Transcript SISTER CALLISTA ROY - Rebecca H. Joostens, RN

SISTER CALLISTA ROY
By Jammie Galeaz, Rebecca Joostens and
Jeanette Dornak
http://www.bc.edu/schools/son/faculty/featured/theorist.html
SISTER CALLISTA ROY
Why We Chose this Theory
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We chose this theory for a
multitude of reasons:
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Familiarity with the theorist and use of
her model in current nursing practice
Sister Callista Roy is a Sister of Saint
Joseph, one of us worked for a
Catholic health system which was
founded by eleven Sisters of Saint
Joseph in 1889
The use of goal setting within the Roy
Adaptation model because of it’s
relevance in the field of nursing
Introduction
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Callista L. Roy, RN, PhD, a well known Nurse Theorist, was
born in the year 1939 in Los Angeles, California.
Her education began at Mount Saint Mary’s College; however,
her master’s degree and PhD in pediatric nursing and
sociology are from the University of California
There are four other institutions where she holds honorary
doctorates
Today Dr. Roy is a professor at William F. Connel School of
Nursing at Boston College; she teaches at both
undergraduate and graduate levels.
Dr. Roy is known around the world for her Roy adaptation
model for nursing
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Over the years she has traveled to over 30 countries to discus
topics on this nursing theory
Furthermore, Dr. Roy also has several publications in newspapers,
books, and journal articles related to nursing theory or other
professional subject matter
(“Sr. Callista Roy,” 2007).
Assumptions and Point of view
Author’s motivation for the Model
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The idea of the Roy Adaptation Model (RAM) spawned from
the resiliency of children Dr. Roy cared for in pediatrics
Dr. Roy read books on the concept of adaptation and was
impressed with what she saw in the children so much that
she proposed the goal for nursing was to promote patient
adaptation.
Von Bertalanffy and Helson are the theorist that Dr. Roy used
to create her early prototypes of the RAM.
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Helson’s definition of adaptation is for an individual to respond in
a positive manor to environmental changes and portrays three
kinds of stimuli: focal, contextual, and residual
After 17 years of developing the RAM at Mount St. Mary’s
College, the first article was published in Nursing Outlook. Not
even a month later RAM became a framework for the nursingbased curriculum.
(“Roy Adaptation Model,” 2007).
Assumptions and Point of view
Nursing Knowledge and Development
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By the year1987 over 100,000 nurses
learned using RAM in their practice
One of the changes to the model was the
creation of four modes to which
adaptation is manifested and provides a
base for the assessment portion of the
nursing process.
physiologic
 self concept
 role function
 interdependence
(“Roy Adaptation Model,” 2007).
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Assumptions and Point of view
Philosophic values
Dr. Roy is always re-examining her theory and
tweaking it to fit the nursing needs of today.
 For example, early identifying factors of RAM
include: systems theory, adaptation-level theory,
and humanistic values; however, later she
describes a philosophical assumption of veritivity
being more effective than the philosophical
relativistic approach in that it puts limitations on
progress where veritivity does not.
 In the year 1988, Dr. Roy published a paper on
these philosophical assumptions stressing the
limited view of secular humanism in using certain
conceptual approaches to nursing.
(“Roy Adaptation Model,” 2007).
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Assumptions and Point of view
In the 1990s, Dr. Roy decided to re-define adaptation and progress RAM
into the twenty-first century.
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Dr. Roy expanded her insights to include a mixture of spirituality and
science in this new improved definition of adaptation.
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Her philosophical position expresses that nurses view patients as coextensive with their surroundings, both physical and social environments.
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She encourages nurses to adopt a value-based stance which is founded in
beliefs, and hopes about the individual, and that we accept a discipline that
functions by promoting the well-being of patients and “of the earth.”
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Dr. Roy places emphasis on the idea of “cosmic unity” which is defined as
“persons and the earth have common patterns and mutuality of relations
and meaning and that persons through thinking and feeling capacities,
rooted in consciousness and meaning, are accountable for deriving ,
sustaining, and transforming the universe” (“Roy Adaptation Model,”
2007).
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Today Dr. Roy has expanded the RAM even further with including rational
persons and individual persons, depicting adaptation in three tiers of
integrated life processes, compromised processes, and compensatory
processes
(“Roy Adaptation Model,” 2007).
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Information and Concepts
Global Concepts: HUMAN BEING
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“As an adaptive system, the human
system is described as a whole with
parts that function as unity for some
purpose. Human systems included
people as individuals or in groups,
including families, organizations,
communities, and society as a whole.”
(Roy & Andrews, 1999, p.31)
People adapt to their environment and
this change affects the environment.
Information and Concepts
Global Concept: ENVIRONMENT
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“All the conditions, circumstances, and influences
surrounding and affecting the development and behavior
of persons or groups, with particular consideration of the
mutuality of person and earth resources that includes
focal, contextual, and residual stimuli.” (Roy & Andrews,
1999, p. 18)
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Focal stimuli: “The internal or external stimulus
most immediately confronting the human system.”
(Roy & Andrews, 1999, p. 31)
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Contextual stimuli: “All other stimuli present in the
situation that contribute to the effect of the focal
stimulus.” (Roy & Andrews, 1999, p. 31)
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Residual stimuli: “Environmental factors within or
without the human system with effects in the current
situation that are unclear.” (Roy & Andrews, 1999, p.
32)
Information and Concepts
Global Concept: HEALTH
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“A state and process of being and
becoming integrated as a whole person.
It is a reflection of adaptation, that is,
the interaction of the person and the
environment.”
Roy’s model indicates that health and
illness can coexist. A person can be
physically ill, but if they are adapting
positively in another adaptation mode,
they are also healthy.
(Andrews & Roy, 1991, p/21)
Information and Concepts
Global Concept: HEALTH continued
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Two subsystems process environmental input, or
stimuli, and function as primary coping mechanisms.
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Regulator coping mechanism “responds
automatically through neural, chemical, and
endocrine processes” (Andrews & Roy, 1991, p
14)
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Cognator coping mechanism “responds
through four cognitive-emotive channels:”
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perceptual information processing
Learning
Judgement
Emotion
(Andrews & Roy, 1991, p. 14)
These coping mechanisms respond based on an
adaptive mode. The regulator coping subsystem
responds through the physiological adaptation
mode. The cognator coping subsystem responds
through either the self-concept, interdependence,
or role function adaptation modes.
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The following slides describe the adaptation
modes.
Information and Concepts
Global Concept: HEALTH continued
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Physiological Adaptation Mode
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Meets basic need for physiological integrity
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Oxygenation
Nutrition
Elimination
Activity and rest
Protection
Senses
Fluid and electrolyte and acid-base balance
Neurological function
Endocrine function
(Alligood & Tomey, 2010):
Information and Concepts
Global Concept: HEALTH continued
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Self-Concept Adaptation Mode
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Meets basic need for psychic and spiritual
integrity
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Body sensation
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Body image
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Self-consistency
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Self-ideal or self-expectancy
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Moral-spiritual-ethical self
(Alligood & Tomey, 2010):
Information and Concepts
Global Concept: HEALTH continued
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Interdependence Adaptation Mode
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Meets basic need for relational integrity or
security in nurturing relationships
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Significant others in a person’s life
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Give and receive love, respect, and
value
(Alligood & Tomey, 2010):
Information and Concepts
Global Concept: HEALTH continued
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Role Function Adaptation Mode
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Meets basic need for social integrity
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Knowledge of society’s expectations are
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Appropriate action within society
(Alligood & Tomey, 2010):
Information and Concepts
Global Concepts: NURSING
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Nursing is…“The science and practice that expands
adaptive abilities and enhances person and environmental
transformation.” (Alligood & Tomey, 2010)
Nurses are to be aware of the adaptive behaviors of the
person as well as the environmental stimuli that influence
the behavior.
Nurses plan interventions based on the stimuli and help the
person positively adapt to the stimuli.
Nurses use the following process (Alligood & Tomey,
2010):
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Assessment of behavior
Assessment of stimuli
Nursing diagnosis
Goal setting
Intervention
Evaluation
Interpretation & Inference and
Implications & Consequences
Assessment of the 4 Global Concepts
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Roy’s Model of nursing expands hugely on
the 4 Global Concepts.
Roy’s Model describes how each of the
concepts are related to each other and
how they effect/change each other
Roy delves further into each concept,
creating additional concepts within each
umbrella term.
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For example, her concept of environment
breaks the environment down into various
types of stimuli.
Interpretation & Inference and
Implications & Consequences
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The following questions led Roy to her
theory:
Who is the focus of nursing care?
 What is the target of nursing care?
 When is nursing care indicated?
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Roy’s influences behind this theory
include: family, her religious
background, mentors, clinical
experiences, and education
(Current Nursing, 2010)
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Interpretation & Inference and
Implications & Consequences
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This theory is unique to nursing in that it
clarifies who and what is at the center of the
nursing care. All concepts center around how
everyone and every thing surrounding the
patient effects the patient’s outcome.
The patient is a being who is effected by our
nursing care and the environment in which they
receive that care.
The Nurse guides the patient through their time
of health and/or illness towards a positive
outcome: adaptation.
Interpretation & Inference and
Implications & Consequences
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Evaluation of the nursing model: this model is allencompassing for all nurses and in all areas of nursing.
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The concepts are very broad and can therefore be used
in multiple ways
For example:
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Her concept of a person is that each individual is
many pieces that work together to form the whole
that works in unity. No matter what area of nursing
or what your focus is, that area of the person/ body
is being studied, this concept stands true
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Health and wellness are inevitable parts of
everyone’s life; can refer to any type of un-wellness.
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Her definition of the concept of adaptation is a
positive response to any stimuli- no matter the
environment- therefore this could apply to any
nursing environment.
(Current Nursing, 2010)
Interpretation & Inference and
Implications & Consequences
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What practice situations can/has this
model been used in?
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This model can be used in many different
clinical settings. It is applicable to any
situation.
This model was used by Roy herself in both
Maternity and Pediatric Nursing
This model can be used from labor and
delivery, newborn care and all the way
through the end of life.
Since Health and Illness are both described
as part of everyone’s life, a co-existence of
the two can be had and can lead to the
patient being allowed to have a dignified
passing just as much as a patient can
experience a time a healing.
Resources and Web-links
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Current Nursing. (2010, November 13). Roy's adaptation
model. Retrieved from
http://currentnursing.com/nursing_theory/Roy_adaptation_m
odel.html
Lewis, T. (1988). Leaping the chasm between nursing theory
and practice. Journal of Advanced Nursing, 13(3), 345-351.
Retrieved from EBSCOhost.
Roy Adaptation Model. (2007). Boston College. Retrieved
October 11, 2007, from
http://www.bc.edu/~royca/htm/ram/htm
Roy, C., & Andrews, H. (1991). The Roy adaptation model:
The definitive statement. Norwalk, CT: Appleton & Lange.
Roy, C., & Anderews, H. (1999). The Roy adaptation model
(2nd ed.). Upper Saddle River, NJ: Pearson Education, Inc.
Sr. Callista Roy, PhD, RN, FAAN. (2007). Boston College.
Retrieved October 10, 2007, from
http://www.bc.edu/schools/son/faculty/theorist.html
Tomey, M.A. & Alligood, M.R (2005). Nursing Theorists and
their Work (7th ed.). St. Louis: Elsevier.