Table 1.

Summary of Model Changes

Conceptual Change	Model Change
Terminology was modified to improve clarity.	Residual stimuli changed to individual and family characteristics. Contextual stimuli changed to individual and family responses. Self-care changed to self-management.
Additional variables were added to the model to increase specificity of factors influencing adaptation.	Treatment modality and family environment added to individual and family characteristics. Stress added to psychosocial responses. Severity of psychosocial responses differentiated. Self-efficacy, family functioning, and social competence added to individual and family responses. Self-management separated from other individual and family responses. Quality of life added as an adaptation outcome.
More recursive pathways in the model were defined and additional pathways are proposed.	Psychosocial responses influences and is influenced by individual and family responses. Self-management influences and is influenced by coping, self-efficacy, family functioning, and social competence. Individual and family responses influence and are influenced by adaptation. Adaptation influences psychosocial responses.