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Sister Callista Roy: Roy Adaptation Model

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Ada Y.

on 25 November 2013

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Transcript of Sister Callista Roy: Roy Adaptation Model

Sister Callista Roy
Four Modes of Adaptation
Physiological Mode
The maintenance of physical health.
Basic needs such as oxygen, nutrition, and body temperature.

How the family provides for the members' physical needs aka survival
Role Function Mode
Interdependence Mode
Maintaining a balance between independence and dependence on others

How the family interacts with others in the surrounding such as neighbors and community groups aka transactional patterns
Question 1
Is there anything that you feel is important and needs to be addressed as part of the adaptive
modes and isn’t?
Question 2
How would you compare the
6 step nursing process to the
DMF we use?
Question 3
Do you like this theory? Should
we try to incorporate it
in our practice or should we
scrap it?
Semantic clarity
All elements are clearly defined, making the theory easy for nurses to understand
Semantic consistency
The definitions of the concepts are consistent with each other and in relations to the main theme of the theory
Structural clarity
There are several systems including subsystems, and concepts but overall, it is clear and logical
Pieces of relationships or concepts have been integrated into the whole
The underlying conceptual network can easily be identified
Connections and reasoning within the theory are apparent
Structural consistency
The theory uses a hierarchical format to organize the concepts and labels them as major concepts, and subconcepts
The theory is clearly demonstrated by different categories such as the four adaptive modes and the adaptive processes

#3: How general is this theory?

Breadth of scope and purpose
It is relatively broad and general, the theory interrelates the individual and the physical environment
The purpose of the theory is to use the six step nursing process to assess the patients and come up with interventions that will help the patients achieve their goals by minimizing their stressors
To whom?
This concept can be applied to all individuals, families and communities
The concepts are broad so they can be applied to any health behaviours (instead of being limited to a specific human experience such as pain)
This theory is best applied to the present and future because it focuses on adaptive responses that occurs in an individual's daily life
Specific specialties of nursing?
No, the purpose does not specifically apply to specialties or groups of nursing
# 5 How important is this theory?
Born in 1939 in Los Angeles, California
In 1963, received her baccalaureate degree in nursing from Mount Saint Mary's College
Earned her Master's degree in nursing in 1966 from University of California-Los Angeles
Also has a Master's and PhD in Sociology
The Roy Adaptation Model
She was a graduate student when she developed the basic concepts of the model because Dorothy Johnson had challenged her to develop a conceptual model for nursing during a seminar
The model was then published in 1970
The Roy Adaptation Model is now one of the most widely used frameworks in nursing practice
Six Step Nursing Process
Step 1: Assessment of Behaviour
Six Step Nursing Process
Step 2: Assessment of Stimuli
Six Step Nursing Process
Step 3: Nursing Diagnosis
Six Step Nursing Process
Step 4: Goal Setting
Six Step Nursing Process
Step 5: Intervention
Six Step Nursing Process
Step 6: Evaluation
Main Concepts
The individual strives to maintain a balance between these systems and the outside world, but there is no absolute level of balance.
According to Roy, adaptation refers to “the process and outcome whereby thinking and feeling persons as individuals or in groups, used conscious awareness and choice to create human and environmental integration”.
Looked at an individual as a holistic adaptive system which is constantly interacting with the internal and external environmental stimuli and the coping processes.
This model comprises the four domain concepts
It also involves a six-step nursing process
Self Concept Mode
Perceptions of one's physical and self

Solidarity, companionship, understanding continuity, value, integrity provided to the family members as one unit aka growth
One's identity changes as one progresses in life

How the family communicates, includes decision making, communication pattern, how role changes are tolerated, and the effectiveness of the communication aka continuity
Main Concepts
Goal of nursing
- 4 adaptive modes
#1: How clear is this theory
to nurses using the material?
#2: How simple is this theory?
There are four adaptive modes in this theory that are relatively simple and nicely laid out
There are also five major concepts and subconcepts
Overall, it would be a complex theory, but the linear relationship between the items of each category simplifies the relationships
#4: How accessible is this theory?
Chinn, P. L., & Kramer, M. K. (2011). Integrated theory and knowledge development in nursing (8th ed.). St.
Louis, MO: Elsevier Mosby

Connell School of Nursing. (2013). The Roy adaption model. Retrieved from http://www.bc.edu/schools/

Nursing Theory. (2013). Roy adaption model. Retrieved from http://www.nursing-theory.org/theories-and-

Shosha, G.A., & Kaladeh, M. A. (2012) A critical analysis of using Roy's adaptation model in nursing research.
International Journal of Academic Research 4(4), 26-31. Retrieved from http://www.academia.edu/1775
# 6:Three Questions to Facilitate Discussion
Theorist Critique by:
Nancy Chan, Katarina Ivancic, Vicky Tieu, Anita Wong and Ada Yu

N3225-Professional Growth-Nursing Inquiry
Instructor: Roberta Jokanovich
November 14, 2013

Thank you

Sister Callista Roy
Are the concepts concrete or abstract ?
Indicators used in practice
- This theory is frequently used in practice to facilitate Research, teaching, and nursing practice
- The six step nursing process is like solving a problem by finding the needs of the individuals from the adaptive modes and creating nursing interventions to meet the patient’s needs. This six step nursing process aims to improve application of nursing care from addressing stimulus and behaviour to nursing diagnosis, creating goals and evaluating the process to see the effectiveness of the interventions
- The adaptive modes are use to care for an individual as whole starting with meeting their basic needs (Physiologic-physical), seeing the individual as a person with goals and values (Self-concept identity), understanding the different roles they play (Role function), and treating the patient with integrity and respect (interdependence)
Are the concepts clinically relevant
- The components of this model includes: person, health, environment, nursing, and adaptation
- This is relevant in providing nursing care in a holistic manner by looking at the individual’s bio-psycho-social- spiritual being.
- The four adaptive modes and the 6 step process help guide nurses on how to help patients adapt to any situation
- Everyone deals with stressors differently, therefore by using the concepts we can make sure to meet their needs and have optimal adaption occur

Few subconcepts were mentioned earlier such as the different stimuli (focal, contextual, and residual). Six step nursing process can be seen as a subconcept to the four adaptive modes.
There is another subconcept to the adaptive system: the regulator and the cognator. Classified as coping processes, in the regulator subsystem people respond automatically to the environmental stimuli through innate, physiological adaptive processes while in the cognator subsystem, people process changes in the environment through cognitive and emotional channels involving personal perception, learning, judgement and emotion.
Clinical significance
- This theory is important in a way that contributes to the growth and development of current nursing practice.
- This theory is valuable to nurses because through evaluation nurses are able to find areas of improvement and success
- This has clinical significance for us because we are constantly learning about new ways of proceeding with nursing care, and it helps build and shape the way we care for patients.
- Every patient who we care for is different and adapt differently therefore it is important to meet all the adaptive modes to facilitate a clear transition.
- EBP practice is the base of what is best but as nurses we alter them to better accommodate the patient health and healing process.
Example: You noticed that the patient had been lying in bed for a while and had red elbows, and you assess them and they were non-blanching. From this assessment data you help the patient by providing pillows and getting the patient to mobilize more often to help prevent further pressure on that area. To evaluate the success of this intervention the patient’s elbows should be clear of redness and if they continue to be red or non-blanching to find interventions that best suit this patient.
Basic assumptions
1) A person can be categorized into the different modes (just the 4) for study and care
2) Nursing is strictly based on causality
3) In order to respond positively to environmental changes, a person must adapt.
4) Nursing is humanistic and values others opinions and perspectives (especially that of the patient).
Understand/like? Why would you adopt it?
The model strives to increase the quality of care and life of people but at times it can be too much all at once.
This model works great as a basis but due to the complexity and length of it, it might not work in more specific or intense situations.
Focusing on one aspect of the model each time is probably more ideal.

-involves gathering data about the behavior of the person
A problem solving approach for gathering data, identifying the capacities, and needs of the human adaptive system, selecting and implementing approaches for nursing care, and evaluation of the outcome of care provided.
-involves the identification of internal and external stimuli that are influencing the person's adaptive behaviors
-Focal Stimuli- those most immediately confronting the person
-Contextual- all other stimuli present that are affecting the situation
-Residual- stimuli whose effect on the situation are unclear
-involves the formation of statements that interpret data about the adaptation status of the person, including the behavior and the most relevant stimuli
-involves the establishment of clear statement of the behavioral outcomes for nursing care
-involves the determination of how best to assist the person in attaining the established goals
-judging the effectiveness of the nursing intervention in relation to the behavior and in comparison with the goal established
Concepts are largely concrete
- the theory came about through Sister Callista's Roy influence and experience with family, education, religion, mentors and clinical experience making it evidence-based and based off of data
-the concepts are measurable and goal-oriented

There is an abstract portion
-theory is individualized where nursing interventions are thoughts and what the thoughts on what needs to be changed can be more mentally constructed
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