CAPS-Short Form User Manual 3-3-16

CAPS:Short Form 03-3-16, C.
Roy 1
Coping and Adaptation Processing Scale (CAPS):

Short Form (15-Item)
Sr. Callista Roy, Ph.D., R.N., FAAN

Professor and Nurse Theorist
William F. Connell School of Nursing
Boston College, Chestnut Hill, MA
[email protected]
Information for Users
May 1, 2005
CAPS:Short Form 03-3-16, C. Roy 2
Description of the Instrument
The Coping and Adaptation Processing Scale (CAPS): Short Form is a 15-item
instrument that represents all original concepts of the CAPS long form (47 items). The
CAPS: Short Form uses a Likert scale format with response choices ranging from 4
(always) to 1 (never). Each item of the CAPS is a short statement about how an
individual responds to experiencing a crisis or extremely difficult event. Three items are
reversed scored. The possible range of scores is from 60 to 15 with a high score
indicating a more consistent use of the identified strategies of coping. The instrument is
based on a middle-range theory (MRT) of coping and adaptation processing (See Figure
1; Roy, 2009). The original pool of items for this scale came from qualitative and
quantitative studies based on the major concepts of this MRT and this earlier work is
explained as a significant part of the research by Roy over 25 years (Roy, 2011).
Definitions Related to Use of the CAPS Scale

Coping strategies—Behaviors whereby adaptation processing is carried out in daily
situations and in critical periods; categories synthesized from behaviors in four
adaptive modes, physiologic, self-concept, role function and interdependence.
Adaptation processing—Patterning of coping behaviors that take in, handle, and respond
to stressors and are directed toward survival, growth, reproduction, mastery, and
transcendence.
Coping and adaptation processing—the patterning of innate and acquired ways of taking
in, handling, and responding to a changing environment in daily situations and in
critical periods that direct behavior toward survival, growth, reproduction,
mastery, and transcendence.
Capacity of coping and adaptation processing—the ability of the person based on their
patterns of responding to changes in the environment that uses their coping styles
and strategies to adapt effectively to challenges.
Definitions from the Roy Adaptation Model

Regulator--broad coping subsystem of the person that includes neural-chemical-
endocrine-processes that are largely innate and automatic.
Cognator—a second major subsystem which includes both cognitive and emotional
processing and responses of perceptual-information process, learning, judgment and
emotion.
Adaptation Levels—in each of four adaptive modes, physiologic needs, self-concept, role
function, interdependence
Adaptive mode processes described on three levels:
1. Integrated-Adaptation level where the structures and functions of the life
processes work to meet needs
2. Compensatory-Adaptation level where the cognator and regulator are activated
a challenge to the life processes
3. Compromised-Adaptation level resulting from inadequate integrated and
compensatory life processes; an adaptation problem
Scoring The Coping and Adaptation Processing Scale: Short Form
Raw Scores
To score the Coping and Adaptation Processing Scale:
3) First, reverse score the three negative items so that higher scores mean greater
coping.
In reverse scoring 1=4; 2=3; 3=2; and 4=1
The items to reverse score are: 5, 13, and 14
2) Total scores are obtained by summing the numeric responses on each item.
Range of scores for 15 items is: 60 to 15
3) Some authors in using the longer (47 item) form have chosen to split the group in half
to identify persons who have high and low capacity of coping (Gonzalez, 2008); others,
notably Gloria Carvajal from La Sabana University, Chia, Colombia, used quartiles.
How to Use Scores

 One important use of the CAPS scores is for testing the same group of
participants before and after an intervention. Statistical analysis for differences in
related groups can then be performed. Such differences have been found
(Gonzales, 2008).
 A second use of the CAPS is to compare two groups who may be expected to
differ on coping and adaptation. One might be an intervention group and the other
a control group. Gonzales also found these differences.
 Another use of the CAPS is to give as a pre-test to select participants who may
have low coping capacity; to identify areas of weakness and to design
interventions to enhance coping in these areas.
 The CAPS may also be given as a co-variant in a study of other variables of
interest such as transition following discharge from the hospital in a study focused
on preparation for discharge.
Table 1. Initial Psychometrics of CAPS-Short Form
Reliability Correlations Probability Theoretical Explanation
Chronbach’s Alpha .82

of Internal Consistency
Validity
Face Validity Items based on Middle-
range Theory of Coping &
Adaptation Processing—all
adaptive modes; all types
of cognitive processes
included
Concurrent Validity .377 >0.05
Quality of Life
Measure
(n=41)
Divergent Validity -.391 >0.05
Self-report of Cognitive
Deficits of difficulty
concentrating and memory
(n=34)
Rationale and Method for Developing CAPS in Short Form
Coping has long been recognized as an important construct in studying and dealing with
people and their health. The Coping and Adaptation Processing Scale (CAPS) was
initially developed to address unresolved issues in understanding and measuring the
complex construct of coping. For example, the widely used instrument by Lazarus and
colleagues has sometimes been referred to as the standard in the field, yet a number of
authors, as reported by Aldwin (2007) noted the construct validity of the instrument was
not strong, given an unstable factor structure. Extensive use in nursing research had not
yielded a cumulative body of knowledge. The 47-item CAPS was translated into 6
languages and used in at least 13 countries on 4 continents and found to be helpful. One
concern reported by scholars globally has been the respondent burden of the length of the
tool. A project was conducted that aimed at: Shortening the 47-item CAPS scale while
maintaining: (i) good model fit, (ii) adequate content coverage across the various
domains of the MRT of Coping and Adaptation Processing, (iii) and metric equivalence
across 2 ethnic groups. When this was achieved it is hoped that the CAPS: Short Form
will help reduce respondent burden, and increase the generalizability of the measure for
diverse populations.
The method used to shorten and revise the 47-item CAPS scale was an item response
theory (IRT) model analysis along with the MRT of Coping and Adaptation Processing.
Secondary data from 2 samples were used: Sample 1—Patients with chronic neurologic
deficits in the USA (n=347) and Sample 2—Patients with acute cardiac conditions in
Panama (n=327). The Graded Response Model (GRM) was used to calibrate item
parameters; these item parameters along with their associated Categorical Response
Curves (CRCs) were used to inform item selection. Differential item function (DIF)
testing was used to identify items that functioned similarly across the two samples; items
without DIF were preferred for the shortened scale.
IRT procedures using the statistical models of curves and differences resulted in the
following:
 12 items were potentially most useful; 4 items showed some potential, with
relevant curves and small differences
 With redundancy removed 14 items remained and all were ranked high by the
theorist on a ladder of coping
 These items reflected all major concepts of the MRT
 One item from the original pool of 72 items was put back in the scale based on
significant research of the concept of spirituality in coping in studies based on the
Roy Adaptation Model over the past 25 years (Harvey, 2013)
After items for the shortened CAPS were selected, the reliability and validity of the scale
was tested and found to be promising (See Table 1).
Implications for Research and Practice
The Coping and Adaptation Processing Scale (CAPS): Short-Form can be a practical tool
to effectively and efficiently measure coping and adaptation in people dealing with both
chronic and acute health conditions. Future research involves testing the tool in various
clinical population and global settings. Keeping a data base on the developing work will
be important in testing the promise of this tool change. From developing knowledge of
how people cope, the nurse can help patients to enhance their selected strategies in a
given situation and provide opportunities and support for developing new strategies and
flexibility in using them.
References
Aldwin, C. (2007) Stress, Coping, and Development: An Integrative Perspective. New

York: Guilford Press.
Gonzalez, Y. (2008) Evaluación de la Eficacia del Cuidado como Intervención
Terapéutica: Un Programa Educativo con Enfoque Cognitivo. (Doctoral
dissertation). Universidad Nacional de Colombia, Bogotá, Colombia.
Harvey, B. (2011). Evolution of Spirituality Research Based on the Roy Adaptation
Model. Poster presented at University Research Day, Boston College, February
2011.
Roy, C, (2009) The Roy Adaptation Model. Third Edition. New Jersey: Pearson
Education, Inc.
Roy, C. (2011) Research Based on the Roy Adaptation Model: Last 25 Years. Nursing
Science Quarterly, 24(4), 312-320. nsq.sagepub.com
Roy, C., Bakan, C., Li, Z., and Nguyen, T. H. Coping Measurement: Creating Short Form
of Coping and Adaptation Processing Scale Using Item Response Theory and
Patients Dealing with Chronic and Acute Health Conditions. (in review)

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CAPS:Short Form 03-3-16, C.

Coping and Adaptation Processing Scale (CAPS):

Sr. Callista Roy, Ph.D., R.N., FAAN

Information for Users

Description of the Instrument

Definitions Related to Use of the CAPS Scale

Definitions from the Roy Adaptation Model

Scoring The Coping and Adaptation Processing Scale: Short Form

How to Use Scores

Table 1. Initial Psychometrics of CAPS-Short Form

Reliability Correlations Probability Theoretical Explanation

Chronbach’s Alpha .82

Rationale and Method for Developing CAPS in Short Form

Implications for Research and Practice

Aldwin, C. (2007) Stress, Coping, and Development: An Integrative Perspective. New

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