Translating Roy’s adaptation model into pediatric epilepsy care: a CARE-compliant clinical case analysis

Abstract Background Childhood epilepsy is a chronic neurological disorder that affects physical health, emotional well-being, social participation, academic functioning, and family life. Although Roy’s Adaptation Model (RAM) offers a comprehensive framework for addressing adaptation to chronic illness, its practical operationalization in pediatric epilepsy nursing has rarely been described in CARE-compliant clinical case reports. This study aimed to illustrate how RAM can be operationalized to support clinical reasoning, nursing assessment, care planning, and outcome evaluation through a CARE-compliant clinical case analysis. Methods A theory-based CARE-compliant clinical case analysis was conducted in 2024 in a pediatric ward in Clinical Application and Evidence Gap, Iran. The case involved an 8-year-old boy with recurrent epilepsy despite ongoing antiepileptic treatment. Data were collected through medical record review, interviews with the child and parents, clinical observation, and physical assessment. Findings were organized according to RAM’s physiological, self-concept, role function, and interdependence modes. Adaptive problems were translated into nursing diagnoses, followed by stimulus analysis and implementation of individualized nursing interventions delivered over six weeks through weekly 45-minute sessions with parental participation, supported by weekly telephone follow-up and seizure diary monitoring. Results Assessment identified maladaptive responses across all four adaptive modes, including recurrent seizures and sleep disturbances, low self-esteem, impaired role performance, and social isolation. During the six-week follow-up, improvements were observed in seizure frequency (approximately four to fewer than two episodes per month), sleep quality, self-confidence, school participation, social engagement, and parental confidence in epilepsy management. Given the single-case design, these observations should be interpreted descriptively rather than as evidence of a causal intervention effect. Conclusions This case demonstrates the feasibility of operationalizing Roy’s Adaptation Model as a structured clinical reasoning framework for pediatric epilepsy nursing care Although findings from a single case are not generalizable, they suggest that theory-guided nursing care may facilitate comprehensive assessment and individualized adaptation-focused care and warrant further evaluation in larger longitudinal studies.