Adaptation Model By Roy
Callista Roy Adaptation Model
The Roy adaptation model for nursing defines person as a holistic adaptive system that is in constant interaction with the environment (Roy & Andrews, 1999). As a holistic adaptive system, the person can be described as a set of interrelated arts with inputs, control and feedback processes, and outputs functioning as a whole for some purpose.
Inputs for the system are stimuli received externally from the environment (external stimuli) and internally from within the self (internal stimuli). These stimuli are classified as focal, contextual, or residual. The stimuli immediately confronting the person are called focal stimuli.
All other stimuli in the
situation that contribute to the effect of the focal stimuli are called
contextual stimuli. Stimuli whose effects on the given situation are unclear
are called residual stimuli. Thus, the environment comprises all the possible
inputs for the human adaptive systems (Roy & Andrews).
Control or Regulators of Adaptation System
The control processes of the system are two coping mechanisms, the regulator and. Cognat or subsystems, to adapt or cope with a changing environment. The process of perception links the regulator and cognat or subsystems, outputs of the system are responses, called behaviors, that result from regulator and cognat or activity. Behaviors are manifested in four adaptive modes physiological, self-concept, role function, and interdependence.
Behavior can be observed, measured, or subjectively reported, and in
collaboration with the person, judged as adaptive or ineffective. Adaptive
responses maintain or promote integrity or health, whereas ineffective
responses disrupt integrity. Through feedback processes, behaviors (responses)
provide further input for the person as a system.
Goals of Adaptation Model
The goal of nursing is “the promotion of adaptation in each of the four modes, thereby contributing to the person's health, quality of life, and dying with dignity” (Roy & Andrews, 1999, p. 55). Roy defines health as “a state and a process of being and becoming an integrated and whole person” (Roy & Andrews , p. 54).
In essence, health reflects adaptation of the individual's adaptive systems in an ever-changing environment. The role of the nurse is to promote health through promotion of adaptation and enhancing the person-environment interaction through the use of the nursing process.
Within
the Roy adaptation model, nursing interventions are conceptualized as the
management or manipulation of stimuli. Assumptions of the Roy adaptation model
are both scientific and philosophical. The scientific assumptions are derived
from systems theory and adaptation level theory, whereas the philosophical
assumptions are related to humanism (Roy & Andrews).
Element of Models' Assumptions
The elements and assumptions of the Roy adaptation model provide a perspective for nursing research by suggesting what phenomena to study, identifying the research questions, and identifying appropriate methods of inquiry. The phenomena of study are persons as individuals or in groups.
The
distinctive nature of the research questions is related to basic life processes
and patterns, coping with health and illness, and enhancing adaptive coping.
Multiple methods are appropriate when conducting research based on the Roy
adaptation model (Roy & Andrews, 1999).
Characteristics of Roy Model
A search of the literature revealed numerous studies that used the Roy adaptation model as the conceptual framework for the research, with considerable variability in the clarity and specificity of the links between the Roy adaptation model and the research. Some studies used the model in the development of data collection instruments within the four adaptive models, while other studies used the four adaptive modes as a framework for data analysis.
Chiou (2000) conducted a meta-analysis of nine empirical studies based on Roy's adaptation model to determine the magnitude of the interrelationships of the four modes. The results indicated that more research is needed to determine the credibility of Roy's adaptation model ( Chiou ). Additional studies identified specific concepts from the model, such as interdependence mode or physical self, and used them as the basis for the research.
Nursing Research and Roy Adaptation Model
A number of studies identified specific links, conceptually and operationally, between the Roy adaptation model and the research variables. In these studies, specific concepts were linked to the various aspects of the model, including focal, contextual, and residual stimuli control processes and adaptive modes.
Yeh (2003) used this approach in research examining the relationships among social support, parenting stress, coping style, and psychological distress in parents caring for children with cancer. Zhan (2000) examined the relationship between cognitive adaptation processes and self-consistency in hearing impaired elderly. These concepts were then operationalized by identifying specific measurement tools.
Several studies identified nursing interventions as the management or manipulation of stimuli, and some specifically tested propositions derived from the model. A urine control theory of the middle range sub structed from Roy's adaptation model was studied to explain the phenomenon of urine control in memory impaired incontinent elders at home ( Jirovec , Jenkins, Isenberg, & Baiardi, 1999).
This intervention study found that Roy's adaptation model was a useful
model to explain the phenomenon of urine control ( Jirovec et al.).
Roy Model Nursing Research Designs
Among the studies there were differences in methodologies, designs, data collection procedures, and data analysis techniques. A review of the research designs used in the studies revealed both cross-sectional and longitudinal designs, as well as prospective and ex-post-facto designs.
Case
study, single group, and comparison group designs were all represented in the
studies reviewed. Additionally, designs ranged from exploratory, including
descriptive-correlational and descriptive comparative, to experimental and
quasi-experimental.
Roy Model and Data Collection
Similarly, variety was found in the approaches used for data collection. Data were collected by record reviews, observation, interviews, researcher-developed questionnaires, and standardized questionnaires such as the Norbeck Social Support Questionnaire and the State Trait Anxiety Inventory.
Methods of data analysis were both quantitative and qualitative. Several studies used qualitative data analysis procedures such as content analysis and the constant comparative method for grounded theory. Shyu (2000) illustrated the role function mode in Roy's adaptation model using constant comparison to analyze the data.
Yeh (2001) used a qualitative approach to establish a framework for the adaptation process of Taiwanese children with cancer. The studies reviewed revealed that the Roy adaptation model was appropriate for guiding research in a variety of settings and populations.
Shyu's study was conducted in Taiwan with families whereas Zhan (2000) recruited older hearing impaired individuals from the northeastern part of the United States. Villareal (2003) demonstrated the use of Roy's adaptation model in young women contemplating smoking cessation. Roy's adaptation model has also guided research related to menopausal women ( Cunningham , 2002) .
Among those who have built a program of research using the Roy adaptation model are J Fawcett, SE Pollock, and L Tulman . Fawcett and Tulman (1990) conducted methodological instrument development and substantive research related to childbearing families.
Retrospective and longitudinal studies examined factors associated with functional status during the postpartum period, and one study (Fawcett, 1990) tested an intervention derived from the Roy adaptation model. Pollock (1993) and colleagues conducted a series of five longitudinal studies to examine human.
Responses to chronic illness by identifying predictors of adaptation to chronic illness and determining whether adaptive responses differed by diagnostic group. These studies by Fawcett, Pollock, and Tulman demonstrate the usefulness of the Roy adaptation model as a guide for nursing research and support the credibility of the model.
Using the
Roy adaptation model to guide nursing research has contributed to both the
basic and the clinical science of nursing. Increased understanding of the
factors influencing adaptive responses are examples. Studies have provided some
confirmation for the model, demonstrated its ability to generate new
information, and contributed to clinical practice.
Research that continues to test the model and the relationships among its components is needed. One area that has been identified as a research concern is the overlap between the four adaptive modes. Further research may clarify this issue. Additional research should test nursing interventions to promote adaptive responses.
Overall, the Roy adaptation model is a very useful model in practice and as a guide to research. The Roy adaptation model continues to make a significant contribution to nursing science as it continues to evolve.
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