SISTER CALLISTA

ROY’S
ADAPTATION
MODEL
TALA, STEPHANIE ANNE V.
PAPAY, MARY JANE
ADAPTATION MODEL
“The model provides a way of thinking about
people and their environment that is useful in any
setting. It helps one prioritize care and challenges
the nurse to move the patient from survival to
transformation.”
SISTER CALLISTA ROY
• She was born on October 14, 1939 in Los Angeles, California.
• A nurse theorist and a professor at the William F. Connell
School of Nursing at Boston College,. Massachusettes where
she educates doctoral, master’s, and undergraduate students.
• Before this prior arrangement, Roy was a Post-Doctoral Fellow
and Robert Wood Johnson Clinical Nurse Scholar at the
University of California San Francisco.
• She earned her Bachelor of Science in Nursing in 1963 from
Mount Saint Mary College, Los Angeles.
• Her Master’s degree in Pediatric Nursing was finished in 1966
and Doctorate in Sociology was conferred on her in 1977 from
the University of California, Los Angeles.
• She also holds honorary doctorates from four other institutions.
• Her postdoctoral studies in Neuroscience Nursing were at the
University of California at San Francisco.
• She is a Fellow of American Academy of Nursing and active in
many nursing organizations (Sigma Theta Tau and the North
American Nursing Diagnosis Association (NANDA)).
• Dr. Roy is best known for her work on the Roy Adaptation
Model of Nursing.
• Roy has numerous publications, including books and journal
articles, on nursing theory and other professional topics:
- Introduction to Nursing: An Adaptation Model
- Essentials of the Roy Adaptation Model
- Theory Construction in nursing: An Adaptation Model
- Essentials of the Roy Adaptation Model
- Roy Adaptation Model: The Definitive Statement
• Her works have been interpreted into several languages all
over the world. Dr. Roy also has giver invited papers, lectures,
and workshops throughout North America and 30 other
countries over the past 30 years on topics related to nursing
theory, research, curriculum, clinical practice, and professional
trends for the future.
NURSING
METAPARADIGM
• Person - a biopsychosocial being in constant interaction with a
changing environment. The person is an open, adaptive system who
uses coping skills to deal with stressors. It includes people as
individuals or in groups. An Adaptive system has cognator and
regulator subsystems which act to maintain adaptation in the four
adaptive modes: physiological, self-concept, role-function, and
interdependence.

• Environment- conditions, circumstances and influences that

surround and affect the development and behavior of the person. She
described stressors as stimuli and uses the term “residual stimuli” to
describe those stressors who influence on the person are not clear.
Three kinds of stimuli: Focal, Contextual, and Residual. Significant
stimuli in all human adaptation: stages of development, family, and
culture.
• Health - health and illness are on a continuum with many different states
or degrees possible. Health is the process of being and becoming an
integrated and whole person. Adaptation is the process and outcome
whereby thinking and feeling, as an individual and in groups, use conscious
awareness and choice to create human and environmental integration.

• Nursing – is the science and practice that expands adaptive abilities and
enhances person and environment transformation. Roy’s goal of nursing is
the promotion of adaptation in each of the four modes, hereby contributing to
the person’s health, quality of life and dying with dignity. Nursing is about the
decrease, enhancement, modification and alteration of the stimulus to
achieve adaptation.
 ROY ADAPTATION
MODEL
• Roy, a sister of Saint Joseph of Carondelet, developed the Roy
Adaptation Model (RAM) in 1964 in response to a challenge by her
professor, Dorothy E. Johnson to develop a conceptual model for
nursing practice.
• Roy recognized the works of Von Bertalanffy’s General System
Theory and Helson’s Adaptation Theory as a basis of scientific
assumptions for her model.
KEY CONCEPTS:
- The person is adapting in a stable interaction with the environment
either internal or external.
- The environment serves as the source of a range of stimuli that we
either threaten or promote the person’s unique wholeness.
- The person’s major tasks is to maintain integrity in face of these
environmental stimuli
KEY TERMINOLOGY
• Integrity- degree of wholeness achieved by adapting to changes in
need.
• Stimulus- any changes in the internal and external environment that
induces a response in the adaptive system.
3 TYPES OF STIMULI
1. Focal- those most immediately confronting the person, it attracts the
most attention.
2. Contextual- all other stimuli that strengthens the effect of the focal
stimulus.
3. Residual- those stimuli that can affect the focal stimulus but the
effects are unclear.
• Adaptation level- ability to respond positively in a situation
(integrated, compensatory or compromised).
2 CATEGORIES OF COPING MECHANISMS
1. Regulator subsystem- transpires through neutral, chemical, and
endocrine processes like the increase in vital signs – sympathetic
response to stress.
2. Cognator subsystem- occurs through cognitive-emotive
processes, for instance the effects of prolonged hospitalization for a
four-year old child.
• Innovator subsystem- allows the person to change to higher
levels of potential through cognitive and emotional strategies.
FOUR ADAPTIVE
MODES
• Physiological
- Deals with maintenance of the physical body. It includes basic human
needs such as air, water, food, and temperature regulation.
• Self- Concept
- Refers to psychological and spiritual characteristics of the person. The
person’s perceptions of his or her physical and personal self are
included in this mode.
• Role Function
-primary, secondary, and tertiary roles that a person performs in a society.
• Interdependence
- Coping mechanism from close relationship which results to giving and
receiving of love, respect, and value.
NURSING PROCESS
• Is a goal oriented, problem-solving approach for gathering data,
identifying the capacities and needs of the human adaptive system,
selecting and implementing approaches for nursing care, and
evaluation the outcome of care provided.
Step 1: Assessment of Behavior
- Data gathering about the behavior of the person as an adaptive
system in each of the adaptive modes.
Observable behavior: Vital signs (temperature, pulse rate, respiratory
rate, blood pressure)
Non-observable behavior: feelings experienced by the person (anxiety)
Step 2: Assessment of Stimuli
- The nurse analyzes the subjective and objective behaviors and
look more deeply for possible causes of a particular set of
behaviors.
Step 3: Nursing Diagnosis
- Formulation of statements that interpret data about the adaptation
status of the person, including the behavior and most relevant
stimuli.
Step 4: Goal Setting
- Establishment of clear statements of the behavioral outcomes for
nursing care which is realistic and attainable. Done with the client.
Step 5: Intervention
-determination of how best to assist the person in attaining the
established goals.
Step 6: Evaluation
- Judging the effectiveness of the nursing intervention in relation to the
behavior after it was performed in comparison with the goal established.
ACCEPTANCE BY THE
NURSING COMMUNITY

• Practice – useful for nursing practice because it outlines the

features of the discipline and provides direction for practice,
education, and research.
• Education – serve as basis for student nurses who render care for
clients to promote adaptation with regard to their adaptive modes.
• Research – RAM culminated a number of propositions in which in
return generated specific hypothesis that can be developed and
tested.
ANALYSIS
• Simplicity – RAM is considered complex in terms of structure
because it is composed of several major concepts, sub-concepts, and
four effector modes.
• Generality – RAM is described as broad in scope, which is
considered an advantage because it can be used for theory building
and testing.
• Empirical Precision – RAM’s branched from different fields such
as Physiological, Psychology, Sociology, and Nursing. The empirical
data indicates that this theory has substance. It offers a guide to
researchers who wants to integrate physiological phenomena in their
study.
• Derivable Consequences – RAM has clearly identified the
nursing process which is a important tool in nursing practice.