THE ROY'S ADAPTATION MODEL
Introduction
Sr.Callista Roy, a prominent n urse theorist, writer, lecturer, researcher
and teacher
Professor and Nurse Theorist at the Boston
College of Nursing in Chestnut Hill
Born at Los Angeles on October 14, 1939 as
the 2nd child of Mr. and Mrs. Fabien
Roy
she earned a Bachelor of Arts with a major in
nursing from Mount St. Mary's College, Los
Angeles in 1963.
a master's degree program in pediatric
nursing at the University of California ,Los
Angeles in 1966.
She also earned a master’s and PhD in Sociology
in 1973 and 1977 ,respectively.
Sr. Callista had the significant opportunity
of working with Dorothy E. Johnson
Johnson's work with focusing knowledge for
the discipline of nursing convinced Sr. Callista
of the importance of describing the nature of
nursing as a service to society and prompted her
to begin developing her model with the goal of
nursing being to promote adaptation.
She joined the faculty of Mount St. Mary's
College in 1966, teaching both pediatric and
maternity nursing.
She organized course content according to a
view of person and family as adaptive systems.
She introduced her ideas about ‘Adaptation
Nursing’ as the basis for an integrated nursing
curriculum.
Goal of nursing to direct nursing education,
practice and research
Model as a basis of curriculum impetus for
growth--Mount St. Mary’s College
1970-The model was implemented in Mount St.
Mary’s school
1971- she was made chair of the nursing department
at the college.
Influencing Factors
Family
Education
Religious Background
Mentors
Clinical Experience
Theory description
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The central questions of Roy’s theory are:
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Who is the focus of nursing care?
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What is the target of nursing care?
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When is nursing care indicated?
Roy’s first ideas appeared in a graduate
paper written at UCLA in 1964.
Published these ideas in "Nursing outlook"
in 1970
Subsequently different components of her
framework crystallized during 1970s, ’80s, and
’90s
Over the years she identified assumptions on
which her theory is based.
Explicit assumptions (Roy 1989; Roy
and Andrews
1991)
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The person is a bio-psycho-social being.
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The person is in constant interaction with a
changing environment.
-
To cope with a changing world, person uses
both innate and acquired mechanisms which are
biological, psychological and social in origin.
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Health and illness are inevitable dimensions of
the person’s life.
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To respond positively to environmental changes ,the
person must adapt.
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The person’s adaptation is a function of the
stimulus he is exposed to and his adaptation level
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The person’s adaptation level is such that it
comprises a zone indicating the range of
stimulation that will lead to a positive
response.
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The person has 4 modes of adaptation:
physiologic needs, self- concept, role function
and inter-dependence.
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"Nursing accepts the humanistic approach of
valuing other persons’ opinions, and view
points" Interpersonal relations are an
integral part of nursing
-
There is a dynamic objective for existence
with ultimate goal of achieving dignity and
integrity
Implicit assumptions
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A person can be reduced to parts for study
and
care.
-
Nursing is based on causality.
-
Patient’s values and opinions are to be
considered and respected.
-
A
state of adaptation frees an individual’s energy
to respond to other stimuli.
Roy Adaptation Model Concepts: Early and
Revised
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Adaptation -- goal of nursing
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Person -- adaptive system
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Environment -- stimuli
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Health -- outcome of adaptation
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Nursing -- promoting adaptation and health
Concepts-Adaptation
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Responding positively to environmental
changes
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The process and outcome of individuals and
groups who use conscious awareness, self
reflection and choice to create human and
environmental integration
Concepts-Person
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Bio-psycho-social being in constant
interaction with a changing environment
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Uses innate and acquired mechanisms to adapt
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An adaptive system described as a whole
comprised of parts
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Functions as a unity for some purpose
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Includes people as individuals or in
groups-families, organizations, communities, and
society as a whole
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Focal - internal or external and immediately
confronting the person
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Contextual- all stimuli present in the
situation that contribute to effect of focal
stimulus
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Residual-a factor whose effects in the
current situation are unclear
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All conditions, circumstances, and influences
surrounding and affecting the development and
behavior of persons and groups with particular
consideration of mutuality of person and earth
resources, including focal, contextual and
residual stimuli
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Inevitable dimension of person's life
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Represented by a health-illness continuum
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A state and a process of being and becoming
integrated and whole
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To promote adaptation in the four adaptive
modes
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To promote adaptation for individuals and
groups in the four adaptive modes, thus
contributing to health, quality of life, and
dying with dignity by assessing behaviors and
factors that influence adaptive abilities and by
intervening to enhance environmental
interactions
-
Cognator subsystem — A major coping process
involving 4 cognitive-emotive channels:
perceptual and information processing, learning,
judgment and emotion.
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Regulator subsystem — a basic type of
adaptive process that responds automatically
through neural, chemical, and endocrine coping
channels
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Derived Four Adaptive Modes
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500 Samples of Patient Behavior
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What was the patient doing?
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What did the patient look like when needing
nursing care?
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Physiologic Needs
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Self Concept
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Role Function
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Interdependence
Four Adaptive Mode Categories
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Tested in practice for 10 years
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Criteria of significance, usefulness, and
completeness were met
Sample Proposition and Hypothesis for Practice
Theory Development
Questions Raised by 21st Century
Changes
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How can ethics and public policy keep pace
with developments in science?
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How can nurses focus on human needs not
machines?
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How can nurses contribute to creating meaning
and purpose in a global society?
Scientific
Assumptions for the 21st Century
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Systems of matter and energy progress to
higher levels of complex self organization
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Consciousness and meaning are constitutive of
person and environment integration
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Awareness of self and environment is rooted
in thinking and feeling -
Human decisions are accountable for the
integration of creative processes.
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Thinking and feeling mediate human action
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System relationships include acceptance,
protection, and fostering of interdependence -
Persons and the earth have common patterns
and integral relations
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Person and environment transformations are
created in human consciousness
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Integration of human and environment meanings
results in adaptation
Philosophical Assumptions
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Persons have mutual relationships with the
world and God
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Human meaning is rooted in an omega point
convergence of the universe
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God is intimately revealed in the diversity
of creation and is the common destiny of
creation -
Persons use human creative abilities of
awareness, enlightenment, and faith
-
Persons are accountable for the processes of
deriving, sustaining, and transforming the
universe
Adaptation and Groups
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Includes relating persons, partners,
families, organizations, communities, nations,
and society as a whole
Adaptive Modes
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Physiologic
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Self Concept
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Role Function
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Interdependence
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Physical
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Group Identity
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Role Function
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Interdependence
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Underlying Need of Social integrity
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The need to know who one is in relation to
others so that one can act
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The need for role clarity of all participants
in group
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Integrated
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Compensatory
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Compromised
Integrated Life Processes
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Grieving as a growth process, higher levels
of adaptation and transcendence
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Role transition, growth in a new role
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Hypoxia
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Unresolved Loss
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Stigma
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Abusive Relationships
The nursing process
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First level assessment
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Second level assessment
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Diagnosis
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Goal setting
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Intervention
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evaluation
Usefulness of Adaptation Model
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Scientific knowledge for practice
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Clinical assessment and intervention
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Research variables -
To guide nursing practice
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To organize nursing education
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Curricular frame work for various nursing
colleges
Characteristics of the theory
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Theories can interrelates concepts in such a
way as to present a new view of looking at a
particular phenomenon.
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Theories must be logical in nature
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Theories should be relatively simple yet
generalizable
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Theories can be the basis for the hypotheses
that can be tested
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Theories contribute to and assist in increasing
the general body of knowledge of a discipline
through the research implemented to validate
them
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Theories can be utilized by the practitioners
to guide and improve their practice
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Theories must be consistent with other
validated theories, laws and principles but will
leave open unanswered questions that need to be
investigated
Testability
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RAM is testable
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BBARNS (1999) reported that 163 studies have
been conducted using this model.
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RAM is complete and comprehensive
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It explains the reality of client, so nursing
interventions can be specifically targeted.
Research studies using RAM
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Middle range theories have been derived from
RAM
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1998-Ducharme et al described a
longitudinal model of psychosocial
determinants of adaptation
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1998-Levesque et al presented a MRT of
psychological adaptation
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1999-A MRNT , the urine control theory by
Jirovec et al
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Dunn, H.C. and Dunn, D. G.
(1997). The Roy Adaptation |
