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Adaptation model

Sister Callista Roy


Born on October 14,1939 in los Angeles, California She was a Post-Doctoral Fellow and a Robert Wood Johnson Clinical Nurse scholar at university of California Achieved BSN at Mount Saint Marry Collage, los Angeles in 1963 Masters degree in pediatric nursing in 1966 and doctorate in sociology was conferred on her in 1977 in university of California.

Person

Roy views a person as a biopsychosocial being in constant interaction with a changing environment.

Environment -

Roy viewed environment as conditions, circumstances and influences that surround and affect the development and behavior of the person.

Health -

Roy wrote that health and illness are on a continuum with many different states or degrees possible.

Nursing -

Roy viewed nursing as the science and practice that expands adaptive abilities and enhances person and environmental transformation.

ROY ADAPTATION MODEL

The Roy Adaptation Model or RAM was developed on 1964 in response to a challenge by her professor Dorothy E. Johnson

As roy develops her model she recognized the works of Von Bertalaffys general system theory and helsons adaptation theory as a basis of scientific assumption for her model

RAM Key Concepts


The person is adapting in a stable interaction with the environment, either internal nor external The environment serves as the source of a range of stimuli that will either threaten or promote the persons unique wholeness The persons major task is to maintain integrity in face of these environmental stimuli

Roy and andrews defined INTEGRITY as the degree of wholeness achieved by adapting to changes in needs. As roy draws on the works of helson, she categorized these stimuli as being FOCAL,CONTEXTUAL, or RESIDUAL.

FOCAL- those most immediately confronting the

person, it attracts the most attention.


CONTEXTUAL- all other stimuli that strengthens the

effect of the focal stimulus.


RESIDUAL- those stimuli can affect the focal stimulus

but the effects are unclear.

ADAPTATION LEVEL

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 persons adaptation level may be described as integrated, compensatory, or compromised The adaptation level is modulated by a persons coping mechanism and control processes

Coping process
Coping has been defined in psychological terms by Susan Folkman and Richard Lazarus as 'constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing'.

REGULATOR SUBSYSTEM transpires

though neutral, chemical and endocrine processes like the increase in vital signs-sympathetic response to stress

COGNATOR SUBSYSTEM occurs

through cognitive-emotive processes

Two control processes

The STABILIZER SUBSYSTEM and THE INNOVATOR SUBSYSTEM. These two coincides with the regulator and cognator subsystems when a person responds to a stimulus. The innovator subsystem, on the other hand, allows the person to change to higher levels of potential through cognitive and emotional strategies

The four adaptive modes


Direct observation of the processes of the regulator and cognator subsystem is not possible, the response of the two subsystems can be observed by any of the four adaptive modes Physiological Self-concept Role function Interdependence adaptive modes

PHYSIOLOGICAL
individual group

five physical needs Oxygenation, nutrition, elimination, activity and rest, and protection Four complex processes Sences; fluids, electrolytes, and acidbase

Operating resources: Participants, capacities, physical facilities, and fiscal resources

Need is a psychic and spiritual integrity so that one can be or exist with a sense of unity, meaning, and purposefulness in the universe.

Need is group identity integrity through shared relation, goal, values, and co-responsibility for goal achievement; implies hones, soundness, and completeness of identification with the group
group

individual

INDIVIDUAL

GROUP

Need is social integrity; knowing one who is in relation to others so one can act; role set is the complex of positions individual holds; involves role development, instrumental and expressive behaviors, and role taking process

Need is role clarity, understanding and committing to fulfill expected tasks so group can achieve common goals; process of integrating roles in managing different roles and their expectations; complementary roles are regulated

Need is to achieve relational integrity using process of affectional adequacy

Need is to achieve relational integrity using processes of developmental an resource adequacy

individual

group

NURSING PROCESS
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 Non-observable behavior- feelings of a person Step 2- assessment of stimuli a stimuli is defined as any change in the internal and external environment that includes a response in the adaptive system

Step 3 nursing diagnosis formulation of statements that interpret data about the adaptation status of the person, including the behavioral and most relevant stimuli Step 4 goal setting Establishment of clear statements of the behavioral outcomes for nursing care which is realistic and attainable

Step

5 determination of how best to assist the person in attaining .


6 judging the effectiveness of the nursing in relation to the behavior after it was performed in comparison with the goal established.

Step

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