The Roy Adaptation Model Model as a means of implementing client care by nurse. Developed in 1976 Developed by Roy in 1976, She first began organizing her theory of nursing as she developed course curriculum for nursing students at Mount St. Mary's College. She introduced her ideas as a basis for an integrated nursing curriculum. the Adaptation Model of Nursing asks three central questions: Who is the focus of nursing care? What is the target of nursing care? and When is nursing care indicated? This model looks at the patient from a holistic perspective. Roy explained that adaptation occurs when people respond positively to environmental changes, and it is the process and outcome of individuals and groups who use conscious awareness, self-reflection, and choice to create human and environmental integration. The three concepts of her model are the human being, adaptation, and nursing. Under the concept of adaptation are four modes: physiological, self concept, role function, and interdependence. The physiological mode deals with the maintenance of the physical body. This includes basic human needs such as air, water, food, and temperature regulation. The function of the mode of self-concept is the need for the maintenance of the mind. The person's perceptions of his or her physical and personal self are included in this mode. Social integrity is emphasized in the role function mode. This addresses people's adaptations to different role changes that occur throughout a lifetime. The interdependence mode also addresses social integrity. This mode deals with the balance between independence and interdependence in a person's relationships with other people. According to Roy's model, the goal of nursing is to promote adaptation of the patient during illness and health in all four of the modes. Nursing is not rigid. And by applying Roy's Adaptive Model of Nursing to your nursing practice, you can be sure that the care you give your patients will be the highest quality you can provide for that individual patient in his or her individual situation.

The Adaptation Model of Nursing asks 3 central questions: Who is the focus of nursing care? What is the target of nursing care? When is nursing care indicated? This model looks at the patient from a holistic perspective. It’s about the patient, not about you. QSEN Quality & Safety in Nursing Education When the patient can no longer adapt and needs assistance from medical/nursing/RT/PT/SW/pharm, etc… Nursing needs to know all of these specialties.

Essential Parts of Nursing Model Person Environment Nursing Health The Adaptation Model states that health is an inevitable dimension of a person's life, and is represented by a health-illness continuum. Health is also described as a state and process of being and becoming integrated and whole. View person in relation to the environment and how nursing interacts with the person to promote health within this environment. Person –adaptive system, as a system person takes in (input) stimuli and processes this input (coping mechanisms) to produce a response, or output (behaviors). Adaptive Behavior –effective response Ineffective behavior –problems 2. Environment –world within and around the person. Environment is constantly changing and presenting new challenges. Person has ability to make new responses to these changing condition, allowing opportunity to grow, develop, and enhance meaning of life for self and others. Environmental changes called Stimuli. Focal –immediately confronting person Contextual –influencing the current situation Residual –may influence adaptation level, but effect not confirmed 3. Nursing –acts to enhance interaction of person within the environment to promote growth, meaningful life, harmony with his/her social and physical environment. 4. Health –state and process of being and becoming as integrated and whole person.

The Roy Adaptation Model Sister Callista Roy Bachelor of Arts, Nursing –Mount St. Mary’s College, Los Angeles, 1963 Master’s, Pediatric Nursing –UCLA, 1966 Master’s & PhD, Sociology 1973, 1977 After working as a staff nurse and in administrative positions at St. Mary's Hospital in Tucson, Arizona, and St. Joseph's Hospital in Lewiston, Idaho, Roy joined the faculty of Mount St. Mary's College in 1996. She also served as Department Chair between 1971 and 1982. While working at the University of Portland, Roy helped create a Master's program in Nursing. And at the Connell School of Nursing, she was involved in developing a Ph.D. program in Nursing. She also served as a visiting professor to colleges around the world, including La Sabana University in Colombia, the University of Lund in Sweden, and the University of Conception in Chile. Between 2003 and 2006, Roy served on the Board of the International Network for Doctoral Education. She is also Faculty Senior Nurse Scientist at the Yvonne L. Munn Center for Nursing Research at Massachusetts General Hospital. Adaptive system with cognator and regulator subsystems acting to maintain adaptation in four adaptive modes: physiologic, self-concept, role function, and interdependence. Nurses and nursing students who admire a particular theorist are more likely to use that theorist's model in their own nursing practices. If there's a theory or model that's particularly popular, it will be seen more often in the healthcare field since nurses will use it.

The Roy Adaptation Model Views person as an adaptive system Goal of patient is to help person adapt to changes using 4 modes Nursing theories helps to describe, explains, predicts, or prescribes nursing care. Theory gives perspective to assessing situation, organize data and methods for analyzing and interpretation. Nursing theory help to iswb=ntify the focus, means, and goals of practice. A set of statements or principles devised to explain a group of facts or phenomena, especially one that has been repeatedly tested or is widely accepted and can be used to make predictions about natural phenomena. 2. The branch of a science or art consisting of its explanatory statements, accepted principles, and methods of analysis, as opposed to practice: a fine musician who had never studied theory. 3. A set of theorems that constitute a systematic view of a branch of mathematics. 4. Abstract reasoning; speculation: a decision based on experience rather than theory. 5. A belief or principle that guides action or assists comprehension or judgment: staked out the house on the theory that criminals usually return to the scene of the crime. 6. An assumption based on limited information or knowledge; a conjecture.

The Roy Adaptation Model External and internal stimuli affect patient response (inputs) Stimuli Focal Contextual Residual The person is an adaptive

The Roy Adaptation Model Coping mechanisms are innate or acquired Regulator Cognator Adaptive or ineffective behaviors (output) Compensating Compromised Part of person’s internal and external environment Can include patient’s age, sex, developmental level, roles, pathophysiology, medically prescribed treatments, motivation, availability of health services. Compromised –unable to function optimally, especially with regard to immune response, owing to underlined disease, harmful environmetal exposure, or the side effect of a course of tx.

Four Modes of the Roy Adaptation Model Physiological Mode Self-Concept Mode Role Function mode Interdependence Mode Physiologic and Psychologic aspect of the person Body and mind

Physiological Mode (Physical) Behavior pertaining to the physical aspect of the human system Physical and chemical processes Associated with way person responds physically to stimuli from environment Stimuli can be internal or external

Maslow’s Hierarchy of Needs Needs areas: Oxygenation Nutrition Elimination (Fluid & Solid) Rest & Activity Protection Fluid & Electrolytes Neurosensory Maslow’s Hierarchy of Needs Page 54.

Self-Concept Beliefs and feelings about oneself at a given time. Two modes: Physical Self (and spiritual) Personal Self (self-consistency, self-ideal, moral- ethical self) Need to know who one is so can exist in this society. Physical –perception of how one’s body feels and functions as well as how one feels about one’s body. Body image Personal –how one perceives one self in relation to actual performance, WHAT AND WHO I AM expectations for self, spiritual/ethical perception Also formed by perceptions of others. Self-esteem changes form time to time. WHEN SEE SELF AS MEETING EXPECTATIONS SET BYSELF AS WELL AS OTHERS, THERE WILL BE AGREEMENT/HARMONY Example: now that in nursing school, have high expectations to pass and excel, but if you don’t you’re self-concept goes down and start to think am I cut out for this, can I do it? “WANT TO DEVELOP A POSITIVE SELF-CONCEPT”

Role Function Mode Societal expectations about how a person occupying one position behaves toward a person occupying another social position. Primary Secondary Tertiary Expectations are the socio-cultural norms of the society learned through socialization, observation, experiences, informal and formal education. Social Integrity –the need to know who one is in relation to others so that one can act. Primary –pt age, developmental status Secondary –those that occupy much of pt time and energy (nursing student, mother, father, etc) Tertiary –usually temporary and are normally by choice, hobbies “WANT TO PERFORM SOCIAL ROLES”

Interdependence Mode Focuses on close relationships of people Ability to balance acts of giving and receiving Significant others Support systems Giving and receiving of whatever one can offer: love, respect, and values, nurturing, time, commitment, material possessions, knowledge Ability to balance acts of giving and receiving Receptive-Dependence Needs: Help-Seeking Attention-Seeking Affection-Seeking Contributive-Independence Needs: Initiative-Taking Obstacle-Mastery “WANT TO ACHIEVE BALANCE BETWEEN DEPENDENCE AND INDEPENDENCE, THUS= INTERDEPENDENCE”

The Roy Adaptation Model The four modes are interrelated. Behavior in physiological mode may have an effect on or act as a stimulus for one or all of the other modes. In addition, a given stimulus may affect more than one mode or a particular behavior may be indicative of adaptation (or lack of integrity) in more than one mode. Example: Cancer patient