NURSING THEORY
Roy Adaptation Model
Introduction:
Sister Callista Roy began her nursing career in 1963 after receiving her BS
in nursing from Mount Saint Mary’s college Los Angels.
In 1966 she received her MS in Nursing and in 1977, her doctorate in
Sociology from the university of California.
In 1976 Roy published “Introduction to Nursing: An Adaptation Model”.
The model contains five essential elements. Patience (the person receiving Nursing
care), Goal of Nursing (adapting to change), Health environment and direction of
Nursing activities (facilitating adaptation).
1. All of the elements are inter related.
2. Systems coping mechanisms, and adaptive models are used to address these
elements.
II Systems:
A. General Information:
1. Are a set of organized components related to form a whole. Roy
considers the recipient care to be an open adaptive system.
2. Are greater than the sum of their parts.
3. React to and interact with other system in the environment.
4. React as a whole dysfunction in one component affects the entire
system.
5. Have boundaries that are flexible and open to permit interaction with
other system.
6. Employ a feedback cycle of input though put and output.
B. Input:
1. In Roy’s system input is identified as stimuli which can confirm the
environment or from within a person.
2. Stimuli are classified as food (immediately confronting the person),
Contextual (all other stimuli that are presented) or residual (non specific
such as cultural belief or attitudes about illness).
3. Input also includes a person’s adaptation level. (The range of stimuli to
which a person can adapt easily).
4. Each person’s adaptation level is unique and constantly changing.
C. Throughput:
1. Throughput makes use of a person’s process and effectors.
2. Processes refer to the control mechanism that a person uses as an
adaptive system.
3. Effectors refer to the physiologic function, self concept and role function
involved in adaptation.
D. Output:
1. Output is the outcome of system; when the system is a person, output
refers to the person’s behavior.
2. In Roy’s system, output is categorized as adaptive responses (those that
promote a person’s integrity) or ineffective responses (those that do not
promote goal achievement). For Example, not taking antihypertensive
medication.
3. Adaptive responses are used when a person demonstrates behaviours that
achieve the goals of survival, growth, reproduction and mastery.
4. These responses (or) output provide feedback for the system.
III Coping mechanisms:
A. General Information:
Behaviour patterns that a persons uses for self – control. It can be inherited
or learned.
There are two types:
a. The regulator
b. The cognator
B. Regulator:
1. The regulator system consists of input, internal processes and output. The
input stimuli can come from the external environment or from within the
person.
2. Internal processes including, chemical, neural, and endocrine transmit the
stimuli causing output, a physiologic response.
3. The regulator subsystem controls internal processes related to
physiologic needs (such as changes in the heart rate during exercises).
THE PERSON AN ADAPTIVE (FUNCTION) SYSTEM
PERSON
ADAPTATION
C. Cognator:
The cognator consists of input, internal processes and output. It regulates
self – concept, role function and interdependence. The cognator system
controls internal processes related to higher brain function such as
perception, information processing, learning from past experiences,
judgment and emotion. For example a client with diabetes who decides to
increase insulin intake based on symptoms of high blood glucose.
IV Adaptive Modes:
There are categories of behaviour to adapt to stimuli include physiologi
function, self – concept, role function and interdependence, the regulator and the
cognator act within these modes.
Physiologic Function:
It involves the body’s basic needs and ways to adapt. It includes a person’s
patterns of oxygenation, nutrition, elimination activity and rest, skin integrity,
senses, fluids and electrolytes and neurologic and endocrine function.
Self concept:
It refers to beliefs and feelings about oneself. It comprises the physical – self
includes sensation and body image, personal self includes self – consistency and
self – ideal and moral and ethical self includes self observation and self evaluation.
Role function:
It involves behaviour based on person’s position in society. It is dependent on how
a person interacts with others in a given situation. This can be classified as primary
and secondary or tertiary.
Interdependence:
It involves a person’s relationship with significant others and support systems. It
strikes a balance between dependent behaviours seeking help attention and
affection and independence behaviour taking initiative and obtaining satisfaction
from work. It meets a personal need for love, nurturing and affection.
Roy model and the four concepts of the nursing meta paradigm:
A. Person:
Person is the recipient of nursing care he is a “biopsychologicalli being”
who constantly interacts with a changing environment.
a. Is an adaptive system who uses innate and acquired coping mechanism to
deal with stressors.
b. Can be an individual family group community or society.
B. Environment:
Environment is all conditions, circumstances and influences and affecting
the development of behaviour and groups.
It consists of internal and external environment which provide input in the
form of stimuli. It is always changing and constantly interacting with the
person.
C. Health:
Health is as a health – illness continuum. With one end of the continuum
being death and the other end wellness, health and illness were considered
an inevitable dimension of the person’s life. Health is viewed as the goal of
the person’s behaviour and the person’s ability o be an adaptive organism.
D. Nursing:
A person who expends more energy on coping, leaving less energy available
for achieving the goal of survival growth reproduction and mastery. It
includes assessment, diagnosis goal setting intervention and evaluation.
THEORY ;ROY ADAPTATION MODEL
PATIENT
Stimuli:
Physiological Functions: Behaviour therapy
“Thought stop” (Rubber hand technique)
Patient was assisted to meet his physiological Relaxation technique – prayer,
needs like meditation
Oxygenation Medication
Bathing
Feeding
Elimination
Fluids & electrolytes
Neurologic and endocrine function.
ADAPTATION
