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Yuni Permatasari istanti

Sister Callista
RoyBorn October 14, 1969

Bachelors Degree in Nursing


1963

Masters Degree in Nursing


1966

Masters Degree in Sociology


1973

Doctorate in Sociology 1977

htnursingtheoriestp://.blogspot.com/2008/07/sister-callista-roy-adaptation-theory.html
Origin of Roys Adaptation
Model
Roy adapted some of her theory development
from Harry Helsons Adaptation Theory.

Roy incorporated Helsons theory with Rapoport's


definition of system (Alligood and Tomey 2010).

1500 scholars and students contributed

3
Major Elements of Roys
Adaptation Model
There are three major elements of Roys
adaptation model:

First: Man

Roy develops her concept of manthe


client and the recipient of nursing care
Major Elements of Roys
Adaptation Model contd.

Second: Goal
of nursing

Roys model represents the goal of nursing,


which is to promote adaptation through
adaptive modes
Major Elements of Roys
Adaptation Model contd.

Third: Nursing
activities

Finally, the model maps the process of


nursing activities, most significant
of which are nursing assessment of
client behaviors and nursing interventions.
Concept- Man
She considers man a biopsychosocial being, who,
to be properly understood, must be considered as
a unit or a whole.
A whole is different from and more than the
summation of its individual parts.

Man is an integrated system whose parts have


relationships among them (adaptive system).

The recipient of nursing care was identified as an


adaptive system.
System is defined as a set of parts connected to
function as a whole for some purpose.
Concept- Man ( cont.)

The adaptive system has two major internal control


processes called the regulator and cognator subsystems.
These subsystem are viewed as innate or acquired
coping mechanisms used by the adaptive system to
respond to changing internal and external environmental
stimuli.
The regulator subsystem responds automatically through
neural, chemical, and endocrine coping processes.
Stimuli from the internal and external (through the senses)
act as input to the nervous system.
Concept- Man ( Cont.).

The information is channeled automatically in the


appropriate manner and an automatic unconscious
response is produced (Roy ,1991).
The cognator subsystem responds to inputs from external
and internal stimuli that involve psychological, social ,
physical and physiological factors including regulator
subsystem outputs.
Regulator & congator activity is manifested through
coping behavior in four adaptive modes.
Man-Environment
Interaction
Man is in constant interaction with his environment.

Since man is a living system, he requires matter, energy,


and information from his environment.

The constant interaction of man with his environment is


characterized by both internal and external change. Within
this changing world, man must maintain the integrity of
himself; that is, he must adapt.

The internal and external environments ,in the form of


stimuli, are the inputs into the adaptive system.

Roy identified three classes of stimuli (focal, contextual


and residual).
Focal Stimuli
Internal or external stimulus most
immediately confronting the person
Contextual Stimuli
All other stimuli present that contribute
to the focal stimuli.
Influence how the person can deal with
the focal stimulus.
Contextual Stimuli
Residual Stimuli
Factors whose effect in the current
situation is unclear.
No clear data.
Based on theory or experience of the
nurse.
Adaptation
Man copes with environmental change through
biopsychosocial adaptive mechanisms.

Some adaptive mechanisms are inherited or


genetic processes, the white blood cell defense
system against bacteria seeking to invade the
body.

Other mechanisms are learned, such as the use


of antiseptics to cleanse a wound.
Coping Mechanisms
Innate or acquired ways of responding
to the changing environment.
Innate are genetically determined or
common to the species and automatic
processes.
Acquired are developed through
learning and other process.
Coping Mechanisms
Regulator
Cognator
Coping Mechanisms
Regulator Automatic responses
through neural, chemical and endocrine
coping processes.
Cognator Subsystem
Perceptual/information processing,
learning, judgment, and emotion
Perceptual: Selective Attention, Coding,
Memory
Learning : Imitation, Reinforcement, Insight
Emotion : Defenses are used to seek relief
from anxiety, Make affective appraisal and
attachments
Health-concept
Health is a state of human functioning whereby
the person continually adapts to change.

According to Roy health can be viewed along a


continuum that flows from death and extreme
poor health, through poor health, to a midpoint of
normal health.

The health continuum moves from this midpoint to


good health , to high- level wellness, to peak
health.
Adaptation contd.
Adaptation Level

factors of adaptation:
1. The degree of environmental change.

2. The state of the persons coping.


Adaptation Level contd.

Environmental changes include snow, temperature


change, presence of a virus, radiation from a
nuclear explosion, and industrial pollution.

Environmental change interfaces with the


individuals state of coping.

The condition of the person or his state of


coping is his adaptation level.
Adaptation Level contd.

The individuals adaptation level will determine


whether a positive response to internal or
external environmental will be elicited .

The individuals adaptation level is determined by


the focal, contextual, and residual stimuli. In
any environment-human interaction, the environ-
mental change is the focal stimulus.
Adaptation Level contd.

Contextual stimuli are all other stimuli of the


persons internal or external world that influence
the situation and are measurable or reported by
the person.

Residual stimuli are the makeup or


characteristics of the individual that are present
and relevant to the situation but are difficult to
measure objectively.
Adaptation Level contd.
Modes of Adaptation
Roy identifies four distinct modes or ways of
adapting by which man responds to change:

1- Physiological Needs Mode:

The physiological adaptive mode relates to the


need for physiological integrity as:

Exercise and rest, nutrition and elimination, fluid and electrolytes,


oxygen and circulation, regulation of temperature, regulation of
senses, and regulation of the endocrine systems.
Modes of Adaptation
contd.
2- Self-Concept Mode

Self-concept defined as the composite of believes


and feelings that a person holds about him/herself at
a given time.
Roy states that the psychological integrity of the
individual is an inner requirement or need.

This view is likened to Talcott Parsonss view of the


human personality as a system.,
Modes of Adaptation
contd.

2- Self-Concept Mode

The personality system has the need to maintain its


integrity, which Parsons identifies as system
adaptation, goal attainment, integration, and pattern-
maintenance.
Modes of Adaptation
contd.
2- Self-Concept Mode

The self-concept encompasses perceptions of the


physical and the person self.
The physical-self deals with the body sensation and
body image. Body sensation refers to how one feels
& experiences oneself as a physical being .
The personal self encompasses self consistency,
self-ideal and the moral- ethical spiritual self.
Modes of Adaptation
contd.

3- Role Function Mode

Interpersonal interaction satisfies the humans need


to identify the self in relation to others.

The response of others to the self shapes and


reshapes ones behavior
Modes of Adaptation
contd.
3- Role Function Mode

Social interaction occurs within the contexts


of family, groups, community, and society.

Rules of behavior / limits of behavior, will be set


that guide ones actions.

Behavioral rules or limits that are common within a


society are called norms.
Modes of Adaptation
contd.
4- Interpersonal Mode

Social integrity for an individual requires more


than just the proper performance of roles in social

situations.

The individual acts in ways that will result in


satisfying his needs for love and support. Through
interdependence ones life gains meaning and purpose.
Interdependence is a balance between dependence
and independence
Nursing concept
Roy (1976) defined nursing as a theoretical
system of knowledge which prescribes a process of
analysis and action related to the care of the ill or
potentially ill person.
Furthermore , nursing is a scientific discipline that
is practice oriented (Roy 1991)
The model stipulates that a nurse is needed when
unusual stresses or weakened coping mechanisms
make the persons usual attempts to cope
ineffective.
Nursing concept
Nursing focuses on the person as a total being who
responds to internal and external stimuli
( Roy , 1970)

The goal of nursing is the promotion of adaptation in


each of the four ( adaptive modes contributing to the
persons health , quality of life and dying with dignity
Content of the Model:
propositions
The metapardigm concepts of person, environment, and
health are linked in the following statements:

The changing environment stimulates the person to make


adaptive responses. The person is described as an
adaptive system consistently growing and developing
within a changing environment ( Andrews and Roy, 1991)

A persons health can be described as a reflection of this


interaction or adaptation ( Andrews and Roy, 1991)
Content of the Model:
propositions contd.
The metapridgm concepts of person, health , and nursing
are linked the following statements:

The goal of nursing is the promotion of adaptation in


each of the four adaptive modes, thereby contributing to
the persons health, quality of life, and dying with dignity
( Andrews and Roy, 1991)

The goal of nursing intervention is to maintain and


enhance adaptive behaviors and to change ineffective
behavior to adaptive ( Andrews and Roy, 1991)
Content of the Model:
propositions contd.
The linkages of all four metapardigm concepts
are presented in this statement:

It is the nurses role to promote


adaptation in situation of health and
illness; to enhance the interaction of the
person with the environment, thereby
promoting adaptation (Andrews and Roy,
1991)
Nursing activities and
nursing process.
The nurse, in her first level assessment, observes the for
signs of autonomic activity, signs that invariably are
present when the individuals biopsycohosocial integrity is
threatened.
The client is the first to be aware of coping failure.
Maladaptive behavior as well as adaptive behavior
requiring support becomes the focus of the nurse.

Second level assessment, identify the focal, contextual,


and residual stimuli that combine to determine the
individual's adaptation level.
Nursing activities and
nursing process contd.
The second level assessment leads the nurse to identify the
adaptation problems. This process is referred to nursing
diagnosis.

Intervention: Roy developed nursing intervention as attempt to


manipulate the environment by removing, increasing, decreasing,
and/or altering stimuli for promoting movement toward peak
health and meeting the individual's needs of biological, social,
and psychological integrity.

The nurse concludes the nursing process with an evaluation of


the effectiveness of the nursing intervention in the client goal
achievement.
Roys Adaptation Model

Interaction Capsulate

Acquired Output
Input
Physiological
Environmental Focal Role function Behavioral
Changes Contextual Self-concept Responses
External & Internal
Residual Interdependence Adaptive or Ineffect
Adaptation Process
Innate

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