roy's model presentation

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IN THE NAME OF ALLAH

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CALLISTA ROY:THE ADAPTATION MODEL

By: I. F. K, RN, BSN, MSN

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Objectives

Get a brief about Dr. RoyDefine the theoryThe Metaparadigm of the theoryTo know the types of stimuli To know the Adaptive ModesIs the theory applicableIs the theory practicableCan the theory guide research studiesCan the theory used in educational

programsConclusion

A brief about Dr. Roy

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Callista Roy

Born in Los Angeles, California, on October 14, 1939

Second child of Mr. and Mrs. Fabien Roy

Mother was a licensed vocational nurse

Roy was designated as a 2007 Living Legend by the American Academy of Nursing.

Roy, Sr. C., Zhan, L., & Parker, M. E., ( 2006). Nursing Theories & Nursing Practice. Second Edition. Philadelphia, PA: F. A Davis Company

https://en.wikipedia.org/wiki/American_Academy_of_Nursing

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EducationBachelors Degree in Nursing from

Mount St. Mary’s College in 1963Masters in Pediatric Nursing from

University of California in 1966Suffered with Encephalomyelitis, a neurological

disorder.

Second Masters and PhD in Sociology in 1973 and 1977

Dr. Roy also had the opportunity to be a clinical nurse scholar two-year postdoctoral program in Neuroscience Nursing at University of California, She selected this field to develop her understanding of the holistic person, especially as an adaptive system, and because of her familiarity with this clinical area as a result of her own neurological illnesses


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Professional Experience

Started at age 14 as a nurse aidPediatric NurseNursing instructor in many

different capacitiesShe has lectured across the United

States and in more than thirty other countries

One of her teachers and mentors : Dr. Dorothy Johnson She was Roy’s main influence to develop

herNursing theory

Currently, she is studying the role of lay study in recovery from mild head injury


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Introduction of The Model/Theory

Adaptation was first introduced to Ms. Roy in herpsychology class.

Adaptation of children: While working as a Pediatric nurse, Roy had

noticed the great resiliency of children and their ability to adapt in response to major physical and psychological changes.

Theory development started in 1964.

Alligood, M. R., & Ann Marriner T., (2010). Nursing theorists and their work. Seventh edition. Maryland Heights, MO: Mosby Elsevier.

Define the theory

* According to Roy’s model, the goal of nursing is to help the person adapt to change in physiological needs, self-concepts, role function and interdependent relations during health and illness.

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Roy’s Adaptation Model

Alligood, M. R., & Ann Marriner T., (2010). Nursing theorists and their work. Seventh edition. Maryland Heights, MO: Mosby Elsevier.

Metaparadigm

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Metaparadigm: Person

The Person (or a group) viewed as a adaptive system, their health, and their environment.

Engaging in and interchanging with the environment

Person also refers to families, groups, communities and the whole society.

Andrews, H. A., & Roy, Sr. C., (1999). The Roy Adaptation Model. Stamford, CT: Simon & Schuster Company.


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Metaparadigm: Health

Health is the state and a process of being and becoming an integrated and whole person.

It is a process where he or she is striving to achieve their maximum potential.


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Metaparadigm: Environment

Roy sees the environment as all conditions, circumstances and influences that surround and affect the development and behavior of the person

A change acts as a stimulating and causes adaptive responses.


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Metaparadigm of Nursing

Nursing acts to enhance the interaction of the person with the environment to promote adaptation.

Roy’s Model Continued…

*The person has two major internal processing subsystems:

o The regulator and the cognator.

o These subsystems are the mechanisms used by human beings to cope with stimuli from the internal and external environment.

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Roy’s Model Continued…

Three types of stimuli influence an individual’s ability to cope with the environment:

*Focal stimuli are those that immediately confront the individual in a particular situation. Focal stimuli for a family include needs and changes within the family members, among the environment.

*Contextual stimuli are those other stimuli that influence the situation.

*Residual stimuli include the individual’s beliefs or attitudes that may influence the situation. Contextual and residual stimuli for a family system include nurturance, socialization, and support.

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Types of Stimuli:

*Example: SmokingFocal- nicotine addictionContextual- belief that smoking is enjoyable,

relaxing, part of routineResidual- beliefs about body image, and

weight gain with smoking cessation

Roy’s Model Continued…15

Example on types of Stimuli:

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Adaptive Modes

1. Physiological- oxygenation, nutrition, elimination, activity, rest, and protection

2. Self Concept- Psychological and spiritual elements

3. Role Function- primary, secondary, and tertiary roles the person performs in society

4. Interdependence- coping mechanisms arising from close relationships

Goal: Promote integrated adaptation in all four modes = HEALTH

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Adaptive Modes

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Four Adaptation Modes

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Roy’s Adaptation Model

Developed over the years

Supported through research

A total of 163 studies were conducted by group of seven scholars to test propositions of the model.

Has been in use for more than 49 years in providing direction for nursing practice, education, administration, and research.

Internationally used. Alligood, M. R., & Ann Marriner T., (2010). Nursing theorists and their work. Seventh edition. Maryland Heights, MO: Mosby Elsevier.

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Apply the Nursing Process to Each of the Four Adaptive Modes

1. Assess Behavior 2. Assess Stimuli 3. Nursing Diagnosis 4. Goal Setting 5. Interventions 6. EvaluationULTIMATE GOAL: Promote integrated adaptation in

each of the Four Adaptive Modes

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Examples of Roy’s Model in Practice

Cancer patients -Cook(1999), Gerrish (1989)Amputations - Dawson (1998)Occupational Health -Doyle & Rejacich (1991)Pt’s with Anxiety- Fredrickson (1993)Hospitalized Children- Galligan (1979), Starn &

Niederhauser (1990)Coronary Care Unit- Hamner (1989)Adolescents with Asthma- Hennessy-Harstad (1999)Adult Hemodialysis patients- Keen et al. (1998)Home care- Lankester & Sheldon (1999), Schmitz (1980)Abused Women- Limandri (1986) Patients with alzheimer’s disease- Thornbury & King (1992)

.

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Use of Roy’s model to promote behavior change...

*Using Roy's adaptation model when caring for a group of smoker to quit smoking:

The model served as a guide to assess each member's level of adaptation in each of the four modes to identify actual or potential adaptation problems and then examining the stimuli that influence those problems. Nursing interventions focused on approaches to the management of stimuli to promote adaptation for the group by helping the members move to the phase of thinking of quitting smoking.

* Villareal, E. (2003). Using Roy’s adapation model when caring fpr a group of young women contemplating quitting smoking. Public Health Nusing, 20(5), 377-384

Examples of Roy’s Adaptation Model in Research

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Cross-cultural pain- Calvillo & Flaskerud (1993)Caesarean birth- Fawcett (1990) Cancer patients- Frederickson et al. (1991), Samarel et

al. (1998)Spinal cord injury patients- Harding-Okimoto (1997)Abused women- Limandri (1986)Well adolescents- Modrcin et al. (1998)Spouses of surgical patients- Silva (1987)Elderly persons- Smith (1988), Zhan (2000)Persons with Alzheimer’s disease- Thornbury and King

(1992)Brooke Army Medical Center and U.S. Army Institute of

Surgical Research- Series of studies based on Roy’s Adaptation Model.

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Examples of Roy’s model in Education 24

One of the most widely used models in the U. S. for nursing education.

Geriatric Nurse-Practitioner Program.University of Ottawa School of Nursing,

Canada.Mount Saint Mary’s College, Los Angeles.

*Source: Fitzpatrick & Wall, 2005

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Roy’s Model Applied to Administration

A research study explains how one hospital implemented Roy’s model to develop :

• A Nursing Philosophy

• Mission Statements

• Standards of Practice

• Job Descriptions

• Performance Planning and an Appraisal System

• A Quality Monitoring System

CONCLUSION: highly integrated system of nursing administration and practice.

*Rogers et al.,1991

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Evaluation of Model

AdequacyModel developed

from belief based mainly on pediatric clinical observations.

Use of Harry Helson’s adaptation theory

(Patton, 2004)

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Evaluation of Model

ClarityAdaptive modes have unclear boundaries -Interrelated by perception.

Some use of theoretical jargon.Good assessment method.

(Lewis, 1988; Patton, 2004)

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Evaluation of Model

Complexity Abstract and difficult to

understand

Concept of Person as an

adaptive system

Not easily operational for research

stimuli create an extensive list of potential variables.

Tolson & McIntosh, 1996

Adaptation

Coping Control

Stabilizer

Regulator Cognator Innovator

Cognitive Emotional Output processes

Central processes

Input

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Evaluation of Model

Completeness Addresses all four concepts of a nursing model

(metaparadigm)

Comprehensive and systematic assessment.

Focus on the individual.

Person = adaptive system.

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Clinical Use of the Model for FNPs in primary care setting

Provides guidance for intervention that can enhance quality of life and enhance interaction of the person with the environment

Adaptation to chronic illness

Family functioning

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Clinical Use of the Model for Cardiac Health

Chest pain, decreased levels of activity, fluid overload, sleep disturbance (physiologic mode)

Fear, anxiety, body image disturbance due to bypass surgery (self-concept mode)

Increased dependency on others (role function)

Relationship needs unmet (interdependence mode)

Self-esteem issues (interdependence mode)

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Conclusion

Widely used in different settings and has enduring property (based on system’s theory) (Alligood, 2010)

Updated as knowledge increases and trends change (Alligood, 2010)

As one of the weaknesses of the theory that application of it is time-consuming, application of the model to emergency situations requiring quick action is difficult to complete.

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References33

• Alligood, M. R. (2010). Nursing theory: Utilization and application. Maryland Heights, MO: Mosby, Inc.

• Cody, W. (2006). Philosophical and Theoretical Perspectives for Advanced Nursing Practice. (4th Ed.). Sudbury, MA: Jones and Bartlett.

• Dixon, E.L. (1999). Community health nursing practice and the Roy adaptation model. Public Health Nursing 16(4), 290-300

• Farkas, L. (1981). Adaptation problems with nursing home application for elderly persons: an application of the Roy adaptation nursing model. Journal of Advanced Nursing (6), 363-368.

• Fitzpatrick, J.J., & Whall A.L. (2005). Conceptual models of nursing: Analysis andapplication. Upper Saddle River, NJ: Pearson Education, Inc.

• Lewis, T. (1988). Leaping the chasm between nursing theory and practice. Journal of Advanced Nursing (13), 345-351.

• Yeh, C.H. (2001). Adaptation in children with cancer: Research with Roy’s model. Nursing Science Quarterly 14 (2), 141-148.

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References Continued

• Patton, D. (2004). An analysis of Roy’s Adaptation Model of nursing as used within acute psychiatric nursing. Journal of Psychiatric and Mental Health Nursing (11), 221-228.

• Roders, M., Paul, L. J., Clarke, J., Mackay, C., Potter, M., Ward, W. (1991). The use of the Roy Adaptation Model in nursing administration. Canadian Journal of Nursing Administration 4 (2), 21-26.

• Tolson, D, McIntosh, J. (1996). The Roy Adaptation Model: a consideration of its properties as a conceptual framework for an intervention study. Journal of Advanced Nursing (96), 981-987.

• Villareal, E. (2003). Using Roy’s adaptation model when caring for a group of young women contemplating quitting smoking. Public Health Nursing, 20(5),

377-384.• Yoder, L. H. (2005). Using the Roy adaptation model: A program of research in a

military research service. Nursing Science Quarterly 18(4), 321-323.

roy's model presentation

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