A Holistic Approach to Nursing
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In 1970 while developing curriculum for
nursing students Sister Callista Roy presented
a conceptual framework of her model. In 1976
the first edition of, “Introduction to Nursing: An
Adaptation Model” appeared and was followed
by a second edition in 1984. She once again
updated her writing in 1999 (Chitty & Black,
2011, p. 313).
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The person is viewed as a holistic system.
2. The internal and external stimuli of the
environment affects a persons behavior.
3. Health and wellness are affected by a
persons ability to adapt.
4. The nurse manipulates the environment to
assist the person/patient to adapt.
(Weiland, 2010, p. 282)
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Humans are:
Physiological- requiring maintenance of basic
human needs.
Self-conceptual-requiring maintenance of the
mind.
Self-functional- adapting to changes, personal roles
and maintaining self perception.
Interdependent- relationship with others, finding a
balance of independence and interdependence.
(Nursing Theory, 2011)
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Humans are bio-psycho-social beings.
Humans live in a ever changing environment.
Humans must cope with the changing
environment.
Health and illness are inevitable.
Humans must adapt positively to the
environment.
(Nursing Theory, 2011)
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Environment Concept
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Refers to all internal and external conditions,
circumstances and influences affecting the person
and his or her development and behavior.
According to this model, when one is subjected to
stress their coping mechanisms are ineffective in
processing the adaption of environmental stimuli.
Stimuli can be focal (immediately confronts the
adaptive system), contextual (where the
environmental factor has caused a certain situation),
or residual (environmental factors cannot be
defined)(Mastal, 1980).
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Health Concept
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Process of becoming an integrated and whole person
and a process of being.
There is a distinct difference between the model and
medicine. Medicine is treatment of the disease while
the adaptation covers the wider issues growth,
adaptation, and survival.
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Nursing
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Involves the promotion of adaptation concepts
during health and illness from ineffective or
inadequate response to increase health and wellness.
Focuses on the person and medicine focuses on
biological systems and the patient’s disease.
Uses four modes: physiological, self-concept, role
function and inter-dependence.
(St. Rosemary Education Institution, 2012)
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Person and Relating persons
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A system that adapts to its environment.
Three modes in the adaptation:
 Self-concept-- need for psychic integrity and perception
of worth.
 Role function-- need for social integrity and interaction
with others.
 Physiological mode-- relates to the way individuals
play their functions in accordance with their positions.
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(Mastal & Hammond, 1980)
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The adaptation model views the person as a
holistic system (psychological and biological
being).
External environment has an impact on the
patient’s well being due to interacting with the
environment all the time.
The nurse must consider external stressors and
change interventions in the nursing process for
adaption.
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Roy’s adaptation model was built for nursing and has
use in nursing practice, education, and research
(“Application of Roy’s Adaptation Model (RAM),”
2012).
The model encompasses the four global concepts of
human being, environment, health and nursing.
The model can be used in a variety of settings with the
patient and their environment as the focus for care.
This model has been used in hospitals in all settings to
test the likelihood of improved patient outcomes. The
results gathered from patients and subjects were
achieved desired patient outcomes with providing a
structure and focus from the nursing model (Weiss,
Hastings, & Holy, et al., 1994).
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Prepared by:
Kim Gurizzian
Michelle Johnston
Stephanie Lombardi
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Author. (2012). Sister Callista Roy. Nursing Theory. Retrieved from
http://nursingtheory.org/nursing-theories/Sister-Callista-Roy.php
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Chitty, K. K., & Black, B. P. (2011). Professional nursing: Concepts & challenges (6th e.d).
Maryland Heights: MO, Saunders.
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Mastal, M., & Hammond, H. (1980). Analysis of the Roy adaptation model: A
contribution to holistic nursing. Advances in Nursing Science, (2)4, 71-82.
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Nursing theories: A companion to nursing theories and models. (2012). Application of
Roy’s adaptation model (RAM). Retrieved from
http://currentnursing.com/nursing_theory/application_Roy's_adaptation_model.html
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St. Rosemary Education Institution. (2012). “The Roy Adaptation Model,
Environment/Society, Nursing.” Retrieved on Friday October 2012 from
http://schoolworkhelper.net/the-roy-adaptation-model-health-environmentsocietynursing/
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Weiland, S. A. (2010). Integrating spirituality in critical care: An APN perspective using
Roy’s adaptation model. Critical Care Nursing, 33(30), p282-291.
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Weiss, M. E., Hastings, W. J., Holly, D. C., et al. (1994). Using Roy Adaptation Model in
practice: Nurses perspectives. Nursing Science Quarterly(7), p. 80-86. doi:
10.1177/089431849400700208
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You are working in a sub acute rehab facility caring for
a 75 year old male who is post stroke with left side
hemiplegia. The patient is reportedly “upset” and it
has been documented that he frequently yells at the
staff while they are assisting him with his ADL’s. The
patient’s spouse is at bedside during the day and
leaves for home after supper to shower and rest. On
this particular day the patient is observed yelling at his
spouse and caregivers saying “just leave me alone, you
don’t know what you’re doing.” The patient’s wife is
now tearful and leaves for home.
As the patient’s nurse, how would you use Roy’s
Adaptation Model to care for this patient and his
family?