Calista Roy's Adaptation Theory of Nursing - Research Paper Example

Running head: CALLISTA ROY’S ADAPTATION MODEL Callista Roy’s Adaptation Model: Implications for Emergency Nursing Abstract Callista Roy’s Adaptation Model remains one of the most salient theoretical and practical frameworks in nursing care. Much has been written and said about the quality and efficiency of the adaptation model in practical nursing settings. This paper provides a brief overview of the model. A review of literature is performed, to highlight the most important practical findings. Analysis of Roy’s Adaptation Model in the context of emergency nursing is conducted. Implications of the model for emergency nursing care are provided. Keywords: Roy, Roy’s Adaptation Model, nursing care, emergency nursing. Callista Roy’s Adaptation Model: Implications for Emergency Nursing Callista Roy’s Adaptation Model remains one of the most salient theoretical and practical nursing care frameworks. Much has been written and said about the quality and efficiency of Roy’s Adaptation Model for practicing nurses. Numerous dimensions of the model and their applicability in nursing were explored. Yet, many aspects of Roy’s model remain unclear. The current state of research provides abundant information about the main concepts, assumptions, and philosophic foundations of Roy’s Adaptation Model. Simultaneously, the body of evidence supporting the relevance of the model in emergency nursing is very scarce. Future researchers must focus on the analysis of Roy’s Adaptation Models and the effects it causes on the quality of emergency nursing; practicing nurses working in emergency departments must have a clear vision of Roy’s model and use its basic assumptions, to foster adaptation mechanisms and recovery among ED patients. Callista Roy’s Adaptation Model: A Brief Overview Sister Callista Roy had been a member of the Sisters of Saint Joseph of Carondelet since 1966 (Sitzman & Eichelberger, 2011). Her model of adaptation remains one of the foundational elements of contemporary nursing theory and practice. Roy’s conceptual model became a relevant response to the teaching and practical challenges in contemporary nursing; the model was first published in 1970, but enthusiastic analysis and application of the model continue even today (Sitzman & Eichelberger, 2011). The discussed model builds on two philosophic premises: humanism and veritivity (Nayback, 2009). Humanism is essentially about treating individuals as creative and purposeful, who exhibit intrinsic holism and constantly seek to maintain inner integrity through interpersonal processes (Naybank, 2009). Veritivity also suggests that human existence always has a defined purpose, and there is always an inherent value and explicit meaning of life (Nayback, 2009). The two basic concepts of Roy’s Adaptation Model are systems and adaptation; the former refers to “a grouping of units that are related and connected, thus forming a unified whole”, whereas the latter describes and comprises the coping mechanisms individuals use to achieve the desired level of integrity (Sitzman & Eichelberger, 2011). Callista Roy assumes that all humans are purposeful beings, who constantly interact with the environment and utilize four types of adaptation (Sitzman & Eichelberger, 2011). These types of adaptation include (1) physiologic-physical; (2) self-concept group identity; (3) role function; and (4) interdependence (Sitzman & Eichelberger, 2011). Physiologic-physical adaptation covers situations, when individuals succeed in meeting their basic needs for nutrition and oxygen, activity and rest, elimination and protection (Sitzman & Eichelberger, 2011). Physiologic-physical adaptation also implies that individuals can achieve and sustain adequate levels of fluids, acid-base, and electrolytes (Sitzman & Eichelberger, 2011). Self-concept group identity adaptation takes place, when individuals achieve the level of integrity and spiritual wellbeing required to promote the sense of purpose (Sitzman & Eichelberger, 2011). Role function adaptation implies that individuals have a clear understanding of their place and role in relation to other individuals (Sitzman & Eichelberger, 2011). Self-concept group identity adaptation also means that individuals are aware of the multiple roles they fulfill in relation to others (Sitzman & Eichelberger, 2011). Finally, interdependence adaptation includes human striving to create and maintain satisfying relationships with others; here, meaningful communication is of the utmost importance (Sitzman & Eichelberger, 2011). Roy’s Adaptation Model is based on four assumptions. First, humans are holistic and adaptive, individually and in groups (Sitzman & Eichelberger, 2011). Second, the environment comprises and produces internal and external stimuli, which influence individuals and groups (Sitzman & Eichelberger, 2011). Third, health is the state of wholeness or physical and spiritual soundness, leading to wholeness (Sitzman & Eichelberger, 2011). Fourth, the goal of nursing is to promote the four basic modes of adaptation, for the purpose of creating and maintain integrity and human adaptive capabilities (Sitzman & Eichelberger, 2011). Sitzman and Eichelberger (2011) claim, that Roy’s Adaptation Model is universally applicable in traditional nursing processes. This is, probably, why the model remains one of the most popular objects of theoretical and empirical analysis. Roy’s Adaptation Model: A Review of Literature Various aspects of Roy’s Adaptation Model have been explored in abundance. More often than not, researchers analyze the applicability of the model in various nursing contexts and situations. The results of previous studies confirm the universality and usefulness of Roy’s model across a number of nursing environments. Nayback (2009) analyzed the role of Roy’s Adaptation Model in examining combat veterans. In this study, Nayback (2009) assumed that combat veterans operated as human adaptive systems and had sufficient capabilities to achieve better physiological and psychological state. Nayback (2009) used Roy’s Adaptation Model to analyze the posttraumatic stress disorder phenomenon among combat veterans. The researcher found that Roy’s model could serve a reliable framework for understanding how combat veterans with PTSD used their adaptive mechanisms, to cope with the stress of PTSD and achieve the state of integrity and wholeness (Nayback, 2009). Unlike Nayback (2009), Patton (2004) analyzed the use and applicability of Roy’s model in acute psychiatric nursing. It should be noted, that the only way to test the applicability of nursing models in practice is to engage in concurrent and retrospective analysis of their usefulness (Patton, 2004). Yet, little research into the use and value of Roy’s Adaptation Model in acute psychiatric nursing has been performed until present (Patton, 2004). Nonetheless, Patton (2004) assumes that Roy’s model holds a promise to support the development of specific practice theories covering one of the four adaptation types. Roy’s Adaptation Model was also successfully applied in the field of pre-amputation assessment, giving nurses a unique opportunity to evaluate and predict the quality of patient responses to their new physical state (Dawson, 1998). Dawson (1998) chose Roy’s Adaptation Model, since the latter was extremely useful in defining and evaluating the adaptations amputees would have to make to their lives, both in the short and long run. The model allows developing and monitoring adaptive behaviors to maintain the sense of integrity and wholeness after amputation (Dawson, 1998). Despite their utility, all these studies have little to do with emergency nursing. Objectively, few researchers ever tried to reconsider the adaptation model through the prism of emergency nursing. The paucity of research on Roy’s Adaptation Model in emergency nursing complicates the creation of relevant care frameworks, but several conclusions are still possible. Roy’s Model and Emergency Nursing: The Gap in Knowledge Emergency nursing is usually defined as “the provision of immediate nursing care to people who have defined their problems as an emergency or where nursing intervention may prevent an emergency arising” (Jones, Endacott & Crouch, 2002, p.1). With this in mind, emergency nursing always places the patent into the center of the caring process, and emergency nurses fulfill a wide range of interdependent roles, to respond to patients’ presentations of emergency states and illnesses (Jones et al., 2002). Nursing, individuals, health, and the environment are the main values underlying emergency nursing (Jones et al., 2002). In this sense, Roy’s Model of Adaptation fits perfectly well in the system of principles and values, on which emergency nursing builds. Like emergency nurses, Callista Roy emphasizes the importance of individuals, the environment, and health. Simultaneously, the nature of emergency nursing implies that nurses have little time to take relevant health decisions. This, in turn, raises the question of the model’s applicability in emergency nursing contexts. Nyqvist &Sjoden (1993) analyzed the conceptual structure of Roy’sAdaptation Model in neonatal intensive care units. The model proved to be useful in classifying mothers’ responses to emergency nursing environments and their adaptability potential (Nyqvist & Sjoden, 1993). Simultaneously, the researchers discovered that the four modes of adaptation in Roy’s model displayed considerable overlaps and, as a result, were unadvisable for application in emergency contexts (Nyqvist & Sjoden, 1993). In a similar vein, Fawcett (1990) sought to apply Roy’s model in situations involving unplanned Caesarean childbirth. An emergency situation by all means, unplanned Caesarean section poses a number of challenges to practicing nurses in emergency departments. Fawcett (1990) used Roy’s Adaptation Model, to develop a nursing intervention for women facing unplanned Caesarean section. Women’s responses were classified, to determine and enhance their adaptive capacities in emergency situations (Fawcett, 1990). The researcher found that Roy’s Adaptation Model was extremely applicable and could strengthen women’s adaptive capabilities, only when their responses to nurses’ questions could be easily classified (Fawcett, 1990). Bearing in mind that emergency nurses usually have little time for activities like classification and analysis, most probably, the applicability and utility of Roy’s model in emergency nursing are questionable. Apparently, future research is needed to clarify the scope and application of Roy’s Adaptation Model in emergency nursing. Simultaneously, practicing nurses working in emergency departments must have a clear vision of Roy’s model and use its basic assumptions, to foster adaptation mechanisms and recovery among ED patients. Conclusion Callista Roy’s Adaptation Model is one of the most popular theoretical and practical nursing care frameworks. Various dimensions of Roy’s model were researched in abundance. Roy’s Model of Adaptation fits perfectly well in the system of principles and values, on which emergency nursing builds. Like emergency nurses, Callista Roy emphasizes the importance of individuals, the environment, and health. Unfortunately, the paucity of research relating to the use of Roy’s model in emergency nursing questions its applicability in emergency nursing environments. Future research is needed to clarify the scope and application of Roy’s Adaptation Model in emergency nursing. References / Annotated Bibliography Dawson, S. (1998). Pre-amputation assessment using Roy’s Adaptation Model. Adult/Elderly Care Nursing, 7(9), 536-542. The article describes Roy’s Adaptation Model and its application for assessing a male patient undergoing amputation. The model is used to detect external and internal stressors, which lead to inadequate, ineffective responses. Simultaneously, practicing nurses can use the model to ensure that the patient produces relevant and useful adaptive responses. The study shows that the model helps patients to undergo amputation and adapt their lifestyle to meet their physical and psychological needs. Fawcett, J. (1990). Preparation for Caesarean childbirth: Derivation of a nursing intervention from the Roy Adaptation Model. Journal of Advanced Nursing, 15, 1418-1425. Fawcett describes a nursing intervention, based on Roy’s Adaptation Model and used to manage women facing unplanned Caesarean section. The nursing intervention is used to prepare women for dealing with the emergency situation. The article includes four different studies, which re-affirm the validity of Roy’s Adaptation Model in emergency nursing. The researcher concludes that the applicability of Roy’s Adaptation Model depends upon the quality and classification of patients’ adaptive responses. Implications and recommendations for future research are provided. Jones, G., Endacott, R. & Crouch, R. (2002). Emergency nursing care: Principles and practice. Cambridge University Press. The field of emergency nursing constantly evolves. The goal of the textbook is to support qualified nurses who seek to work in emergency nursing. The book is written by practicing nurses, who offer easy-to-read and comprehensible information about skills, abilities, and complexities faced by nurses in emergency departments. Nayback, A.M. (2009). PTSD in the combat veteran: Using Roy’s Adaptation Model to examine the combat veteran as a human adaptive. Issues in Mental Health Nursing, 30, 304-310. Posttraumatic Stress Disorder affects thousands of combat veterans. In this article, the researcher tries to demonstrate how Roy’s Adaptation Model can help nurses to understand the posttraumatic stress disorder phenomenon. Dawson re-evaluates the current state of PTSD research in the context of Roy’s model. The model appears to be extremely applicable in PTSD analysis and treatment and treats combat veterans as human adaptive systems. Nyqvist, K.H. & Sjoden, P.O. (1993). Advice concerning breastfeeding from mothers of infants admitted to a neonatal intensive care unit: The Roy adaptation model as a conceptual structure. Journal of Advanced Nursing, 18, 54-63. The researchers focus on the analysis of the Roy’s Adaptation Model and its utility in neonatal intensive care units. The model is used to help mothers in ICU develop relevant breastfeeding behaviors. The applicability of Roy’s model in ICU was found to be questionable, as the four modes of adaptation proposed by Roy showed considerable overlaps. The researchers recommend that additional elements of Roy’s model are developed, to be used in the analysis and assessment of patient responses in emergency situations. Patton, D. (2004). An analysis of Roy’s Adaptation Model of nursing as used within acute psychiatric nursing. Journal of Psychiatric and Mental Health Nursing, 11, 221-228. The goal of the article is to analyze the use of Roy’s Adaptation Model in acute psychiatric nursing environments. The researcher examines various aspects of Roy’s model and its usability in acute psychiatric nursing. Patton discovers a serious gap in research and the lack of information concerning Ray’s model and its use in acute psychiatric settings. Simultaneously, the model itself is well developed and researched, and has the potential to enhance the quality of nursing approaches in psychiatry. Sitzman, K. & Eichelberger, L.W. (2011). Understanding the work of nurse theorists: A creative beginning. Jones & Bartlett Publishers. The textbook is written and intended to engage nursing students in critical thinking. The language of the book is easy to understand, even for beginning students. The book makes nursing theories, concepts, and frameworks accessible and understandable for students. In the meantime, students are motivated to make their contribution to the development of nursing theories. Read More