A Research on Sister Callistas Roy Adaptation Model - Term Paper Example

A Research on Sister Callista’s “Roy Adaptation Model” Top of page 2. 3. Introduction 4. How Roy's theory was developed 5. How the theory is internally structured 6. How the theory is used 7. When compared to other models 8. Conclusions 9. References 10. Appendices This research examines the use of Roy's Adaptation Model of Nursing in clinical practice and nursing. It is known that Roy's model is well developed and hence has the potential to positively influence nurse practice and patient outcomes within nursing practice. But it should be appreciated that a greater level of research-based evidence is needed so that to fully justify the use of the model within clinical practice. Question one The Roy adaptation model My research is based on the Roy Adaption Model. The basic concept of this model was developed by Roy while she was still a graduate at the University of California-Los Angeles. The Roy Adaption model was first published in 1970. This model presents a human being as a holistic adaptive system in constant interaction with both external and internal environment. The major work of the human system is to maintain integrity in the eye of environmental stimuli and whereas the objective of nursing is to foster successful development. This model focuses on the responses of the human adaptive system; this may be individual or a group to a dynamic environment. Adaptation is the main feature of the model. Here Problems in adaptation come when the adaptive system not capable of coping with or respond to the dynamic stimuli from the external and internal environments in a way that maintains the integrity of the system (Andrews & Roy, 1986). The proponent of the model was largely influenced by Harry Helson adaptation theory. it is this theory that triggered her mind to develop the model. The Roy adaption model is presently one of the major widely used frameworks in nursing practice. It is universally used in nursing. Roy also got influence from Raporpots definition of systems and concepts from Lazarus and Seyle (Roy&Roberts.1981). The proponent has also published books on the model. It fundamental to note that the philosophic beliefs and values that the model is based are that human meaning is rooted in omega point convergence of the globe, people have a mutual relationship with the world and a God figure, thinking and feeling mediate human and actions, awareness of self and environment is rooted in thinking and feeling among others. Question two The Roy adaptation model focuses on six step nursing process. It should be noted that in relation to each of this steps or processes, the person called the nurse depends highly developed technical, interpersonal and institutive skills. This is done while assessing and initiating interventions involving approaches like anticipatory guidance, physical care, counseling and health teaching. The Roy Adaption model was first published in 1970. This model presents a human being as a holistic adaptive system in constant interaction with both external and internal environment ( Barone & Roy,1996). The major work of the human system is to maintain integrity in the eye of environmental stimuli and whereas the objective of nursing is to foster successful development. The model focuses on adaptation. This is a key in this research. The model is focused on the roles of a person in a society and when in a group. it should be noted that the fundamental need which underlie the role function of the mode is social integrity and this is the need to understand who is in relation in order that such a person to know how to act. Question three Overview of the model In the Roy Adaptation model the key terms are: regulator subsystem, adaptation, adaptive modes and cognator subsystem. As stated the goal and aim of nursing is to foster successful adaptation. Roy and Andrew1991 define adaptation as the process and outcome whereby thinking and feeling persons as individuals or groups, use conscious awareness and choice to create human and environmental integration. That adaptation results into maximum health and well being to quality of life and death which is dignified. The adaptation level stands for the condition of life process and Roy described these levels as integrated, compensatory compromised life process. The integrated life process can change to compensating one and this attempt at establishing adaptation. Accordingly the models coping process entails both innate coping mechanisms and acquired coping mechanisms. Innate are generally determined. acquire are learned through responses(Roy,2009.pg 41).The second process is the cognator subsystem and this merely responds through learning,judgements and emotions, perceptual and information processing. Take note that the cognator regulator and stabilizer-innovator subsystems function to retain integrated life process. These are manifested in behaviors of the person or group. These behaviors can be viewed in four adaptive modes which are self concept-group identity mode, physiologic-physical mode, role function mode and interdependence mode. These four enable one to interact and respond to environment. Physiologic-physical mode is seen through activities of all tissues, organs cells and system making up the body. The four basic needs are nutrition, oxygenation etc. self concept group identity mode are things to do with the physical self, personal self and moral ethical-spiritual self. The role of the function mode is to focus on the roles of the person in the society and within groups. Finally the interdependence mode is a group of behavior similar to what is described as interdependent relationship. It looks at interactions related to the giving and receiving of love, value and respect. The following have been defined; human being, environment and health. In the Roy adaption model, human beings are defined as holistic adaptive system. The human system is defined as a whole with parts that function as unity for a particular purpose. Additionally humans are defined as a group or individual. The main focus of nursing is the person and he is the recipient of nursing care. A person is defined as an adaptive system with cognator and regulator systems acting to maintain adaptation. Secondly, environment is defined as the world within and around humans as adaptive systems (Roy, 2009). It entails all conditions, circumstances and influences surrounding and affecting the development and behavior of persons and groups. This is mainly consideration of naturality of person and earth resources. Thirdly health is viewed as a state and a process of being and becoming integrated and whole displays persons and environment mutuality. Here health is seen as unrealistic and simplistic because it fails to accommodate the coexistence of illness and well being. That accordingly it excludes individuals with chronic disabilities, or terminal illness deal effectively with challenges. In this model health is seen as a reflection of adaptation. In the Roy adaptation model the goal of nursing is to promote adaptation for groups and individuals in four adaptive modes, hence contributing to health, quality of life and dignified death and this is through monitoring behavior and factors that affect adaptive abilities and to promote environmental factors. In the mode nursing has been defined as a health care profession that that focuses on human life process and patterns of people with a commitment to promote health and full life potentials and this is for an individual, group, families and universal society. Nursing is defined as science and practice ( Barone & Roy,1996). Question four There are also theories that have applied similar principles found in the Roy Adaptation model. The other theories which have been generated are Orem's Self-Care Deficit Theory. This one focuses upon the nurse helping the patient become more independent in meeting their health needs. Although it is not made in Roy's model, it is shows that the nurse strives to help the patient become more self-sufficient in their care. More over Roper, Logan and Tierney developed their model around how nurses help patients achieve their activities of daily living. However this is slightly more medical in nature than Roy's model. The final model is Barker's Tidal Model which was developed from a series of studies which examined the need for psychiatric nursing care and how power exists in nurse and patient relationships. This model supports the concept that mental illness is caused by problems in living. This Model emphasizes the importance of the nurse interacting with the patient in trying to get a lived comprehension of what the patient is experiencing. Question five The aspects of the model have been tested. The illustration below is a clinical test that was carried out by Roy while she was a nurse at the Intensive Care Unit. On one particular a particular patient when Roy was still an ICU nurse. A pastor affected with a serious liver problem. Specialists came and went to his ICU bed but they could not diagnose the problem. Time was running out and the pastor was slipping fast (Barone & Roy, 1996). The pastor went into a coma. The Doctors were giving up. it was a good idea that he was brought to the ICU immediately because the basic physiologic needs were met at once. The pastor was immediately incubated for oxygenation, an NGT was inserted in place mainly for nutrition, then a Foley catheter was inserted whose work was of elimination and enema was put in place to facilitate elimination of wastes. During this period visitors were restricted early on to give maximum rest and to minimize cross contamination. Isolation measures were also put in place. Every time the patient is assigned to Roy she tries to speak to him as if he listens and can answer. The wife and the daughter never lost hope on him. They were always there to tell him how much they love and want him. During the time the adaptation process was a long one, but the pastor did adapt and went on to recover. Although ICU environment is not a very suitable place for adaptation, but given the situation and condition of the patient at that time that was the best place to support the body’s power to adapt. Many days passed and amazingly, the pastor woke up from coma. From there everything just fell into the right place. Believe it or not the pastor was transferred to a regular room and eventually discharged with a clean bill of health ( Barone & Roy,1996). Question six Here my chosen patient is called James. He is 40 years old with three school age children. James suffered multiple facial injuries as a result of an accident on the road caused by a vehicle. By observing him you will realize that the injuries have healed within complication but he has remained with residual scaring. Here there will be assessment using the four adaptive modes. The nurse uses intuition, skills, measurement and interviewing skills to gather data or information. Remember that the nurse involves James in the assessment to find the nurse’s own perception. James has overly adapted well except the one mode which is self concept mode. Here some of his behaviors are ineffective example avoidance of social gathering, wearing dark glasses and big caps. The nurse and James need to set goals to enhance adaptation. The goals involve statements of measurable behavioral result of nursing care that will promote adaptive related body image in a self concept adaptive mode (Andrews & Roy, 1986). The nurse and James may chose to either change stimuli or strengthen Mr. James’ adaptive process. The evaluation should focus on judging the efficiency of the nursing interventions in relation to Mr. James’ behaviors. It the other problems feature then they should be addressed simultaneously using the process and incorporate best practices. Question seven This model is essential in applying to patient care in organization in work environment. When the four use principles are admistered appropriately then the patient will intergrate successfully. A good example is a patient who suffers septicemia because of cellulitis/ osteomilitis of the velateral lower extremities and patient is homeless and no relatives to count upon. Here the four stages that involve adaptation must be followed. The environmental factor must be observed because this patient has no one or home. The nurse will use intuition, skills, measurement and interviewing skills to gather data or information from this patient. Take note that the nurse will involve the patient in the assessment to find the nurse’s own perception. The patient overly adapts well except the one mode which is self concept mode if noticed will need to be addressed. If some of his behaviors will be ineffective example avoidance of social gathering, feeling dejected it means the nurse and the patient will need to set goals to enhance adaptation. The goals will involve statements of measurable behavioral result of nursing care that will promote adaptive related body image in a self concept adaptive mode (Roy, 1974). The nurse that will be taking care of this patient may chose to either change stimuli or strengthen the patient’s adaptive process. The evaluation should focus on judging the efficiency of the nursing interventions in relation to the patient’s behaviors. It the other problems feature then they should be addressed simultaneously using the process and incorporate best practices in cases involving a patient who suffers septicemia because of cell a patient who suffers septicemia because of cellulitis/ osteo a patient who suffers septicemia because of cellulitis/ osteomilitis for the velateral lower extremities and patient is homeless and no relatives to count upon (Roy, 1974). . References Andrews F & Roy, C. (1986). Essentials of the Roy adaptation model. Norwalk, CT: Appleton Century-Crofts. Barone , J & Roy, C. (1996). Roy’s adaptation model in research: Rehabilitation nursing. New York: National League for Nursing. Boston-Based Adaptation Research in Nursing Society. (1999). Roy adaptation model-based research: Sigma Theta Tau International Center Nursing Press. Morgillo-Freeman, S. & Roy, C. (2005). Cognitive behavior therapy and the Roy Adaptation: New York: Springer Roy, C. (1974). Conceptual models for nursing practice (pp. 135-144). New York: Appleton-Century-Crofts. Roy, C. (1980). Conceptual models for nursing practice (2nd ed., pp. 179-188). New York: Appleton-Century-Crofts. Roy, C. (1981). A systems model of nursing.New York: Pergamon. Roy, C. (1983). A conceptual framework for clinical specialist practice. In Hamrick, A. B. & J. Spross Roy, C. (1983). Roy adaptation model. In I. Clements & F. Roberts (Eds.).A theoretical approach to family health (pp. 255-278). New York: Wiley. Roy, C. (1983). Theory development in nursing: A proposal for direction. In N. Chaska (Ed.), The nursing profession: (pp. 453-467). New York: McGraw-Hill. Roy, C. (1987). Roy’s adaptation model. In R. R. Parse (Ed.): Major paradigms, theories, and critiques (pp. 35-45). Philadelphia: Saunders. Read More