Nursing Theorist: Roy Adaptation Model Jeanette Ratliff, RN Chamberlain College of Nursing Course Number: Summer 2011 Nursing Theorist: Roy Adaptation Model Sister Callista Roy was not only a pioneer in the field of nursing, but also a leader. Her dedication to the health community is inarguable. As serving numerous roles as leader, her thoughts and visions touched many. One example of her mark in nursing is the Roy Adaptation Model. It is in this model that health is defined as a state of adaptation that occurs as a result of successfully adapting to stressors.
It is a positive response to an environmental change as well as coping successfully with stressors and environmental changes. Roy defines the environment in terms of individual’s external surroundings and influences that affect a person’s development. Adaptation can be applied to terms of health or illness. Because both health and illness are not concrete terms, a continuum of the two serve as an example of Roy’s model and it’s adaptability to abstract terms. Her model serves as a picture of reality.
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Perhaps it is less important that our society sees change and self-concept as critical, and thus create a reality that makes the Roy Adaptation Model an effective conceptual model for nurses (Andrews and Roy, 1991). Major Concepts of the Theory Within the Roy Adaptation Model (RAM), there are four major concepts. The first concept places emphasis on humans as an adaptive system. Roy focuses on man as being an adaptive system which can function as an individual or within a group setting. By using a holistic approach to conceptualize the human system, George (2002) reiterates how Roy places emphasis on holism, and its overall core to her model.
Roy describes man as a feedback system that has inputs and outputs, as well as controls and feedback. It is in this component of the model that Roy defines the four modes of the human adaptive response as physiological, self-concept, role function, and interdependence mode. The second major concept of the Ram is the environment. Roy’s model focuses on the effects that the environment has on human adaptation. According to Roy, stimuli from both within and around the system are represented by the environment. The third concept of RAM is health.
George, (2002) notes that health according to Roy’s model is measured by man’s adaptability to change. Health is not simply the absence of disease, but a perspective by which one is experiencing, such as an emotional or physical state. The fourth and final concept of RAM is the goal of nursing. “Roy defines the goal of nursing as the promotion of adaptive responses in relation to the four adaptive modes: physiological-physical, self-concept-group identity, role function, and interdependency” (George, 2002, p308). Adaptive responses support the human adaptive system through actions which affect health in a positive manner.
Goals of nursing are to aid in reducing ineffective responses by supporting adaptive responses. The use of Roy’s model by nurses is to serve as a guide to help man and insure positive adaptation (George, 2002). Interrelationships of Concepts According to Andrews & Roy (1991), the RAM was inspired by pediatrics and bases on theorists Helson and Von Bertalanffy’s views. Helson stated adaptation as a process of responding positively to environmental changes and described three types of stimuli: focal, contextual, and residual.
The adaptation model is made up of four main concepts; person, health, environment, and nursing which involves a six step nursing process to carry out (Andrew & Roy, 1991). Roy believes that stressors are considered stimuli. These stimuli can be divided into classes which include focal, contextual, and residual. Focal stimuli are the stimulus which directly confronts a person. Contextual stimuli are noted as all other stimuli present with either a positive or negative impact on the situation. Residual stimuli are known as the external or internal factors with current effects that are unclear (George, 2002).
Roy believes that a combined effect of stimuli will determine a person’s adaptation level. There is a zone which shows the correlation between adaptive response and the range of stimulation. When stimuli fall outside the zone, Roy points out that the individual is without effective coping skills. Therefore the individual is unable to respond positively. Coping mechanisms consist of regulator and cognator subsystems. The regulator subsystem is made up of automatic neural endocrine and chemical activity. The cognator subsystem consists of cognitive and emotive pathways.
These pathways involve information processing, learning, judgment, and emotions (George, 2002). In the final component of her model Roy address the goal of nursing is to promote adaptation in each of the four modes. By doing so, promotes a person’s health, quality of life, and dying and dignity. The four models according to Andrews and Roy, (1991) are physiological, self-concept, role function and interdependence. Roy’s model includes six steps in order to carry out the nursing process. These steps are assessment of behavior, assessment of stimuli, nursing diagnosis, goal setting, interventions, and evaluation.
To assess behavior, it is stressed that behavior is observed and compared to norms and considered either adaptive or ineffective. The assessment of stimuli involves classifying the stimuli into one of the three stimuli categories, focal, contextual, and residual, and assessing how the affects behavior. Nursing diagnosis note ineffective behaviors and identify the probable causes. Goal setting is focused on setting realistic and attainable goals and involves the person to follow through with the goal. In the intervention step, the stimuli are manipulated.
In the evaluation step, the changes are evaluated by observing the change in behavior. If it is found that the behavior is ineffective, then the interventions are revised (Andrews & Roy, 1991). Logic of the Theory Roy’s greatest emphases in her model, as mentioned earlier, are the adaptation properties of man, hence the title Roy Adaptation Model. The ability to adapt to external and internal stimuli is crucial to the survival of man. Developing on the adaptability of the individual, nursing practice should be directed to promote this process (Ramini, Brown, & Buckner, 2008).
Messner and Neff Smith, (1986) point out that Roy’s model provides guidelines for utilizing the nursing process to meet the needs of our patients. Messner also points out that as a multitude of stressors both physical and psychosocial begin to develop in the presence of suboptimal adaptation, and that these stressors precipitate the need for additional adaptation. It is within this model that Roy identifies that stimuli elicit a coping mechanism or adaptive response. This response is addressed as either effective or ineffective, using feedback to verify the results of the response (Andrews & Roy, 1991).
By carefully looking toward the individual, nurses can begin planning effective interventions to promote development as well as advocate the needs of that individual (Magee & Roy, 2008). As we begin to look toward others works, we can see how Roy’s model is embraced by others to validate their findings. Her concept of adaptation has been tested a number of times, proving to the nursing community reliability in her work. Looking back upon my career, working for a hospice agency in Clarksdale, MS. a particular patient was diagnosed with a terminal illness.
The patient was diagnosed with lung cancer which had metastasized throughout his body. Specialists had come and gone in recent days giving little hope for a distant future. The patient although quite ill remained optimistic. At this point in my career, I thought the patient was not realistic about his given situation. Family continued making their appearance throughout the days to come bringing food and supplies to help the day pass. Working in hospice, I found that rules and regulations were adapted to meet the individuals’ needs and to facilitate a positive outcome. One such request was to bring the family dog in for a visit.
To no surprise, the dog was well received by all including patients and staff. Time progressed and the patients’ condition remained constant. Family continued their trips and what was to be only a four to six week ordeal continued on for two months. The patent, gaining comfort with his condition went home on hospice with little change in his status. Throughout this time his attitude toward his diagnosis never faltered between both himself and his family. His ability to adapt to the given situation through the promotion of positive compliance is an excellent example of RAM.
The communication between the patient, family and staff to provide positive patient adaptation, without a doubt had an effect on the patients’ disease process. Conclusion In conclusion, because both health and illness are concrete terms, a continuum of the two serves as an example of Roy’s model and it adaptability to abstract terms. The four major concepts within the Roy Adaptation Model are adaptive system, environment, health and the goal of nursing. Roy believed that stressors are considered stimuli which can be divided into classes. Roy’s model included six steps to carry out the nursing process.
These steps are assessment of behavior, assessment of stimuli, nursing diagnosis, goal setting, interventions and evaluation. Roy’s greatest emphases in her model, as mentioned earlier, are the adaptation properties of man. References Andrews, H. & Roy, C. (1991). The adaptation model. Norwalk, CT: Appleton & Lange. Boston-Based Adaptation Research in Nursing Society. (1999). Roy adaptation model based research: 25 years of contributions to nursing science. Indianapolis, IN: Sigma Theta Tau International.. George, J. B. (2002). Nursing theories: The base for professional nursing practice (5th ed. . Upper Saddle River, NJ: Prentice Hall. Jackson, D. A. (1990). Roy in the post anesthesia care unit. Journal of Post Anesthesia Nursing, 5(3), 143-148. Magee, T. & Roy, C. (2008). Predicting school-age behavior problems: The role early childhood risk factors. Pediatric Nursing, 34(I) 37-43. Messner, R. & Neff Smith, M. (1986) Neurofibromatosis, relinquishing the masks; a quest for quality of life. Journal of Advanced Nursing, (11) 459-464. Ramini, S. K. , Brown, R. , & Buckner, E. B. (2008). Embracing changes: Adaptation by adolescents with cancer.
Pediatric Nursing, 34(1) 72-79. Score Sheet for Draft Paper |Category |Possible Points|Points Earned |Comments | |Content: Use these as Headings | |Introduction |7 | |7 | |SinSingle paragraph clearly defines the key components (with | | | | | | |citations) and explains ontent to be covered | |Review of the Professional Nursing |30 |30 |33 | |Thorough literature review with key concepts of articles explained. |Literature | | | | |Minimum 3 professional sources reviewed | |Application of Clinical Example |20 | |20 | |Provided appropriate clinical example & thoroughly elaborated on | | | | | | |application (with appropriate citations) as directed in the topic | | | | | | |prompt. | |Conclusion |8 | |8 | |Briefly summarized and drew appropriate conclusions.
No new | | | | | | |information was added. | |APA Format | | | | |Title Page |2 |2 |Correctly formatted Running head, page numbers, and short title in header. | | | | |Follows APA format for title, name, and affiliation. |Margins, font, spacing, headings |3 |3 |Correctly formatted margins, font, spacing, and headings. | |Citations |10 |10 |Content cited in the text appropriately with minimum to no errors. At | | | | |least one quote, but not more than 3 direct quotes. | |References |10 |10 |References begin on new page & are double spaced with hanging indent.
Each| | | | |reference is properly formatted based on type of resource. All in text | | | | |citations have references & vice versa. | |Professional Writing | | | | |Organization, clarity, structure, |5 |5 | |Organized logically, written clearly with good structure nd with | |paragraphing | | | |appropriate paragraphs. Evidence of original thought & analysis of | | | | | |topic. | |Spelling, apostrophe use, grammar, |5 |3 | |Written with combination of first and third person. Mostly used | |professional wording, and person | | | |professional language and tone. | |Total |100 |97 | |