ADAPTATION MODEL (SISTER CALLISTA ROY)

To fulfill the assignment of the basic concepts of nursing course taught

By Nina Indriyawati, MNS

COMPILED BY:

GROUP 2

1. Dwi Aisyah Fitri P1337420623109

2. Intan Permata Sari P1337420623034

3. Nurrona Rizqina P1337420623062

APPLIED UNDERGRADUATE NURSING STUDY PROGRAM AND NURSING

PROFESSION PROGRAM SEMARANG MINISTRY OF HEALTH POLYTECHNIC
SEMARANG

2023

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 FOREWORD

Praise the author's gratitude to God Almighty, because thanks to His grace and grace the
author can complete this paper on time. This paper was made to fulfill the Nursing Philosophy
course assignment from Mrs. Nina Indriyawati, MNS. Entitled "Theory of Nursing Model (Sister
Callista Roy)" In this preparation we cannot be separated from the help of various parties.
This paper was prepared with maximum effort and also thanks to the help of various
parties. Parties who are willing to take the time, energy and thought to complete this paper.
Therefore we express our deepest gratitude to all those who have helped in completing this
paper.
Therefore, we realize that there are still many shortcomings in the scientific work that we
have made. Maybe in terms of language, sentence structure or other things that we are not
aware of. Therefore, we as writers really hope for criticism and suggestions as a means of
improving better scientific work. Hopefully this paper is useful for us and reader.

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 TABLE OF CONTENTS
3.1 PAPER TITLE.............................................................................................................................
3.2 FOREWORD..............................................................................................................................
3.3 TABLE OF CONTENTS...............................................................................................................
3.4 CHAPTER 1 INTRODUCTION....................................................................................................
1.1 BACKROUND...........................................................................................................................

1.2 STATEMENT OF THE PROBLEM ..............................................................................................

1.3 PURPOSE ................................................................................................................................

3.5 CHAPTER II DISCUSSION..........................................................................................................

2.1 PROFIL OF CALLISTA ROY .......................................................................................................

2.2 CONCEPTS OF THEORY CALLISTA ROY....................................................................................

2.3 NURSING PARADIGM..............................................................................................................

2.4 WEAKNESSES OF THE CALLISTA ROY.............................…………………………………………….......16

3.6 CHAPTER III CLOSING.............................................................................................................

3.1 CONCLUSIONS.....................................................................................................................
3.2 SUGGESTION.......................................................................................................................
3.7 BIBLIOGRAPHY………………………………………………………………………………………….…………18

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 CHAPTER I

INTRODUCTION

1.1 Background

Roy's Adapted Model was derived from various previous theories,

including Harry Helson's theory of psychophysics which expanded into
social and behavioral sciences. In Helson's adaptation theory, the
adaptation process is a function of the incoming stimulus and the
adaptive rate. Stimulus is all factors that can cause a response. Stimuli
can arise from both internal and external environments (Roy, 1984 in
Alligood 2014). The degree of adaptation represents the combined
effect of the following three classes of stimulus: Focal stimulus
(stimulus that triggers the individual immediately); Contextual stimulus
(other stimuli that add to the impact of focal stimulus); and Residual
stimulus (environmental factors whose impact is not clear in a given
situation).

Roy (Roy & Roberts, 1981) combined Helson's theory with

Rapoport's definition of systems to view humans as adaptive systems.
Based on Helson's adaptation theory, Roy (1970) developed and
refined his adaptation model with clan theory concepts from
Dohrenwenel, Lazarus, Mechanic, and Selye (Alligood, 2014).

Roy in his theory explains 4 kinds of essential elements in

nursing adaptation, namely humans, environment, health, and nursing.
Roy's adaptation model explains how individuals are able to improve
their health in maintaining adaptive behavior because humans are
holistic creatures who have adaptive systems that are always adapting.

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Nurses need to understand this concept as a conceptual framework in
providing nursing care in nursing practice using a nursing process
approach. Based on this, Sister Callista Roy's nursing concept theory
and model need to be studied as a way to develop science and
practice, especially related to providing nursing care to patients with
various cases.

1.2 Statement Of Problem

1. What is the concept of Callista Roy Model and Theory?

2. How is Callista Roy's theoretical model applied?

1.3 Purpose
1) General Purpose :

Able to understand the concepts of models and theories of Callista

Roy B.

2) Special Purpose :

Knowing Callista Roy's Profile or Curriculum Vitae Understanding

Callista Roy Theory Concepts Understanding the Nursing Paradigm
Knowing the Weaknesses of Theory Being able to understand the
application of Roy's adaptation model to the nursing process
approach

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 CHAPTER II

DISCUSSION

2.1 Callista Roy Profile

Sister Callista Roy was a sister of Saint Joseph of Carondet. Roy was
born on October 14, 1939 in Los Angeles, California. Roy received a
Bachelor of Art Nursing in 1963 from Mount Saint Marys College in Los
Angeles and a Saint in Nursing in 1966 from the University of California
Los Angeles. After earning her nursing degree, Roy began her
education in sociology and received her M.A in 1973 and ph. D in 1977
at the University of California.

While working at the master's level, in a seminar with Dorothy E.

Johnson, Roy was challenged to develop a model of nursing concepts.
Roy works as a paediatric nursing staff and announces the resilience of
children and adds a response to physiological-psychological changes.
The concept of adaptation influenced Roy within the framework of his
concept corresponding to nursing. This central concept and model was
developed when Roy graduated from the university in California Los
Angeles from 1964 to 1966. Roy began operating his model in 1968
when Mount Saint Marys College used an adaptation framework
established by a Pisipol from the nursing curriculum. Roy adapted the
first model presented from literature in an article published in Nursing
Outlook in 1970.

Roy was associate professor and chair of the department or

nurshing at Mount Saint Marys College until 1982. from 1983-1985 Roy
was the Robert Wood Johnson Post Doctoral Fellow at the University of
California San Francisco as a nursing scholar in Neuroscience. During

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 this time Roy conducted a search on the intervention of injured nurses
and her experience of model nurses at clinics. In 1988 Roy was just
beginning to compile graduate theory nurses at Boston College of
Nursing.

Roy published many books, periodical articles and presented many

lectures and workshops on his nurse adaptation theory. Some of the
ethics and new descriptions of the Roy Adaption Model (RAM)
published in The Roy Adaptoin Model are definite expressions.

In 1981 Roy was a member of Sigma Theta Tau and Roy also
received the National Founder prize during his stay at Fosterus
Proffesional Nurshing Standars. His achievements were entered in 1984
as honorary physicians of the Humane Letters by Alverno College. In
1985 he received the honor of physician from eastern Michigan
University and in 1986 A.J.N. awarded the book to Roy's main
adaptation model. Roy is recognized worldwide as an American
personality and a Follow of the American Academy of Nurshing.

2.2 Concept of Theory

1. Understanding

Roy's adaptation nursing model is a nursing model that aims to

help a person to adapt to changing physiological needs, self-
concept, role functioning, and interdependent relationships during
healthy illness (Marriner-Tomery, 1994). Callista Roy's adaptation
theory views the client as an adaptation system. Roy's adaptation
model outlines how individuals are able to improve their health by
maintaining adaptive behavior because according to Roy, humans
are holistic creatures who have adaptive systems that are always
adapting.

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2. Major Concepts The Conceptual Framework of Roy's Adaptation
Model

The Major concepts that build the conceptual framework of

roy's adaptation model are:

1) The system is a unity of several units that are interconnected

and form a whole unit characterized by input, control,
process, output, and feedback.
2) The degree of adaptation is a fixed change as a result of focal,
contextual and residual stimuli to individual standards, so that
humans can respond adaptively on their own
3) Adaptation problems are events or situations that are
inadequate to a decrease or increase in demand.
4) A focal stimulus is a degree of change or stimulus that directly
requires humans to respond adaptively. The focal stimulus is
the precipitation of changes in behavior.
5) A contextual stimulus is all the other stimuli that accompany
and contribute to the behavioral changes caused or stimulated
by the focal stimulus.
6) Residual stimuli are all factors that may contribute to behavior
change, but cannot yet be validated.
7) The regulator is a subsystem of coping mechanisms with
automatic responses through neural, cemical, and endocrine
processes.
8) The cogniator is a subsystem of coping mechanisms with
responses through complex processes of information
perception, taking, decision and learning.
9) The adaptive effector model is the cognator, namely:
Physiological, pean function, interdependence and self-
concept.

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 10) Adaptive responses are responses that increase human
integrity in achieving human goals for sustaining life,
reproductive growth.
11) Physiological needs include basic needs and how adaptation
processes are carried out for fluid and electrolyte regulation,
activity and rest, elimination, nutrition, circulation and
regulation of temperature, sensation, and endocrine
processes.
12) Self-concept is all the beliefs and feelings that an individual
holds at one time in the form of perception, participation, to
other people's reactions and direct behavior. Includes a view
of the physical (body image and self-sensation) of the
personality that produces self-consistency, self-ideals, or self-
expectations, personal morals and ethics.
13) Role appearance is the appearance of role functions related to
their duties in the social environment.
14) Intersuspension is an individual's relationship with others that
is important and as a support system. This model includes
how to maintain physical integrity with the maintenance and
influence of learning.

2.3 Nursing Paradigm

Four important elements included in the nursing adaptation model
are: (1) human; (2) Environment; (3) health; (4) Nursing. The nursing
element consists of two parts, namely nursing objectives and nursing
activities, also included in important elements in the concept of
adaptation.

1. Human

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 Roy suggested that humans are an adaptive system. As an adaptive
system, humans can be described holistically as a whole that has input,
control, output, and feedback processes. The control process is a
coping mechanism manifested by means of adaptation.

More specifically, humans are defined as an adaptive system with

the activity of cognators and regulators to maintain adaptation in four
ways of adaptation:

 Physiological Functions.
 Self-Concept.
 Role Functions.
 Interdependence.

In the nursing adaptation model, the human being is described as a

living, open and adaptive system that can experience forces and
substances with changes in the environment. As an adaptive system
humans can be described in terms of system characteristics, so humans
are seen as a single interconnected unit between functional units as a
whole or several functional units for some purpose.

As a system, humans can also be described by the terms input,

process control and feedback and output. Input in humans as an
adaptation system is to receive input from the external environment
and the inner environment of the individual himself.

Inputs or stimuli include opposite variables whose feedback can be

compared. This standard variable is an internal stimulus that has a
degree of adaptation and represents the range of human stimuli that
can be tolerated by the efforts that are usually made.

The human control process as an adaptation system is an identified

coping mechanism: the regulatory subsystem and the cognator
subsystem. Regulators and cognators are described as actions in

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 relation to four adaptive effectors: physiological function, self-concept,
role function and interdependence.

a. Model of physiological functions.

Physiological functions relate to the structure of the body and

its functions. Roy identified nine basic physiological needs that
must be met to maintain integrity, which are divided into two
parts, namely:

 Elementary Level physiological function model.

 Model of Physiological Functions with Complex Processes.

b. Self-concept model.

The self-concept model deals with psychosocial with specific

emphasis on the psychosocial and spiritual aspects of the human
being. The needs of this self-concept are related to psychic
integrity including perception, mental activity and expression of
feelings. Self-concept according to Roy consists of two
components, namely the physical self and the personal self.

I. The Physical Self: That is, how a person perceives himself relates to
his bodily sensations and body image. Difficulty in this area is often
seen in times of loss, such as after surgery, amputation or loss of
sexual ability.
II. The Personal Self: It deals with the consistency of the self, self-
ideal, moral-ethical and spiritual self of the person. Feelings of
anxiety, loss of strength or fear are severe in this area.

c. Role function mode.

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 The role function model recognizes the pattern of a person's
social interaction patterns in relation to others, which are reflected
in primary, secondary and tertiary roles. The focus is on how a
person can portray himself in society according to his position. d.
Interdependence Mode. Interdependence mode is the final part of
the mode described by Roy. The focus is interaction to give and
receive mutual love or affection, attention and mutual respect.
Interdependence is a balance between dependence and
independence in accepting something for himself.

Dependency is indicated by the ability to affiliate with others.

Independence is shown by the ability to take the initiative to take
action for himself. Interdependence can be seen from the balance
between two extreme values, namely give and take.

The output of the human being as an adaptive system is an

ineffective response. Adaptive responses maintain or enhance
integrity, while ineffective or maladaptive responses compromise
integrity. Through the feedback process, responses provide further
input to humans as a system. The regulatory and cognition
subsystem is a mechanism of adaptation or coping with
environmental changes, and is demonstrated through biological,
psychological, and social changes.

The regulatory subsystem is a description of responses related

to changes in the nervous system, body chemistry and endocrine
organs and the cognitive subsystem is a description of responses
related to cognitive and emotional changes, including perception,
information processing, learning, and reasoning and emotional
making, which includes maintaining to seek help.

2. Healthy concept

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 According to Roy, health is defined as the state and process of
becoming a whole and integrated human being as a whole. Human
integrity or wholeness implies indirectly that health or
uncompromised condition refers to completeness or unity and the
highest possibility of fulfilling human potential. So Integrity is healthy,
whereas conditions where there is no integrity are less healthy.

This definition of health is more than the absence of illness but

includes an emphasis on healthy well-being. In the nursing adaptation
model, the concept of healthy is linked to the concept of adaptation.
Energy-free adaptation of coping is ineffective and allows humans to
respond to other stimuli. This release of energy can promote healing
and enhance health.

It is the liberation of energy that connects the concepts of

adaptation and health. Adaptation is a central component in the
nursing model. It describes humans as adaptive systems. Adaptation
is considered both the coping process to the stressor and the end
product of the coping. The adaptation process includes a holistic
function to positively influence health and it enhances integrity.

The adaptation process including all human and environmental

interactions consists of two processes, namely:

 The first part of the process begins with changes in the internal and
external environment that require a response. The change is a
stressor or focal stimulus and is mediated by contextual and residual
factors. The parts of the stressor produce an interaction usually called
stress.
 The second part is the coping mechanisms that stimulate to produce
adaptive and ineffective responses.

The product of adaptation is the result of the adaptation process

and is described in terms of conditions that enhance human goals
which include: survival, growth, reproduction and mastery called

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 integrity. This final condition is the equilibrium dynamic equilibrium
condition which includes an increase and decrease in response -
response.

Each new adaptation condition is influenced by adaptation, so the

dynamics of human equilibrium are at a higher level. Such a large
distance from the stimulus can be agreed upon by the success of the
human being as an adaptive system. So increased adaptation leads to
higher levels of well-being or healthy state. Adaptation is then
referred to as a function of incoming stimuli and levels of adaptation.

Pain is a condition of an individual's inability to adapt to stimuli

that come from inside and outside the individual. Healthy and sick
conditions are very individually perceived by the individual. A
person's ability to adapt (coping) depends on the individual's
background in interpreting and perceiving health-sickness, such as
education level, occupation, age, culture and others.

3. Environmental concept

Roy defined the environment as all conditions of internal and

external origin, which affect and result in the development of the
behavior of a person and group. The external environment can be
physical, chemical, or psychological that the individual receives and
perceives as a threat. While the internal environment is the state of
mental processes in the individual's body (in the form of experience,
emotional abilities, personality) and biological stressor processes
(cells and molecules) originating from within the individual's body.
With a good understanding of the environment will help nurses in
improving adaptation in changing and reducing the risks resulting
from the surrounding environment.

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4. Nursing

Roy (1983) describes nursing as a scientific discipline and practice.

As a science, nursing observes, classifies and relates processes that
positively affect health status. As a discipline, practice, nursing uses a
knowledge approach to provide services to people. More specifically,
she defines nursing as the science and practice of improving
adaptation to improving health as the goal of positively influencing
health.

Nursing improves individual and group adaptation in health-

related situations, so the nursing adaptation model describes more
specifically the development of nursing science and nursing practice
based on the science of nursing. In the model, nursing consists of
nursing goals and nursing activities.

Nursing is dealing with human beings as a whole that interacts

with environmental changes and responses to internal and external
stimuli that affect adaptation. When unusual stressors or weak coping
mechanisms make ordinary human efforts ineffective coping, humans
need a nurse. This does not have to be, however, interpreted to mean
that nursing activity is not only given when the human being is sick.
Roy agrees, the holistic approach of nursing is seen as a process to
maintain a good state and a higher level of functioning.

Nursing consists of two, namely nursing goals and nursing

activities. The purpose of nursing is to enhance human interaction
with the environment.

So increased adaptation in each of the four ways of adaptation,

namely:

1) Physiological functions.
2) Self-concept.
3) Role functions.
4) Interdependence.

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 Encouragement towards enhancing the integrity of adaptation
and contributing to human health, quality of life and peaceful death.
Nursing goals are achieved when the focal stimulus is in an area with
a degree of human adaptation. When the focal stimulus is in that area
where humans can make an adjustment or effective response.

Adaptation frees energy from ineffective coping efforts and allows

the individual to respond to other stimuli. Such conditions can
achieve improved healing and health. So the important role of
adaptation is emphasized in this concept.

2.4 Weaknesses of the Callista Roy Adaptation Model

The weakness of Roy's adaptation model focuses on the target. This

adaptation model only focuses on the adaptation process and how to
solve patient problems using the nursing process without explaining
caring attitudes towards patients, even though nurses without caring
attitudes will cause stressors for their patients. Therefore it is necessary to
apply nurse caring behavior to support this adaptation model, where
caring will be very important in fostering interpersonal relationships
between nurses and their patients.

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 CHAPTER III
CLOSING
3.1 Conclusions
1. The nursing profession recognizes four levels of theory, which
consist of meta theory, grand theory, middle range theory, and
practice theory.
2. Grand theory can act as a basis for middle range theory.
3. Roy's conceptual model is one of the grand theories that focus on
models conceptual adaptation. The key concept in Roy's conceptual
model is human, goals, health, environment, and nursing activities

3.2 Suggestion

1. Nurses must be able to increase the patient's adaptive response to

healthy situations or sick.
2. The nurse must be able to act to prepare the patient for anticipation
change through strengthening regulators, cognators and other
coping mechanisms.

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 BIBLIOGRAFI

Ariani Y. Model Konseptual Keperawatan “Adaptation Model” [Laporan]. - [s.l.] : Sister

Callista Roy, 2011.
H.A. Roy S.C-Andrews The Roy Adaption Model: The Definitive Statement [Buku]. -
California : Appletonn & Large., 1991.
Phillips K. Roy Adaption Model: Sister Callista Roy [Jurnal] // Nursing Theorist and Their
Work. - [s.l.] : Nursing Theorist and Their Work, 129 – 140., 2010. - hal. 129 – 140..

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