SISTER CALLISTA ROY

o Adaptation Model
o Roy's theory is grounded on humanism with the belief that a person has his own creative
power and has coping abilities to enhance wellness.
o “The model provides a way of thinking about people and their environment that is useful
in any setting. It helps one prioritize care and challenges the nurse to move the patient
from survival to transformation.”
o She viewed humans as biopsychosocial beings constantly interacting with a changing
environment and who cope with their environment through Biopsychosocial adaptation
mechanisms.

two categories ofcoping mechanisms according to Roy namely the regulator

and the cognator subsystems:

Regulator Subsystem transpires through neutral, chemical and endocrine processes like the
increase in vital signs-sympathetic response to stress.

Cognator Subsystem, on the other hand, occurs through cognitive-emotive processes.

o For instance, are the effects of prolonged hospitalization for a four-year old child.
o The degree of internal or external environmental change and the person’s ability to
cope with that change is likely to determine the person’s health status. Nursing
interventions are aimed at promoting physiologic, psychologic, and social functioning
or adaptation.
o The Roy adaptation model views the patient as an adaptive system.
o According to Roy’s model, the goal of nursing is to help the person adapt to changes in
physiological needs, self-concept, role function, and interdependent relations during
health and illness.
o The need for nursing care occurs when the patient cannot adapt to internal and
external environmental demands.
o All individuals must adapt to the following demands: meeting basic physiological needs,
developing a positive self-concept, performing social roles, and achieving a balance
between dependence and independence.
o The nurse determines which demands are causing problems for a patient and assesses
how well the patient is adapting to them.
o Nurses direct care at helping the patient adapt to the changes. For example, a patient
recovering from a worsening of heart failure needs nursing interventions to assist in
adapting to the resultant activity in tolerance.

ROY ADAPTATION MODEL: KEY CONCEPTS AND THEORETICAL ASSERSTIONS

Figure: Adaptive/Effective Response through Four Adaptation Models The goal of
nursing is to promote the person's adaptation along the four adaptive modes (physiologic,
self-concept, role function, and interdependence).

Adaptation: the process and outcome whereby thinking and feeling persons, as individuals
and in groups, use conscious awareness and choice to create human and environmental
integration Coping Process: innate or acquired ways innate or of interacting with the
changing of environment

The person is able to adapt if he is able to cope with the constantly changing environment.
There are two types of systems at work: regulators and cognators.

o Regulator subsystem — a basic type of adaptive process that responds automatically

through neural, chemical, and endocrine coping channels; automatic response to
stimulus
o Cognator subsystem — A major coping process involving 4 cognitive-emotive
channels: perceptual and information processing, learning, judgment and emotion;
Adaptive Responses: responses that promotes integrity of the human system, that is, survival,
growth, reproduction, mastery, and personal and environmental transformation. The level of
adaptation of a person is determined by the combined effect of stimuli, which could either
be focal, contextual or residual.

FOCAL STIMULI

o internal or external stimulus immediately affecting the system

o those that immediately confront the person, e.g., pricking of skin tissue during injection
of drugs.
 o Contextual stimuli are all other stimuli present or contributing factors in the situation,
e.g., inability to explain the procedure and the need for the drug.
o Residual stimuli are unknown factors such as beliefs, attitudes or traits that have an
intermediate effect or influence on the present situation. For example, the false belief
that a patient cannot bathe after an injection.
o Significant stimuli in all human adaptation include stage of development, family, and
culture

Ineffective Responses: responses that do not contribute to integrity of the human system.

o Roy's model revolves around the concept of man as an adaptive system. The person
scans the environment for stimuli and ultimately adapts. The nurse, as part of his
environment, assists the person in his effort to adapt by appropriately managing his
environment.

o an adaptive system with coping mechanisms manifested by the adaptive modes:

o physiologic, self-concept, role function and interdependence

PHYSIOLOGY ADAPTIVE MODE

o behavior pertaining to the physical aspect of the human system

o determined by physiologic needs, e.g., sleeping after a day's work. In the physiologic
mode, the focus is on five needs (oxygenation, nutrition, elimination, activity, rest and
protection) and on four regulatory processes (the senses, fluids and electrolytes,
neurologic, and endocrine functions).
SELF CONCEPT MODE

o the composite of beliefs and feelings held about oneself at a given time.
o Focus on the psychological and spiritual aspects of the human system.
o Need to know who one is, so that one can exist with a state of unity, meaning, and
purposefulness of 2 modes (physical self, and personal self)
o ,determined by interaction with others. For example, it's nice to hear someone say,
“you’re beautiful in your suit."
ROLE FUNCTION MODE

o Set of expectations about how a person occupying one position behaves toward
another occupying another position
o refers to the performance of duties based on given societal norms or expectations.
o Basic need : social integrity, the need to know who one is in relation to others so that
one can act
o The need for role clarity of all participants in group
Example: In today's society, a “mothering" role often includes being a breadwinner and so a
working woman needs to return to her work soon after the delivery of her baby.

INTERDEPENDENCE MODE

o Behavior pertaining to interdependent relationships of individuals and groups. Focus

on the close relationships of people and their purpose. Each relationship exists for
some reason. Involves the willingness and ability to give to others and accept from
others. Balance results in feelings of being valued and supported by others.
o Basic need: feeling of security in relationships
o involves ways of seeking help, affection, and attention. It is also the ability to love,
respect, value and accept.
o Includes people as individuals or in groups-families, organizations, communities, and
society as a whole
ENVIRONMENT

o encompasses all conditions, circumstances, and influences surrounding and affecting

the development and behavior of humans as adaptive systems, with particular
consideration of person and earth resources
o elements: represented by stimuli from within the human adaptive system and stimuli
from around the system
HEALTH

o a state and a process of being and becoming an integrated whole human being.
Conversely, illness is lack of integration.
o Integrity – soundness or an unimpaired condition leading to wholeness
NURSING

o the science and practice that expands adaptive abilities and enhances person and
environment transformation
o an external regulatory force that can modify stimuli, which produce adaptations
o Stimulus - something that provokes a response, point of interaction for the human
system and the environment
o Nursing can either maintain, increase or decrease stimuli. The consequence of nursing
is the person's adaptation to these stimuli depending on his position on the health-
illness continuum.
o Goal: 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.