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A Written Report Presented to

Dr. Corazon B. dela Pea of the Graduate School of
San Pedro College, Davao City


In Partial Fulfilment
of the Requirements in


Michael Philip F. Cervantes, RN

September 2016

According to Sister Callista Roy, "Health is not freedom from the inevitability of
death, disease, unhappiness, and stress, but the ability to cope with them in a
competent way. Health is defined as the state where humans can continually adapt to
stimuli. Because illness is a part of life, health is the result of a process where health
and illness can coexist. If humans can continue to adapt holistically, they will be able to
maintain health to reach completeness and unity within themselves. If they cannot adapt
accordingly, the integrity of the person can be affected negatively meanwhile, the goal of
nursing is the promotion of adaptation for individuals and groups in each of the four
adaptive modes, thus contributing to health, quality of life, and dying with dignity. In this
application of theory Roys Adaptation model will be used with the touch of Lieningers
Transcultural Nursing. It is an attempt to merge two theories in the field of community
health nursing.
We are always confronted with stimuli and stress especially on the journey of
achieving our dreams in life but what if, this happens on the time that we are not ready
and on circumstances we do not expect? Can Roys Adaptation Theory will help us
adapt through this situation? And as a nurse how will we act or intervene? This is the
reason why Adaptation Theory was used to primarily guide us when this happens. We
cannot deny the fact that we are constantly battling with stress and as what they have
said if you cannot handle this it could have a negative impact. Remember there is a very
thin line between sanity and insanity. Adaptation also could mean survival that is why it

is utmost importance and of course as the highest form of animal, we have cultures,
different cultures that should also take into consideration to break barriers into our
differences and will facilitate good caring.
Ms. Artem is 16 years old. She is the second sibling and the only daughter of the
family who had three children. Her parents were a devout catholic and believe in the
sanctity of marriage. Ms. Artem for a while has been away from the family to study in the
city. On the second year of her study she got pregnant by her boyfriend who is also her
classmate. Upon knowing that she is pregnant the couple tries to hide it and even to the
point of thinking abortion. However, it is good that the friend of Ms. Artem is the
daughter of a Barangay Health Worker who then reported it to the nurse and
consequently informs the parents. The parents at first were shocked and disowned their
daughter. The nurse thinking of the health of the mother and the unborn child visits the
pregnant woman. The woman does not know what to do and was afraid that if she is
gonna visit the health center for prenatal care, she would be the talk of the town. She is
also afraid that she will become fat and would age a lot during pregnancy. After knowing
the situation, the community nurse intervenes. According to Sister Callista Roy a
nurses role in the Adaptation Model is to manipulate stimuli by removing, decreasing,
increasing or altering stimuli so that the client will be able to adapt. Nurses must:
1. Assess the behaviors manifested from the four adaptive modes.
2. Assess the stimuli, categorize them as focal, contextual, or residual.
3. Make a statement or nursing diagnosis of the persons adaptive state.

4. Set a goal to promote adaptation.

5. Implement interventions aimed at managing the stimuli.
6. Evaluate whether the adaptive goal has been met.
In this situation guided by the Roys Adaptation Model. The first step of the nurse
is to visit and talk to the family about the pregnancy. The nurse could utilize help from
the BHW in achieving and scheduling the visit. The nurse upon meeting family will
assess the adaptive mode. In the physiologic mode, adaptation involves the
maintenance of physical integrity. Basic human needs such as nutrition, oxygen, fluids,
and temperature regulation are identified with this mode (Fawcett, 1984). In assessing
a family, the nurse would ask how the family provides for the physical and survival
needs of the family members and in this case the pregnant women. The nurse then
counsels the family that during pregnancy the woman needs additional intake of
nutrients and vitamins vital to the growth of the unborn like Iron, folic acid, vitamin C and
calcium. A function of the self-concept mode is the need for maintenance of psychic
integrity. Perceptions of ones physical and personal self are included in this mode.
Families also have concepts of themselves as a family unit. Assessment of the family in
this mode would include the amount of understanding provided to the family members,
the solidarity of the family, the values of the family, the amount of companionship
provided to the members, and the orientation (present or future) of the family (Hanson,
1984). The nurse then emphasizes the importance of understanding and family support
during pregnancy. That acceptance is the best key and it is beneficial to unborn and the
pregnant woman. The need for social integrity is also emphasized in the role function
mode. When human beings adapt to various role changes that occur throughout a

lifetime, they are adapting in this mode. According to Hanson (1984) the familys role
can be assessed by observing the communication patterns in the family. Assessment
should include how decisions are reached, the roles and communication patterns of the
members, how role changes are tolerated, and the effectiveness of communication
(Hanson, 1984). In this situation, the lifestyle and perhaps the behavioral changes the
family adjust during the course of pregnancy, they are adapting in this mode.
The need for social integrity is also emphasized in the interdependence mode.
Interdependence involves maintaining a balance between independence and
dependence in ones relationships with others. Dependent behaviors include affection
seeking, help seeking, and attention seeking. Independent behaviors include mastery of
obstacles and initiative taking. According to Hanson (1984), when assessing this mode
in families, the nurse tries to determine how successfully the family lives within a given
community. The nurse would assess the interactions of the family with the neighbours
and other community groups, the support systems of the family, and the significant
others (Hanson, 1984). In this case the nurse helps the client and the family cope up
with the controversy and uphold the importance of prenatal care outweighing the latter
and ensure client that confidentiality will be strictly observed.
The goal of nursing is to promote adaptation of the client during both health and
illness in all four of the modes. The nurse may need to manipulate the environment, an
element or elements of the client system, or both in order to promote adaptation. Now
the nurse then guided by the principle of Lienengers transcultural nursing, the nurse
then negotiates the clients family that even though they believe in the sanctity of
marriage first before living together and given the circumstances that Ms. Artem was still

sixteen years old. That they would allow the couple for a couples seminar to educate
them about the responsibilities, health changes, family planning, birth planning and
about the warning signs of pregnancy. The nurse will also schedule Ms. Artem for
Prenatal care and clinic visits. The nurse also informs the pregnant women about the
benefits and services given in prenatal care, that the responsibility of a mother does not
end on the termination of pregnancy and how her partner and family can help her
throughout that process.
Roys Adaptation Model proved not only useful in clinical setting but on the
different fields of nursing. It is also designed not only for individuals but to families and
communities as well. It is also possible to combine different theories when it comes to
nursing care as long as it will guide us in achieving our goals and more importantly to
good nursing and thereby promoting health for the ultimate goal of nursing is caring so
that individuals, families, or communities achieve health and optimum level of


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