Seminar on:

The Theory of Adaptation

Model
Sr. Callista Roy
 Born at Los Angeles on October 14, 1939 as the 2nd
child of Mr. and Mrs. Fabien Roy

 At age 14 she began working at a large general

hospital, first as a pantry girl, then as a maid, and
finally as a nurse's aid.

 She entered the Sisters of Saint Joseph of

Carondelet.

 she earned a Bachelor of Arts with a major in nursing

from Mount St. Mary's College, Los Angeles in 1963.
 A master's degree program in pediatric nursing at the
University of California ,Los Angeles in 1966.
 She also earned a master’s & PhD in Sociology in 1973
& 1977 ,respectively.
 Sr. Callista had the significant opportunity of working
with Dorothy E. Johnson.
 Johnson's work with focusing knowledge for the
discipline of nursing convinced Sr. Callista of the
importance of describing the nature of nursing as a
service to society and prompted her to begin
developing her model with the goal of nursing being
to promote adaptation.
 She introduced her ideas about ‘Adaptation
Nursing’ as the basis for an integrated nursing
curriculum.

 Goal of nursing to direct nursing education,

practice and research.

 1970- The model was implemented in Mount St.

Mary’s school.
 Family.

 Education.

 Religion background.

 Mentors.

 Clinical experience.
 “Adaptation is the process by which an
individual or group makes conscious choices to
cope with his or her situation.”

Adaptive responses increase people's ability

to cope, and to achieve goals including survival,
growth, mastery of their lives and ‘personal and
environmental transformation’.
The central questions of Roy’s theory are:
1. Who is the focus of nursing care?
2. What is the target of nursing care?
3. When nursing care is indicated?

 Roy’s first ideas appeared in a graduate paper

written at UCLA in 1964.
 Published these ideas in “Nursing outlook” in 1970.
 Subsequently different components of her
framework crystallized during 1970’s,80’s & 90’s.

 Over the years she identified assumption on

which her theory is based.
Scientific
 Systems of matter and energy progress to higher
levels of complex self-organization
 Consciousness and meaning are constitutive 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

 Integration of human and environment meanings

results in adaptation
Philosophical
 Persons have mutual relationships with the world
and God
 Human meaning is rooted in an 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
 Human as adaptive system

 Health

 Environment

 Nursing & six step nursing process

 An adaptive system with coping processes
 Described as a whole comprised of parts
 Functions as a unity for some purpose
 Includes people as individuals or in groups (families,
organizations, communities, nations, and society as
a whole).
 An adaptive system with cognator and regulator
subsystems acting to maintain adaptation in the four
adaptive modes: physiologic-physical, self-concept-
group identity, role function, and interdependence
 All conditions, circumstances, and influences
surrounding and affecting the development and
behavior of persons and groups with particular
consideration of mutuality of person and earth
resources.

 Three kinds of stimuli: focal, contextual, and

residual.

 Significant stimuli in all human adaptation include

stage of development, family, and culture.
 Health: a state and process of being and
becoming integrated and whole that reflects
person and environmental mutuality

 Adaptation: the process and outcome whereby

thinking and feeling, persons as individuals and
in groups, use conscious awareness and choice
to create human and environmental integration
 Adaptive Responses: responses that promotes
integrity in terms of the goals of the human system,
that is, survival, growth, reproduction, mastery, and
personal and environmental transformation.

 Ineffective Responses: responses that do not

contribute to integrity in terms of the goals of the
human system.

 Adaptation levels represent the condition of the life

processes described on three different levels:
integrated, compensatory, and compromised.
 Nursing is the science and practice that expands
adaptive abilities and enhances person and
environment transformation
 Nursing goals are to promote adaptation for
individuals and groups in the adaptive modes, thus
contributing to health, quality of life, and dying
with dignity
 This is done by assessing behavior and factors that
influence adaptive abilities and by intervening to
expand those abilities and to enhance
environmental interactions
 System-a set of parts connected to function as a
whole for some purpose.
 Stimulus-something that provokes a response, point
of interaction for the human system and the
environment
 Focal Stimuli-internal or external stimulus
immediately affecting the system
 Contextual Stimulus-all other stimulus present in
the situation.
 Residual Stimulus-environmental factor, that effects
on the situation that are unclear.
 Regulator Subsystem-automatic response to
stimulus (neural, chemical, and endocrine)

 Cognator Subsystem-responds through four

cognitive responds through four cognitive-
emotive channels (perceptual and information
processing, learning, judgment, and emotion)

 Behavior -internal or external actions and

reactions under specific circumstances
 Physiologic-Physical Mode

 Behavior pertaining to the physical aspect of the

human system

 Physical and chemical processes

 Nurse must be knowledgeable about normal

processes

 5 needs (Oxygenation, Nutrition, Elimination,

Activity & Rest, and Protection)
 Self Concept-Group Identity Mode

The composite of beliefs and feelings held

about oneself at a given time. Focus on the
psychological and spiritual aspects of the human
system. Need to know who one is, so that one
can exist with a state of unity, meaning, and
purposefulness of 2 modes (physical self, and
personal self)
 Role function Mode

Set of expectations about how a person

occupying one position behaves toward a
occupying another position. Basic need-social
integrity, the need to know who one is in
relation to others
 Interdependence Mode
Behavior pertaining to interdependent
relationships of individuals and groups. Focus on
the close relationships of people and their
purpose. Each relationship exists for some
reason. Involves the willingness and ability to
give to others and accept from others. Balance
results in feelings of being valued and supported
by others. Basic need - feeling of security in
relationships.
 Adaptive Responses-promote the integrity of the
human system.

 Ineffective Responses-neither promote nor

contribute to the integrity of the human system

 Copping Process-innate or acquired ways innate

or of interacting with the changing of
environment
 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 the outcome of care provided.
There are six steps;
 First level assessment

 Second level assessment

 Diagnosis

 Goal setting

 Intervention

 evaluation
 Roy’s adaptation model is testable.

 BBARNS (1999) reported that 163 studies have

been conducted using this model.

 Roy’s adaptation model is complete and

comprehensive.

 It explains the reality of client, so nursing

intervention can be specifically targeted.
 Nursing practice

 Education

 Research
 Using Roy’s six –step nursing process, the nurses
assesses first the behaviors and second the stimuli
affecting those behaviors. In a third step the nurse makes
a statement or nursing diagnosis of the person’s adaptive
state and fourth, sets goals to promote adaptation. Fifth,
nursing interventions are aimed at managing the stimuli
to promote adaptation. The last step in the nursing
process is evaluation. By manipulating the stimuli and not
the patient, the nurse enhances the interaction of the
person with their environment, thereby promoting health
 The adaptation model is also useful in
educational setting. Roy states that the
model defines for students, the distinct
purpose of nursing which is to promote man’s
adaptation in each of the adaptive modes in
situations of health and illness.
 If research is to affect practitioners’
behavior, it must be directed at testing and
retesting conceptual models for nursing
practice. Roy has stated that theory
development and the testing of developed
theories are nursing’s highest priorities. The
model must be able to regenerate testable
hypotheses for it to be researchable.
Thank you...