ADAPTATION MODEL

SISTER CALLISTA ROY

ABOUT THE THEORIST
SISTER CALLISTA ROY
Born on October 14, 1939 in Los Angeles, California
Nurse theorist and a professor at the William F. Connel
School of Nursing at Boston College, Massachusetts
Post-Doctoral Fellow and Robert Wood Johnson Clinical
Nurse Scholar at the University of California, San
Francisco
(1963) Bachelor of Science in Nursing from Mount Saint
Mary College, Los Angeles
(1996) Master’s Degree in Pediatric Nursing
(1997) Doctorate in Sociology from the University of
California, Los Angeles
ABOUT THE THEORIST
SISTER CALLISTA ROY
Her postdoctoral studies in Neuro science
Nursing were at the University of California,
San Francisco

A fellow of American Academy of Nursing

and active in many nursing organizations:
Sigma Theta Tau and North American
Nursing Diagnosis Association (NANDA)

Best known for her work on Roy Adaptation

Model of Nursing
Her other scholarly works includes conceptualizing, measuring, and
developing the philosophical basis for the Adaptation Model and for
the Epistemology of Nursing.

Publications (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
 Roy Adaptation Model: The Definitive Statement

Dr. Roy has given 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.
 CONTENT OF THE THEORY

Roy’s model focuses on the concept of

adaptation of the person.

Her concepts of nursing, person, health and environment

are all interrelated to this central concept.
 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.
RAM has been re-conceptualized to be used in 21st century.
Key ideas of this conceptual framework were first published in an
article entitled, Adaptation: A Conceptual Framework for Nursing
(Roy, 1970).
It greatly influences the nursing community and has inspired nursing
scholars to publish books related to the model, and it has been put
into action in various healthcare settings and applied to various
populations.
 ADAPTATION MODEL
Basis of scientific assumptions for RAM:
 Von Bertalanffy’s (1968) General System Theory
 Helson’s (1964) Adaptation Theory

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
will either threaten or promotes the person’s unique wholeness.
 The person’s major task is to maintain integrity in face of these
environmental stimuli.
BOX 9.B TYPES OF STIMULI
FOCAL Those most immediately confronting the
person, it attracts the most attention.
CONTEXTUAL All other stimuli that strengthens the
effect of the focal stimulus. These are all
the environmental factors that present to
the person from within or without but
which are not the center of the person’s
attention and/or energy.
RESIDUAL Those stimuli that can affect the focal
stimulus but the effects are unclear.

The three types of stimuli act together and influence the adaptation level
which is defined as the ability to respond positively in a situation.
A person’s adaptation level may be described as integrated, compensatory,
or compromised (Roy and Andrews, 1999).
The Adaptation Level is modulated by a person’s coping processes which
are the innate or acquired ways of interacting with the changing
environment.

Innate coping mechanisms are determined genetically or common among

the species and are viewed generally as automatic processes, while
acquired coping mechanisms are those developed through strategies like
learning. Thus, a person does not respond passively to environmental
stimuli.
Two categories of coping mechanisms according to Roy:
Regulator subsystem - transpires through neutral, chemical and endocrine
processes like the increase in vital signs — sympathetic response to stress.
Cognator subsystem - occurs through cognitive-emotive processes. For
instance, are the effects of prolonged hospitalization for a four-year old child.

Roy identified two control processes:

Stabilizer subsystem - associated with system maintenance and involving
established structures, values and daily activities whereby participants in a
group accomplish the purpose of the social system.
Innovator subsystem - allows the person to change higher levels of
potential through cognitive and emotional strategies.
Table 9.a ROY’S ADAPTIVE MODES
Adaptive Mode Individual Group
  The way a person responds as a physical being to stimuli from the environment
Physiological–Physical Goal: Physiological Integrity
Mode Five Physiological Needs: Operating resources:
1.Oxygenation Participants, capacities, physical facilities, and
2. Nutrition fiscal resources.
3. Elimination  
4. Activity and rest  
5. Protection
 
Four Complex Process:
1. Senses
2. Fluid and acid base balance
3. Neurologic function
4. Endocrine function
  Physiological and spiritual characteristics of the person consists of all beliefs and feelings
Self Concept – Group that one has formed about oneself.
Mode They incorporate two components: physical self (body sensation and body movement )
and personal self (self-consistency, self-ideal and moral-ethical spiritual self ).
Need is a psychic and spiritual integrity so Need is a group integrity through shared
that one can be or exist with a sense of relations, goals, values and co-responsibility for
unity, meaning, and purposefulness in the achievement; implies honest, soundness and
universe. completeness of identifications with the group.
Table 9.a ROY’S ADAPTIVE MODES
Adaptive Mode Individual Group
Primary, secondary, or tertiary roles that a person perform in the society. According
Role Function Mode to Roy and Andrews (1991) a role is a set of expectations about how a person
occupying one’s position behave towards a person occupying another position.
Goal: Social integrity
Need is a social integrity; knowing one Need is a role clarity, understanding and
who is in relation to others so one can committing to fulfill expected tasks so group
act; role set is the complex of positions can achieve common goals; process of
individuals holds; involves role integrating roles in managing different roles
development, instrumental and and their expectations; complementary
expressive behaviors, and role taking roles are regulated.
process.
  Coping mechanisms from close relationship which results to giving and receiving of
Interdependence Mode love, respect, and value. Occurs between the person and the most significant other
or between the person and support system.
Goal: Affectional adequacy
Need is to achieve relational integrity Need is to achieve relational integrity using
using process of affectional adequacy. processes of developmental and resource
Example of which is giving and adequacy. Example is learning and maturing in
receiving love, respect, and value relationships and achieving certain needs.
through effective relations and
communication.
Adaptation is done through two main coping subsystems, namely the regulator and cognator.
Roy did not explain further the mechanism of regulator and cognator because its mechanism
cannot be directly observed and unknown. However, its behaviors are manifested in the four
adaptive modes.

According to Roy and Andrews (1999), health is a state and a process of being and becoming
an integrated and whole person. It is an indication of how well an individual has adapted to
environmental stimuli.
 NURSING PROCESS
It is a goal-oriented, problem-solving approach to guide the provision of
comprehensive, competent nursing care to a person or group of persons.

It relates directly to the view of the person as an adaptive system

(Andrews and Roy, 1991).

It is a 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 of the outcome
of care provided.
 
STEP 1: ASSESSMENT OF BEHAVIOR NURSING PROCESS
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
In this level of assessments, the nurse analyzes the subjective and objective behaviors and look more deeply for
possible causes of a particular set of behaviors (Roy and Andrews, 1999).
 
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 dear statements of the behavioral outcomes for nursing care which is realistic and attainable.
This is done together 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 using intervention in relation to the behavior after it performed in comparison with
the goal established.
 METAPARADIGM IN NURSING
NURSING
Nursing is the science and practice
that expands adaptive abilities and
enhances person and environment
transformation.
PERSON
Roy’s model view the person as a
biopsychosocial being in constant
interaction with a changing
environment.
HEALTH
Health and illness are on a continuum
with many different states or degrees
possible.
She states that health is the process of
being and becoming an integrated and
whole person.
ENVIRONMENT
Roy viewed environment as conditions,
circumstances and influences that
surround and affect the development
and behavior of the person.
 THEORETICAL/CONCEPTUAL FRAMEWORK

Roy suggests that

Roy's theory of the
although direct observation
of the processes of the Person as an
regulator and cognator Adaptive System
subsystems is not claims that the four
possible, the behavioral adaptive modes are
responses of these two interrelated through
subsystems can be perception.
observed in any of the four
adaptive modes, namely:
(1) Physiological-Physical, An adaptive or
(2) Self- concept-group, ineffective response
(3) Role function and in one mode can
(4) Interdependence influence adaptation
adaptive mode. in the other modes.
 ACCEPTANCE BY THE NURSING COMMUNITY
PRACTICE
It is a valuable theory for nursing practice because it includes a goal that is
specified as the aim for activity and prescription of activities to attain the
goal.

EDUCATION
Roy’s Adaptation model can serve as basis for student nurses who render
care for clients to promote adaptation with regard to their adaptive modes
RESEARCH
Roy’s theory culminated a number of propositions in which in return
generated specific hypothesis that can be developed and tested.
 THEORY ANALYSIS/EVALUATION
CLARITY
In Roy’s model, terms and concepts are clearly defined and is consistent all throughout,
such as her concepts on the metaparadigm of nursing and the four adaptive modes.
SIMPLICITY
Roy’s model is considered complex in terms of structure because it is composed of several
major concepts (nursing, person, health-illness, environment, adaptation, and nursing
interventions), sub-concepts (regulator and cognator), four effector modes (physiological, self-
concept, role function, and interdependence)
GENERALITY
The Roy’s Adaptation Model is described as broad in scope, which is considered an
advantage because it can be used for theory building and testing.
ACCESSIBLITY
The RAM's broad scope branched from different fields such as Physiological,
Psychology, Sociology and Nursing.
IMPORTANCE
The RAM has clearly identified the nursing process which is an important tool in nursing
practice.
 REFERENCES
St. Rosemary Educational Institution. (n.d.) [Sister Callista Roy] [photograph].
Retrieved from http://schoolworkhelper.net/wpcontent/uploads/2012/05/
Callista-Roy.jpg

Roy, C. (1984). The Person As an Adaptive Model. Introduction to Nursing: An

Adaptation Model. Upper Saddle River, NJ: Prentice Hall Health.

Alligood, M. (2014). Human Adaptive System. Nursing Theorists and Their Work,
8th ed. Elsevier Health Sciences.

Balita, C. & Octaviano, E. (2020). Chapter 9: Nursing Conceptual Models Sister

Callosta Roy Adaptation Model. (pp. 137-143) Theoretical Foundations in Nursing
National Nursing Core Competency Standards Aligned Outcomes- Based
Approach. Ultimate Learning Series.