ROY'S ADAPTATION THEORY

ROY'S ADAPTATION THEORY

BIOGRAPHY

• Sr. Callista Roy, a prominent nurse theorist, writer, lecturer, researcher and teacher


• Born at Los Angeles on October 14, 1939


• At age 14 she began working at a large general hospital, first as a pantry girl, then as a maid, and finally as a nurse's aid.


• She entered the Sisters of Saint Joseph of Carondelet


• She earned a Bachelor of Arts in Nursing from Mount St. Mary's College, Los Angeles in 1963.


• 1964-While doing  her master's degree, Roy was challenged in a seminar by nursing faculty member Dorothy E. Johnson to develop a conceptual model for nursing.


• 1964-66  conceptualization of  adaptation model based on Harry Helson's  [physiologic psychologist] Adaptation Theory


• a master's degree program in paediatric nursing at the University of California ,LosAngeles in 1966.


• 1968 model put into  practice


• 1970-The model was implemented in Mount St. Mary’s school


• 1971- she was made chair of the nursing department at the college.


• She also earned a MA in Sociology in 1973 and  Ph.D in sociology in 1977,  from the university of California.


• 1978 award, fellow of American Academy of Nursing


• 1981 :National Founder's Award for Excellence in Fostering Professional Nursing Standards


• 1984 Honorary Doctorate of Humane Letters by Alverno College,


• 1985 Honorary Doctorate from Eastern Michigan University,


• 1986 AJN Book of the Year Award for Essentials


• 1991 Award National League For nursing


• Roy has published many books, chapters, and periodical articles and has presented numerous lectures and workshops focussing on her nursing adaptation theory

ADAPTATION THEORY

Roy's Adaptation theory views the client as a biophysical-adaptive system that employs a feedback cycle of input[stimuli], throughput[control process] and output  behaviour or adaptive responses. Both the individual and the environment are sources of stimuli that require modification to promote adaptation, an ongoing purposive response. adaptation responses contribute to health, which she define as the process of being and becoming integrated; ineffective or maladaptive responses do not contribute to health. Each person’s adaptation level is unique and constantly changing.

Individual respond to needs[stimuli] in one of the four modes:

• The physiologic mode: involves the bodies basic physiologic needs and ways of adapting with regard to fluid and electrolyte, activity and rest, circulation and oxygen, nutrition and elimination, protection, the senses and neurological and endocrine function.


• The self-concept mode: includes two components: the physical self, which involves sensation and body image and the personal self, which involves self-ideal, self-consistency, self-consistency and the moral ethical self


• The role function mode: is determined by the need for social integrity and refers to the performance of duties based on given positions within the society.


• The interdependence mode: involves one’s relations with significant others and support systems that provide help, affection and attention.

CONCEPTS

The purpose of the theory is to identify the types of demands placed on a client & the client's adaptation to the demands.

• Adaptation -- goal of nursing


• Person -- adaptive system


• Environment -- stimuli


• Health -- outcome of adaptation


• Nursing -- promoting adaptation and health

Concepts-Adaptation

• 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

Concepts-Person

• Bio-psycho-social being in constant interaction with a changing environment


• Uses innate and acquired mechanisms to adapt


• An adaptive system described as a whole comprised of parts


• Functions as a unity for some purpose


• Includes people as individuals or in groups-families, organizations, communities, and society as a whole

Concepts-Environment

• Focal - internal or external stimuli that immediately confronting the person


• Contextual- all stimuli present in the situation that contribute to effect of focal stimulus


• Residual-a factor whose effects in the current situation are unclear


• All conditions, circumstances, and influences surrounding and affecting the development and behaviour of persons and groups with particular consideration of mutuality of person and earth resources, including focal, contextual and residual stimuli

Concepts-Health

• Health is the process of being and becoming an integrated and whole person (Andrews & Roy)

• Inevitable dimension of person's life


• Represented by a health-illness continuum

Concepts-Nursing

• 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 behaviour and factors that influence adaptive abilities and by intervening to enhance environmental interactions

Concepts-Subsystems

• Cogitator subsystem — A major coping process involving 4 cognitive-emotive channels: perceptual and information processing, learning, judgement and emotion.


• Regulator subsystem — a basic type of adaptive process that responds automatically through neural, chemical, and endocrine coping channels

 

USE IN NURSING

 

1. NURSING PRACTICE

RAM offers guidelines to nurse in developing the nursing process. 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 the outcome of care provided

The elements :

First level assessment ,Second level assessment , Diagnosis, Goal setting, Intervention , evaluation

Assessment of Behaviour: the first step of the nursing process which involves gathering data about the behaviour of the person as an adaptive system in each of the adaptive modes.

Assessment of Stimuli: the second step of the nursing process which involves the identification of internal and external stimuli that are influencing the person’s adaptive behaviours.

Stimuli are classified as:

1) Focal- those most immediately confronting the person;

2) Contextual-all other stimuli present that are affecting the situation and

3) Residual- those stimuli whose effect on the situation are unclear.

Nursing Diagnosis: step three of the nursing process which involves the formulation of statements that interpret data about the adaptation status of the person, including the behavior and most relevant stimuli

Goal Setting: the forth step of the nursing process which involves the establishment of clear statements of the behavioral outcomes for nursing care.

Intervention: the fifth step of the nursing process which involves the determination of how best to assist the person in attaining the established goals

Evaluation: the sixth and final step of the nursing process which involves judging the effectiveness of the nursing intervention in relation to the behavior after the nursing intervention in comparison with the goal established.

By manipulating the stimuli and not the patient, the nurse enhances the interaction of the person with their environment, thereby promoting health.

 

1. EDUCATION

The adaptation model is also useful in educational setting. Roy states that the model defines for students the distinct purpose of nursing which is to promote man’s adaptation in each of the adaptive modes in situations of health and illness. It helps to organize nursing education and Curricular frame work for various nursing colleges

• RESEARCH

If research is to affect practitioners’ behaviour, it must be directed at testing and retesting conceptual models for nursing practice. Roy has stated that theory development and the testing of developed theories are nursing’s highest priorities. The model must be able to regenerate testable hypotheses for it to be researchable.