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SEMINAR

ON
CALLISTA ROY’S
THEORY
Submitted to: Submitted by:
Ms. Satinder Kaur Mam Deeksha Rana
Demonstrator M Sc (N) Ist Year
UCON, FARIDKOT UCON, FARIDKOT
CALLISTA ROY’S THEORY
Introduction about the theorist:
Sister Callista Roy is a highly respected nurse
theorist, writer, Lecturer and teacher who
currently holds the position of professor and
nurse theorist at the Boston William F. Connell
School of nursing.
Dr Roy was born in Los Angeles, California,
on Oct 14, 1939
Academic Record:
•She began working at a large general hospital as a
pantry girl, then as a mind, and finally as a nurse’s aid.
•1963: Bachelor of Arts in Nursing from Mount Saint Marry
College.
•1966: Master of Science in Pediatric Nursing from
University of California.
•1973: M.A. in Sociology from University of California
•1977: Phd in sociology from University of California.
•Post Doctoral Programme in Neuroscience Nursing.
At University of California.
Achievements
• She is a fellow of American Academy Of
Nursing.
• 1978 to 1982- Associate Professor and chair
person of department of Nursing at Saint
Marry College.
• 1983-1982- Clinical Nurse Scholar in
Neuroscience in University of California.
• 1988-Became graduate faculty nurse theorist
at Boston College of Nursing.
The Roy Adaptation Model
• The Roy Adaptation model has been in use for
approximately 35 years, providing direction for
nursing practice, education, administration, and
research.
• The Roy Adaptation model has evoked much
interest and respect since 1964 inception by
sister Roy as a part of her graduate work.
• Roy defines adaptation as the process and
outcome whereby the thinking and feeling
person uses conscious awareness and choice to
create human and environmental integration.
Conti…
• Roy’s work focuses on the increasing
complexity of person and environment self
organization, and on the relationship among
persons, universe, and what can be considered
a Supreme being or God.
Scientific Assumptions
• System of matter and energy progress to
higher levels of complex self organization.
• Consciousness and meaning are constitutive of
person and environment.
• Awareness of self and environment is rooted
thinking and feeling.
• Human decisions are accountable for the
integration of creative processes.
• Thinking and feeling mediate human action.
Conti…
• System relationship include acceptance,
protection, and fostering of interdependence.
• Persons and earth have common patterns and
integral relationship.
• Persons and environment transformation are
created in human consciousness.
• Integration of human and environment
meaning results in adaptation.
Philosophic Assumptions

• Persons have mutual relationships with the


world and with a God figure.
• God is intimately revealed in the diversity of
creation is the common destiny of creation.
• Persons use human creative abilities of
awareness, Enlightenment, and faith.
• Persons are accountable for entering the
process of deriving, sustaining, and
transforming the universe.
ROY’S ADAPTATION MODEL
 The RAM in Nursing led to some result in
attainment of an optimum level of wellness by the
person. The model represents person as a system
having:
• Input or stimuli
• Control process comprising of coping mechanisms.
• Effectors which provide from or manifestation to
control process
• Output that may be adaptive or ineffective responses.
 
INPUT
• Adaptive system has input coming from
external environment as well as from the
person. In Roy’s system, input is identified as
stimuli and also adaptation level.
Types of stimuli

FOCAL RESIDUAL
STIMULI STIMULI

CONTEXTUAL
STIMULI
 Focal Stimuli: The stimulus most
immediately confronting the human system is
the focal stimulus.
• Demands the highest awareness from the
human system.
• It is clear of the system’s consciousness.
 Contextual stimuli: These are all other
stimuli of the human system’s internal and
external worlds that can be identified as
having a positive or negative influence on the
situation.
Conti…
• Residual stimuli: Residual stimuli are those
internal and external factors whose current
effects are nonspecific such as cultural beliefs
or attitudes about the illness.
Control process
• Roy has used the term coping mechanism to describe
control process of the person as an adaptive system.
Some coping mechanism are inherited or genetic such
as WBC defense against microorganisms. Others are
learnt such as use of antiseptics to cleanse a wound.
The control process is primary or functional
subsystem consists of:
• The regulator.
• The cognator coping mechanisms.
• Regulator: It refers to individual’s
physiologic response to stress. It is a coping
subsystem that responds automatically through
neural, chemical and endocrine process.
• Cognator: It is related to higher brain
functions. It is a coping subsystem that
responds automatically through , chemical and
endocrine process.
Effectors
Although cognator and regulator processes are essential
to the adaptive responses of the person, these processes
are not directly observed. Roy identified 4 modes for
assessment of behavior that result from coping
mechanisms:
• Physiological needs.
• Self- concept.
• Role function.
• Interdependence.
These modes provide form or manifestations of cognator
or regulator activiy.
• Output: It is the response of the person. It can
be observed. Intuitively perceived by the nurse,
measured and subjectively reported by the
person. Output may be adaptive or ineffective
responses.
Adaptive response: Those that promote the
integrity of the person in terms of goals of
adaptive: survival. Growth, reproduction and
mastery.
Ineffective Response: Those that neither
promote integrity nor contribute to the goals of
adaptation.
THE FOUR MAJOR CONCEPTS OF THE ROY
ADAPTATION MODEL:
• Humans as adaptive systems as both
individuals and groups.
• Environment.
• Health.
• The goal of nursing.
CONCEPTS-HUMANS
• Bio-psychosocial being in constant with changing
environment.
• Uses innate and acquired mechanisms to adapt.
• An adaptive system described as whole comprised
of parts.
• Functions as a unity for some purposes
• Includes people as individuals or in groups- families,
organizations, communities, and society as a whole.
• Roy conceptualizes the human system in a holistic
perspective.
Conti…
• Holism is the aspect of unified meaningfulness
of human behavior in which the human
system is greater than the sum of individual
parts.
• Characteristics of a system includes inputs,
output, controls, and feedback.
CONCEPTS- ENVIRONMENT
• ROY specifically defines environment as “all
conditions, circumstances, and influences that
surround and affect the development and
behavior of humans as adaptive a systems,
with particular consideration to person and
earth resources”.
• Change environment stimulates the person to
make adaptive responses.
• Environment is the input into person as an
adaptive system involving both internal and
external factors. These factors may be slight or
large negative or positive.
• Factors in the environment that affects the
person are categorized as focal, contextual
and residual stimuli.
Concepts- health
Roy define health as a state and process of
being and becoming an integrated and whole
person. The integrity of the person and the
environment transformation.
CONCEPTS- GOAL OF NURSING
• Roy defines the goal of nursing as the promotion
of adaptive responses in relation to the four
adaptive modes.
• Human responses includes not only problems,
need , and deficiencies but also capacities,
knowledge, skills, abilities, and commitments.
• Nursing activities support adaptive responses and
seek to reduce ineffective responses.
• Nursing activities support adaptive responses and
seek to reduce ineffective responses.
Conti…
• The nurse may anticipate that the human system
has a potential for ineffective responses
secondary to stimuli likely to be present in a
particular situation.
• The nurse acts to prepare the human system
through anticipatory guidance.
• The actions are taken to manage the focal,
contextual or residual stimuli so that total
stimuli fall within the adaptive level of the
person.
ROY’S THEORY AND NURSING PROCESS:
• It is 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 of the outcome of care provided.
• Roy offers the following broad aims for nursing
in response to the assumptions written the 21st
century. “nurses aim to enhance system
relationship through acceptance , protection and
Conti…
• fostering of interdependence and to promote
personal and environmental transformations”.
ASSESSMENT OF BEHAVIOUR
• First step of the nursing process which
involves gathering data about the behavior of
the person as an adaptive system in each of the
adaptive modes.
• Roy defines behavior as “ actions or reactions
under specific circumstances. It can be
observable or non observable”.
• Assessment of client in each of four adaptive
modes enhances a systematic and holistic
approach.
Conti…
• Example: Assessment of behavior focuses on the
physiologic mode responses during the first hour of recovery
time after a person experiences surgery and general
anesthesia.
• Patient is received from surgery.
• Before surgery, vital signs were, HR-80bts/mt, BP-
120/80mm Hg, RR-16/mt.
• After 45 minutes in recovery , her vital signs are : HR-
150/mint, BP- 90/60 mm of Hg, RR- 32/mint.
• Increased regulator output response is signalled by
sympathetic nervous system stimulation of heart in response
to decrease BP.
ASSESSMENT OF STIMULI
• When ineffective behaviors or adaptive behaviors
requiring support are present, the nurse assess
internal, and external stimuli that may be
affecting behavior.
• In this phase of assessment . the nurse collects
data about the focal, contextual, residual stimuli
challenging the person’s coping.
• The nurse assess the adaptation level, a significant
internal stimulus, to assess life processes as
integrated, compensated, or compromised.
Conti…
• Other areas of stimuli to be considered include the acquired
coping processes of the cognator and innovator mechanisms and
changes in the environment.
• Example- Immediately assessment of stimuli is done.
• Focal stimulus: Decrease in arterial blood pressure secondary to
an unknown underlying cause.
• Contextual stimuli: Age 45 yrs, cool extremities, no food or
drink for 12 hrs, less amount of I/V fluids and 10cc of urine
excreted during the first 45 mints in recovery, 1.5 hrs of general
anaesthesia, estimated blood loss of 500cc during surgery and
level of consciousness slow to respond to tactile stimuli after 45
mints in recovery.
• Residual stimuli: history of renal infections.
NURSING DIAGNOSIS
• Step three of nursing process which involves
the formulation of statements that interpret
data about the adaptation status of the person,
including the behavior and most relevant
stimuli.
• Example: Decreased arterial blood pressure
secondary to fluid volume deficit and loss of
blood during surgery.
GOAL SETTING
• This involves the establishment of clear
statement is described as one that includes the
behavior desired, the change expected, and a
time frame.
• A complete statement is described as one that
includes the behavior desired, the change
expected, and a time frame.
• Goals may be short term and long term relative
to situation.
Conti…
• Example: Goals are set with the basic survival
of the person as a priority. The nurse then
intervenes by altering contextual stimuli so
that an adaptive response is promoted.
• Goal of a adequate circulatory volume to
maintain a blood pressure to baseline levels
within 15 minutes is set.
INTERVENTION:
• This involves the determine of how best to
assist the person in attaining the established
goals. The nurse plans specific activities to
alter the selected stimuli appropriately.
• Nursing activities manage stimuli by “
altering, increasing , decreasing, removing, or
maintaining them” as most appropriate to the
situation.
Conti…
• Example: Interventions are taken so that focal
and contextual stimuli are altered and
adaptation is promoted. The nurse plans and
then takes the following interventions steps.
• I/V rate is increased to 300cc/hr.
• Foot end of the bed is elevated to increased
venous return.
• Patient is verbally and tactilely stimulated and
told to take slow deep breaths.
Conti…
• Nurse prepares vasopressor medications for
immediate use and applies an external
continues blood pressure cuff for constant
blood pressure monitoring.
EVALUATION
• Sixth and final step of the nursing process which
involves judging the effectiveness of the nursing
intervention in relation to the behavior after the
nursing intervention in comparison with the goal
established.
• If the goals have not been achieved, the nursing
process continues with additional questions relating
to the accuracy and completeness of the assessment
data, the match between identified goals and the
client system’s wishes, and the way in which the
interventions were carried out.
Conti…
• Readjustment to goals and interventions are
made on the basis of evaluation data.
• Example: Mr. John has been suffering with
DM for past 10 years. Diabetic foot ulcer and
recent amputation made his life more stressful.
APPLYING ROY’S MODEL TO FAMILY
ASSESSMENT
1: ADAPTATION MODES:
A: Physiologic mode:
1 : To what extent is the family able to meet
the basic survival needs of its members.
2: Are any family members having difficulty
meeting basic survival needs.?
• B: Self – concept mode:
1: How does the family view itself in terms of
its ability to meet its goals and to assist its
members to achieve their goals?
2. What are the values of the family?
• C. Role Function Mode:
1: Describe the roles assumed by the family
members.
2: To what extent are the family roles
supportive.
3: How are family decisions reached.
Conti…
D: Interdependence Mode:
1: To what extent are family members and
subsystems within the family allowed to be
independent in goal identification and
achievement( e.g, adolescents).
2: To what extent are the members supportive
of one another?
3: What are the family’s support systems?
Significant others?
Conti…
4: To what extent is the family open to
information and assistance from outside the
family unit? Willing to assist other families
outside the family?
5: Describe the interaction patterns of the
family in the community.
II: ADAPTIVE MECHANISMS
• 1: Regulator.
• 2: Cognator
• 1: Regular: Physical Status of the family in
terms of health? i.e nutritional status , physical
strength, availability of physical resources.
• 2: Cognator: Educational level, knowledge
base of family, source of decision making,
power base, degree of openness in the system
to input, ability to process.
III: Stimuli
• 1: Focal stimuli.
• 2: Contextual stimuli.
• 3: Residual stimuli:
• 1: Focal Stimuli:
1 : What are the major concerns of the family at
this time?
2: What are the major concerns of the
individual members?
• 2: Contextual Stimuli:
What elements in the family structure,
dynamic, and environment are impinging on
the manner and degree to which the family can
cope with and adapt to their major concerns.
3: Residual
• What knowledge skills, beliefs, and values of this
family must be considered as the family attempts
to adapt(i.e. stage of development, cultural
background ,spiritual/religious beliefs ,goals,
expectations)?
• The nurse assesses the degree to which the
family’s actions in each mode are leading to
positive coping and adaptation to the focal
stimuli. If coping and adaptation are not health
promoting, assessment of the types of stimuli
Conti…
and effectiveness of the regulators provides the
basis for design of nursing intervention to
promote adaptation.
ROY’S WORK AND THE CHARACTERISTICS OF THE
THEORY:
• Theories can interrelate concepts in such a
way as to create a different way of looking at a
particular phenomenon.
• Theories must be logical in nature.
• Theories should be relatively simple yet
generalizable.
• Theories can be basis for hypothesis that can
be treated or for theory to be expanded.
Conti…
• Theory contributes to and assists in increasing
the general body of knowledge.
• Theory can be used by practitioners to guide
and improve their practice.
• Theory must be consistent with other validated
theories, laws principles but will leave open
unanswered questions that need to be
investigated.
APPLICATIONS OF THE ROY
ADAPTATION MODEL
• Nursing Practice.
• Nursing Education.
• Nursing Research.
Nursing Practice
• R.A.M is a very useful method in nursing
practice specially in those setting where there
are convert psychological needs which are as
essential as physical one.
• Roy’s models are very effective in pediatrics
as well as community and rehabilatory
nursing.
• Using Roy’s six step nursing process, the
nurse
1. Assesses the behavior.
Conti…
2: Assesses stimuli affecting those behavior.
3: Makes a statement or nursing diagnosis of
the person’s adaptive state.
4: Sets goals to promote adaptation.
5: Nursing interventions are aimed at managing
the stimuli to promote adaptation.
6: Evalution.
• By manipulating the stimuli and not the
patient, the nurse enhances the interaction
Conti…
of the person with their environment, thereby
promoting health.
• The model puts emphasis on identifying and
reinforcing positive behavior which speeds
recovery.
Nursing Education
• The adaptation model is also useful in educational
setting.
• Roy states that 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.
• In the early 1980’s the school of nursing at the
university of Ottawa experienced a major curriculum
change. The Roy adaptation model was one of the
models to be included in the first year of the
baccalaureate program. The professors had to meet
four challenges during this change:
Conti…
1: Adapting the course to be congruent with the
Roy model.
2: Developing teaching tools suitable for student
learning.
3: Sequence of content for student learning.
4: Obtaining competent role models
Nursing Research
Roy provides a conceptual model for nursing
process and this has been a basis for number of
research being done.
For example: Measuring functional status
after child birth ,functional status during
pregnancy.
• If research is to affect practitioner’s behavior,
it must be directed at testing and retesting
conceptual models for nursing practice.
Conti…
• Roy has stated that theory development and
testing of development of theories and
nursing’s highest priorities. The model must be
able to regenerate testable hypotheses for it to
be researchable.
• Roy has describe strategies for knowledge
development based on the model and a
structure of knowledge to guide research.
Conti…
• Knowledge: development strategies include
model construction: theory development
phiolosophical explication: and research
quantitative, and instrument development.
• The structure for knowledge includes the broad
categories of the basic and clinical science of
nursing.
 Basic nursing science discovers knowledge about
persons and groups from a nursing perspective
that can provide understanding for practice.
Conti…
• The clinical science of nursing investigates
specially the role of the nurse in promoting
adaptation and human and environmental
transformations.
Research input
• Building a middle – range theory od adaptive
spiritualit.
• Marjorie C. Dobratz, R; DNSc 1
• Professor Emeritus, university of Washington, Tacoma
• Abstract: The purpose of this article is to describe a
Roy adaptation model based- research abstraction,
the findings of which were synthesized into middle
range theory of adaptive spirituality on quality of life
psychosocial adjustment, well being, adaptive coping,
and
Conti…
• The self concept mode. Qualitative fingings
showed the importance of spiritual
expressions, values, and beliefs in adapting to
chronic illness, death and other life
transitions. These findings were abstracted
into six theoretical statements, a conceptual
definition of adaptive spirituality, and three
hypotheses for future testing.
Research input-II
• Urine control theory derived from roy conceptual
framework.
• Jirovec MM, Jenkins J, isenberg M, Baiardi.
• Abstract:
• Sister callista roy developed the roy adapation
model which is based on the human being is an
open system.
• The system responds to environment stimuli
through the cognator and regulator coping
mechanism for individual.
Conti..
• The responses occur through at least one of four modes-
physiological physical, self concept role function, and
interdependence.
• The responses in these modes are usually visible to
others and can be identified as adaptive or ineffective.
• Adaptive behaviors that need support and ineffective
behaviors are then analyzed to identify the association
stimuli.
• Nursing care focuses in altering stimuli or strengthening
adaptive processes to result in adaptive behaviors.
Summary
• Introduction about theorist.
• The Roy adaptation model.
• Scientific assumptions.
• Philosophic assumptions.
• Roy’s theory and nursing process.
• Applying Roy’s model to family assessment.
• Roy’s work and characteristics of the theory.
Refrences
• Parker E, marilyn nursing theorist and nursing
practice. 2nd edition, published by Jaypee
Brothers. P No 268-274.
• Alligood and tomey Marrier Nursing Theorist and
their work 4th edition published by Mosby P No.
240-250.
• http//www.be.edu/schools/son/faculty/feaured/
theorist/roy adaptation association. Html.
• http://nursingtheories.blogspot.in/2008/07/siste
r-callista-roy-adaptation-theory
. html

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