Sr.

Callista Roy’s Adaptation Model of Nursing

DR. NEMIA T. ALIMBUYUGIN

TFN - PROFESSOR
 EDUCATION
 1963-1968: Bachelor’s degree in nursing from Mount Saint
Mary’s college in Los Angeles and received an
Master’s degree program in pediatric nursing at the
University of California
 1973 –1977: received both a master’s
degree in sociology and a doctorate in sociology from the University
of California.
 1964 -1966 : She developed the model’s basic concepts while she
was a graduate student at the University of California
 EDUCATION
 1968: she began operationalizing her model when Mount Saint Mary’s College
adopted the adaptation framework as the nursing curriculum’s philosophical
foundation
 1982 :Roy was an associate professor and chairperson of the Department of
Nursing at Mount Saint Mary’s College
 1983 : was promoted to the professor’s rank at both Mount Saint Mary’s College
and the University of Portland. She helped initiate and taught in a summer
master’s program at the University of Portland.
 1991 :she founded the Boston Based Adaptation Research in Nursing Society
(BBARNS), which would later be renamed the Roy Adaptation Association.
Roy’s other scholarly work includes conceptualizing and measuring coping
and developing the philosophical basis for the adaptation model and
nursing’s epistemology. She belongs to the Sisters of St. Joseph of
Carondelet.
 EDUCATION
 1981:received Founder’s award for excellence in
fostering professional nursing standard.
 1982:was associated professor and chair person of the
Department of Nursing at Mount Saint Mary’s college
 1984:got honorary Doctorate from Averno College and
from Eastern Michigan University in
 1985: began the newly created position of nurse theory

osition of nursetheorist
 1987: st at Boston College School of Nursing.
 Awards & honors:
 2013 – Distinguished Graduate Award, Bishop Conaty/Our Lady of
Loretto High School
– Honorary Doctoral Degree, Holy Family University
– Alumni Award for Professional Achievement, UCLA
– Excellence in Nursing, The University of Antioquia, Medellin
Colombia
 2011 – Nursing Science Quarterly Special Issue Honoring the work of

Callista Roy, Vol. 24, Num. 4, Oct. 2011

– Faculty Senior Scientist Poster Exemplar Award, Yvonne L.
Munn
Center for Nursing Research and the Nursing Research Expo
 Awards & honors:
 2011 – The Sigma Mentor Award, Sigma Theta Tau International
Alpha Chi Chapter
 2010 – University of Southern Alabama Picture Gallery of Theorist,
University of Alabama
 2010 – Inducted to Nurse Researcher Hall of Fame, Inaugural Class,
Sigma Theta Tau International, Honor Society of Nursing
 2010 – “Sixty Who have Made a Difference,” UCLA School of
Nursing, 6th Anniversary
 2010 – Inductee, Sigma Theta Tau International Nurse Researcher
Hall of Fame
 2007 – American Academy of Nursing Living Legend Award
 Adaptation Model of Nursing
Sr. Callista Roy’s Adaptation Model of
Nursing was developed in 1976. The
prominent aims to explain or define the
provision of nursing. In her theory, she sees the
individual as a set of interrelated systems that
maintain a balance between these various
stimuli.
In Adaptation Model, Roy defined nursing as a
“health care profession that focuses on human life
processes and patterns and emphasizes the
promotion of health for individuals, families,
groups, and society as a whole.”

Inspired the development of many middle-range

nursing theories and adaptation instruments.
Roy’s model was conceived when nursing theorist Dorothy Johnson challenged
her students to develop conceptual models of nursing during a seminar. Johnson’s
nursing model was the impetus for the development of Roy’s Adaptation Model.

Roy’s model incorporated concepts from Adaptation-level Theory of Perception

from renowned American physiological psychologist Harry Helson, Ludwig von
Bertalanffy’s System Model, and Anatol Rapoport’s system definition.

First, consider the concept of a system as applied to an individual. Roy

conceptualizes the person in a holistic perspective. Individual aspects of parts act
together to form a unified being. Additionally, as living systems, persons are in
constant interaction with their environments. Between the system and the
environment occurs an exchange of information, matter, and energy. Characteristics
of a system include inputs, outputs, controls, and feedback.
 Assumptions
Scientific Assumptions
•Systems of matter & energy progress to higher levels of complex self-organization.
•Consciousness and meaning are constructive of person and environment integration.
•Awareness of self and environment is rooted in thinking and feeling.
•Humans, by their decisions, are accountable for the integration of creative processes.
•Thinking and feeling mediate human action.
•System relationships include acceptance, protection, and fostering of interdependence.
•Persons and the earth have common patterns and integral relationships.
•Persons and environment transformations are created in human consciousness.
•Integration of human and environmental meanings results in adaptation.
 Philosophical Assumptions

•Persons have mutual relationships with the world and God.

•Human meaning is rooted in the omega point convergence of the
universe.
•God is intimately revealed in the diversity of creation and is the
common destiny of creation.
•Persons use human creative abilities of awareness,
enlightenment, and faith.
•Persons are accountable for the processes of deriving,
sustaining, and transforming the universe.
 Major Concepts of the Adaptation Model
The following are Callista Roy’s Adaptation Model’s major concepts, including the
definition of the nursing metaparadigm as defined by the theory

Person:
“Human systems have thinking and feeling capacities, rooted in consciousness
and meaning, by which they adjust effectively to changes in the environment
and, in turn, affect the environment.”
- Humans are holistic beings that are in constant interaction with their
environment.
- Humans use a system of adaptation, both innate and acquired, to respond to the
environmental stimuli they experience.
- Human systems can be individuals or groups, such as families, organizations,
and the whole global community
Environment:
“The conditions, circumstances and influences surrounding
and affecting the development and behavior of persons or
groups, with particular consideration of the mutuality of person
and health resources that includes focal, contextual and
residual stimuli.”
- defined as conditions, circumstances, and influences that
affect humans’ development and behavior as an adaptive
system.
- is a stimulus or input that requires a person to adapt. These
stimuli can be positive or negative.
 STIMULI CATEGORY
1.Focal stimuli are that confront the human system and
require the most attention.
2.Contextual stimuli are characterized as the rest of the
stimuli present with the focal stimuli and contribute to its
effect.
3.Residual stimuli are the additional environmental
factors present within the situation but whose effect is
unclear. This can include previous experience with certain
stimuli.
Health
“Health is not freedom from the inevitability of death, disease,
unhappiness, and stress, but the ability to cope with them in a
competent way.”
- is defined as the state where humans can continually adapt to
stimuli. Because illness is a part of life, health results from a
process where health and illness can coexist.
- If a human can continue to adapt holistically, they will
maintain health to reach completeness and unity within
themselves. If they cannot adapt accordingly, the integrity of
the person can be affected negatively.
Nursing
“[The 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.”
- nurses are facilitators of adaptation.
- They assess the patient’s behaviors for adaptation, promote
positive adaptation by enhancing environment interactions
and helping patients react positively to stimuli.
- nurses eliminate ineffective coping mechanisms and
eventually lead to better outcomes.
Adaptation
- is the “process and outcome whereby thinking and feeling persons as
individuals or in groups use conscious awareness and choice to create
human and environmental integration.”
Intornal Processes
Regulator
The regulator subsystem is a person’s physiological coping mechanism.
The body attempts to adapt via regulation of our bodily processes,
including neurochemical and endocrine systems.
Cognator
The cognator subsystem is a person’s mental coping mechanism. A
person uses his brain to cope via self-concept, interdependence, and
role function adaptive modes.
Four Adaptive Modes

The subsystem’s
four adaptive modes
are how the regulator
and cognator
mechanisms are
manifested; in other
words, they are the
external expressions
of the above and
internal processes.
 Physiological-Physical Mode
Physical and chemical processes are involved in the
function and activities of living organisms. These are the
actual processes put in motion by the regulator subsystem.
This mode’s basic need is composed of the needs
associated with oxygenation, nutrition, elimination,
activity and rest, and protection. This model’s complex
processes are associated with the senses, fluid &
electrolytes neurologic function, and endocrine function.
Self-Concept Group Identity Mode
In this mode, the goal of coping is to have a sense of unity, meaning the
purposefulness in the universe, and a sense of identity integrity. This
includes body image and self-ideals.
Role Function Mode
This mode focuses on the primary, secondary, and tertiary roles that a
person occupies in society and knowing where they stand as a member of
society.
Interdependence Mode
This mode focuses on attaining relational integrity through the giving
and receiving of love, respect and value. This is achieved with effective
communication and relations.
 Levels of Adaptation
Integrated Process
The various modes & subsystems meet the needs of the environment.
These are usually stable processes (e.g., breathing, spiritual realization,
successful relationship).
Compensatory Process
The cognator & regulator are challenged by the environment’s needs but
are working to meet the needs (e.g., grief, starting with a new job,
compensatory breathing).
Compromised Process
The modes & subsystems are not adequately meeting the environmental
challenge (e.g., hypoxia, unresolved loss, abusive relationships).
 Six-Step Nursing Process
A nurse’s role in the Adaptation Model is to manipulate stimuli by
removing, decreasing, increasing, or altering stimuli so that the patient.
1.Assess the behaviors manifested from the four adaptive modes.
2.Assess the stimuli, categorize them as focal, contextual, or residual.
3.Make a statement or nursing diagnosis of the person’s adaptive state.
4.Set a goal to promote adaptation.
5.Implement interventions aimed at managing the stimuli.
6.Evaluate whether the adaptive goal has been met.
 Roy’s Adaptation Model
World View: Reciprocal Interaction World View
• Holistic view of person and adaptive systems
• People represent unity in diversity
• Humans interact with a changing environment
Content of the Nursing Model: the 4 concepts (human beings, environment, health, nursing) and
NON-RELATIONAL propositions or constitutive definitions:
 Analysis
 As one of the weaknesses of the theory that applying it is time-consuming, applying
the model to emergencies requiring quick action is difficult to complete, the
individual might have completed the whole adaptation process without the benefit of
having a complete assessment for thorough nursing interventions.
 Adaptive responses may vary in every individual and may take a longer time
compared to others. Thus, the span of control of nurses may be impeded by the time
of the patient’s discharge.
 Unlike Levine, although the latter tackled adaptation, Roy focused on the whole
adaptive system itself. Each concept was linked with the coping mechanisms of every
individual in the process of adapting.
 When an individual presents an ineffective response during his or her adaptation
process, the nurses’ roles were not clearly discussed.
 The main point of the concept was to promote adaptation, but none were stated on
preventing and resolving maladaptation.
 Strengths of the Roy’s Adaptation Model :
 suggests the influence of multiple causes in a situation, which is a strength when
dealing with multi-faceted human beings.
 the sequence of concepts in Roy’s model follows logically. In the presentation of
each of the key concepts, there is the recurring idea of adaptation to maintain
integrity. Every concept was operationally defined.
 the concepts of Roy’s model are stated in relatively simple terms.
 a major strength of the model is that it guides nurses to use observation and
interviewing skills in doing an individualized assessment of each person.
 The concepts of Roy’s model are applicable within many practice settings of nursing.
Weaknesses of the Roy’s Adaptation Model :
 painstaking application of the model requires a significant input of time and effort.
 Roy’s model has many elements, systems, structures, and multiple concepts.
 Thank you for Listening

“Cultivate the virtue of hope-- take the long

view and believe in it.”
– Sr. Callista Roy