The Roy Adaptation Model (3rd Edition)l
Fidelia Boldul
She was a Robert Wood Johnson postdoctoral fellow at the University of California, San Francisco, from 1983 to 1985 as a clinical nurse scholar in neuroscience. During this time, she researched nursing interventions for cognitive recovery in head injuries and the influence of nursing models on clinical decision making.
Sr. Callista Roy has numerous publications, including books and journal articles, on nursing theory and other professional topics. Her works have been translated into many languages all over the world.
First, consider the concept of a system as applied to an individual. Roy conceptualizes the person in a holistic perspective. Individual aspects of parts act together to form a unified being. Additionally, as living systems, persons are in constant interaction with their environments. Between the system and the environment occurs an exchange of information, matter, and energy. Characteristics of a system include inputs, outputs, controls, and feedback.
Based on Roy, humans are holistic beings that are in constant interaction with their environment. Humans use a system of adaptation, both innate and acquired, to respond to the environmental stimuli they experience. Human systems can be individuals or groups, such as families, organizations, and the whole global community.
Roy categorized these stimuli as focal, contextual, and residual. Focal stimuli are that confront the human system and require the most attention. Contextual stimuli are characterized as the rest of the stimuli present with the focal stimuli and contribute to its effect. Residual stimuli are the additional environmental factors present within the situation but whose effect is unclear. This can include previous experience with certain stimuli.
Health is defined as the state where humans can continually adapt to stimuli. Because illness is a part of life, health results from a process where health and illness can coexist. If a human can continue to adapt holistically, they will maintain health to reach completeness and unity within themselves. If they cannot adapt accordingly, the integrity of the person can be affected negatively.
As one of the weaknesses of the theory that applying it is time-consuming, applying the model to emergencies requiring quick action is difficult to complete, the individual might have completed the whole adaptation process without the benefit of having a complete assessment for thorough nursing interventions.
Unlike Levine, although the latter tackled adaptation, Roy focused on the whole adaptive system itself. Each concept was linked with the coping mechanisms of every individual in the process of adapting.
Boston Based Adaptation Research in Nursing Society (1999). Roy adaptation model based research: 25 years of contributions to nursing science. Indianapolis, IN: Sigma Theta Tau International Center Nursing Press.
This investigation examined the risk-resistance adaptation model for children with sickle cell disease and their primary caregivers. Participants were 55 children, ranging in age from 5 to 16 years with a mean age of 9 years 2 months, diagnosed with sickle cell disease and their primary caregivers, recruited from a university medical center. Measures included adjustment (i.e. primary caregiver and child adjustment), risk factors (i.e. disease and disability, functional independence, and psychosocial stressors), resistance factors (i.e. intrapersonal health locus of control, social-ecological), and stress processing (coping). Primary caregivers' adjustment was associated with developmental coping,changeR2=.08, and child adaptation was associated with an internal health locus of control,changeR2=.22. An indirect effect of primary caregivers' coping on child adjustment was found through influence on primary caregivers' adjustment,changeR2=.11. The findings support research among other chronically ill populations that suggests an association between coping and disease adjustment. The results were interpreted to support the use of theoretically driven models in predicting the adaptation of children with chronic illness and adjustment in their caregivers.
The authors appreciate the cooperative spirit of the physicians and staff of the Georgia NIH Sickle Cell Center and particularly the kind assistance of Joan Donegan for data collection. Anita L. Hurtig, Ph.D., and Jan Wallander, Ph.D., were consultants for this study.
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