- Sr.Callista Roy- nurse 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.
- Bachelor of Arts with a major in nursing - Mount St.
Mary's College, Los Angeles in 1963.
- Master's degree program in pediatric nursing -
University of California ,Los Angeles in 1966.
- Master’s and PhD in Sociology in 1973 and 1977.
- Worked with Dorothy E. Johnson
- Worked as f faculty of Mount St. Mary's College in 1966.
- Organized course content according to a view of person
and family as adaptive systems.
- RAM as a basis of curriculum i at Mount St. Mary’s
- 1970-The model was implemented in Mount St. Mary’s
- 1971- she was made chair of the nursing department at
- The person is a bio-psycho-social being.
- The person is in constant interaction with a changing
- To cope with a changing world, person uses both innate
and acquired mechanisms which are biological,
psychological and social in origin.
- Health and illness are inevitable dimensions of the
- To respond positively to environmental changes, the
person must adapt.
- The person’s adaptation is a function of the stimulus he
is exposed to and his adaptation level
- The person’s adaptation level is such that it comprises
a zone indicating the range of stimulation that will lead
to a positive response.
- The person has 4 modes of adaptation: physiologic needs,
self- concept, role function and inter-dependence.
- "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.
- 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
- A state of adaptation frees an individual’s energy to
respond to other stimuli.
- Adaptation -- goal of nursing
- Person -- adaptive system
- Environment -- stimuli
- Health -- outcome of adaptation
- Nursing- promoting adaptation and health
- Responding positively to environmental changes.
- The process and outcome of individuals and groups who
use conscious awareness, self reflection and choice to
create human and environmental integration
- Bio-psycho-social being in constant interaction with a
- Uses innate and acquired mechanisms to adapt
- An adaptive system described as a whole comprised of
- Functions as a unity for some purpose
- Includes people as individuals or in groups-families,
organizations, communities, and society as a whole.
- Focal - internal or external and immediately confronting
- Contextual- all stimuli present in the situation that
contribute to effect of focal stimulus
- Residual-a factor whose effects in the current situation
- 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
- Inevitable dimension of person's life
- Represented by a health-illness continuum
- A state and a process of being and becoming integrated
- To promote adaptation in the four adaptive modes
- 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.
- Regulator subsystem — a basic type of adaptive process
that responds automatically through neural, chemical, and
endocrine coping channels
- Derived Four Adaptive Modes
- 500 Samples of Patient Behavior
- What was the patient doing?
- What did the patient look like when needing nursing
Four Adaptive Modes
- Physiologic Needs
- Self Concept
- Role Function
Adaptation and Groups
- Persons have mutual relationships with the world and God
- Human meaning is rooted in an omega point convergence of
- 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
- Includes relating persons, partners, families,
organizations, communities, nations, and society as a
- Self Concept
- Role Function
- Group Identity
- Role Function
Role Function Mode
- Underlying Need of Social integrity
- The need to know who one is in relation to others so
that one can act
- The need for role clarity of all participants in group
- A zone within which stimulation will lead to a
positive or adaptive response
- Adaptive mode processes described on three levels:
Integrated Life Processes
- Adaptation level where the structures and functions of
the life processes work to meet needs
- Examples of Integrated Adaptation
- Stable process of breathing and ventilation
- Effective processes for moral-ethical-spiritual growth
- Adaptation level where the cognator and regulator are
activated by a challenge to the life processes
- Compensatory Adaptation Examples:
- Grieving as a growth process, higher levels of
adaptation and transcendence
- Role transition, growth in a new role
- Adaptation level resulting from inadequate integrated
and compensatory life processes
- Adaptation problem
- Compromised Adaptation Examples
- Unresolved Loss
- Abusive Relationships
THE NURSING PROCESS
- RAM offers guidelines to nurse in developing the
- The elements :
- First level assessment
- Second level assessment
- Goal setting
Usefulness of Adaptation Model
- Scientific knowledge for practice
- Clinical assessment and intervention
- Research variables
- To guide nursing practice
- To organize nursing education
- Curricular frame work for various nursing colleges
Characteristics of the theory
- logical in nature
- relatively simple yet generalizable
- can be the basis for the hypotheses that can be tested
- contribute to and assist in increasing the general
body of knowledge of a discipline
- can be utilized by the practitioners to guide and
improve their practice
- consistent with other validated theories, laws and
- Middle range theories have been derived from RAM
- 1998-Ducharme et al described a longitudinal model of
psychosocial determinants of adaptation
- 1998-Levesque et al presented a MRT of psychological
- 1999-A MRNT , the urine control theory by Jirovec et
- Dunn, H.C. and Dunn, D. G. (1997). The Roy Adaptation
Model and its application to clinical nursing practice.
Journal of Ophthalmic Nursing and Technology. 6(2),
- Samarel, N., Fawcett, J., Krippendorf, K., Piacentino,
J.C., Eliasof, B., Hughes, P., Kowitski, C., and
Ziegler, E. (1998). Women's perception of group support
and adaptation to breast cancer. Journal of Advanced
Nursing. 28(6), 1259-1268.
- Chiou, C. (2000). A meta-analysis of the
interrelationships between the modes in Roy's adaptation
model. Nursing Science Quarterly. 13(3), 252-258
- Yeh, C. H. (2001). Adaptation in children with cancer:
research with Roy's model. Nursing Science Quarterly.
- Zhan, L. (2000). Cognitive adaptation and
self-consistency in hearing-impaired older persons:
testing Roy's adaptation model. Nursing Science
Quarterly. 13(2), 158-165.
- 5 elements - person, goal of nursing, nursing
activities, health and environment
- Persons are viewed as living adaptive systems whose
behaviours may be classified as adaptive responses or
- These behaviors are derived from regulator and
- These mechanisms work with in 4 adaptive modes.
- The goal of nursing is to promote adaptive responses
in relation to 4 adaptive modes, using information about
person’s adaptation level, and various stimuli.
- Nursing activities involve manipulation of these
stimuli to promote adaptive responses.
- Health is a process of becoming integrated and able to
meet goals of survival, growth, reproduction, and
- The environment consists of person’s internal and
- George B. Julia , Nursing Theories- The base for
professional Nursing Practice , 3rd ed. Norwalk,
Appleton & Lange.
- Wills M.Evelyn, McEwen Melanie (2002). Theoretical
Basis for Nursing Philadelphia. Lippincott Williams&
- Meleis Ibrahim Afaf (1997) , Theoretical Nursing :
Development & Progress 3rd ed. Philadelphia,
- Taylor Carol,Lillis Carol (2001)The Art &
Science Of Nursing Care 4th ed.
- Potter A Patricia, Perry G Anne (1992) Fundamentals Of
Nursing –Concepts Process & Practice 3rd ed. London
Mosby Year Book.
- Vandemark L.M. Awareness of self & expanding
consciousness: using Nursing theories to prepare nurse
–therapists Ment Health Nurs. 2006 Jul; 27(6) : 605-15
- Reed PG, The force of nursing theory guided- practice.
Nurs Sci Q. 2006 Jul;19(3):225
This page was last updated on: