Impact of Care Based on the Roy Adaptation Model on the Level of Consciousness Among ICU Patients in Pakistan

Background: Patients in intensive care units (ICUs) frequently experience decreased levels of consciousness due to critical illness and neurological complications. Nursing interventions grounded in theoretical frameworks may enhance patients’ adaptive responses and promote recovery. Objectives: This study aimed to evaluate the association between Roy Adaptation Model-based nursing care and changes in the level of consciousness among patients in the ICU. Methods: A quasi-experimental study was conducted in 2026 among 100 ICU patients in a teaching hospital in Pakistan. Two comparable ICU wards were selected; one served as the intervention ward and the other as the control ward. The wards were not randomly assigned, and individual patients were not randomly allocated. Eligible patients were consecutively recruited according to the ward to which they were admitted. Patients in the intervention ward received nursing care guided by the Roy Adaptation Model, whereas patients in the control ward received standard routine care. The level of consciousness was assessed using the Glasgow Coma Scale (GCS) twice daily for seven consecutive days. Results: There were no statistically significant differences in GCS scores between the groups during the first three days of the study. From the morning assessment on day 4 onward, the intervention group had significantly higher GCS scores than the control group (P < 0.05). For example, on the morning of day 4, the mean GCS score was 11.92 ± 2.21 in the intervention group compared with 10.69 ± 2.09 in the control group; on the evening of day 7, the corresponding scores were 12.88 ± 2.22 and 11.52 ± 2.17, respectively. Repeated-measures analysis also showed a significant time-by-group interaction, F (13, 1274) = 7.88, P < 0.001, partial η2 = 0.074, indicating different patterns of change in GCS scores over time between the two groups. Conclusions: Roy Adaptation Model-based nursing care was associated with greater improvement in GCS scores among ICU patients than standard routine care. Given the quasi-experimental two-ward design, potential residual confounding, and lack of assessor blinding, these findings should be interpreted with caution and warrant confirmation in larger multicenter studies with more rigorous controlled designs.