Roy Adaptation Model: Theory Description

03/18/2013
Sister Callista Roys Adaptation Model (RAM) is representative of a grand nursing
theory whose conceptual framework is focused on the interconnected, holistic
individual and his/her interaction with the environment. As McEwen (2011)
outlines, the foundation for Roys theory can be attributed to several individuals
including Helson, von Bertalanffy, Rapport, Lazarus, and most significantly to
Dorothy Johnsons model for behavioral systems. Roy also combines spirituality
within her model to illustrate how adaptation is integrated with health through
four modes of functioning including psychological, self-concept, role function and
interdependence (Tourville, C. and Ingalls, K, 2003). According to Roy, adaptation
is the outcome observed when responses to environmental changes are
positively experienced. As described by Tourville and Ingalls (2003), Roys model
is based on the assertion that a persons ability to adapt is a positive response
for life development and maturity related to physical needs and quality of life.
MAJOR METAPARADIGM CONCEPTS
The metaparadigm concepts embedded within the RAM include person,
environment, nursing and health. There is a constant interaction on many levels
allowing individuals and groups (including families, communities, etc.) mutability
and transformation. Utilizing the nursing process, nurses can assess for
maladaptive behaviors and develop care plans with interventions that augment
adaptation positively for improved outcomes (Kenney, 2013, p.368).

Person defined as a whole with parts that function as a unity for some
purpose (Roy, 1999, p31).
o This applies to the individual (a bio-psycho-social being), to people
within groups and/or society in general. Coping mechanisms employed may
either be
innate
or acquired based on previous experiences.

Environment stimuli that impact behavior and ability to adapt.

o These may be viewed as inputs into the adaptive model that

affect transformation. Stimuli may be focal (internal or external immediately
encountered); contextual (includes all stimuli influencing behavior toward focal);
or residual (effects may not be easily observable or known).

Nursing utilizes the four modes of adaptation to promote health and

integration for clients
o This applies to the nursing process and nurses ability to influence
positive adaptive responses to contribute to health

Health outcome or output of adaptation

o This includes the continuum of health

APPLICATION TO PRACTICE
Roys Adaptation Model has been used extensively as the conceptual framework
for
nursing curriculum and translates for use in practical nursing settings promoting

direct purpose. The RAM may also be applied to the nursing practice utilizing the
nursing process to assess behaviors affected by stimuli and develop
interventions that promote positive adaptation.
Examples Using RAM
Barone, S. H. (2012). Coping and adaptation in adults living with spinal cord
injury. Journal of Neuroscience Nursing, 44(5), 271-283.
Barone, S., Roy, C., Frederickson, K. (2008). Instruments used in roy adaptation
model-based research: Critique, examples and future Directions. Nursing Science
Quarterly, 21(4), 353-363.
Weiland, S. (2010). Integrating spirituality into critical care: An APN perspective
using Roys adaptation model. Critical Care Nursing Quarterly, July-Sep: 33(3),
282- 291.
RELEVANCE TO PERSONAL PRACTICE
Review of Roys perspective on the continuum of health wherein responses to
environmental stimuli shapes the integration of health and self-awareness,
broadened my appreciation for utilizing this as a guide to structure initiatives for
patient safety. I will be participating in a trial of a new model proposed for
nursing education and professional development specifically around discharge
education. The model, developed by a colleague to trial in both a pediatric and
adult ICU setting, will examine the efficacy of a new model for increasing patient
education while striving for increased staff engagement, autonomy and
accountability within the framework of shared governance. As a new Professional
Development Manager, it is this spirit of collaboration, investigation and
application that is shaped by the theory utilized. The theory or model will provide
the framework by which professionalism will be fostered and enhanced with the
ultimate goal of improved patient outcomes and quality measures.
The research to test the efficacy of a newly developed model for promoting
professional development adherers to Roy's stance that evaluating theories is an
obligation for nursing and should take precedence. Superimposing Roy's
adaptation model to the research will assist in guiding implementation.
Additionally, the conceptual framework will provide the structure to evaluate the
nurses' ability to adapt to the changing environment created with expectations
for increased engagement and ownership of outcomes as well as the nurses'
ability to adopt and adapt a new model to impact practice and increase
efficiency. This highlights the interdependence and role function mode of
adaptability and clearly defines goals for nurses for increased autonomy.
References
The Cognator and the Regulator. [Online images].
Retrieved from http://nursingtheories.weebly.com/sister-callista-roy.html
Kenney, J. (2013). Theory-based advanced practice nursing. In S. Denisco & A.
Barker (Eds.), Advanced Practice Nursing: Evolving roles for the transformation of
the professional (pp. 361-377). Burlington, MA: Jones & Bartlett.
McEwen, M., & Wills, E. M. (2011). Theoretical basis for nursing. (3rd ed.).

Philadelphia, PA: Lippincott Williams & Wilkins.

Roy, C.(2009). The Roy adaptation model (3rded.) Upper Saddle River, NJ:
Pearson.
Roy Adaptation Model. [Online image]. Retrieved from
http://images.search.yahoo.com/r/_ylt=A0PDoS65S0dRMEsA6yCjzbkF;_
ylu=X3oDMTBtdXBkbHJyBHNlYwNmcC1hdHRyaWIEc2xrA3J1cmw-/SIG=12av24pn
g/EXP=1363655737/**http%3a//nnsnchez.girlshopes.com/callistaroysadaptation/
Sister Callista Roy. [Online image]. Retrieved from
http://nursingtheories.blogspot.com/2008/07/sister-callista-roy-adaptationtheory.html
Tourville, C. and Ingalls, K. (2003). The living tree of nursing theories. Retrieved
from SHU eReserves-NU433.