Sister Callista Roy's
Adaptation Model
Amy Lampen
Laura Braun
Ashley Borowiak
Introduction
Roy's Adaptation Model focuses on a person's coping
(adaptive) abilities in response to a constantly changing
environment (Lopes, Pagliuca, & Araujo, 2006).
Nursing can promote effective coping by asking, "How can
I modify this patient's environment to facilitate his
adaptation?" (Chitty & Black, 2011, p. 311).
Development of the Model
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Roy believed that the environment and the individual are
sources of stimuli that require modification to promote
adaptation in the patient (Chitty & Black, 2011, p. 313).
Health is defined as the process of achieving adaptation
with the environment stimuli so the person is integrated
and a whole (Shosha & Al kalaldeh, 2012).
Adaptation is manifested by four interrelated modes of
behavior including physiological, self-concept, role
function and interdependence modes.
Roy's values on nursing and
knowledge development
• Awhen
person’s behavioral responses are ineffective for coping
the demands of the environment are too high or the
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person’s adaptive resources are too low (Chitty & Black,
2011, p. 313).
Nursing goals are to promote adaptation for individuals
contributing to health, quality of life, and dying with
dignity.
Nurses need to assess patient behavior and factors that
influence adaptive abilities. By doing this, nurses can plan
interventions to expand abilities to adapt and enhance
environmental interactions (Connell School of Nursing,
2010).
What influenced Roy's
Adaptation Model?
According to Debra R. Hanna (2013), "Roy's specific life
values included, among others, her Roman Catholic
religious beliefs, her commitment to living as a
consecrated religious Sister of St. Joseph of
Cardondelet, and belonging to a religious order that
derives its rule from the spirituality of St. Ignatius of
Loyola, founder of the Society of Jesus (also known as
the Jesuites)" (p. 53). Hanna (2013) also states that "It
is no coincidence that Modras's description of Ignatian
humanism is consistent with Roy's description of
humanism, which differs in a major way from the
contemporary, secular approach to humanism. Also Roy
(1997) has mentioned having been influenced by the
posthumous writings of another Jesuit priest, the late
Reverend Pierre Teilhard de Chardin (1881-1955) (p.
53).
Influences on Roy's theories
(cont'd)
Roy had worked in a pediatric unit and
was impressed with the resiliency of
the children she cared for. Having
little knowledge on the concept of
adaptation and with much
encouragement, she developed her
concepts and theories to form a
popular framework in nursing today
(Connell School of Nursing, 2010).
Concepts of Roy's Adaptation
Model
Roy's Adaptation Model includes the main four
global concepts of nursing but also adds one
more. Her model includes the person which
is the adaptive system, the environment
which is the stimuli to the person, health
which revolves around the outcome of the
person's ability to adapt to the stimuli,
nursing which is us promoting the persons
adaptation and health and lastly adaptation
which is the main goal of nursing.
Roy's Model and it's Influences
on the Global Concepts
Human being: The person must learn to adapt by being consciously
aware and use choice in order to integrate their condition with
their environment with the help of nursing.
Environment: Three kinds of stimuli exist in the environment
including focal, contextual and residual. All conditions,
circumstances and influences surrounding a person affect their
healing process and the development and behavior of a person.
According to Roy, having a healthy environment for the patient is
key for healing.
Health: The health of a person relies heavily on the state of their
environment and their ability to adapt to it. Roy defines health as
“a state and process of being and becoming integrated and whole
that reflects person and environmental mutuality.”
Nursing: Nursing is a science which expands adaptive abilities in
patients and enhances the transformation in person and
environment through assessment, diagnosis, goal setting,
intervention and evaluation.
Interpretation and Inference
• In the 1970's, Roy's publication presented the concept
of environment as being limited to place.
o Roy further defined the concept of environment by
making several revisions after her first publication
• Humanism is a term often used in the discipline of
(Lopes et al., 2006)
nursing, but it has not been firmly defined in a single
way by nurse scholars.
o Roy's view of humanism is tied to her own values
based on her life experience.
(Hanna, 2013)
Implications and Consequences
• "Although the model originated in the United States,
scholars who now use the Roy adaptation model come
from the global community" (Roy, Whetsell, &
Frederickson, 2009, p. 209).
• "Publications in various journals sought to
•
contribute to the understanding and application
of her model" (Lopes et al., 2006).
Nurses, who were educated about the concepts prior
to implementing "the Roy Model in their practice, felt
that their professionalism was enhanced" (Weiss,
Hastings, Holly, & Craig, 1994).
Is Roy's Adaptation Model
unique?
Roy's adaptation model is a unique model that
"is widely used for education, research, and
nursing practice today
(Chitty & Black, 2011, p. 313)."
This is the only model that is "focused on the
individual as a biophysical adaptive system
and described nursing as a humanistic
discipline that emphasizes the person's
adaptive or coping abilities (Chitty & Black,
2011, p. 313)."
Does this model have a
narrow view?
"Sister Roy continues to update, revise, and refine it for use in practice,
research, theory, and administration" (Chitty & Black, 2011, p. 313).
According to Pamela Senesac (2013), a nurse with a doctorate degree at
Boston College where Roy is also a professor and nursing theorist, Roy’s
model is being actively used in the following areas in addition to many
more:
A NICU as an ideology for nursing
An acute surgical ward as a means of documenting compliance with
the nursing process
In an 18-bed unit in a rehab facility o integrate the professional basis
of patient care
In a 125-bed orthopedic hospital to facilitate an integrated system of
nursing
In a 145-bed hospital to increase clarity in provider roles and to
strengthen interdisciplinary collaboration and effectiveness
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Practice Situation
Chitty & Black (2011), describe a situation with a
patient that is receiving home care by a nurse
for a wound. Once the wound is non-resolving
the nurse further investigates using Roy's
Adaptation Model and by asking questions based
on the thought process of RAM. From his
assessment, he discovered that the patient
needed to be tested for diabetes. The nurse was
able to see the environmental stimuli that was
negatively affecting the patient's healing process
and further intervene.
Case Study
A seventy-nine year old man, with a history of congestive heart failure (CHF), lost
his wife last year and now lives alone. His wife used to cook all of his meals and
manage his medications for him. He still remains social with his friends, meeting
them for coffee and breakfast each morning. He enjoys being outdoors and
reading, though his eye sight has diminished lately, and he is embarrassed to share
this with his children. While he maintains his appointments with his physician, the
patient has had an increasing number of hospital admissions related to CHF and
often waits until his symptoms are severe before seeking medical attention. His
lasix are scheduled BID and he does not like taking his night time dose because he
is up all night urinating. Though he has children who are active in his care, they
are busy taking care of their own children. His daughter drops in to check on him a
few times a week, bringing him dinners that she has frozen for him to eat
throughout the week. For lunch or sometimes dinner, the patient will have a can
of soup and enjoys drinking things such as gatorades and juices.
Using what you have learned from the presentation and your textbook, complete
an assessment on the patient’s environment. What conclusions can you reach as to
why the patient's condition is worsening? What type of interventions would you
then complete?
References
Chitty, K.K., & Black, B.P. (2011). Professional nursing: Concepts and Challenges (6th
ed.) Maryland Heights, MO: Saunders.
Connell School of Nursing (2013). The Roy adaptation model. Boston College William
F. Connell School of Nursing. Retrieved from
http://www.bc.edu/content/bc/schools/son/faculty/featured/theorist/Roy_Adap
tation_Model.html
Current Nursing.(2012, January 26). Nursing Theories. In Roy's Adaptation Model.
Retrieved from
http://currentnursing.com/nursing_theory/Roy_adaptation_model.html
Hanna, D.R. (2013). Roy's Specific Life Values and the Philosophical Assumption of
Humanism.Nursing Science Quarterly, 26(1), 53-58. doi: http://0dx.doi.libcat.ferris.ed/10.1177/0894318411419210
References cont.
Lopes, M., Pagliuca, L., & Araujo, T. (2006, March). Historical evolution of the
concept environment proposed in the Roy Adaptation Model. Revista LatinoAmericana de Enfermagem, 14(2), 259-265. doi:10.1590/S010411692006000200016
Roy, C., Whetsell, M., & Frederickson, K. (2009, July). The Roy Adaptation Model
and research. Nursing Science Quarterly, 22(3), 209-211.
doi:10.1177/0894318409338692
Senesac, Pamela (2013). Implementing the Roy adaptation model: From theory to
practice. Retrieved from
http://www.bc.edu/content/bc/schools/son/faculty/featured/theorist/Roy_
Adaptation_Model/Practice.html
Shosha, G.A., Al kalaldeh, M. (2012). A critical analysis of using roy’s adaptation
model in nursing research. International Journal of Academic Research, (4)4, 2631.
Weiss, M. E., Hastings, W. J., Holly, D. C., & Craig, D. I. (1994). Using Roy's
adaptation model in practice: nurses' perspectives. Nursing Science Quarterly,
7(2), 80-86. doi:10.1177/089431849400700208