GOVT.

COLLEGE OF NURSING, BIKANER

SUBJECT: - ADVANCE NURSING

PRACTICE LESSION PLAN ON

SISTER CALLISTA ROY’S ADAPTATION MODEL

SUBMITTED TO: SUBMITTED BY:

Mrs.SUDIPTA PAUL Mr. KRISHNA KANT BHARDWAJ
ASSISTANT PROFESSOR M.Sc. NURSING PREVIOUS
GOVT. COLLEGE OF
NURSING, BIKANER
 LESSION PLAN
INTRODUCTION

NAME OF STUDENT : MR.KRSHNA KANT BHARDWAJ

NAME OF EVALUATOR : Mrs.SUDIPTA PAUL
NAME OF SUBJECT : ADVANCED NURSING PRACTICE
NAME OF TOPIC : CALLISTA ROY’S ADAPTATION
MODEL DATE
TIME
CLASS : M.SC. NURSING 1ST YEAR
DURATION
METHOD OF TEACHING : LEACTURE
A.V. AIDS : PROJECTOR, BLACK BOARD,PPT

PREVIOUS KNOWLEDGE: STUDENT HAS BASIC KNOWLEDGE ABOUT ROY’S ADAPTATION MODEL
THEORY.

GENERAL OBJECTIVE: - At the end of the teaching student will be able to enhance their knowledge about ROY’S
Adaptation theory and apply this knowledge in their clinical practice.

SPECIFIC OBJECTIVES: -
After this leading session students will able to: -

 Define the key terms related to nursing theory.

 Explain the purpose of the Roy’s theory.
 Describe the development of Roy’s theory.
 Explain the methods of adaptation model.
 Enlist the use of adaptation model in nursing
 Define the concepts related to Roy’s theory.
  Explain the implication of nursing process.

S. TIME SPECIFIC CONTENT A.V. TEACHING EVALUATI0N

NO. OBJECTIVES AIDS LEARNER
ACTIVITY
1. 4 Min to explain about PPT Student teacher Do you know
INTRODUCTION: -
Sister Callista introduce about anything about
Roy. Sister Callista Roy is a highly respected nurse theorist, topic and Sister Callista
writer, lecturer, and teacher theorist Roy’s
students are Adaptation
listen carefully. Model?

 Born: October 14, 1939 in Los Angeles, California.

 Bachelor degree in Nursing from Mount St Mary’s
 College in 1963.
 Master in Pediatric Nursing from University of
California 1966.
 M.A. and PhD from University of California, Los
Angeles, 1973.
 Currently serves as faculty member and nurse
theorist at Boston College.
 Honoured as a Living Legend by The
American Academy of Nursing and The
Massachusetts Association of Registered
Nurse.

2. 2 Min
To explain PPT Student teacher What is the
factor that explain the influencing
influencing. factor that factor?
influence the
theory.
Influencing factors in development of theory:
 Family
 Education
 Religious Background
3. 15 Min PPT Student teacher What do you
To explain  Mentors explain the key mean by theory
the key terms.  Clinical Experience term use in this and key terms
KEY TERMS: model. of theory?

Theory:
A theory is a set of related statements thar describe or
explains phenomena in a systematic way.

Nursing theory:
“A nursing theory is a set of concept, definitions,
relationships & assumptions or propositions derived from
nursing models or from other disciplines and project a
purposive, systematic view of phenomena by designing
specific inter-relationships among concepts for the purpose
of describing, explaining, predicting and prescribing.

System:
A system is a set of units so related or connected as to form
a unity or whole and characterized by input, outputs and
control and feedback processes.

Adaptation
Adaptation refers to the process and outcome whereby
thinking and feelings, persons as individuals or in groups
use conscious awareness and choice to create human and
environmental integration.
Adaptation level:
A person’s adaptation level is a constantly changing point,
made up of focal, contextual, and residual stimuli, which
represent his own standard of the range of stimuli to which
one can respond with ordinary adaptive responses.

Adaptation Problems:
Adaptation problems are described as the difficulties related
to the indicators of positive adaptation.
Focal Stimulus:
A local stimulus is the degree of change or stimulus most
immediately confronting the person and the one to which
the person must make an adaptive response that is the factor
that precipitates the behaviour.

Contextual Stimuli:
Contextual stimuli are all other stimuli present in the
situation that contributes to the effect of the focal stimulus,
i.e., contextual stimuli are all the environmental factors that
present to the person from within or without but which are
not the center of the person's attention and/or energy.
Residual Stimull:
Residual stimuli are environmental factors within or
without the human system with effects in the
current situation that are unclear.

Coping Processes:
Coping processes are innate or acquired ways of interacting
with the changing environment.

Innate Coping Mechanisms

Innate coping mechanisms are genetically determined or
common to the species and are generally viewed as
automatic processes, human do not have to think about
them.
Acquired Coping Mechanism
Acquired coping mechanisms are developed through
strategies such as learning. The experience encountered
throughout life contributes to customary responses to
particular stimuli.
Regulator Subsystem:
A regulator is a subsystem coping mechanism which
responds automatically through neural-chemical-endocrine
processes.
 Cognator Subsystem:
A cognator is a subsystem coping mechanism which
responds through complex processes of perception and
information processing learning judgment and emotion.

Adaptive Responses:
Adaptive responses are those that promote integrity in
terms of the goals of human systems.

Ineffective Responses:
Ineffective responses are those that do not contribute to
integrity in terms of the goals of the human system.

Adaptive modes:
Adaptive modes are a classification of way of coping that
manifest regulator and cognator activity, that is
physiological, self-concept role function and
interdependence.

4.
2 Min To explain PPT Student teacher What is the
the purpose of explain the purpose of
the theory. purpose of Roy’s Model?
 PURPOSE OF MODEL: model.
The purpose of this model is directed toward promoting
5. adaptation in each of the four-response made, there by
5 Min contributing to the person’s health, quality of life and dying
To describe the with dignity. Nursing care is then directed at helping the PPT Student teacher What is the
Development of client adapt. explain the development of
theory.
development of model?
Development of theory: model.
1. Philosophical assumptions
2. Scientific assumptions

1. Philosophical assumptions:
 Persons have mutual relationship with the world and
God
 Human meaning is rooted in an omega point
convergence of the universe.
 God is intimately revealed in the diversity 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.
 2. 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.
 Human decisions are accountable for the integration
of creative processes.
 Thinking and feeling mediate human action.
 System relationship include acceptance,
protection and fostering of interdependence.
 Persons and the earth have common patterns and
integral relations.
 Person and environment transformations are created
in human consciousness.
6.  Integration of human environment meanings results
10 To explain in adaptation. PPT Student teacher What is the
Min the Roy’s explain the Roy’s
Adaptation Roy’s Adaptation
Model ROY’S ADAPTATION MODEL : Adaptation model?
model.
The RAM in nursing practice led to some result in
attainment of an optimum level of wellness by the person.
 o Input or stimuli
o Control processes comprising of coping mechanism
o Effectors which provide form or manifestation to
control process
o Output that may be adaptive or ineffective responses.

Input:
Adaptive system has input coming from external
environment as well as from the person. In Roy's system,
input is identified as stimuli. Adaptation level is determined
by the combined effect of focal, contextual and residual
stimuli. Adaption occurs when the person responds
positively to environmental changes.
Types of stimuli:
o Focal stimuli
o Contextual stimuli
o Residual stimuli

Control process: -
Roy has used the term coping mechanism to describe
control processes of the person as an adaptive system.
Some coping mechanisms are inherited or genetic such as
WBC defense against microorganisms. Others are learnt
such as use of antiseptics to cleanse a wound. The control
process is primary or functional subsystem consists of:
 The regulator
 The cognator coping mechanisms.

Effectors: -
Although cognator and regulator processes are essential to
the adaptive responses of the person, these processes are
not directly observed, Roy identified 4 modes for
assessment of behavior that result from coping
mechanisms:

1. Physiological needs
 2. Self-concept
3. Role function
4. Interdependence.

Output: -
It is the response of the person. It can be observed,
intuitively perceived by the nurse, measured and
subjectively reported by the person. Output may be
adaptive or ineffective responses.

 Adaptive response
 Ineffective response

7.
5 Min To explain the PPT Student teacher What is the use
USE OF ADAPTATION MODEL IN NURSING:
use of model in explain the use of model in
nursing of model in nursing?
 Scientific knowledge for practice.
nursing.
 Clinical assessment and intervention.

 Research variables.

 Guide nursing practice.

 Organize nursing education.

  Curricular framework for various nursing colleges.
8.
8 Min To explain FOUR MAJOR CONCEPTS OF THE PPT Student teacher What is the
the four major ROY ADAPTATION MODEL: explain the major concept
concept of Roy’s major concept of RAM?
Adaptation  Human as adaptive systems of RAM.
model.  Health
 Environment
 The goal of nursing

1. Human as adaptive systems:

The first area is humans as adaptive systems, both as
individuals and in groups. The model offers a point of view
or paradigm for shaping nursing activities. The focus of
nursing relationships and interactions can be at the level of
the individual, groups, organizations, communities, and
societies in which they are included. Any of these may be
considered a human system and each is considered by the
nurse as a holistic adaptive system. The idea of an adaptive
system combines the concepts of system and adaptation.
 2. Environment:
According to Roy, stimuli from within the human adaptive
system and stimuli from around the system represent the
element of internal and external environment. Roy
specifically defines environment as "all conditions,
circumstances, and influences that surround and affect the
development and behavior of humans as adaptive systems,
with particular consideration to person and earth resources."
3. Health:
Roy defines health as "a state and process of being and
becoming an integrated and whole person." The integrity
of the person and environment transformation. Roy states
that the term integrity is used to mean "soundness or an
unpaired condition leading to wholeness." One's sense of
purpose in life and the meaning of life, according to Roy,
are significant factors relating to integration and wholeness.
4. Nursing:
Roy defines the goal of nursing as the promotion of
adaptive responses in relation to the four adaptive modes:
o The physiological- physical
o Self-concept-group identity
o Role function
o Interdependence.
Adaptive responses are those that positively affect health,
that is, support the integrity of the human adaptive system.
In the perspective of the RAM, human responses include
not only problems, needs, and deficiencies but also
capacities, assets, knowledge, skills, abilities, and
commitments.
 The implication of nursing process:
RAM offers guidelines to nurse in developing the nursing
9. process that six steps:
3 Min
To explain Student teacher What is the
 First level assessment PPT
the model explain the purpose of
implication in  Second level assessment model implicate
nursing process.  Diagnosis implicate in model in
 Goal setting nursing nursing
 Intervention process. process?
 Evaluation

APPLICATION OF ROY’S ADAPTATION

MODEL:
o In Education
10. Student teacher What is the
7 Min o In Practice PPT
To explain o In Research explain the application of
the application of Roy’s
application of Roy’s Adaptation
RAM. Adaptation Model?
In Education: Model.
The model has given nursing educators a conceptual
framework for their curriculums.
It has had widespread use by baccalaureate programs in
USA and elsewhere. In some cases, every course in a
program included the term adaptation in its title. The
adaptation model is currently in use at Mount Saint Mary's
College Department of Nursing in Los Angeles. Mount
Saint Mary's program demonstrates the relationship of
nursing theory to nursing education.
Three vertical strands run throughout the curriculum:
1. The adapting person (theory strand)
2. health-illness (theory strand)
3. nursing management (practice strand).
There are two horizontal strands in the curriculum:
1.Nursing process
2 Student adaptation and leadership

In Practice:
 The model is useful for nursing practice, because I
outline the features of the discipline and provide
direction for practice, education.
 The model considers goals, values, the patient and
practitioner interventions.
 Introduced a nursing process with two-level
assessment.
 When using the six steps nursing process the
nurse performs the functions.
Example……
 Newman applied the Roy’s model to caregivers of
 chronically ill family member.
 Focal stimulus - chronically ill family member.
 Contextual stimuli - caregiver’s age gender and
relationship to the chronically ill family
member.
 Physical adaptive mode - the caregiver’s physical
health status.
 Self-concept model – the care giver’s emotional
responses to caregiving.

In Research:
 This model has been used extensively to guid
knowledge development through nursing research.
 The influence of the Roy’s adaptation model on
nursing research is evidenced by the vast number
of qualitative and quantitative research studies, it
has guided.

SUMMARY:

Today we have discuss about the definition of theory,

nursing theory, key terms, purpose of roy's theory,
development of Roy's theory. explain the methods of
model. concepts of roy's theory, use of adaptation model in
nursing.

CONCLUSION: -
Roy's adaptation model has its foundation in the
behavioural science. The Roy's model as evolving from
psychodynamic nursing. The central focus of roy's model is
the person adapt to changes in physiological needs, self-
concept, role function, & interdependent relation during
health and illness.
Bibliography:

o Text book of advanced Nursing practice, Navdeep Kaur Brar - H.C. Rawat, Jaypee Brothers, 1st edition,

o Advance Nursing Practice, Shebeer.P. Basheer, S. Yaseen Khan , EMMESS, 3rd edition – 2022,

o Advance concepts of Nursing practice, Reddamma GG, Jaypee brothers 1st edition, 2021,

o Fundamental of Nursing Kozier, Dorling Kindersley pvt. Ltd, 2nd edition, 2006,

o Fundamental of Nursing, Carol Taylor, Lippincott publications, 6th edition, 2005,

o Fundamental of Nursing, Potter and Perry, Mosby publications, 4th edition, 1997,

o Nursing Administration, B.T. Basavanthappa 3rd edition, Jaypee Brother,

Research Articles: The Effectiveness of Roy's Adaptation Model for Patients with Chronic Kidney
Disease Undergoing Pre-Dialysis

ABSTRACT
Introduction: Patients with chronic kidney disease (CKD) undergoing pre- dialysis requires a good self-management to
control low protein intake and maintain kidney function. Adaptation to the existing stimulus through coping and adjustment
mechanisms is important to maintaining good kidney function. However, few studies applied nursing theory based to guide
intervention in helping the adaptation of patient CKD with their condition. The purpose of this study is to evaluate the
effectiveness of Roy's adaptation model towards physiological and psychological adaptation response among patients
with CKD undergoing pre-dialysis.
Methods: This study was conducted using a quasi-experiment to patients with CKD pre-dialysis, age over 18-year-old.
We modified Roy’s adaptation model for patient with CKD undergoing pre-dialysis.
Keywords: Chronic kidney disease; pre- dialysis; physiological adaptation response; psychological adaptation behavior,
Roy's adaptation model.
Results: A total of 70 subjects agreed to join the study. 38 subjects in Bandung, West Java, Indonesia intervention and 32
subjects in the control group. The mean of eGFR ranged from 26.3 to 26.6 mL/min/1.73 m2. We found that Roy's
adaptation model has significantly improved drinking behavior, reduce protein intake, blood creatinine, and psychosocial
adaptation response after the intervention.
Conclusion: These study findings suggested that Roy's adaptation model is effective to help patients with CKD
undergoing pre-dialysis improve their behavior and maintain kidney function. Model dissemination, advocacy to related
units, and
application in nursing care in patients with chronic kidney disease pre-dialysis are necessary.