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Celebrating 50 Years of the RAM & 25 Years of the RAA

Q & A Interview

with Sr. Callista Roy

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I was born in Los Angeles, CA and grew up in that area. I was the 2nd of 14 children. I hold a BA in nursing from Mt. St Mary's College, an MS, in Pediatric Nursing, and an MA and PhD in Sociology from University of California, Los Angeles. In addition I was a post-doc fellow in neuroscience nursing for two years at the University of California, San Francisco.

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As a master's student at University of Calif. Los Angeles, I was studying Advanced Pediatric Nursing with Dorothy E. Johnson and became convinced of the importance of clearly describing the goal of nursing to develop knowledge for practice. I had read only one paragraph on adaptation, but from my practice was aware of the great resiliency of children who could adapt to difficult changes, but needed the help of nurses. Thus, I boldly asserted that the goal of nursing is to promote patient adaptation. Dorothy Johnson asked what I meant by that. I have now spent a lifetime exploring the answer to her question. Using the model as the basis of the curriculum at Mount St. Mary's College was very important in the development of the model.

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Major concepts are the person or group as an adaptive system; the environment as internal and external stimuli; health as being and becoming whole and integrated; and nursing as the art and science of promoting adaptation. The philosophic and scientific assumptions are basic underlying concepts. The model aims to promote patient adaptation of individuals, families, and communities. The widespread use of the model in each of these areas is well documented, for example, in all areas of practice, all levels of education, and in quantitative and qualitative research.

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Measurement is a difficult issue because the concepts have specific meaning within the model. Not many tools are developed specifically for these concepts. One suggestion is to read the paper we published after we reviewed the first 25 years of research. Reference:  Barone, S., Roy, C., & Frederickson, K. (2008). Instruments Used in Roy Adaptation Model Based Research: Review, Critique and Further Directions. Nursing Science Quarterly. 21 (4), 353-362. In addition the research reviews can be used to see tools used by others for various concepts and how they worked for them. 

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Major developments in educational curricula include the fact that by 1987 over 100,000 nurses graduated from programs based Roy Model. Evidence that the model has been the basis of research is provided by review of the English-Speaking literature from 1973-2015. Results showed close to 450 studies from more than 16 countries over 5 continents with participants from all clinical areas including rural women, navy nurses, and faith communities (books published by Sigma Theta Tau International and Springer). The impact on practice through implementation projects has been reported in the literature and the thinking of countless nurses in caring for patients have been affected, including myself.

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The model provides a way of thinking about people and their environment that is useful in any setting. It helps one prioritize care and challenges the nurse to move the patient from survival to transformation.

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Although my own basic spiritual beliefs have not changed, the breadth and depth with which I am able to express them have been expanded by my own spiritual experiences. Such experiences include retreats on de Chardin and on earth spirituality, reading, and association with scholars of various faiths. In about 1983, I began to explore the philosophical assumptions of the model and have updated these in 1988, 1997, and 2000 (see relevant publications).

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Veritivity is a philosophical assumption that recognizes the purposefulness of human existence and the common purposefulness of all people. It is also more grounded than relativism and has the possibility of providing a worldview of cosmic unity, whereby persons and environment are integrated and achieve a final common destiny.

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That is yet to come and may be made by one of my students.

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The areas of further development for the Roy Adaptation Model include:

  • further clarification of the relationship among the adaptive modes
  • study of the role of the cognator and regulator in promoting adaptation
  • further explanation of the philosophical assumptions of the model
  • strategies to implement the model in practice
  • research instruments to measure the key concepts of the model
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Some changes include expansion of the philosophical basis and relation to spirituality. The cultural assumptions of the model were published. The model now has additional theoretical basis in all four adaptive modes for both individuals and for groups. Clinical research is conducted throughout the world. Work is developing on instruments to measure the major concepts of the model. The Coping and Adaptation Processing Scale: Short Form is translated into at least four languages.

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The earlier books focused mainly on the patient as an individual adapting in four adaptive modes. There was less exploration of human life processes, coping abilities, and adaptation levels. The 2009 edition describes both individual, or person, and group, or relational person, adaptive life processes in all four modes. The cognator-regulator and stabilizer-innovator as major coping processes are further described and three levels of adaptation are explored with examples of each: integrated life processes, compensatory, and compromised processes.