Callista Roy Adaptation

Model

Presentors
Kiran aAbbas
Asma Nazir
Sidra Naz
 Roys Adaptation theory

He was a prominent
nurse theorist,
writer,
lecturer,
Researcher,
teacher and
professor at
Boston College of nursing in Los
Angeles.
Roys Adaptation Model

Sister Callista Roy ,a member of sisters of saint

Joseph of Carondeler , was born in October 14
1939 in Los Angeles, California.
She received a Bachelors of Arts in Nursing in
1963 from Mount saint Marys college in Los
Angeles. And a master of science in in Nursing
from the University of California in 1966.
After getting the nursing degrees ,she began her
education in Sociology, receiving both an M.A. in
Sociology and a Ph.D. in sociology in 1977from
the University of California.
 During her masters degree ,she was challenged in seminar with
Dorothy E. Johnson to develop a conceptual model for nursing.
She had worked as a pediatric staff nurse and had noticed the great
resiliency of children and their ability to adapt in response to major
physical and physiological changes. The basic concepts of model
were developed while Roy was the graduate student of UCLA from
1964 to 1966.
Roy was an associate professor and chairperson in department of
nursing in Mount Saint Mary's College until 1982. From 1983 to
1985, she was a Robert Wood Johnson Post Doctoral Fellow at the
University of California in San Francisco clinical nurse scholar in
neuroscience.
 She also conducted research on nursing interventions for cognitive
recovery in head injuries and on the influence of nursing models on
clinical decision making.
In 1988 ,she began a newly created position of graduate faculty
nurse theorist at Boston College school of nursing.
Roy has published many books ,chapters and periodical articles and
has presented lectures and workshops focussing on her nursing
adaptation theory .she is the member of SigmaTheta Tau, having
received the National Founder,s Awardfor excellence in Fostering
Professional Nursing Standards in 1981.
Her achievements include a 1984Honorary Doctorate of Humane
Letters by Alverno College , a Honorary Doctorate from Eastern
Michigan Universit, and a 1986 AJN Book of the year Award for
essentials of Roy Adaptation Model.
 In 1988 ,she began a newly created position of graduate
faculty nurse theorist at Boston College school of
nursing.
She also conducted research on nursing interventions for
cognitive recovery in head injuries and on the influence
of nursing models on clinical decision making.
Roy has published many books ,chapters and periodical
articles and has presented lectures and workshops
focusing on her nursing adaptation theory .she is the
member of Sigma Theta Tau, having received the
National Founder's Award for excellence in Fostering
Professional Nursing Standards in 1981.
 Her achievements include a 1984Honorary
Doctorate of Humane Letters by Alverno College
, a Honorary Doctorate from Eastern Michigan
University, and a 1986 AJN Book of the year
Award for essentials of Roy Adaptation Model.

Roy has been recognized in the World Who's

Who of Women, Personalities of America and
as a fellow of American Academy of Nursing.
Harry Helsons Theory

Roy's Adaptation Model for nursing

also included the citation of Harry
Helsons work in Psychophysics
that extended to social and
behavioral science ,Roy 1984.
According to Helsons theory:-

Adaptation:- is the process of responding positively to

environment changes ,Roy and Robert 1981,
combined Helsons work with rapports definition of
system to view the person to adaptive system.
After the development of her model Roy presented
it a framework for nursing practice , research and
education.
More than 1500 faculty and students have
contributed to the theoratical development of the
adaptation model by 1987, it was estimated that
over 100,000 nurses in U.S and Canada had been
prepared to practice by using the Roy Model.
In introduction to nursing and Adaptive Model Roy
1976, discussed self concept and group identity
mode.
Continue
Social interaction theories are cited to provide
the theoretical basis ,Roy suggestion that self
arises from social interaction ,1984.
Additional development of the model occurred
during the later 1900 into the 21 century.these
developments included update scientific and
philosophical assumptions a redefinition of
adaptation levels,extension of the adaptive
modes to group level knowledge development .
Major concepts and definitions:

SYSTEM: a set of parts connected to

function as a whole for some purpose that
does so by virtue of interdependence of its
parts .System also has input, output, control
and feedback process.
Adaptation problems:
these describes the difficulties related
to indicators of positive adaptation.
 Adaptation level: Adaptation level
represents the condition of life processes
described on three level as integrated,
compensatory and comromised it is a changing
point made up of :-
Focal stimuli
Contextual stimuli
Residual stimuli
 Focal stimli: which immediately confront the
individual.

Contextual stimuli: Which all other stimuli

present that contribute to effect of the focal
stimuli.

Residual stimuli: enviornmental factors with

in or without the human system.
 Coping process: process of interacting innate
or acquired with the changing of environment.
Innate coping mechanism: Are genetically
determined to the species and are generally
viewed as automatic processes.
Acquired coping mechanism: Developed
throughout strategies such as learning.
Regulator subsystem: is a major coping
process involving the neural, chemical,
endocrine system.
 Cognator subsystem: is major coping
processes involves four cognitive emotive
channels :
Perceptual
Information processing
Learning
Judgment and emotion.
Adaptive responses: Responses that promote
integrity in the terms of goals of human system.
 Ineffective responses: the responses
that do not contribute to integrity in term of goals
of human system.
Integrated life process: it is the
structure and function of life process are working
as a whole to meet the human needs.
Adaptive Modes

Physiological Mode
Self-Concept Mode
Role Performance Mode
Interdependence
Physiological Mode

Physiological needs involve the Bodys

basic needs and ways of dealing with
adaptation in regard to fluid and
electrolyte; exercise and rest, elimination,
circulation and oxygen, and regulation
which includes temperature, and
endocrine regulation.
Self-concept Mode

.Self-concept is composite of beliefs and

feelings that holds about oneself at a given
time.
It is formed from perceptions, particularly of
others reactions.
Its components include:
The physical Self:
It includes sensation and body image.
The Personal Self:
it is made up of self consistency, self ideal or
expectancy.
Role Performance Mode

Role Function is the performance of duties

based on given positions in society. The
way one performs a role is dependent on
ones interaction with the other in given
situation.
 Trunk of the
tree is ones
primary role
that is ones
developmental
level e.g. adult
female
Secondary role
branch off this
e.g. wife,
mother,
teacher etc.
Tertiary roles
branch off from
secondary roles
Analyzing Role Performance by imagining tree formation
e.g. mother
role must
involve other
Interdependence

The interdependence mode involves ones

relations with others and support system.
In this mode one maintains psychic
integrity by meeting needs for affection.
Callista Roys Model
Person as Adaptive System
According to Roy:
As an open, living system, the person receives
input or stimuli from both the environment and the
self.

Input
The adaptation level is determined by combined
effect of
Focal stimuli
Contextual stimuli
Residual stimuli
Focal Stimuli

Focal stimuli are that Internal or external stimuli

which confronts the human system, and requires
the most attention
 Contextual stimuli

Contextual stimuli
are characterized as
the rest of the stimuli
that present with the
focal stimuli, and
contribute to its
effect.
Residual Stimuli

Residual
stimuli are the
additional
environmental factors
present within the
situation, but whose
effect is unclear.
Subsystems in Model

There are two interrelated subsystems in Roys

Adaptation model
The Primary or Control Process
Subsystems
The secondary or Effector Subsystems

Primary or Control Process Subsystems involve

Coping Mechanisms that are:
Regulator
Cognator
Regulator

The regulator subsystem is a persons physiological

coping mechanism. Its the bodys attempt to adapt
via regulation of our bodily processes, including
neurochemical, and endocrine systems.

Cognator
A cognator is a subsystem coping mechanism
responds through complex processes of learning,
judgment and emotion.
The secondary or Effector Subsystems

Physiological function
Self concept
Role function
Interdependence
Output

Output of a person as a system are the responses of

the person. These responses can be observed or
perceived by Nurse or subjectively reported by the
person.
Roy has categorized output of system as

Adaptive Responses
That promote the integrity of a person.
Ineffective Responses
That do not meet the goal.
Callista Roys Model
Person as Adaptive System
Metaparadigm

Human Being
Human being is in constant interaction with a changing
environment and recipient of nursing care.
Environment
All conditions, circumstances that surround and effect
the development and behavior of person or group. Thus
all stimuli external or internal are the part of
environment.
 Health
A state and process of being and becoming an
integrated a whole person.

Nursing
Roy defines the goal of Nursing as The Promotion
of adaptive responses in relation to four adaptive
modes
Nursing seeks to reduce ineffective responses and
promote adaptive responses.
Nursing process
and Roy's
adaptation model
Scenario

Mrs. Asia, a 45 year old, married, and mother of

two daughters, is a school teacher, diagnosed
with CA breast (right, stage II).operated for
BCS(breast conserving surgery).she has family
history of CA breast.
Patient has following complaints:
She is not able to use her right arm because of
surgery, and feels burning during movement.
She is very upset because of loss of hair and
has fear that her husband will keep distance
from her.
Conti..

She is on sick leave, she can not teach and can

not go to school, she need someone to help her
with house duties.
She has complaints that she is not able to take
care of her family and fulfill her responsibilities.
Diagnosis:
impaired physical mobility related to illness
as evidence by inability to move limb(arm).
disturb body image related to hair loss
secondary to chemotherapy as evidence by
patient depressed mood and fear about
effect on body.
altered family process related to mother
illness as evidence by strained family
pattern
Roys model can be applied to nursing
process, in following modes
Physiological mode
Self concept mode
Role function mode
Interdependent mode
PHYSIOLOGIC MODE

Assessment of stimuli
Focal stimulus
Breast conserving surgery + SLNB
SLNB: Sentinel lymph node biopsy
Contextual stimulus
Burning
Nursing Diagnosis: impaired physical mobility
related to surgical process as evidenced by
inability to move limb.
Nursing interventions
Early Period
Limited ROM exercise, finger-wrist motions on postoperative day 1,
Elbow motions on postoperative day 3 (extension, flexion),
Informed about active arm-elbow exercise program after consulting
with the surgeon and sutures and drains withdrawn ( postoperative
five to seven days)
Patient encouraged to comply with the exercises, repetition number
and variations are increased
Informed that these exercises should be done three times a day for
20 minutes until normal angles are obtained in all moves
Patient is encouraged to engage in daily activities (combing hair,
eating, brushing teeth )
A booklet including exercises is handed-out.
Late period

Two-three times a day rest of the affected

arm and elevation,
Not sleeping over the side of the affected
arm.
Apply the exercise program for 20 minutes
three times a day.
SELF-CONCEPT MODE

Assessment of stimuli
Focal stimulus
Breast CA
Contextual stimuli
BCS,
Chemotherapy
Residual stimulus
Belief and thoughts on chemotherapy side effects (alopecia),
Newspaper information
Nursing Diagnosis: disturbed body image related to loss of
hair(alopacia) secondary to chemotherapy as evidenced
by patients depressed mood and fear about affect on
marital relationship.
Nursing interventions

Evaluation of the patient in terms of body image during every stage

of cancer treatment,
The loss is accepted, grief and anger are normalized and
encouraged to express feelings,
The patients husband is informed that his attitude towards his
spouses body image alterations are very critical, that he should
change any negative opinion he has about the disease, and that he
should encourage his wife to Express her feelings and help her
accept the changes,
The reason for disturbed body image is defined.
Use of hair softener during showers is suggested,
Use of shampoos with nutrients, thorough cleansing and gentle
drying are recommended ,
 Electrical hair dryers are not suggested,
Combing of the hair should not be done too frequently, by using soft
brushes,
Wigs or scarves are recommended before treatment,
If she prefers a wig it is suggested that she buys one before losing
her hair, to match her hair color,
Eye pencil, brow pencil, fake eyebrows are recommended,
Informed that the hair will grow back 1-2 months after the end of
chemotherapy, will look like pre-treatment form 3 to 5 months,
Informed that the new hair might appear differently,
The patient is introduced to other patients who had lived this
experience before.
The patient is encouraged to join support groups and group therapy
ROLE FUNCTION MODE

Assessment of stimuli
Focal stimulus
Breast CA
Contextual stimulus
BCS, Chemotherapy
Nursing Diagnosis: Insufficiency in fulfilling roles
Nursing interventions

Personal responsibilities regarding motherhood and

spouse,
Encouraged to face obstacles in roles and share lately
encountered stressors,
Parents are given opportunities regarding childcare,
Support systems are evaluated (family, friends).
Encouraged to speak to her employer about her present
situation,
It is emphasized that the employer might have requests
from the individual and a planning that is suitable for
both sides can be made.
INTERDEPENDENCE MODE

Assessment of stimuli
Focal stimulus
Breast CA
Contextual stimulus
Spouse, family, friends
Nursing Diagnosis: Altered family process
related to illness of mother as evidenced by
strained family pattern.
 Nursing Interventions
Create environment where all family members can express their
feelings.
Family members are assisted to identify their support systems and
use these when needed,
The patient is encouraged to define their relationship with family
members,
The patient is encouraged to develop efficient coping methods for
problems occurring in family process (spending time with members,
sharing problems and creating solutions) and to continue
communication and interaction with family members.
Family members might be given education on coping and problem
solving methods.
If required they might be encouraged for professional support .
Evaluation: