Nursing Theories 2

8/4/2019 Nursing Theories 2

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Roy's Adaptation Model

Sr.Callista Roy


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THEORY DESCRIPTION

The central questions of Roys theory are:

Who is the focus of nursing care?

What is the target of nursing care?

When is nursing care indicated?


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ROY ADAPTATION MODEL CONCEPTS

Adaptation -- goal of nursing

Person -- adaptive system

Environment -- stimuli

Health -- outcome of adaptation

Nursing -- promoting adaptation and health


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Concepts-Adaptation

Responding positively to environmental

changes.

The process and outcome of individuals andgroups who use conscious awareness, self

reflection and choice to create human and

environmental integration


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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 ofparts

Functions as a unity for some purpose Includes people as individuals or in groups-families, organizations, communities, and society as

a whole.


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Concepts-Environment

Focal - internal or external and immediately

confronting the person

Contextual- all stimuli present in the situationthat contribute to effect of focal stimulus

Residual-a factor whose effects in the current

situation are unclear


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Concepts-Health

Inevitable dimension of person's life

Represented by a health-illness continuum A state and a process of being and

becoming integrated and whole


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Concepts-Nursing 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 behaviors and factors that

influence adaptive abilities and by intervening to enhance

environmental interactions


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Concepts-Subsystems

Cognator subsystem A major coping process involving 4

cognitive-emotive channels(perceptual and information

processing, learning, judgment, and emotion)

Regulator subsystem a basic type of adaptive process that

responds automatically through neural, chemical, and endocrine

coping channels


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Four Adaptive Modes

Physiologic Needs

Self Concept Role Function

Interdependence


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Adaptation and Groups

Includes relating persons, partners,

families, organizations,communities, nations, and society

as a whole


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Adaptation LevelA zone within which stimulation will lead to a

positive or adaptive response

Three levels

1. Integrated

2. Compensatory

3. Compromised


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Integrated Life Processes

Adaptation level where the structures and functions

of the life processes work to meet needs

Stable process of breathing and ventilation


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Compensatory Processes

Adaptation level where the cognator and regulator

are activated by a challenge to the life processes

Role transition, growth in a new role


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Compromised Processes

Adaptation level resulting from

inadequate integrated and

compensatory life processes

HypoxiaUnresolved Loss


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Usefulness of Adaptation Model

Scientific knowledge for practice

Clinical assessment and intervention

Research variables

To guide nursing practice

To organize nursing education Curricular frame work for various nursing

colleges


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Jean Watson's Philosophy ofNursing


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The seven assumptions1. Caring can be effectively demonstrated and

practiced only interpersonally.

2. Caring consists of carative factors that result in

the satisfaction of certain human needs.

3. Effective caring promotes health and individual or

family growth.

4. Caring responses accept person not only as he or

she is now but as what he or she may become.


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The seven assumptions

5.Caring is more healthogenic than is curing. A

science of caring is complementary to the

science of curing.

6. The practice of caring is central to nursing.

7. A caring environment is one that offers the

development of potential while allowing the

person to choose the best action for himself or

herself at a given point in time.


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The ten primary carative factors

1. The formation of a humanistic- altruistic system of values.2. The installation of faith-hope.

3. The cultivation of sensitivity to ones self and to others.4. The development of a helping-trust relationship

5. The promotion and acceptance of the expression of positive and

negative feelings.


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The ten primary carative factors

6. The systematic use of the scientific problem-solving method for decision making

7. The promotion of interpersonal teaching-learning.

8. The provision for a supportive, protective and /or corrective mental, physical,

socio-cultural and spiritual environment.

9. Assistance with the gratification of human needs.

10. The allowance for existential-phenomenological forces.


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Watsons ordering of needs

* Lower order needs (biophysical needs)

o The need for food and fluid

o The need for elimination

o The need for ventilation


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* Lower order needs (psychophysical needs)

o The need for activity-inactivity

o The need for sexuality


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* Higher order needs (psychosocial needs)

o The need for achievement

o The need for affiliation

o Higher order need (intrapersonal-

interpersonal need)

o The need for self-actualization


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Watsons theory and the four

major concepts

Human being refers to

.. a valued person in and of him or herself tobe cared for, respected, nurtured, understood

and assisted; in general a philosophical view of a

person as a fully functional integrated self. He,human is viewed as greater than and different

from, the sum of his or her parts.


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Health

A high level of overall physical, mental and

social functioning

A general adaptive-maintenance level of dailyfunctioning

The absence of illness (or the presence of efforts

that leads its absence)


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Environment/society

* Caring (and nursing) has existed in every

society.

* A caring attitude is not transmitted fromgeneration to generation.

* It is transmitted by the culture of the profession

as a unique way of coping with its environment.


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Nursing

* Nursing is concerned with

promoting health, preventingillness, caring for the sick and

restoring health.


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Nursing

It focuses on health promotion and

treatment of disease. She believes that

holistic health care is central to the

practice of caring in nursing


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Nursing

She defines nursing as:

a human science of persons and human

health-illness experiences that are

mediated by professional, personal,

scientific, esthetic and ethical human

transactions.


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From Novice to Expert

Patricia E. Benner


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LEVELS OF NURSING EXPERIENCE

1. Novice

2. Advanced beginner

3. Competent

4. Proficient5. Expert


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Novice

Beginner with no experience

Taught general rules to help perform tasks

Rules are: context-free, independent of specific

cases, and applied universally

Rule-governed behavior is limited and inflexible

Ex. Tell me what I need to do and Ill do it.


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Advanced Beginner

Demonstrates acceptable performance

Has gained prior experience in actual situations

to recognize recurring meaningful components

Principles, based on experiences, begin to be

formulated to guide actions


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Competent Demonstrates acceptable performance

Has gained prior experience in actual situations to

recognize recurring meaningful components

Principles, based on experiences, begin to beformulated to guide actions


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Competent

Gains perspective from planning own actions

based on conscious, abstract, and analytical

thinking and helps to achieve greater efficiencyand organization

typically a nurse with 2-3 years experience on the job inthe same area or in similar day-to-day situations


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Proficient

Perceives and understands situations as whole

parts

More holistic understanding improves decision-making

Learns from experiences what to expect in

certain situations and how to modify plans


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Expert No longer relies on principles, rules, or

guidelines to connect situations and determine

actions

Much more background of experience

Has intuitive grasp of clinical situations

Performance is now fluid, flexible, and highly-

proficient


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Nursing Theories 2

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