Sister Callista Roy:Sister Callista Roy:Roy Adaptation ModelRoy Adaptation Model

ImageImage

Mid 1960’s through Mid 1960’s through the 1970’sthe 1970’s

CaringCaring

StereotypesStereotypes

Evolving ImageEvolving Image

The Female Liberation MovementThe Female Liberation Movement

FeminismFeminism

EmpowermentEmpowerment

ProfessionalsProfessionals

Personal ImagePersonal Image

Sister NurseSister Nurse

Nurse ScholarNurse Scholar

Callista Roy-time lineCallista Roy-time line

October 14, 1939 Callista Roy Born

1963 BA (Nursing)1966

MS (Nursing)

1966-83 Dept. of Nursing (MSMC)

1964-66 Conceptualization of

Model

1968 Model put into

practice

1971-74 Chair, Dept of

Nursing (MSMC)

1971 Integration of Psychiatric

Concept

1973 MA (Sociology)

1977 PhD (Sociology)1978-79

Study, Project Director

1978 Award, Fellow of American

Academy of Nursing1981 Founder’s Award

1991 Award, National

League for Nursing

1987 100,000 (est.)

nursing students graduated with knowledge of

RAM

1991 Research,

Measurement of…adapting to

situations…

1987-Present Professor,

and Nurse Theorist. School

of Nursing, Boston College

Metaparadigm:Metaparadigm:PersonPerson

Humans are holistic, adaptive Humans are holistic, adaptive systemssystems

A whole with the parts that function A whole with the parts that function in unity for some purposein unity for some purpose

Not limited to just the individual can Not limited to just the individual can include; groups, families, include; groups, families, organizations, communities, and organizations, communities, and society as a wholesociety as a whole

Metaparadigm Metaparadigm EnvironmentEnvironment

Includes all the Includes all the conditions, conditions, circumstances, and circumstances, and influences surrounding influences surrounding and affecting the and affecting the development and development and behaviours of the behaviours of the person.person.

Stimuli include can be Stimuli include can be categorized as focal, categorized as focal, contextual and residual.contextual and residual.

Internal and ExternalInternal and External

Metaparadigm Metaparadigm HealthHealth

A state and a process of being and A state and a process of being and becoming integrated as a whole becoming integrated as a whole person person

Reflection of adaptation that is the Reflection of adaptation that is the interaction of the person and the interaction of the person and the environment environment

Metaparadigm Metaparadigm NursingNursing

Acts to enhance the Acts to enhance the interaction of the interaction of the person with the person with the environment to environment to promote adaptationpromote adaptation

A science and practice A science and practice that expands adaptive that expands adaptive abilities and enhances abilities and enhances person and person and environmental environmental transformation.transformation.

Metaparadigm Metaparadigm AdaptationAdaptation

Added by RoyAdded by Roy Process and outcome whereby thinking Process and outcome whereby thinking

and feeling persons use conscious and feeling persons use conscious awareness and choice to create human awareness and choice to create human environment integrationenvironment integration

““every human life is purposeful in a every human life is purposeful in a universe that is creative and persons universe that is creative and persons are inseparable from the environment” are inseparable from the environment”

(Dr. Callista Roy). (Dr. Callista Roy).

Roy Adaptation ModelRoy Adaptation Model(RAM)-Terms(RAM)-Terms

System-a set of parts connected to function as a System-a set of parts connected to function as a whole for some purposewhole for some purpose

Stimulus-something that provokes a response, Stimulus-something that provokes a response, point of interaction for the human system and the point of interaction for the human system and the environmentenvironment

Focal Stimuli-internal or external stimulus most Focal Stimuli-internal or external stimulus most immediately affecting the systemimmediately affecting the system

Contextual Stimulus-all other stimulus present in Contextual Stimulus-all other stimulus present in the situationthe situation

Residual Stimulus-environmental factor, that Residual Stimulus-environmental factor, that effects on the situation that are uncleareffects on the situation that are unclear

TermsTerms

Regulator Subsystem-automatic response to Regulator Subsystem-automatic response to stimulus (neural, chemical, and endocrine)stimulus (neural, chemical, and endocrine)

Cognator Subsystem-responds through four Cognator Subsystem-responds through four cognitive-emotive channels (perceptual and cognitive-emotive channels (perceptual and information processing, learning, judgment, and information processing, learning, judgment, and emotion)emotion)

Behaviour-internal or external actions and Behaviour-internal or external actions and reactions under specific circumstancesreactions under specific circumstances

Adaptive Responses-promote the integrity of the Adaptive Responses-promote the integrity of the human systemhuman system

Ineffective Responses-neither promote not Ineffective Responses-neither promote not contribute to the integrity of the human systemcontribute to the integrity of the human system

TermsTerms

Copping Process-innate or acquired Copping Process-innate or acquired ways of interacting with the changing ways of interacting with the changing environmentenvironment Innate-genetically determined, Innate-genetically determined,

automatic processautomatic process Acquired-developed through learning, Acquired-developed through learning,

deliberate and consciousdeliberate and conscious

4 Modes of Adaptation4 Modes of Adaptation

1.Physiologic-Physical 1.Physiologic-Physical ModeMode

Behaviour pertaining to Behaviour pertaining to the physical aspect of the physical aspect of the human systemthe human system

Physical and chemical Physical and chemical processes processes

Nurse must be Nurse must be knowledgeable about knowledgeable about normal processesnormal processes

5 needs (Oxygenation, 5 needs (Oxygenation, Nutrition, Elimination, Nutrition, Elimination, Activity & Rest, and Activity & Rest, and Protection)Protection)

2.Self Concept-Group Identity Mode2.Self Concept-Group Identity Mode The composite of beliefs The composite of beliefs

and feelings held about and feelings held about oneself at a given timeoneself at a given time

Focus on the psychological Focus on the psychological and spiritual aspects of the and spiritual aspects of the human systemhuman system

Need to know who one is, Need to know who one is, so that one can exist with so that one can exist with a state of unity, meaning, a state of unity, meaning, and purposefulnessand purposefulness

2 modes (physical self, and 2 modes (physical self, and personal self)personal self)

Goal: psychological Goal: psychological integrityintegrity

3.Role Function Mode3.Role Function Mode Set of expectations about how a person Set of expectations about how a person

occupying one position behaves toward occupying one position behaves toward a person occupying another positiona person occupying another position

Basic need-social integrity, the need to Basic need-social integrity, the need to know who one is in relation to othersknow who one is in relation to others

Goal: Social integrityGoal: Social integrity

4.Interdependance Mode4.Interdependance Mode Behaviour pertaining Behaviour pertaining

to interdependent to interdependent relationships of relationships of individuals and groupsindividuals and groups

Focus on the close Focus on the close relationships of people relationships of people and their purposeand their purpose

Each relationship Each relationship exists for some reasonexists for some reason

Involves the Involves the willingness and ability willingness and ability to give to others and to give to others and accept from othersaccept from others

Balance results in Balance results in feelings of being feelings of being valued and supported valued and supported by othersby others

Basic need-feeling of Basic need-feeling of security in security in relationshipsrelationships

Roy Roy Adaptation Adaptation

ModelModel

Feedback

Stimulus

Responses

Physiologic Mode

Self Concept Mode

Role Function Mode

Interdependence Mode

Human System

NIPISSING BUDDING NIPISSING BUDDING NURSING THEORISTSNURSING THEORISTS

Presents…

The Life and Times of The Life and Times of Julie P.Julie P.

Screen Play by: M.Hansen

Directed by: S.J.Fitzgerald

Scene 1Scene 1

Child has just been Child has just been diagnosed with DMdiagnosed with DM

Mother is trying to Mother is trying to maintain a positive maintain a positive attitude about the attitude about the experienceexperience

Scene 2Scene 2

Evidence of Evidence of ineffective ineffective adaptationadaptation

Scene 3Scene 3

Nurse offers Nurse offers suggestion suggestion (intervention)(intervention)

Scene 4Scene 4

Change in Julie P’s Change in Julie P’s behaviourbehaviour

Adaptation evidentAdaptation evident

Scene 5Scene 5

Building on past Building on past interventions interventions

Offering more Offering more choiceschoices

Scene 6Scene 6

Effective Effective Adaptation Adaptation achievedachieved

6 Step Nursing Process6 Step Nursing Process

1.1. Assesses the behaviours manifested from Assesses the behaviours manifested from the four adaptive modesthe four adaptive modes

2.2. Assess the stimuli, and categorize them Assess the stimuli, and categorize them into type of stimuliinto type of stimuli

3.3. Create a nursing diagnosis of the Create a nursing diagnosis of the person’s adaptive stateperson’s adaptive state

4.4. Set goals to improve adaptationSet goals to improve adaptation5.5. Implement interventions to achieve goalsImplement interventions to achieve goals6.6. Evaluate if goals have been metEvaluate if goals have been met

Assess. Assess. Of Of

BehaviouBehaviourr

Assess. Assess. Of Of

StimuluStimuluss

Nsg. Nsg.

Dx.Dx.Set Set

GoalsGoalsInterventiInterventionon

EvaluatioEvaluationn

-Data -Data gathering gathering about the about the behavior of behavior of the person the person as an as an adaptive adaptive system in system in each of the each of the adaptive adaptive modesmodes

-identify -identify stimulistimuli

-consult -consult with clientwith client

-it is -it is classified classified as focal, as focal, contextual contextual or residualor residual

--FormulatiFormulation of on of statementstatements that s that interpret interpret data data about the about the adaptatioadaptation status n status of the of the person, person, including including the the behavior behavior and most and most relevant relevant stimulistimuli

--establishmestablishment of clear ent of clear statements statements of the of the behavioral behavioral outcomes outcomes for nursing for nursing care which care which is realistic is realistic and and attainableattainable

-change -change stimulusstimulus

-appropriate, -appropriate, with the with the highest highest probability probability of achieving of achieving goalsgoals

-agreed -agreed upon with upon with clientclient

--assessmenassessment of t of behaviour behaviour response, response, in relation in relation to goalto goal

-may cause -may cause negative negative feedback feedback and have and have to set new to set new goalsgoals

Six Step Nursing

Process

Our personal philosophyOur personal philosophy

The positive energy exchange that The positive energy exchange that occurs between a nurse and the occurs between a nurse and the client results in a true, caring, client results in a true, caring, therapeutic relationship, conducive therapeutic relationship, conducive to a healing environment.to a healing environment.

ReferencesReferences

George, J.B. (2002). George, J.B. (2002). Nursing Theories, The Base for Nursing Theories, The Base for Professional Professional Nursing Practice.Nursing Practice. Upper Saddle River, NJ. Prentice Upper Saddle River, NJ. Prentice Hall.Hall.

Fawcette, J. (2002). The Nurse Theorists: 21Fawcette, J. (2002). The Nurse Theorists: 21stst Century Century Updates-Callista Roy. Updates-Callista Roy. Nursing Quarterly.Nursing Quarterly. 15:4,3008-310 15:4,3008-310

Roy, C. & Andrews, H.A. (1999). Roy, C. & Andrews, H.A. (1999). The Roy Adaptation Model. The Roy Adaptation Model. Stamford, CT. Appleton & Lance.Stamford, CT. Appleton & Lance.

Tomey, A.M. & Alligood, M.R. (2002). Tomey, A.M. & Alligood, M.R. (2002). Nursing theorists and Nursing theorists and their their work.work. St.Louis: Mosby St.Louis: Mosby

Unknown. Unknown. Implementing the Roy adaptation model: From Implementing the Roy adaptation model: From theory to theory to practice.practice. Retrieved from Retrieved from www2.bc.eduwww2.bc.edu on on November 12, 2006.November 12, 2006.