Sister Callista Roy

ADAPTATION THEORY

“When push comes to a shove, we will seldom disappoint ourselves. We all harbour greater stores of strength than we think. Adversity brings the opportunity to test our mettle and discover for ourselves the stuff of which we are made.”

PHILOSOPHICAL UNDERPINNINGS OF THE THEORY

          Johnson’s nursing model was the impetus for the development of Roy’s Adaptation Model. Roy also incorporated concepts from Helson’s adaptation theory, von Bertalanffy’s system model, Rapoport’s system definition, the stress and adaptation theories of Dohrenrend and Selye, and the coping model of Lazarus (Philips, 2002). 

MAJOR ASSUMPTIONS, CONCEPTS AND RELATIONSHIPS ASSUMPTIONS

In the Adaptation Model, assumptions are specified as scientific assumptions or philosophical assumptions.

Scientific Assumptions

• Systems of matter and energy progress to higher levels of complex self- organization.
• Consciousness and meaning are constitutive of person and environment integration
• Awareness of self and environment is rooted in thinking and feeling
• Humans by their decisions are accountable for the integration of creative processes.
• Thinking and feeling mediate human action
• System relationships include acceptance, protection, and fostering of interdependence
• Persons and the earth have common patterns and integral relationships
• Persons and environment transformations are created in human consciousness
• Integration of human and environment meanings results in adaptation (Roy&Andrew, 1999, p.35).

Philosophical Assumptions

• Persons have mutual relationships with the world and God
• Human meaning is rooted in the omega point convergence of the universe.
• God is intimately revealed in the diversity of creation and is the common destiny of creation.
• Persons use human creative abilities of awareness, enlightenment, and faith.
• Persons are accountable for the processes of deriving, sustaining and transforming the universe (Roy & Andrew, 1999, p. 35).

The Four Modes of Adaptation

1. Physiologic-Physical :  Mode Physical and chemical processes involved in the function and activities of living organisms; the underlying need is physiologic integrity as seen in the degree of wholeness achieved through adaptation to change in needs.
2. Self-concept :  Group Identity ModeFocuses on psychological and spiritual integrity and sense of unity, meaning, and purposefulness in the universe.
3. Role Function Mode :  Roles that individuals occupy in society, fulfilling the need for social integrity. It is knowing who one is in relation to others.
4. Interdependence Mode :  The close relationships of people and their purpose, structure and development individually and in groups and the adaptation potential of these groups.

ROY’S THEORY AS APPLIED TO:

NURSING PRACTICE

          Using Roy’s six –step nursing process, the nurse assesses first the behaviors and second the stimuli affecting those behaviors. In a third step the nurse makes a statement or nursing diagnosis of the person’s adaptive state and fourth, sets goals to promote adaptation. Fifth, nursing interventions are aimed at managing the stimuli to promote adaptation. The last step in the nursing process is evaluation. By manipulating the stimuli and not the patient, the nurse enhances the interaction of the person with their environment, thereby promoting health.

Hamner in 1989 discussed the Roy model and how it could be applied to nursing care in a cardiac unit (CCU). Hamner describes the model as enhancing care in the CCU and being consistent with the nursing process. Hamner found that the model assessed all patients’ behavior, so that none was excluded. The author discovered that the Roy model provides a structure in which manipulation of stimuli are not overlooked. The model puts emphasis on identifying and reinforcing positive behavior which speeds recovery.

EDUCATION

         The adaptation model is also useful in educational setting. Roy states that the model defines for students the distinct purpose of nursing which is to promote man’s adaptation in each of the adaptive modes in situations of health and illness.

In the early 1980’s the School of Nursing at the University of Ottawa experienced a major curriculum change. This change included incorporating a nursing model by which to base their new curriculum. The change included incorporating a nursing model by which to base their new curriculum. The Roy adaptation model was one of the models to be included in the first year of the baccalaureate program. The professors had to meet four challenges during this change:

1. Adapting the course to be congruent with the Roy model,

2. Developing teaching tools suitable for student learning.

3. Sequencing of content for student learning

4. Obtaining competent role models.

RESEARCH

         If research is to affect practitioners’ behavior, it must be directed at testing and retesting conceptual models for nursing practice. Roy has stated that theory development and the testing of developed theories are nursing’s highest priorities. The model must be able to regenerate testable hypotheses for it to be researchable.

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