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M.

RATHIS
LECTURER
 Origins of the Roy’s Adaptation Model
 Philosophical claims.
 Scientific Assumptions.
 Strategies for knowledge Development
 Influences from other scholars
 World view
 Major Elements of Roy’s Adaptation Model.
 The four adaptive modes.
 Nursing activities and nursing process
 Strengths And Weaknesses Of Roy’s Model
SISTER CALLISTA ROY

Born October 14, 1969 .


Origins of the Roy’s
Adaptation Model

 Dr. Roy credits her major influences in her


personal and professional growth to her
family, her religious commitment, and her
teachers.
 She earned a Bachelor’s degree in nursing
at (1963) Mount St. Mary's College, in Los
Angeles.
Origins of the Roy’s
.Adaptation Model cont’d

 She expanded her love and concern for children,


working in pediatric nursing and soon had the
opportunity to enroll in a master's degree program
in pediatric nursing at the University of California
at Los Angeles (in 1966, she earned a master’s
degree in pediatric nursing and in sociology in
1975).
• In 1966 she joined the faculty of Mount St.
Mary's College, teaching both pediatric and
maternity nursing and began organizing course
content according to a view of the person and
family as adaptive systems.
Origins of the Roy’s
.Adaptation Model cont’d
 In 1968, She began actively introducing her ideas
about Adaptation Framework to nursing as the
philosophical basis of the baccalaureate nursing
curriculum

Roy first published her conceptual model


titled ”Adaptation: A conceptual framework for
nursing”, in (1970).
 In (1971 and 1973) she published additional
elements of model& implications for practice and
education.
Origins of the Roy’s
Adaptation Model
.cont’d
 She received input on the use of the model in
education and practice. By 1987 at least 100,000
nurses had been educated in programs using the
Roy Adaptation Model.

 She has also played a key role in at least 30


research projects. Her current clinical research
continues her long-time interest in neuroscience.
 In 1985, she completed a 2-year postdoctoral
fellowship in neuroscience science at California
University.
Philosophical claims

 In 1988, Roy published a major paper on her


philosophical assumptions which characterized by
the general principles of humanism, holism,
activity, creativity, purpose, value, mutuality and
worth of human beings.

 Roy (1987, 1988, 1989) has presented the


Philosophical claims of the adaptation model in
the form of scientific and philosophical
assumptions and values about nursing.
Philosophical claims
cont’d
 The scientific assumptions were drawn from
general system theory (Bertalanffy, 1968)and
Helson’s (1964) adaptation level theory
 The (general system ) theory assumption
focused primarily on holism,
interdependence, control processes and
information feedback.
 Helson focused on all behavior as adaptive.
This behavior is the function of both the
stimulus coming in and the adaptation level.
Philosophical claims
.cont’d
 Roy (1992) explained that the model assumes the
universal importance of promoting adaptation in
states of health and illness. (Fawcett, 1995).

 By the late 1990s Roy re-defined adaptation for


the 21 Century. She drew upon expanded insights
in relating spirituality and science to present a new
definition of adaptation and related scientific and
philosophical assumptions
Scientific Assumptions
Explicit

 The person is a bio-psycho-social being.

 The person is in constant interaction with a changing


environment.

• To cope with a changing world, the person uses both


innate and acquired mechanisms, which are biologic,
psychologic, and social in origin.
Scientific Assumption
.cont’d
Explicit

 Health and illness are one inevitable dimension of


the person’s life.

 To respond positively to environmental changes, the


person must adapt.

 Adaptation is a function of the stimulus a person is


exposed to and his adaptation level.
Scientific Assumption
.cont’d
Explicit

 The person's adaptation level is such that it


comprises a zone indicating the range of stimulation
that will lead to a positive response.

 The person is conceptualized as having four modes


of adaptation: physiologic needs, self concept, role
function, and interdependence relations (Meleis,
1991& Fawcett, 1995).
Scientific Assumption
.cont’d
Implicit

 A person can be reduced to parts for study and


care.
 Nursing based on causality.
 Patients’ values and opinions are to be considered
and respect.

 A state of adaptation frees an individual’s energy to


respond to other stimuli (Meleis, 1991).
Strategies for
knowledge
Development
 Roy’s Adaptation model evolved from a combination of
inductive and deductive thinking.
 Deductive: this approach used by Roy to develop her
conceptualization of adaptation and the factors that
influence the level of adaptation.
 Roy’s conceptualization of the person as an adaptive
system was deduced from general system theory
 Inductive: she used this approach to identify the four
modes of adaptation through classification of “ about 500
samples of behavior of patients collected by nursing
students over a period of several months in all clinical
settings.
Influences from other
Scholars
Roy was influenced by:

 Studies of Social sciences.


 Clinical practice in pediatric nursing
 Dorthy Johnson’s focus on behavior.
 Martha Roger’s concerns with holistic man.
 Dorothea Orem’s notion of self-care.
 Work of Helson (1964, Adaptation level theory ) and
Bertalanffy ( 1968, general system theory)
 Nightingale (1859) & Peplau (1952).
World View

 The Roy Adaptation Model reflects the reciprocal


interaction world view.
 She repeatedly emphasized the need to view the
person as a holistic adaptive system that function
as a whole & is more than the mere sum of its
parts…)
 Roy also emphasized the active nature of the
person (the human system has the capacity to
adjust effectively to changes in the environment
and , in turn, affects the environment
Major Elements of Roy’s
Adaptation Model

There are three major elements of Roy’s


adaptation model:

First: Man

Roy develops her concept of man—the


client and the recipient of nursing care
Major Elements of Roy’s
.Adaptation Model cont’d

Second: Goal
of nursing

Roy’s model represents the goal of nursing,


which is to promote adaptation through
adaptive modes
Major Elements of Roy’s
.Adaptation Model cont’d

Third: Nursing
activities

Finally, the model maps the process of


nursing activities, most significant
of which are nursing assessment of
client behaviors and nursing interventions.
Concept- Man
 She considers man a biopsychosocial being, who,
to be properly understood, must be considered as
a unit or a whole.
 A whole is different from and more than the
summation of its individual parts.

 Man is an integrated system whose parts have


relationships among them (adaptive system).

 The recipient of nursing care was identified as an


adaptive system.
 System is defined as a set of parts connected to
function as a whole for some purpose.
Concept- Man ( cont.)

 The adaptive system has two major internal control


processes called the regulator and cognator subsystems.
 These subsystem are viewed as innate or acquired coping
mechanisms used by the adaptive system to respond to
changing internal and external environmental stimuli.
 The regulator subsystem responds automatically through
neural, chemical, and endocrine coping processes.
 Stimuli from the internal and external (through the senses)
act as input to the nervous system.
Concept- Man ( Cont.).

 The information is channeled automatically in the


appropriate manner and an automatic unconscious
response is produced (Roy ,1991).
 The cognator subsystem responds to inputs from external
and internal stimuli that involve psychological, social ,
physical and physiological factors including regulator
subsystem outputs.
 Regulator & congator activity is manifested through coping
behavior in four adaptive modes.
Man-Environment
Interaction
 Man is in constant interaction with his environment.

 Since man is a living system, he requires matter, energy,


and information from his environment.

 The constant interaction of man with his environment is


characterized by both internal and external change. Within
this changing world, man must maintain the integrity of
himself; that is, he must adapt.

 The internal and external environments ,in the form of


stimuli, are the inputs into the adaptive system.

 Roy identified three classes of stimuli (focal, contextual and


residual).
Adaptation

 Man copes with environmental change through


biopsychosocial adaptive mechanisms.

 Some adaptive mechanisms are inherited or


genetic processes, the white blood cell defense
system against bacteria seeking to invade the
body.

 Other mechanisms are learned, such as the use of


antiseptics to cleanse a wound.
Health-concept
 Health is a state of human functioning whereby
the person continually adapts to change.

 According to Roy health can be viewed along a


continuum that flows from death and extreme poor
health, through poor health, to a midpoint of
normal health.

 The health continuum moves from this midpoint to


good health , to high- level wellness, to peak
health.
.Adaptation cont’d
Adaptation Level

Significance factors of adaptation:


1. The degree of environmental change.

2. The state of the person’s coping.


Adaptation Level cont’d.

 Environmental changes include snow, temperature


change, presence of a virus, radiation from a
nuclear explosion, and industrial pollution.

 Environmental change interfaces with the


individual’s state of coping.

 The condition of the person or his state of


coping is his adaptation level.
.Adaptation Level cont’d

 The individual’s adaptation level will determine


whether a positive response to internal or
external environmental will be elicited .

 The individual’s adaptation level is determined by


the focal, contextual, and residual stimuli. In any
environment-human interaction, the environ-
mental change is the focal stimulus.
.Adaptation Level cont’d

 Contextual stimuli are all other stimuli of


the person’s internal or external world that
influence the situation and are measurable
or reported by the person.

 Residual stimuli are the “makeup” or


characteristics of the individual that are
present and relevant to the situation but
are difficult to measure objectively.
.Adaptation Level cont’d
Modes of Adaptation
Roy identifies four distinct modes or ways of
adapting by which man responds to change:

:Physiological Needs Mode- 1

The physiological adaptive mode relates to the


need for physiological integrity as:

Exercise and rest, nutrition and elimination, fluid and electrolytes,


oxygen and circulation, regulation of temperature, regulation of
senses, and regulation of the endocrine systems.
Modes of Adaptation
cont’d.

:Physiological Needs Mode- 1

Adaptation occurs as the individual maintains his


integrity through positive response to need deficits or
excesses
Modes of Adaptation
.cont’d
Self-Concept Mode- 2

 Self-concept defined as “ the composite of believes


and feelings that a person holds about him/herself at
a given time”.
 Roy states that the psychological integrity of the
individual is an inner requirement or need.

This view is likened to Talcott Parsons’s view of the


human personality as a system.,
Modes of Adaptation
.cont’d

Self-Concept Mode- 2

The personality system has the need to maintain its


integrity, which Parsons identifies as system
adaptation, goal attainment, integration, and pattern-
maintenance.
Modes of Adaptation
.cont’d
Self-Concept Mode- 2

• The self-concept encompasses perceptions of the


physical and the person self.
•The physical-self deals with the body sensation and
body image. Body sensation refers to “ how one feels
& experiences oneself as a physical being “.
•The personal self encompasses self consistency,
self-ideal and the moral- ethical – spiritual self.
. Modes of Adaptation cont’d

 Self-consistency refers to the striving “to


maintain a consistent self- organization
and to avoid disequilibrium”.
 Self-ideal refers to “what one like to be or is
capable of doing”.
 The moral-ethical- spiritual self
encompasses “ one’s belief system &
evaluation of who one is.
Modes of Adaptation
cont’d.

Role Function Mode- 3

 Interpersonal interaction satisfies the human’s need


to identify the self in relation to others.

 The response of others to the self shapes and


reshapes one’s behavior
Modes of Adaptation
.cont’d
Role Function Mode- 3

 Social interaction occurs within the contexts


of family, groups, community, and society.

 Rules of behavior / limits of behavior, will be set


that guide one’s actions.

 Behavioral rules or limits that are common within a


society are called norms.
Modes of Adaptation
.cont’d
Interpersonal Mode- 4

 Social integrity for an individual requires more


than just the proper performance of roles in social

situations.

 The individual acts in ways that will result in


satisfying his needs for love and support. Through
interdependence one’s life gains meaning and purpose.
 Interdependence is a balance between dependence
and independence
Nursing –concept

 Roy (1976) defined nursing as “ a theoretical


system of knowledge which prescribes a process of
analysis and action related to the care of the ill or
potentially ill person.
 Furthermore , nursing is a scientific discipline that
is practice oriented (Roy 1991)
 The model stipulates that a nurse is needed “ when
unusual stresses or weakened coping mechanisms
make the person’s usual attempts to cope
ineffective.
Nursing –concept

 Nursing focuses on the person as a total being


who responds to internal and external stimuli
( Roy , 1970)

 The goal of nursing is the “ promotion of


adaptation in each of the four ( adaptive modes
contributing to the person’s health , quality of life
and dying with dignity
Content of the Model:
propositions
The metapardigm concepts of person, environment, and
health are linked in the following statements:

 The changing environment stimulates the person to make


adaptive responses. The person is described as an
adaptive system consistently growing and developing within
a changing environment ( Andrews and Roy, 1991)

 A person’s health can be described as a reflection of this


interaction or adaptation ( Andrews and Roy, 1991)
Content of the Model:
.propositions cont’d
The metapridgm concepts of person, health , and
nursing are linked the following statements:

 The goal of nursing is the promotion of adaptation in


each of the four adaptive modes, thereby contributing to
the person’s health, quality of life, and dying with dignity
( Andrews and Roy, 1991)

 The goal of nursing intervention is to maintain and


enhance adaptive behaviors and to change ineffective
behavior to adaptive ( Andrews and Roy, 1991)
Content of the Model:
.propositions cont’d

The linkages of all four


metapardigm concepts are
presented in this statement:
 It is the nurse’s role to promote
adaptation in situation of health and
illness; to enhance the interaction of
the person with the environment,
thereby promoting adaptation
(Andrews and Roy, 1991)
Nursing activities and nursing
process.
 The nurse, in her first level assessment, observes the
for signs of autonomic activity, signs that invariably are
present when the individual’s biopsychsocial integrity is
threatened.
 The client is the first to be aware of coping failure.
Maladaptive behavior as well as adaptive behavior
requiring support becomes the focus of the nurse.

 Second level assessment, identify the focal, contextual,


and residual stimuli that combine to determine the
individual's adaptation level.
Nursing activities and nursing
process cont’d.
 The second level assessment leads the nurse to
identify the adaptation problems. This process is
referred to nursing diagnosis.

 Intervention: Roy developed nursing intervention as


attempt to manipulate the environment by removing,
increasing, decreasing, and/or altering stimuli for
promoting movement toward peak health and
meeting the individual's needs of biological, social,
and psychological integrity.

 The nurse concludes the nursing process with an


evaluation of the effectiveness of the nursing
intervention in the client goal achievement.
Roy’s Adaptation Model

Interaction Capsulate

Acquired Output
Input
Physiological
Environmental Focal Role function Behavioral
Changes Contextual Self-concept Responses
External & Internal Residual Interdependence Adaptive or Ineffective
Adaptation Process
Innate

Feedback
Figure 14-3 The person as an adaptive system.
Strengths And Weaknesses
Of Roy’s Model

Strengths of Roy’s
Model

It guides the nurse to utilize observation and


interviewing skills in doing an individualized assessment
of each client. Behavior related to the four adaptive
modes is collected during the first level assessment.
Physiological needs, self-concept, role function, and
interdependence.
Strengths And Weaknesses
of Roy’s Model cont’d.
Strengths of Roy’s
Model
 The close association between intervention strategies and
assessment data may clarify for the nurse the importance
of individualized assessment of each client individually.

 The model also suggests that after assessment, the nurse


is to make judgments regarding the client’s adaptation
through the four adaptive modes in relation to need
excesses or deficits that are created secondary to
environmental change.
Strengths And Weaknesses
.of Roy’s Model cont’d
Weaknesses of Roy’s
Model

 Roy fails, however, to define or operationalize


these concepts (4 adaptive modes) .

 Question the association that is drawn between


need deficits or excesses created by a threat to
integrity and the behavioral manifestation of that
need in the adaptive mode.
Strengths And Weaknesses
.of Roy’s Model cont’d

Weaknesses of Roy’s
Model

How can the nurse be sure that observed behavior


related to an adaptive mode represents a need deficit
identified by the model since need deficits or excesses
are not directly observable?
Strengths And Weaknesses
.of Roy’s Model cont’d

Weaknesses of Roy’s
Model

 The major assumption of the model that man is a


biopsychosocial being by nature. Does this
conceptual approach truly reflect the nature of
man’s relationship with his environment?

 Only further research of the model can give us


this answer.