Roy Adaptation Model 16:11

1
 Roy Adaptation Model 16:11

2 OBJECTIVES

By the end of this presentation, students

Discuss
will Roy Adaptation
be able to: Model

Discuss the Human as an Adaptive System

Discuss the Four Adaptive Modes of

Adaptation
Relationship of Roy Adaptation Model and
Nursing Process

Analyze Roy Adaptation Model

 BIOGRAPHY
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• Born at Los Angeles on October 14, 1939.

• Sister Callista Roy- nurse theorist, writer, lecturer, researcher.
• Professor and Nurse Theorist at the Boston College of Nursing in Chestnut Hill.
• Bachelor of Arts with a major in nursing - Mount St. Mary's College, Los Angeles in
1963.
• Master's degree program in pediatric nursing - University of California ,Los Angeles
in 1966.
• Master’s and PhD in Sociology in 1973 and 1977.
 Roy Adaptation Model 16:12

4 CONTINUED
• She is known for creating the adaptation model of nursing
• 1968-She began operationalizing her model when Mount St. Mary’s college adopted
the adaptation framework as nursing curriculum.
• 1971- She was made chairperson of the nursing department at the Mount Saint
Mary’s college.
• Roy was designated as a 2007 Living Legend by the American Academy of Nursing.
 Roy Adaptation Model 16:12

5 THEORETICAL SOURCES

• Johnson’s nursing model was the impetus for the development of the RAM.
• 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.
• The coping model of Lazarus (Phillips, 2010)
 DEFINITION OF ROY’S
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ADAPTATION THEORY
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“The goal of nursing is to promote adaptation for individuals and groups in each of the
four adaptive modes i.e.
Physiological needs
Self-concepts
Role-function
Interdependent relations thus contributing to health quality of life and dignity with
dying”.
 Roy Adaptation Model 16:12

7 ROY’S ADAPTATION
MODEL
• According to Roy, adaptation is defined as ”The process and outcome of individuals
and groups who use conscious awareness, self reflection and choice to create human
and environmental integration”.
• The Roy Adaptation Model focuses on the interrelatedness of four adaptive systems.
• It is a deductive theory based on nursing practice.
• The RAM guides the nurse who is interested in physiologic adaptation as well in
psychological adaptation.
MAJOR ASSUMPTIONS OF ROY'S
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ADAPTATION MODEL
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 Roy divides assumptions into Three categories:

• Philosophical
• Scientific
• Cultural
 PHILOSOPHICAL
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9 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.
• Persons use human creative abilities of awareness, enlightenment, and faith.
• Persons are accountable for sustaining and transforming the universe.
 SCIENTIFIC ASSUMPTIONS
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• Systems of matter and energy progress to higher levels of

complex self-organization.
• Consciousness and meaning are constructive 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.
 Roy Adaptation Model 16:12

11 CONTINUED
• 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 environmental meanings results in
adaptation.
 Roy Adaptation Model 16:12

12 CULTURAL
ASSUMPTIONS
• Cultural experiences influence how RAM is expressed.
• A concept central to the culture may influence the RAM to some extent.
• Cultural expressions of the RAM may lead to changes in practice activities such as
nursing assessment.
• As RAM evolves within a culture, implications for nursing may differ from
experience in the original culture

(Roy, 2009, p. 31)

 Roy Adaptation Model 16:12

Major Concepts
13

 Person adaptive system

 Environment stimuli
 Health outcome of adaptation
 Nursing promoting adaptation
and health
 PERSON
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• “Human systems have thinking and feeling capacities

by which they adjust effectively to changes in the
environment.’’
• Bio-psycho-social being in constant interaction with a
changing environment.
• Uses innate and acquired mechanisms to adapt.
 ENVIRONMENT
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• “The conditions, circumstances that influences surrounding an

affecting the development and behavior of persons or groups.’’
• Environment act as a stimulus that affect on human system.
 Roy Adaptation Model 16:12

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 There are three types of stimulus:

Focal- internal or external and immediately confronting the person.

Contextual- all stimuli present in the situation that contribute to
effect of focal stimulus
Residual- a factor whose effects in the current situation are unclear.
This can include previous experience with certain stimuli.
 Roy Adaptation Model 16:12

HEALTH
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• “Health is not freedom from the death, disease,

unhappiness, and stress, but the ability to cope with
them in a competent way.”

• Health and illness are Inevitable dimension of

person's life.

• Represented by a health-illness continuum.

 Roy Adaptation Model 16:12

18 NURSING
• In Adaptation Model, nurses are facilitators of adaptation.
• “The goal of nursing is the promotion of adaptation for
individuals and groups in each of the four adaptive modes, thus
contributing to health and quality of life.”
• Nurses help in increasing positive and decreasing negative
adaptation mechanism by assessing patients' behaviors and
interaction with environment.
 INTERNAL PROCESSES
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19 OR SUB-SYSTEMS

Regulator
• The regulator subsystem is a person’s physiological coping
mechanism. The body responds automatically to adapt through
regulation of our bodily processes, including neurochemical and
endocrine systems.

Cognator
• The cognator subsystem is a person’s mental coping mechanism. A
person uses his brain to cope via self-concept, interdependence, and
role function adaptive modes.
 Responses

• ADAPTIVE RESPONSES – RESPONSES THAT PROMOTE

INTEGRITY OF THE PERSON IN TERMS OF GOALS OF
SURVIVAL, GROWTH, REPRODUCTION, AND MASTERY.

• INEFFECTIVE RESPONSES – RESPONSES THAT DO

NOT CONTRIBUTE TO ADAPTIVE GOALS.

• THESE RESPONSES SERVE AS FEEDBACK TO THE HUMAN

SYSTEM
• THEN HUMAN SYSTEM DECIDE EITHER TO INCREASE OR
DECREASE EFFORTS TO COPE WITH STIMULI.
 FOUR ADAPTIVE MODES
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21
Physiologic-Physical Mode
• Physical and chemical processes involved in the function and
activities of living organisms. These are the actual processes put
in motion by the regulator subsystem.
• The basic need of this mode is composed of the needs associated
with oxygenation, nutrition, elimination, activity and rest and
protection.
 Roy Adaptation Model 16:12

22
Self-Concept or Group Identity Mode
• In this mode, the goal of coping is to have a sense of unity, meaning of
purposefulness in the universe, as well as a sense of identity and integrity. This
includes body image and self-ideals.
 Continued
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23
Role Function Mode
• This mode focuses on the primary, secondary and tertiary roles
that a person occupies in society, and knowing where he or she
stands as a member of society.
Interdependence Mode
• This mode focuses on attaining relational integrity through the
giving and receiving of love, respect and value. This is achieved
with effective communication and relations.
 Roy Adaptation Model 16:12

Graphic Representation of the Model

24
 Roy Adaptation Model 16:12

25
Roy’s Model (A system model)

• ROY’S MODEL IS A SYSTEM MODEL THAT

FOCUSES ON OUTCOMES.
• THE MAJOR FEATURES OF THE SYSTEM
MODELS ARE THE SYSTEM AND ITS
ENVIRONMENT
• A SYSTEM IS CHARACTERIZED BY INPUTS,
OUTPUTS, CONTROL AND FEEDBACK
PROCESSES.
 ADAPTATION LEVEL
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• A zone within which stimulation will lead to a positive or

adaptive response
• Adaptive mode processes described on three levels:
1. Integrated
2. Compensatory
3. Compromised
 INTEGRATED LIFE
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28 PROCESSES
• Adaptation level where the structures and functions of the
life processes work to meet needs.
• The various modes and subsystems meet the needs of the
environment. These are usually stable processes (e.g.,
breathing, spiritual realization, successful relationship)
• When a person with an illness changes their life style and
adjusts well with the illness.
For example: a diabetic taking medication properly,
eating well, and exercising daily.
 COMPENSATORY
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29 PROCESSES

• Adaptation level where the cognator and regulator are activated by a challenge to the
life processes.
• The cognator and regulator are challenged by the needs of the environment, but are
working to meet the needs (e.g., grief, starting with a new job, compensatory
breathing).
• When a person who does not take care of their illness like their supposed to.
For example: such as diabetic taking lots of medication, eating food that’s not
healthy, and exercising sometimes.
 COMPROMISED PROCESSES
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• Adaptation level resulting from inadequate integrated and compensatory life

processes.
• Adaptation problem.
• When a person illness progresses causing more complications or harm to other
organs.
For example: such as the patients diabetes worsens causing renal failure.
 THE NURSING PROCESS
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A nurse’s role in the Adaptation Model is to manipulate stimuli by removing,

decreasing, increasing or altering stimuli so that the patient.
• First level assessment Assess the behaviors manifested from the four adaptive
modes.
• Second level assessment Assess the stimuli, categorize them as focal, contextual, or
residual.
 Roy Adaptation Model 16:12

32 CONTINUED

• Nursing diagnosis of the person’s adaptive state.

• Set a goal to promote adaptation.
• Implement interventions aimed at managing the stimuli.
• Evaluate whether the adaptive goal has been met or not.
 APPLICATION OF
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33 ADAPTATION MODEL

• Scientific knowledge for practice.

• Clinical assessment and intervention.
• Research variables.
• To guide nursing practice.
• To organize nursing education.
• Curricular frame work for various nursing colleges.
 CHARACTERISTICS OF THE
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THEORY
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• Interrelated.
• Logical in nature.
• Relatively simple yet generalizable.
• Can be the basis for the hypotheses that can be tested.
• Contribute to and assist in increasing the general body of knowledge of a discipline.
• Can be utilized by the practitioners to guide and improve their practice.
• Consistent with other validated theories, laws and principles.
 Roy Adaptation Model
STRENGTHS 16:12

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• The main strength of Roy’s adaptation model is that it can used to

analyze diverse health care related issues.
• The model includes people as individuals, as well as in groups such
as families, organizations, and communities. This also includes
society as a whole.
• A major strength of the model is that it guides nurses to use
observation and interviewing skills in doing an individualized
assessment of each person.
• The concepts of Roy’s model are stated in relatively simple terms.
 Roy Adaptation Model 16:12

36 WEAKNESSES

• The main weaknesses in the Roy’s adaptation model is that

with regard to research, the complete implementation of the
model is perceived as time consuming and need too much
effort.

• Roy’s model has many elements, systems, structures and

multiple concepts.
 Roy Adaptation Model 16:12

37 SUMMARY

• As one of the weaknesses of the theory that applying it is time-consuming, applying

the model to emergencies requiring quick action is difficult to complete, the
individual might have completed the whole adaptation process without the benefit of
having a complete assessment for thorough nursing interventions.

• Adaptive responses may vary in every individual and may take a longer time

compared to others.
 Roy Adaptation Model 16:12

38 CONTINUED

• Roy focused on the whole adaptive system itself. Each

concept was linked with the coping mechanisms of every
individual in the process of adapting.
• When an individual presents an ineffective response during
his or her adaptation process, the nurses’ roles were not
clearly discussed. The main point of the concept was to
promote adaptation, but none were stated on preventing and
resolving maladaptation.
Case study(hypothetical)

MR. XYZ HAVING DM FOR 10 YEARS, DEVELOPED A DIABETIC FOOT ULCER

AND HAVE TO UNDERGO AMPUTATION. ADMITTED TO XYZ HOSPITAL,
ORIENTED TO TIME, PLACE AND PERSON.

HE WAS ANXIOUS ABOUT THE DISEASE CONDITION AND TO GO HOME AS

EARLY AS POSSIBLE. SHOWING SIGNS OF STRESS. TOUCH AND PAIN SENSATION
DECREASED IN LOWER EXTREMITY. MR. XYZ WAS SELECTED FOR APPLICATION
OF RAM IN PROVIDING NURSING CARE.
 REFERENCES
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• Gray,J. (1991).The Roy adaptation model in nursing

practice. In C .Roy & H.A.Andrews (Eds.),The Roy
adaptation model: The definitive statement (pp.429-
443).Norwalk, CT; Appleton & Lange.

• Senesac,P. (2003).Implementing the Roy adaptation

model: From theory to practice. Roy Adaptation
Association Review ,4(2),5.