ADAPTATION
MODEL
SR. CALLISTA ROY
CALLISTA ROY

Born on October 14, 1939 in Los Angeles
California

BSN in 1963 Mount St. Mary College, Los
Angeles

MA in Pediatric Nursing 1966/Doctorate in
Sociology in 1977 University of California,
L.A.

With honorary doctorate from 4 other
institutions

She is a nurse theorist and a professor

She is a fellow in the American Academy of
Nursing, an honorary nursing society that
elects nursing leaders annually

Has numerous publications, including books
& journal articles on nursing theory & other
professional topics
CALLISTA ROY







Her publications:
Introduction to Nursing: An Adaptation Model
Essentials of the Roy Adaptation Model
Theory Construction in Nursing: An Adaptation
Model
Essentials of the Roy Adaptation Model
Roy Adaptation Model: The Definitive
Statement
Her works has been interpreted in several
languages worldwide
METAPARADIGM

PERSON

Is the recipient of nursing care; main focus of nursing

A biopsychosocial being in constant interaction with a
changing environment.

The person is an open adaptive system who uses coping
skills to deal with stressors.

It includes people as individuals or in groups (families,
organizations, communities, nations & society as a whole)
METAPARADIGM

ENVIRONMENT
 Conditions,
circumstances and influences that
surround and affect the development and
behavior of the person.
 Consists
of internal & external environments,
which provide input in the form of stimuli
METAPARADIGM

HEALTH

Was originally described by Roy as a health-illness continuum;
health & illness were considered an inevitable dimension of the
person’s life

More recently, Health is the process of being and becoming an
integrated and whole person.

Is it a reflection of adaptation that is the interaction of the person
& the environment
METAPARADIGM



NURSING
Nursing is the science and practice that expands adaptive
abilities and enhances person and environment transformation.
Roy’s goal of nursing is the promotion of adaptation in each of
the 4 modes thus contributing to health, quality of life and
dying with dignity
The Roy Adaptation Model (RAM)
THE KEY CONCEPTS:
 The person is adapting in a stable interaction with the
environment, either internal or external.

The person’s major task is to maintain integrity in face
of these stimuli.

INTEGRITY- the degree of wholeness achieved by adapting
to changes in needs.

SYSTEM – is a set of parts connected to function as a
whole for some purpose & that does so by virtue of
the interdependence of its parts
* employ a feedback cycle of input, throughput &
output
 Input
– defined as stimuli which can come from the
environment or from within a person

Throughput – makes use of a person’s processes &
effectors
 Processes refer to the control mechanisms that a
person uses as an adaptive system
 Effectors
refer to the physiologic function, selfconcept & role function involves in adaptation

Output – is the outcome of the system, when the
system is a person, the output refers to the person’s
behaviors
Categories of Output:
 Adaptive responses – those that promote integrity in
terms of the goals of the human system
 Ineffective
responses – those that do not contribute to
integrity in terms of the goals of the human system
TYPES OF STIMULI (Helson, 1964)


FOCAL – the internal or external stimulus most
immediately confronting the person, it attracts
the most attention.
CONTEXTUAL – all other stimuli present in the
situation that strengthens/contribute the effect of
the focal stimulus.
TYPES OF STIMULI (Helson, 1964)

RESIDUAL - those stimuli that can affect the
focal stimulus but the effects are unclear.
 The
three types of stimuli act together and
influence the adaptation level which is
defined as the ability to respond positively in
a situation.
COPING MECHANISM
AND CONTROL PROCESSESS

COPING MECHANISM – are the processes that a
person uses for self-control
- are innate or acquired ways of interacting with
the changing environment
- innate coping mechanisms are genetically
determined or common to the species & are
genetically viewed as automatic process
- acquired coping mechanisms are developed
through strategies such as learning
CATEGORIES OF COPING MECHANISM


REGULATOR SUBSYSTEM - major coping process
involving the neural, chemical, and endocrine system
e.g. increase in vital signs- sympathetic response to
stress.
COGNATOR SUBSYSTEM – is a major coping process
involving four cognitive-emotive channels: perceptual
& information processing; learning; judgment &
emotion
e.g. effects of prolonged hospitalization for a 4yearold child
CATEGORIES OF COPING
MECHANISM

CONTROL PROCESSES – stabilizer subsystem &
innovator subsystem:
 Stabilizer
subsystem – analogous to regulator :
concerned with stability
 Innovator
subsystem – analogous to cognator::
concerned with creativity, change & growth
ADAPTATION LEVEL
1.Integrated - Adaptation level at which the
structures and functions of a life process
are working as a whole to meet human
needs.
 Example:
 Stable processes of ventilation, the
complex process of breathing that
exchanges air between lungs and
atmosphere.
ADAPTATION LEVEL
2. Compensatory - Adaptation level at
which the cognator and regulator have
been activated by a challenge to the
integrated life processes
EXAMPLE:
 GRIEVING,
ROLE TRANSITION,
ADAPTATION LEVEL
3. Compromised- Adaptation level
resulting from inadequate integrated
and compensatory life processes;
adaptation problem.
EXAMPLES:
• Hypoxia
• Ventilatory Impairment
• Unresolved loss
• Abusive Relationships


ADAPTIVE MODES
-are categories of behavior to adapt to stimuli
- can be used to determine a person’s adaptation
level
- can be used to identify adaptive or ineffective
responses by observing a person’s behavior in
relation to the adaptive modes
4 ADAPTIVE MODES
PHYSIOLOGICAL
the way a person responds as a physical being to a
stimuli from the environment.
1.
 GOAL:
Physiological Integrity
 Five
Physiologic Needs: oxygenation, nutrition, activity
& rest , elimination & protection
 Four
Complex Processes: senses; fluids, electrolytes &
acid-base balance; neurologic function; endocrine
function
2. SELF-CONCEPT – GROUP IDENTITY MODE
- focuses specifically on the psychological & spiritual aspects of
the human system
Two components:
1. physical self (body sensation and body image)
2. personal self (self consistency, self ideal, and moral ethical
spiritual self)
Group Identity – reflects how people in groups
perceive themselves based on environmental
feedback
- comprised of interpersonal relationships, group
self-image & culture

GOAL: Psychological Integrity
3. ROLE FUNCTION MODE – a role is a set of
expectations about how a person occupying one’s
position behaves towards a person occupying another
position.

GOAL: Social Integrity
Roles are carried out with both
instrumental behaviors
expressive behaviors




Persons perform primary, secondary & tertiary roles
Primary – determines the majority of behavior engaged in by
the person during a particular period of life
Secondary – are those that a person assumes to complete the
task associated with a developmental stage & primary role
Tertiary – related primarily to secondary roles & represent
ways in which individuals meet their role associated obligations
4. INTERDEPENDENCE MODE
focuses on close relationships which results to giving
& receiving of love, respect, value, nurturing,
knowledge, skills, commitments, material possessions,
time & talents
GOAL: Affectional Adequacy.
GOAL OF NURSING IN RAM
PROMOTE ADAPTATION IN
EACH OF THE FOUR ADAPTIVE
MODES
INPUT
Control Processes
Effectors
OUTPUT
Person as an Adaptive System
POINTS TO REMEMBER



Adaptive or ineffective responses result from the 4
modes of coping mechanisms.
Adaptive responses support the integrity of the
person and the goals of adaptation.
Ineffective responses neither promote integrity nor
contribute to the goals of adaptation.
NURSING PROCESS
A problem-solving approach for gathering data,
identifying the capacities and needs of the human
adaptive system, selecting and implementing
approaches for nursing care, and evaluation of the
outcome of care provided.
6 STEPS in the NURSING PROCESS
1.

ASSESSMENT OF BEHAVIOR
Data gathering about the behavior of the person
as an adaptive system in each of the adaptive
modes.


Observable behavior: vital signs
Non-observable behavior: feelings experienced by
the person (anxiety)
6 STEPS in the NURSING PROCESS
2. ASSESSMENT OF STIMULI


A STIMULUS is defined as any change in the internal
and external environment that induces a response in
the adaptive system.
It is classified as focal, contextual or residual.
6 STEPS in the NURSING PROCESS
3. NURSING DIAGNOSIS
 Formulation of statements that interpret data about
the adaptation on status of the person, including the
behavior and the most relevant stimuli.
4. GOAL SETTING
 Establishment of clear statements of the behavioral
outcomes for nursing care which is realistic and
attainable. This is done together with the client.
6 STEPS in the NURSING PROCESS
5. INTERVENTION
 Determination of how best to assist the person in
attaining the established goals.
6. EVALUATION
 Judging the effectiveness of the nursing intervention
in relation to the behavior after it was performed in
comparison with the goal established.