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