as well as
adaptations through their experiences
adjusting to a foreign culture and being
away from the support of family and

friends.

Connecting Theory of Family Stress and

Adaptation with research
The Double ABCX Model
Pile up (aA Factor)

o Pre and post crisis stressors that build up

over time

Family adaptive resources (bB Factor)

o Personal recourses
o Family system
o Social support

Perception and Coherence (cC Factor)

o Acceptance and understanding of the
situation

Family adaptation

(xX Factor)

o Outcome of the family and how they coped

with the change

The Double ABCX Model of Family Stress and Adaptation:

An Empirical Test by Analysis of Structural Equations
with Latent Variables Yoav Lavee, Hamilton I. McCubbin
and Joan M. Patterson Journal of Marriage and Family ,
Vol. 47, No. 4 (Nov., 1985), p. 811-825

Family Stress and Adaptation

without a theoretical framework
Theoretical framework are the definitions or limitations
of what the theories and methods are based
o Examples
The families in this study had all shared similar
experiences through relocating with the military
o Without this common factor, there would be too many variables
in the study to procure accurate outcomes
o This framework provides the guidelines needed to achieve a
more accurate desired outcome

Without framework the research would be based on an

unknown starting point which could very the outcome
producing an unstable theory

How the Theory of Family Stress and Adaptation

Fits with my nursing practice
Pre-assessment

o Assessment of entry level skills prior to the program start

Assess

o Family for readiness to change

o Comprehension level of a the family

Analyze Analyze families for stress

o How are they coping?
o Do they recognize a need for change?
o Are they ready to make a change?

Planning

o Establishing and selecting the lesson plans

o Identify the use of the evidence based plans
o Formulating a four month training program

How the Theory of Family Stress and Adaptation

Fits with my nursing practice (continued)
Implement

o Teach families how to identify the

need for change
o Strategies of learning at
comprehension level of the family
o Teach families how to identify stress

Evaluation

o Individual and families adaptation to

resilience and ground rules

Post evaluation

o Exit level of skills and knowledge of

what the family has learned

Stephen J. Bavolek, Family development Resources,

Inc., Facilitator Training Workbook and Program
Implementation Guide (11th Ed., 2010), Asheville,
NC

Connecting Theory of Family Stress and Adaptation

nursing practice
Definitions of: Nursing theory and nursing practice
o Nursing theory is a concept that provides a framework for nursing
practice (Tourville and Ingalls, 2003, p. 21).
o Nursing practice is the work performed that is supported by the nurse

What links nursing theory and practice?

o Nursing theory and nursing practice are linked together through
scientific knowledge (Tourville and Ingalls, 2003, p. 23).

Connecting Theory of Family Stress and Adaptation

nursing practice (continued)
The evaluation of theory coincides with both the Theory of Family
Stress and Adaptation and nursing practices.
The Double ABCX Theory
Nursing practice

o The American Nurses Association (2010) states The ability to perform at

the expected level requires a process of lifelong learning, and that
Registered nurses must continually reassess their competences and identify
needs for additional knowledge, skills, personal growth, and integrative
learning experiences (p. 13).

References
Bavolek, S. J. (2010). Nurturing Parenting Programs, Facilitator Training Workbook and Program Implementation guide,
(11th ed). Family Development Resources Inc., Asheville, NC
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. ANS Advances in Nursing Science, 1(1), 13-23.
Retrieved from http://ferris.libguides.com
Dudley-Brown, S., (1997). The evaluation of nursing: a method for our madness. International Journal of Nursing

Studies, 34(1), 76-78.

Retrieved from

http://140.131.87.87/nursingnew/eng/data/files/201011/1290754108718416303.pdf

Fawcett, J. (2005). Criteria for Evaluation of Theory. Nursing Science Quarterly, 18(2), 131135.
doi:10.1177/0894318405274823
Froma Walsh (2002). A Family Resilience Framework: Innovative Practice Applications Family Relations, Vol. 51,
No. 2. p. 130-137
Marshall, E. (2011). Transformational leadership in nursing: From expert clinician to influential leader. (1st ed.).
New York: Springer Publishing Company, LLC
Selanders L. C. (1998). The Power of Environmental Adaption: Florence Nightingales Original Theory for Nursing

Practice. Journal of Holistic Nursing 16(2) 247-263. doi: 10.1177/089801019801600213

References
Smith, M. J. and Liehr, P. R. (2003) the theory of Family Stress Middle Range Theory for Nursing. 91- 109. New
York: Springer Publishing Company, Inc

Yoav Lavee, Hamilton I. McCubbin and Joan M. Patterson (1985). The Double ABCX Model of Family Stress and Adaptation: An
Empirical Test by Analysis of Structural Equation with Latent Variables Journal of Marriage and Family, Vol. 47, No.

4. p. 811-825
Tourville, C., & Ingalls, K. (2003). The living tree of nursing theories. Nursing Forum, 38(3), 21-36.