Post on 09-Dec-2021
ADAPTATION MODEL
SR. CALLISTA ROY
CALLISTA ROY
Born on October 14, 1939 in Los Angeles
California
BSN in 1963 Mount St. Mary College, Los
Angeles
MA in Pediatric Nursing 1966/Doctorate in
Sociology in 1977 University of California,
L.A.
With honorary doctorate from 4 other
institutions
She is a nurse theorist and a professor
She is a fellow in the American Academy of
Nursing, an honorary nursing society that
elects nursing leaders annually
Has numerous publications, including books
& journal articles on nursing theory & other
professional topics
CALLISTA ROY
Her publications:
Introduction to Nursing: An Adaptation Model
Essentials of the Roy Adaptation Model
Theory Construction in Nursing: An Adaptation
Model
Essentials of the Roy Adaptation Model
Roy Adaptation Model: The Definitive
Statement
Her works has been interpreted in several
languages worldwide
METAPARADIGM
PERSON
Is the recipient of nursing care; main focus of nursing
A biopsychosocial being in constant interaction with a
changing environment.
The person is an open adaptive system who uses coping
skills to deal with stressors.
It includes people as individuals or in groups (families,
organizations, communities, nations & society as a whole)
An adaptive system has cognator and regulator subsystems
to maintain the 4 adaptive modes- physiologic-physical,
self-concept-group identity,role function,and
interdependence.
METAPARADIGM
ENVIRONMENT
Conditions, circumstances and influences that
surround and affect the development and
behavior of the person.
Consists of internal & external environments,
which provide input in the form of stimuli
Stressors are stimuli that are significant in
human adaptation: stages of development,
family & culture
METAPARADIGM
HEALTH
Was originally described by Roy as a health-illness continuum;
health & illness were considered an inevitable dimension of the
person’s life
More recently, Health is the process of being and becoming an
integrated and whole person.
Is it a reflection of adaptation that is the interaction of the person
& the environment
Adaptation is defined as the process and outcome whereby
thinking and feeling, as individuals and groups, use conscious
awareness and choice to create human and environmental
integration.
METAPARADIGM
NURSING
Nursing is the science and practice that expands
adaptive abilities and enhances person and
environment transformation.
Roy’s goal of nursing is the promotion of adaptation
in each of the 4 modes thus contributing to health,
quality of life and dying with dignity
Nursing is about the increase, enhancement,
modification and alteration of the stimulus to achieve
adaptation.
The Roy Adaptation Model (RAM)
THE KEY CONCEPTS:
The person is adapting in a stable interaction with the environment, either internal or external.
The environment serves as the source of a range of stimuli that will either threaten or promote the person’s unique wholeness.
The person’s major task is to maintain integrity in face of these stimuli.
INTEGRITY- the degree of wholeness achieved by adapting to changes in needs.
SYSTEM – is a set of parts connected to function as a whole for
some purpose & that does so by virtue of the interdependence
of its parts
- Roy considers the recipient of care to be an open adaptive
system
- react & interact with other systems in the environment
- have boundaries that are flexible & open to permit
interaction with other systems
- employ a feedback cycle of input, throughput & output
Input – defined as stimuli which can come from the
environment or from within a person
Throughput – makes use of a person’s processes &
effectors
Processes refer to the control mechanisms that a
person uses as an adaptive system
Effectors refer to the physiologic function, self-
concept & role function involves in adaptation
Output – is the outcome of the system, when the
system is a person, the output refers to the person’s
behaviors
Categories of Output:
Adaptive responses – those that promote integrity in
terms of the goals of the human system
Ineffective responses – those that do not contribute to
integrity in terms of the goals of the human system
TYPES OF STIMULI (Helson, 1964)
FOCAL – the internal or external stimulus most
immediately confronting the person, it attracts
the most attention.
CONTEXTUAL – all other stimuli present in the
situation that strengthens/contribute the effect of
the focal stimulus.
RESIDUAL - those stimuli that can affect the
focal stimulus but the effects are unclear.
The three types of stimuli act together and
influence the adaptation level which is
defined as the ability to respond positively in
a situation.
COPING MECHANISM
AND CONTROL PROCESSESS
COPING MECHANISM – are the processes that a
person uses for self-control
- are innate or acquired ways of interacting with
the changing environment
- innate coping mechanisms are genetically
determined or common to the species & are
genetically viewed as automatic process
- acquired coping mechanisms are developed
through strategies such as learning
CATEGORIES OF COPING MECHANISM
REGULATOR SUBSYSTEM - major coping process
involving the neural, chemical, and endocrine system
e.g. increase in vital signs- sympathetic response to
stress.
COGNATOR SUBSYSTEM – is a major coping process
involving four cognitive-emotive channels: perceptual
& information processing; learning; judgment &
emotion
e.g. effects of prolonged hospitalization for a 4year-
old child
CATEGORIES OF COPING
MECHANISM
CONTROL PROCESSES – stabilizer subsystem &
innovator subsystem
Stabilizer subsystem – analogous to regulator :
concerned with stability
Innovator subsystem – analogous to cognator::
concerned with creativity, change & growth
ADAPTATION LEVEL
1.Integrated - Adaptation level at which the
structures and functions of a life process
are working as a whole to meet human
needs.
Example:
Stable processes of ventilation, the
complex process of breathing that
exchanges air between lungs and
atmosphere.
ADAPTATION LEVEL
2. Compensatory - Adaptation level at
which the cognator and regulator have
been activated by a challenge to the
integrated life processes
EXAMPLE:
GRIEVING, ROLE TRANSITION,
ADAPTATION LEVEL
3. Compromised- Adaptation level
resulting from inadequate integrated
and compensatory life processes;
adaptation problem.
EXAMPLES:
• Hypoxia
• Ventilatory Impairment
• Unresolved loss
• Abusive Relationships
ADAPTIVE MODES – are categories of behavior to
adapt to stimuli
- can be used to determine a person’s adaptation
level
- can be used to identify adaptive or ineffective
responses by observing a person’s behavior in
relation to the adaptive modes
4 ADAPTIVE MODES
1. PHYSIOLOGICAL – the way a person responds as
a physical being to a stimuli from the environment.
GOAL: Physiological Integrity
Five Physiologic Needs: oxygenation, nutrition, activity
& rest , elimination & protection
Four Complex Processes: senses; fluids, electrolytes &
acid-base balance; neurologic function; endocrine
function
2. SELF-CONCEPT – GROUP IDENTITY MODE - focuses
specifically on the psychological & spiritual aspects of the
human system
Self- concept – defined as the composite of beliefs & feelings
about oneself at a given time & is formed from internal
perceptions of other’s reaction
Two components: 1. physical self (body sensation and body
image) 2. personal self (self consistency, self ideal, and
moral ethical spiritual self)
Group Identity – reflects how people in groups
perceive themselves based on environmental
feedback
- comprised of interpersonal relationships, group
self-image & culture
GOAL: Psychological Integrity
3. ROLE FUNCTION MODE – a role is a set of
expectations about how a person occupying one’s
position behaves towards a person occupying another
position.
GOAL: Social Integrity
- Roles are carried out with both instrumental behaviors
(the actual physical performance of a behavior) and
expressive behaviors ( are the feelings, attitudes, likes
or dislikes that a person has about a role or about the
performance of a role)
Persons perform primary, secondary & tertiary roles
Primary – determines the majority of behavior engaged in by
the person during a particular period of life ( age, sec,
developmental stage)
Secondary – are those that a person assumes to complete the
task associated with a developmental stage & primary role
(husband, wife)
Tertiary – related primarily to secondary roles & represent
ways in which individuals meet their role associated obligations
- temporary in nature, freely chosen by the individual
4. INTERDEPENDENCE MODE– focuses on close
relationships which results to giving & receiving of
love, respect, value, nurturing, knowledge, skills,
commitments, material possessions, time & talents
- Occurs between the person and the most
significant other or between the person and the
support system.
GOAL: Affectional Adequacy.
GOAL OF NURSING IN RAM
PROMOTE ADAPTATION IN
EACH OF THE FOUR ADAPTIVE
MODES
POINTS TO REMEMBER
Adaptive or ineffective responses result from the 4
modes of coping mechanisms.
Adaptive responses support the integrity of the
person and the goals of adaptation.
Ineffective responses neither promote integrity nor
contribute to the goals of adaptation.
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 of the
outcome of care provided.
6 STEPS in the NURSING PROCESS
1. ASSESSMENT OF BEHAVIOR
Data gathering about the behavior of the person
as an adaptive system in each of the adaptive
modes.
Observable behavior: vital signs
Non-observable behavior: feelings experienced by
the person (anxiety)
6 STEPS in the NURSING PROCESS
2. ASSESSMENT OF STIMULI
A STIMULUS is defined as any change in the
internal and external environment that induces a
response in the adaptive system. It is classified as
focal, contextual or residual.
In this level of assessment, the nurse analyzes the
subjective and objective behaviors and look more
deeply for possible causes of a particular set of
behaviors.
6 STEPS in the NURSING PROCESS
3. NURSING DIAGNOSIS
Formulation of statements that interpret data about
the adaptation on status of the person, including the
behavior and the most relevant stimuli.
4. GOAL SETTING
Establishment of clear statements of the behavioral
outcomes for nursing care which is realistic and
attainable. This is done together with the client.
6 STEPS in the NURSING PROCESS
5. INTERVENTION
Determination of how best to assist the person in
attaining the established goals.
6. EVALUATION
Judging the effectiveness of the nursing intervention
in relation to the behavior after it was performed in
comparison with the goal established.
Not all beautiful is always good,
But all good is always beautiful.
There is always a room for improvement,
And that is the biggest room in the house.