Sister Callista Roy's

Adaptation Model

Done by:
Malak Al-Basha
Wesal Harahsha
Diala Abdeljawad
Background of Callista Roy
Sister Callista L. Roy (born October 14, 1939) is a nursing theorist,
professor, and author.

She is known for her groundbreaking work in creating the

Adaptation Model of Nursing.
Education and Career
 Roy was born on October 14, 1939, in Los Angeles, California.
 She received: 
 a bachelor’s degree in nursing in 1963. 
 a master’s degree in nursing in 1966.
 a master’s degree in sociology in 1973.
 a doctorate degree in sociology in 1977.
 Roy was challenged in a seminar with Dorothy E. Johnson to develop a conceptual model for
nursing.
 Roy developed the basic concepts of the model from 1964 to 1966 .
 Roy began operationalizing her model in 1968.
 The Roy adaptation model was first published in 1970.
Basis of Adaptation Model
Roy Adaptation Model for Nursing was derived in 1964 from Harry Helson’s Adaptation.

Theory – adaptive responses are a function of the incoming stimulus and the adaptive level.

Roy combines Helson’s work with Rapport definition.

 Combination became definition of a person as an adaptive system.

The model uses concepts from AH Maslow to explore beliefs and values of persons.
Roy’s holistic approach to nursing is based in humanism. 
Major Concepts
Adaptation -- goal of nursing
 Person -- adaptive system
 Environment -- stimuli
 Health -- outcome of adaptation
 Nursing -- promoting adaptation and health
 Adaptation
Responding positively to environmental changes.

The process and outcome of individuals and groups who

use conscious awareness, self reflection and choice to
create human and environmental integration.
Adaptation Level
A constantly changing point, made up of focal, contextual and residual stimuli, which
represent the person’s own standard of the range of stimuli to which one can respond
with ordinary adaptive responses.

Adaptation Problems

Adaptation problems are “broad areas of concern related to adaptation.

These describe the difficulties related to the indicators of positive
adaptation”
 Responses

• Adaptive Responses: responses that promote integrity of

the person in terms of goals of survival, growth,
reproduction, and mastery

• Ineffective Responses: responses that do not contribute to

adaptive goals, that is, survival, growth, reproduction, and
mastery
Four Adaptive Modes
 Physiological: The physiological-physical adaptive mode is concerned with
the way humans interact with the environment through physiological
processes to meet the basic needs of oxygenation, nutrition, elimination,
activity and rest, and protection.

 Interdependence: adaptive mode refers to coping mechanisms arising from

close relationships that result in “the giving and receiving of love, respect, and
value”

 Role Function: adaptive mode refers to the primary, secondary, or tertiary

roles the person performs in society.
• Self-Concept

The self-concept is an internal model that uses self-assessments in order to

define one's self-schemas. Features such as personality, skills and abilities,
occupation and hobbies, physical characteristics, gender

“it focuses specifically on the psychological and spiritual aspects of the

human system. The basic need underlying the individual self-concept mode
has been identified as psychic and spiritual integrity, or the need to know
who one is so that one can be or exist with a sense of unity, meaning, and
purposefulness in the universe
 System
 A system is “a set of parts connected to function as a
whole for some purpose and that does so by virtue of the
interdependence of its parts”

 Systems also have inputs, outputs, and control and

feedback processes”
 Person
“As an adaptive system, the human system is described as a wholewith
parts that function as unity for some purpose. 

Human systems: individuals or in groups.

Persons and the earth have common patterns and mutuality of

relations and meaning 

Roy defined the person as the main focus of nursing, the recipient of

nursing care, a living, complex, adaptive system with internal
processes acting to maintain adaptation in the four adaptive modes.
 Health
Health is a state and a process of being and becoming
integrated and a whole person. It is a reflection of
adaptation, that is, the interaction of the person and
the environment” 

“health is not freedom from the inevitability of death,

disease, unhappiness, and stress, but the ability to cope
with them in a competent way” 
 Environment
Environment is “all the conditions, circumstances,
and influencessurrounding and affecting the development and behavior of
persons or groups, with particular consideration of the mutuality of person and
earth resources that includes focal, contextual, and residual stimuli” .

“Itis the changing environment [that] stimulates the person to make adaptive

responses”

Factors in theenvironment that affect the person are as focal,

contextual, and residual stimuli.
Classes of stimuli
 Focal, is defined as the internal or external stimulus most
immediately challenging the person’s adaptation.

 Contextual, are all other stimuli existing in a situation that

strengthen the effect of the focal stimulus.

 Residual, are any other phenomena arising from a person’s internal

or external environment that may affect the focal stimulus but
whose effects are unclear.
 Nursing
Generally: health care profession that focuses on human life processes and patterns and emphasizes
promotion of health for individuals, families, groups, and society as a whole”.

Specifically: the science and practice that expands adaptive abilities and enhances

person and environmental transformation
.
Nursing: science & practice

“Nursing acts to enhance the interaction of the person with the environment to promote adaptation”

Roy’s 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”
Practice
The RAM is deeply rooted in nursing practice, and this, in part, contributes to its
continued success
RAM one of the most frequently used conceptual frameworks to guide nursing practice,
and it is used nationally and internationally 
 Itwas recognized as a valuable theory for nursing practice because of the goal that
specified its aim for activity and a prescription for activities to realize the goal.
Senesac (2003) reported that the RAM has been used to the greatest extent by individual
nurses to understand, plan, and direct nursing practice in the care of individual patients.
RAM is useful in guiding nursing practice in institutional settings. It has been implemented
in a neonatal intensive care unit, an acute surgical ward, a rehabilitation unit, two general
hospital units, an orthopedic hospital, a neurosurgical unit, and a 145-bed hospital, among
others
Practice
When using Roy’s six-step nursing process, the nurse performs the following six functions:

1. Assesses the behaviors manifested from the four adaptive modes.

2. Assesses the stimuli for those behaviors and categorizes them as focal, contextual, or
residual stimuli.
3. Makes a statement or nursing diagnosis of the person’s adaptive state.
4. Sets goals to promote adaptation.
5. Implements interventions aimed at managing the stimuli to promote adaptation.
6. Evaluates whether the adaptive goals have been met.