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William F. Connell School of Nursing

The Roy Adaptation Model

ASSUMPTIONS

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
  • Persons and environment transformations are created in human consciousness
  • 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

PERSONS AND RELATING PERSONS

  • 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
Adaptive Modes
Individual
Group
Physiologic-physical
Five needs - oxygenation, nutrition, elimination, activity and rest, protection
Four complex processes-senses; fluid, electrolyte, and acid-base balance; neurologic function; endocrine function

Operating resources: participants, capacities, physical facilities, and fiscal resources
Self-concept-group identity
Need is 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 relations, goals, values, and coresponsibility for goal achievement; implies honest, soundness, and completeness of identifications with the group
Role function
Need is social integrity; knowing who one is in relation to others so one can acct; 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
Interdependence
Need is to achieve relational integrity using process of affectional adequacy, i.e., the giving and receiving of love, respect, and value through effective relations and communication
Need is to achieve relational integrity using processes of developmental and resource adequacy, i.e., learning and maturing in relationships and achieving needs for food, shelter, health, and security through independence with others


ENVIRONMENT

  • 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 AND ADAPTATION

  • 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

  • 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 four 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

NURSING PROCESS

  • 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
  1. Assessment of Behavior: the 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
  2. Assessment of Stimuli: the second step of the nursing process which involves the identification of internal and external stimuli that are influencing the person’s adaptive behaviors. Stimuli are classified as: 1) Focal- those most immediately confronting the person; 2) Contextual-all other stimuli present that are affecting the situation and 3) Residual- those stimuli whose effect on the situation are unclear.
  3. Nursing Diagnosis:step three of the 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
  4. Goal Setting: the forth step of the nursing process which involves the establishment of clear statements of the behavioral outcomes for nursing care.
  5. Intervention: the fifth step of the nursing process which involves the determination of how best to assist the person in attaining the established goals
  6. Evaluation: the 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.