Evaluation of Roy's Adaptation Model
Ali H. Alkhatib
A doctorate Student- Cairo University
2007
The Theorist:
Sister Callista Roy is a highly respective nurse theorist,
writer, lecturer, researcher, and teacher who currently hold the
position of Professor and Nurse Theorist at the Boston College of
Nursing in Chestnut Hill, MA. She was born at Los Angeles on
October 14, 1939. Her college education began in a liberal arts
program, where she earned a Bachelor of Arts with a major in
nursing at Mount St. Mary's College, in Los Angeles in 1963.
Sister Callista Roy had the opportunity to enroll in a master's
degree program in Pediatric Nursing at the University of California at Los Angeles in
1964 and received the degree in 1966. Through her studies in pediatric nursing, Sister
Callista Roy had the significant opportunity of working with Dorothy E. Johnson,
whom she regards as one of her most influential mentors. She joined the faculty of
Mount Mary's college in 1966 teaching both pediatric and maternity nursing. In 1968,
she began introducing her ideas about Adaptation Nursing at the basis for an
integrated nursing curriculum.
In 1977, Dr. Roy completed her PhD in sociology at university of California, Los
Angeles. In 1987, she accepted a full-time faculty position as Professor and Nurse
Theorist to help develop and implement a PhD program at Boston College.
Dr. Roy is still best known for developing and continually updating the Roy
Adaptation Model as framework of theory, practice, and research in nursing. (Whall
and Fitzpatrick, 2005) and (Roy personal website).
[email protected]
Roy personal website
The Theory
An overview of Roy's model indicates that it is based upon Helson's (1964)
concept of adaptation or the positive response to continually changing environment.
The three essential elements are the recipient of care, the goal of nursing, and the
nursing interventions. The recipient of care, a patient or client, is synonymous with
person, which is defined as a bio-psych-social being with innate and acquired coping
mechanisms. Nursing goal is to promote adaptation or a positive response to changes
within the internal and external environment. This can be accomplished when nurse
intervene to assist the person in coping effectively with these changes. (Andrews and
Roy, 1986)
According to Roy (1986), her major professional interest is the development of
nursing as a scientific and humanistic discipline with an articulated and tested theory
base that directs nursing practice and nursing education. Her clinical and research
interests focus on neuroscience nursing and are aimed at understanding basic human
cognitive processes, particularly cognitive recovery in persons with head injury
(Whall and Fitzpatrick, 2005).
The development of the adaptation model for nursing has been influenced by Roy's
personal and professional background.
Underlying assumptions
Roy classifies her assumptions as scientific and philosophical. The scientific
assumptions are those that relate to the systems theory and include the following:
1. The person is a bio-psycho-social being in constant interaction with a
changing environment.
2. The person use both innate and acquired mechanisms, which are biological,
psychological, and social in origin, to cope with a changing world.
3. Health and illness are inevitable dimensions of the person's life.
A system is a set of parts connected to function as a whole for some purposes. Roy
views the person as a system whose purpose is survival, growth, reproduction, and
mastery which are the goals of adaptation. The achievement of these goals promotes
the integrity of the individual and thereby contributes to health.
Other scientific assumptions are derived from Helson's Adaptation Level Theory:
1. To respond positively to environmental changes, the person must adapt.
2. The person's adaptation is a function of the stimulus he or she is exposed to
and his or her adaptation level.
3. The person's adaptation level is such that comprises a zone indicating the
range of stimulation that will lead to a positive response.
4. The person is conceptualized as having four modes of adaptation which are the
physiological function, self concept, role function, and interdependence. (Roy,
1980)
In 1984, Roy cited additional assumptions that were philosophical in nature and
derived from humanism. As humanistic nurses, we believe in person's own creative
power and value their opinions and viewpoints, recognize the significance of
interpersonal relationships, and see behaviors as being purposeful and not as a mere
chain of cause and effect.
Roy's scientific assumptions are explicit and provide the base from which her theory
grows. Her philosophical assumptions have been added to enhance the holistic of the
person and to make the person more visible in the care process. (Meleis, 1985)
Basic considerations in the model:
Person:
Initial definitions focused on the person as a bio-psych-social being in constant
interaction with a changing environment. As the model developed, the definition has
evolved and the person is described as a holistic adaptive system, which is in constant
interaction with a changing environment (Whall and Fitzpatrick, 2005). The adaptive
system is reflected in the four adaptive modes: physiologic, self-concept, role
function, and interdependence.
Nursing:
Roy has described nursing as a scientific discipline with a practice orientation.
The science of nursing is interested in understanding the life processes, which
promote adaptation and health, how persons cope with health and illness, and nursing
interventions to promote adaptive coping and health.
Within the model, nursing consists of both the goal of nursing and nursing activities.
Roy has defined the goal of nursing as "the promotion of adaptation in each of the
four modes, thereby contributing to the person's health, quality of life, and dying with
dignity" (Whall and Fitzpatrick, 2005).
Health:
According to Roy and Andrews (1986), health is defined as "a state and a process
of being and becoming an integrated and whole person". Health can be viewed as a
reflection of the interaction or adaptation of human adaptive systems within a
changing environment and health is manifested in the wholeness and integration of
the four adaptive modes.
Environment:
Environment is defined as "all conditions, circumstances, and influences that
surround and affect the development and behavior of human adaptive systems with
particular consideration of person and earth resources". As the world around and
within human adaptive systems, the environment is viewed as input for the human
adaptive system and may be described as internal and external stimuli. These stimuli
may be further classified as focal, contextual, and residual (Roy and Andrews, 1986).
The environment is the source of focal, contextual, and residual stimuli. The focal
stimuli are the internal and external factors that immediately confront the person or
family. Contextual stimuli are the environmental factors that present to the person
from within or without that influence how the person deals with the focal stimulus.
Residual stimuli are the environmental factors within or without the human system,
the effects of which are unclear (Roy and Andrews, 1999).