BACKGROUND:  Components of cognitive appraisal have been studied extensively in the domain of adherence research.  However, limited studies measure cognitive appraisal as theoretically and conceptually defined.  Furthermore, those that do tend to focus on measures of primary appraisal, with little to no measurement of secondary appraisal.

 METHOD:  The computerized databases of CINAHL, PubMed, PsycINFO, and HAPI were searched for this review.  References in published articles were searched, as well as books on the topics of stress, behavior, and cognitive psychology.  An iterative search strategy was used to seek out psychometric data for each instrument.

 RESULTS:  Only five tools were found that measure cognitive appraisal consistent with a theoretical framework for stress, appraisal, and coping.  Limitations in the measurement of appraisal include the small number of tools, limited psychometric data, and consistency in the conceptual definition of cognitive appraisal.  Measures of appraisal occur primarily through uni-dimensional measures that do not reflect the inter-relatedness of all components of the appraisal process.

 CONCLUSIONS:  In spite of nearly three decades of research, cognitive appraisal has not been well studied.  Furthermore, the measurement of cognitive appraisal is a relatively new area of study.  Additionally, there is a need to further establish psychometric properties of tools that measure cognitive appraisal.  Tools measuring cognitive appraisal have limited use in the study of treatment adherence.  Future research examining the relationship between treatment adherence and cognitive appraisal may provide additional insight into factors affecting treatment adherence.