Stuart Stress Adaptation Model

Nursing theories

open access articles on nursing theories and models

Stuart Stress Adaptation Model


  • Stuart Stress Adaptation Model is a model of of psychiatric nursing care, which integrates biological, psychological, sociocultural, environmental, and legal-ethical aspects of patient care into a unified framework for practice.
  • The Stuart Stress Adaptation Model of health and wellness provides a consistent nursing-oriented framework (Stuart, 2009).  


  • "Nature is ordered as a social hierarchy from the simplest unit to the most complex and the individual is a part of family, group, community, society, and the larger biosphere."
  • "Nursing care is provided within a biological, psychological, sociocultural, environmental, and legal-ethical context."
  •  Health/illness and adaptation/maladaptation (nursing world view) are two distinct continuums. 
  • The model includes the primary, secondary, and tertiary levels of prevention by describing four discrete stages of psychiatric treatment: crisis, acute, maintenance, and health promotion.
  • Nursing care is based on the use of the nursing process and the standards of care and professional performance for psychiatric nurses.


  • Biopsychosocial approach - a holistic perspective that integrates biological, psychological, and sociocultural aspects of care.
  • Predisposing factors -risk factors such as genetic background.
  • Precipitating stressors - stimuli that the person perceives as challenging such as life events.
  • Appraisal of stressor - an evaluation of the significance of a stressor.
  • Coping resources - options or strategies that help determine what can be done as well as what is at stake.
  • Adaptation/maladaptation -
  • Levels of Prevention
    • Primary
    • Secondary
    • Tertiary
  • Four stages of psychiatric treatment & nursing care
    • Crisis stage
    • Acute stage
    • Maintenance stage
    • Health promotion stage


  • Stuart Stress Adaptation Model can be used across psychiatric settings.
  • This model is based on standards of psychiatric nursing care and professional performance.


  1. Stuart GW. (2009). Principles and Practice of Psychiatric Nursing, 10th Edition Stuart - Mosby Elsevier, Missouri.
This page was last updated on: 05/12/2020