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Sister Callista Roy
o BORN IN LOS ANGELES IN 1939
o MOTHER WAS A NURSE
o WORKING AT AGE 14
o SISTERS OF SAINT JOSEPH OF CARONDELET
Roy’s Education History
o BACHELOR’S DEGREE
o MASTER’S DEGREE
o PhD
Roy’s Career History
o Idaho and Arizona hospitals
o Mount St. Mary’s College
o Clinical researcher
o Boston College
o Author
o Sisters of St. Joseph
In the Beginning
o DOROTHY JOHNSON
o MOUNT ST. MARY’S COLLEGE
o ADAPTATION MODEL
o MODES OF ADAPTATION
o STIMULI
Roy’s Adaptation Model
oThis model asserts that human beings and groups are holistic, adaptive systems that are continually changing in sync with a continually changing environment (Fawcett, 2005). oCoping processes are necessary for adaptation. Two subsystems of coping are the regulator and cognator subsystems (Fawcett, 2005).
oThe regulator and cognator subsystems work together to respond to changing internal and external stimuli to maintain the integrity of the individual (Cunningham, 2002).
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Roy’s Adaptation Model o There are three types of stimuli that provoke a response: focal, contextual,
and residual stimuli (Fawcett, 2005). o The classification of a particular stimulus may change as rapidly as the
situation changes (Fawcett, 2005).
o When individuals are confronted with stimuli, their coping processes, by way of the regulator and cognator subsystems, are activated and manifested within one or more of Roy’s four adaptive modes (Cunningham, 2002).
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Roy’s Four Adaptive Modes
o Physiological/Physical Mode o Self-Concept/Group Identity Mode
o Role Function Mode
o Interdependent Mode
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Roy’s Adaptation Model
“Adaptation is a process of promoting integrity.”
An individual’s behavioral response to stimuli in the
environment can either be adaptive or ineffective.
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Adaptation Model Continued
o Health defined o Nursing goal: health promotion o Desired result: adaptive response o The nursing processes and adaptation o Incorporation of the nursing process in the
Model
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Philosophical Underpinnings
o SCIENCE: One of the inspirations for Roy’s Adaptation Model came from the work on adaptation by Harry Helson. o Multiple scientific assumptions are delineated within Roy’s Adaptation
Model.
o PHILOSPHY: Roy’s Adaptation Model is based upon multiple
philosophical claims and assumptions. o Philosophy o Religion
Philosophical Underpinnings
o Roy’s Adaptation Model involves many concepts derived from the reciprocal interaction world view.
o Adaptation is continuous
Philosophical Underpinnings
o Adaptation is vital.
o Nurses must support patients in the adaptive
process.
NURSING’S DESTINY
“This is a critical time for the world. We [all nurses] are responsible for
creating a better world.”
Sister Callista Roy - September 23, 2009
Focus on the Client
“No age of situation is particularly outside the scope of the model” (Fawcett p.415)
“Client” is described by Roy as the recipient of nursing care as a “holistic adaptive system.”
Theory Population
The Roy Adaptation model can be used when caring for:
Individuals Families
Groups Communities
Society
Theory in Use
Roy Adaptive Model useful in: Nursing Practice Nursing Administration Nursing Education Nursing Research Experimental Studies Descriptive Studies Correlation Studies
CASE STUDY; o A.P. a 52 year old menopausal female comes to the office today with c/o increase
weight gain over the last 8 months. States “size of tummy” bothers her, she has
always been thin until last year or so.
o Changes in sleep pattern noticed over that time. Awakening with night sweats,
need to void, and hot flashes.
o Pt states attempting to eat healthy foods and watch intake. However family’s
food likes make it challenging to find foods that meet both healthy and likability
aspect of meal preparation.
o Walks 3 times a week for 20-30 minutes however commitments with family and
work make this inconsistent. Other physical findings are negative.
Why the Roy Model?
Provides a holistic perspective Processes to two sub-systems
o Regulator o Cognator
Reviews and assesses the patient’s ability to adapt to
an ever changing environment.
Cunningham (2002)
MODEL
Araich, M. (2001)
Two level assessment
Assessment of stimuli
Focal Residual
Contextual
Planning
Nursing Intervention
Evaluation
Nursing diagnosis
Goal setting
Assessment of Behaviors Physiological
Self-concept Role function
Interdependence
First level assessment
Data Collection Physiologic Data:
weight gain hot flashes night sweats stress incontinence time constraints on exercise limited healthy food choices.
Self-concept: Client states during visit “I do not like my stomach now.”
Role function: Woman Mother Employee
Interdependence Family obligations and tasks limit level of activity. Food preferences dictated by the family as a whole.
Second level assessment
Assessment of stimuli that influence behavior.
Focal: Hormonal changes related to menopause. Contextual: Age Lack of understand physical changes secondary to
menopause. Lack of family understanding of psychologic & physiologic changes. Stressors related to changes that occur with the aging process. Multiple roles within the family. Residual: No current religious affiliation. Limited number of close personal friends. Cunningham (2002)
Diagnosis, Plan, & Interventions Diagnosis: Disturbance in body image R/t menopausal
changes Goal: client will verbalize positive aspect of her
body image with in 3 months. Evaluation; at one week and continually through out process.
Interventions;
Identify specific areas of body image client struggles with.
Journal food and activity for one week. Provide nutritionist or weight
management program to assist client with food intake & weight.
Assist client in examining all hindrance
to walking and look for areas that would enable client to walk.
Have client identify aspects of body
image that are positive.
FINAL THOUGHTS
“My theory will never be completed, never finished. Knowledge needs to keep
developing.”
- Sister Callista Roy, September 23, 2009
References
Araich, M. (2001). Roy’ adaptation model; demonstration of theory integration into process of care in coronary care unit. ICU Nursing
Web Journal , 7(July-October) retrieved September 15, 2009 from http://www.nursing.gr/protectedarticles/Roy.pdf
Coyne, I. (1994). The Roy Adaptation Model in Action. Journal of Advanced Nursing, 20(6), 1177-1177. Retrieved September 18, 2009,
doi:10.1046/j.1365-2648.1994.20061176-4.x
Cunningham, D. (2002). Application of Roy's Adaptation Model When Caring for a Group of Women Coping With Menopause. Journal of
Community Health Nursing, 19(1), 49-60. Retrieved September 16, 2009, doi:10.1207/153276502753635127
DeSanto-Madeya S., (2007) Using case studies based on nursing conceptual model to teach medical-surgical nursing. Nursing Science
Quarterly, 20(4), 324-329 (2007) retrieved September 20, 2009 doi: 10.1177/0894318407307159
Fawcett, J. (2005). Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing Models and Theories (2nd ed.). Philadelphia: F.
A. Davis Company.
References continued
Fawcett, J., & Tulman, L. (1990). Building a program of research from the Roy Adaptation Model of Nursing. Journal of Advanced
Nursing, 15(6), 720-725. Retrieved September 12, 2009, doi:10.1111/1365-2648.ep8531627
Perrett, S.E. (2007, October). Review of Roy Adaptation Model-Based Qualitative Research. Nursing Science Quarterly, 20(4), 349-356,
from CINAHL with Full Text database.
Roy, C., Whetsell, M., & Frederickson, K. (2009, July). The Roy adaptation model and research. Nursing Science Quarterly, 22(3), 209-
211. Retrieved September 27, 2009, from CINAHL with Full Text database.
Tomey, A.M., & Alligood, M.R. (1998). Nursing Theorists And Their Work. St. Louis: Mosby-Year book, Inc.
Sitzman, K., and Eichelberger, L., (2004). Understanding the work of nurse theorists: a creative beginning. Sudbury, MA; Jones and
Bartlett Publishers