Callista Roy Nursing Theorist   By: Megan Davis Brandon Zolynsky Shelley Meyerholtz

Purpose    -The initial formulation of Sister Callista Roy's Adaptation Model came from developing a framework for a nursing curriculum.  -The purpose of Roy's Adaptation Model is to modify the individual and environment in such a way that promote adaptation of the patient. Chitty and Black (2011)

?Questions?   -Roy proclaimed that she "knew what nursing was - it was promoting patient adaptation." Fawcett (2002) -A colleague questioned what she meant by that, and she has been answering the question ever since.

Problems to Solve -The main problem the Nurse is presented with when applying Roy's Adaptation Model is how the environment will be modified in order to facilitate adaptation in the patient -The Nurse must fine tune the demands of environmental stimuli to the patient's adaptive mechanisms in order to achieve an effective adaptive behavioral response conducive to promoting the integrity of the individual. -The Nurse observes patient behavior in relation to environmental stimuli and customizes nursing diagnoses to formulate care plans specific to promoting adaptation. Chitty and Black (2011)

                            Motivation     - Came from working with Dorothy Johnson while studying her graduate degree in 1964   - Dorothy Johnson questioned Sister Roy’s thought on nursing and how it was the promotion of adaptation. That question alone led Sister Roy into years of explaining and defining (Fawcett, J. 2002) - Sister Roy read a book about adaptation and psychology by Harry Helson (1964) which helped her to write her own adaptation theory

Nursing Values and Knowledge - Adaptation theory focused on holistic care and bio-psycho-social system   - The environment needs to be changed to allow adaptation and feelings of comfort by the patient during time of illness -  “To cope with a changing world, a person uses coping mechanisms, both innate and acquired, which are biological, psychological, and social in origin” (Nursing-theory.org 2011) - Focuses on improving practice through research and education

Modes of Adaptation *Physiological: human needs (air, food, water)          *Self Concept: perceptions of self positively                  *Role Function: how people respond to different role changes (mother, provider, care giver)                              *Interdependence: balance between being dependent and independent   (Nursing-theory.org , 2011)

                Influence of Theory         “Callista Roy was greatly influenced by Dorothy Johnson’s commitment to describe the goal of nursing as a way of moving the discipline forward, describing the nature of nursing, and explicating a body of distinctive nursing knowledge” (Fewcett, J. 2002)

Influence Continued.......   Roy has told the story that she was reading a short paragraph on adaptation, and that is what  made her realize what nursing was- promoting patient adaptation.  Fawcett 2002

                Global Concepts

Person- patient that adapts based on coping skills        Environment- internal and external stimuli that affect the development and behavior of the patient            Health- the "whole" patient, includes modes of adaptation (pyschological, self concept, role function, interdependence)     - Illness is effectively adapting to one or more of the modes                  Nursing- system of knowledge related to the care of an ill patient

Where Will You See This Model? This model is said to be an appropriate curriculum guide for Diploma, ADN, BSN, and MSN educational programs                                         Although it is a great model for education you could see this model in any area of nursing due to it being related to adaption . It is also used in research

The 6 Steps of the Roy Adaptation Nursing Process Assessment of Behavior-The nurse must assess the behaviors of the pt and see if they threaten the survival of the family, individual, group or community. Does it also affect the growth and development. 2. Assessment of Stimuli- The nurse must realize that medical treatments are not considered stimuli    3. Nursing Diagnosis- Based on behaviors and stimuli  

                      6 steps continued......  4. Goal Setting- Must make clear outcome based on the human adaptive system   5. Nursing Interventions-The nurse selects and implements nursing approaches that have a high probability of changing stimuli or strengthening adaptive processes 6. Evaluation- Nurse must evaluated the effectiveness of the interventions based on the human adaptive system.

Implications -From Roy's Adaptation Model, we can imply that adaptation is a fundamental basis on which nursing practice can be developed. -Like many Nursing Theory Models, Roy's Adaptation Model can be applied to many aspects of life, not limited to nursing, as adaptation to environmental stimuli can promote integration in most all life facets.  This is why Roy's model is so widely used as a curriculum guide for many Nursing education program

Inference and Interpretation   It is shown through Roy's research and studies that changing the patients environment as needed and assessing the stimuli, you  allow for adaptation to occur which is necessary for the pateint's well being and recovery.

Today -Roy's Adaptation Model continues to serve as a basis for Nursing curriculum development as well as care guidelines throughout nursing. -Two editions of her book The Roy Adaptation Model (Roy & Andrews, 1999) have been published   -Roy is currently serving as faculty at  Boston College's William F. Connell School of Nursing and has turned her attention to contemporary movements in nursing knowledge development and spirituality. (Fawcett, 2002)

CASE STUDY Your patient Mr. Andrews is 67 years old. Mr. Andrews suffered a stroke four days ago that has affected his non-dominant side. He is married, and has three young grandchildren who enjoys spending a lot of time with. Mr. Andrews works as an accountant and enjoys spending time outdoors.   Mr. Andrews is experiencing left sided weakness and has difficulty with fine motor movements.  His strength is improving and he is very motivated and cooperative with his care regimen. Using Roy's adaptation model how would you develop your plan of care for Mr. Andrews? What barriers could be in place to make it difficult to apply Roy's adaptation model to Mr. Andrews care?

References Callista Roy: Adaptation Model 2008. Retreived from: http://nursingtheories.blogspot.com/2008/07/sister-callista-roy-adaptation-theory.html   Chitty, K. K., & Black, B. P. (2011).   Professional Nursing Concepts & Challenges (6th ed.). Maryland Heights, Mo.: Saunders.     Fawcett, J. (2002). The nurse theorists: 21st century updates-Callista Roy. Nursing science quarterly, 15, (4), 308-310. doi:10.1177/089431802236795 Medical dictionary (2012).  Adaptaton Model. Retrieved from http://medical-dictionary.thefreedictionary.com/adaptation+model     Nursing Theory (2011). Roy's Adaptation Model. Retrieved from http://nursing-theory.org/nursing-theorists/roy-adaptation-model.php

References    Nursing Theory (2011). Sister Callista Roy. Retrieved from http://nursing-theory.org/nursing-theorists/Sister-Callista-Roy.php Roy,C. (2011). Extending the Roy Adaptation Model to Meet Changing Global Needs. Nursing Science Quarterly,24 (4), 345-351. doi 10.1177//0894318411419210 Taber's Medical Dictionary, 21st edition(2009). Callista Roy's Adaptation Model.   Retrieved from www.tabers.com/tabersonline/ub/view/Tabers/144307/0/Callista_Roy's_Adapatation_Model