THE ROY’S ADAPTATION MODEL
Roy Adaptation model is published in her
Callista Roy
BIOGRAPHY
 Born in Los Angeles on October 14, 1939
as the 2nd child of Mr. and Mrs. Fabien
Roy
 Sr. Callista Roy is a prominent nurse
theorist, writer, lecturer, researcher, and
teacher.
 She entered the Sisters of Saint Joseph
Carondelet.
 1963 - Bachelor of Arts with Major in
Nursing from the University of California
Los Angeles.
 Roy developed the basic concepts of the
model while she was a graduate student at
the University of California, Los Angeles
from 1964 to 1966
 1966 – Master’s Degree in Pediatric
Nursing from the University of California
Los Angeles
 Roy began operationalizing her model in
1968 when Mount St. Mary’s College
adopted the adaptation framework as the
philosophical foundation of the nursing
curriculum.
 1973 and 1977 – Earned Master’s Degree
and PhD in Sociology
 She worked with Dorothy E. Johnson in a
seminar in developing a conceptual model
for nursing.
 Completed 2 year post doc in
neuroscience at the University of
California, San Francisco
 She conducted research on nursing
interventions for cognitive recovery in
head injuries and on the influence of
nursing models on clinical decision
making
 Roy has published many books, chapters,
and periodical articles and has presented
numerous lectures and workshops
focusing on her nursing adaptation theory
(Roy and Andrews, 1991).
 Had over 100 publications, which includes
11 books with translations in 12
languages.
 The refinement and restatement of the
1999 book, The Roy Adaptation Model
(Roy and Andrews, 1999).
 She is a member of Sigma Theta Tau – an
international community of nurses,
dedicated to the advancement of
knowledge, teaching, learning, and service
through the cultivation of communities of
practice, education, and research.
 Awarded Four Honorary Doctoral Degrees
HONORS AND AWARDS
➢ 1981 – National Founder’s Award for
Excellence in
Fostering Professional Nursing Standards
➢ 1979 – World Who’s Who of Women
➢ 1978 – Personalities of America and fellow of
the
American Academy of Nursing
➢ 1989 – recipient of a Fulbright Senior Scholar
Award
from the Australian-American Educational
Foundation
➢ 1991 – Martha Rogers Award for Advancing
Nursing Science from the National League of
Nursing
➢ 2007 – Living legend, The American Academy
of Nursing
➢ 2010 – Inductee, Sigma Theta Tau’s Nurse
Researcher Hall of Fame
➢ 2011 – Mentor Award, Sigma Theta Tau Society
➢ 2013 - Alumni Award for Professional
Achievement, UCLA
➢ 2013 – Excellence in Nursing, The University of
Antioquia, Medellin
MAJOR WORKS
➢ Generating Middle Range Theory: From
Evidence to Practice
➢ Nursing Knowledge Development and Clinical
Practice
➢ By Callista Roy – The Roy Adaptation Model:
3rd(third) Edition
➢ Roy Adaptation Model-Based Research:25
Years of Contributions to Nursing science
➢ Introduction to Nursing: An Adaptation Model
➢ Theory Construction in Nursing: An Adaptation
Model
CONTENT OF THE THEORY
The Roy Adaptation Model (RAM)
Nursing is to help the person adapt to change in
physiological needs, self concepts, rolefunction and
interdependent relations during health and illness"
Overview of Roy's Adaptation Model
➢ Roy sees the person as a bio-psycho-social being
in a constant interaction with a changing
environment.
➢ Made up of four components: person, health,
environment, and nursing.
➢ The environment is the source of variety of
stimuli that either threaten or promote the person’s
unique wholeness.
➢ Environment stimuli is categorized as focal,
contextual, or residual.
➢ The person’s major task is to maintain integrity
in face of these environmental stimuli.
➢ According to Roy and Andrews (1999), integrity
is defined as the degree of wholeness achieved by
adapting to changes in need.
➢ Roy explained that adaptation occurs when
people respond positively to environmental
changes.
THEORY BASIS
Adaptation Model of Nursing
THEORY GOAL
Nursing can promote an integrated level of
adaptation for individuals and group that can
advance wellness, the quality of life, and death with
dignity.
NURSING FOCUS
The aim of nursing is to increase compliance and
life expectancy. Roy’s Adaptation Model evaluates
the patient in physiologic mode, self-concept mode,
role function mode, and interdependence mode
aiming to provide holistic care.
MAJOR CONCEPTS AND DEFINITIONS
SYSTEM
➢ It is a set of parts connected to function as a
whole for some purpose,
- In addition to having wholeness and related parts,
systems also have inputs, outputs, control, and
feedback processes (Andrews & Roy, 1991, p.7).
ADAPTATION
➢ According to Roy and Andrews (1999),
adaptation refers to “the process and outcome
whereby thinking and feeling persons as
individuals or in groups, use conscious awareness
and choice to create human and environmental
integration.”
ADAPTATION LEVEL
➢ "Adaptation level represents the condition of the
life processes described on three levels as
integrated, compensatory, and compromised” (Roy
& Andrews, 1999, p.30).
➢ A person’s adaptation level is the person’s
ability to respond positively in a situation.
➢It is a constantly changing point made up of
focal, contextual, and residual stimuli which
represent the person’s own standard of the range of
stimuli to which one can respond with ordinary
adaptive responses.
Integrated Life Process – it is the adaptation level
at which the structure and functions of a life
process are working as a whole to meet human
needs
Compensatory Process – it is an adaptation level
at which defense mechanisms have been activated
by a challenge to the integrated life process.
Compromised Process – results from inadequate
integrated and compensatory life processes, and is
an adaption model.
ADAPTATION PROBLEM
➢These describe the difficulties related to the
indicators of positive adaptation.
➢ These are not seen as nursing diagnoses, but as
areas of concern for the nurse related to adapting
person or group within each adaptive mode.
STIMULI
➢Are ways used to describe an environment
➢ There are three types of stimuli and they act
together and influence the adaptation level, which
is the person’s ability to respond positively in a
situation.
THREE TYPES OF STIMULII
FOCAL STIMULUS – “THE INTERNAL OR
EXTERNAL STIMULUS MOST
IMMEDIATELY CONFRONTING THE HUMAN
SYSTEM” (ROY & ANDREWS, 1999).
CONTEXTUAL STIMULI – “ARE ALL
OTHER STIMULI PRESENT IN THE
SITUATION THAT CONTRIBUTE TO THE
EFFECT OF THE FOCAL STIMULUS” (ROY &
ANDREWS, 1991).
RESIDUAL STIMULI – “ARE
ENVIRONMENTAL FACTORS WITHIN OR
WITHOUT THE HUMAN SYSTEMS WITH
EFFECTS IN THE CURRENT SITUATION
THAT ARE UNCLEAR” (ROY & ANDREWS,
1999).
COPING PROCESSES
➢ These are innate or acquired ways of interacting
with the changing environment.
INNATE COPING MECHANISMS – these are
genetically determined or common to the species
and are generally viewed as automatic processes;
humans do not have to think about them.
ACQUIRED COPING MECHANISM – these
are developed through strategies such as learning.
the experiences encountered throughout life
contribute to customary responses to particular
stimuli.
SUBSYTEMS
➢ Subsystems are the ways that describes how we
adapt and these includes regulator and cognator.
REGULATOR SUBSYSTEM – a major coping
process involving the neural, chemical, and
endocrine systems.
Cognator Subsystem – a major coping process
involving four cognitive-emotive channels:
perceptual and information processing, learning,
judgment, and emotion.
RESPONSES
➢ Adaptive Responses – promote integrity in
terms of the goals of human systems
➢ Ineffective Responses – do not contribute to
integrity in terms of the goals of the human systems
THE FOUR ADAPTIVE MODES
- Roy’s model includes four adaptive modes.
These four adaptive modes are the modes in which
clients interact with and adapt to their
environments. (Wills, 2011)
PHYSIOLOGICAL PHYSICAL MODE
- “It is associated with the physical and chemical
processes involved in the function and activities of
living organisms” (Roy & Andrews, 1999).
- This mode’s basic need is composed of the needs
associated with oxygenation, nutrition, elimination,
activity and rest, and protection. This model’s
complex processes are associated with the senses,
fluid and electrolytes, neurologic function, and
endocrine function.
- The basic need of the physiological-physical
mode is physiological integrity, and the basic need
of physical mode is operating integrity.
Self-Concept-Group Identity Mode
- It focuses specifically on the psychological and
spiritual aspects of the human system.
- It is defined as the composite of beliefs and
feelings about one-self at a given time and is
formed from internal perceptions and perceptions
of other’s reactions.
- It’s components include the physical self which
involves sensation and body image, and the
personal self which is made up of self-consistency,
self-ideal, and the moral-ethical-spiritual self.
- The group identity mode is composed of
interpersonal relationships, group self-image, social
milieu and culture.
- The basic need of the group identity mode is
identity integrity.
Role Function Mode
- This focuses on the roles the person occupies in
the society.
- The basic need underlying the role function mode ➢ Awareness of self and environment is rooted in
has been identified as thinking and feeling.
social integrity. ➢ Humans, by their decisions, are accountable for
- Persons perform primary, secondary, and tertiary the integration of creative processes.
roles. ➢ Thinking and feeling mediate human action.
Interdependence Mode
➢ System relationship include acceptance,
- This mode focuses on close relationships of protection, and fostering of interdependence.
people (individually and collectively)
➢ Persons and the earth have common patterns and
- This mode focuses on 2 specific relationships: integral relationships.
significant others and
➢ Persons and environment transformations are
support systems. created in human consciousness.
- The basic need of this mode is termed relational ➢ Integration of human and environmental
integrity. meanings results in adaptation.
- The major areas of interdependence behavior PHILOSOPHICAL ASSUMPTIONS
have been identified as the receptive behavior and
contributive behavior. ➢ God is intimately revealed in the diversity of
creation and is the common destiny of creation.
Perception

-"Perception is the interpretation of a stimulus and ➢ Persons use human creative abilities of
the conscious appreciation" (Pollock, 1993). awareness, enlightenment, and faith.

-Perception links the regulator with the cognator ➢ Persons are accountable for the processes of
and connects the adaptive modes. deriving, sustaining, and transforming the universe.

Six-Step Nursing Process ➢ Persons have mutual relationships with the

world and God.
➢ Roy has conceptualized the nursing process to
comprise the following six simultaneous, ongoing, ➢ Human meaning is rooted in the omega point
and dynamic steps: convergence of the universe.

1. Assessment of behavior THE METAPARIDIGM CONCEPTS

2. Assessment of stimuli  Nursing

 Health
3. Nursing diagnosis  Person
4. Goal setting  Environment

5. Intervention NURSING

6. Evaluation ➢ Roy defines nursing as a “health care profession

Major Assumptions
 Scientific Assumptions
 Philosophical Assumptions
that focuses on human life processes and patterns
and emphasizes promotion of health for
individuals, families, groups, and society as a
whole."

SCIENTIFIC ASSUMPTIONS ➢ Scientifically, as the science and practice that

➢ Systems of matter and energy progress to higher
levels of complex self-organization.
➢ Consciousness and meaning are constitutive of
person and environment integration.
expands adaptive abilities and enhances person and
environmental transformation.
➢ Nurses are facilitators of adaptation.
➢ They assess the patient’s behaviors for
adaptation, promote positive adaptation by
enhancing environment interactions and helping that may affect the focal stimulus but whose effects
patients react positively to stimuli. are unclear.

➢ Nurses eliminate ineffective coping mechanisms

and eventually lead to better outcomes.

➢ The goal of nursing in the RAM is to promote

adaptation in each of the four adaptive mode.

PERSON

➢ Humans are holistic, adaptive systems.

➢ Humans can be individuals or group, families,

organizations, and society as a whole.

➢ Defined as the main focus of nursing, the

recipient of nursing care, a living, complex,
adaptive system with internal processes (cognator
and regulator) acting to maintain adaptation in the
four adaptive modes.

HEALTH

➢ Health is defined as the state where humans can
continually adapt to stimuli.
➢ Since 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.
ENVIRONMENT
➢ The environment is defined as conditions,
circumstances, and influences that affect human’s
development and behavior as an adaptive system.
➢ The environment is a stimulus or input that
requires a person to adapt. These stimuli can be
positive or negative.
➢ Roy categorized these stimuli by the following:
a. Focal Stimulus – the internal or external stimulus
most immediately challenging the person’s
adaptation.
- the phenomena that attracts the most of one’s
attentions.
b. Contextual Stimlus – are all other stimuli
existing in a situation that strengthen the effect of
the focal stimulus.
ACCEPTANCE BY NURSING COMMUNITY
 The Roy’s adaptation model is widely
accepted and applied in the different fields
of nursing – practice, education, and
research.
PRACTICE
 Roy’s model is useful for nursing practice
because it outlines the features of the
discipline and provides distinction for
practice, education, and research. The
model considers goals, values, the patient,
and practitioner interventions.
 It has been used to the greatest extent by
individual nurses to understand, plan, and
direct nursing practice in the care of
individual patients.
EDUCATION
 The Roy Adaptation Model has been used
in the educational setting; has guided the
nursing education of more than 100,000
student nurses in the U.S. and other
countries.
 Roy’s adaptation model-guided education
to improve the majority of coping
strategies which later be applied to nursing
practices.
RESEARCH

c. Residual Stimulus – are any phenomena arising  Roy’s theory has generated a number of
from a person’s internal or external environment general propositions. From these general
 propositions, specific hypotheses can be INTERVENTIONS
developed and tested.
 Roy’s Adaptation Model has been used as As a nurse according to the Adaptation Model,
a conceptual framework in practice-based interventions should help to manage stimuli so that
researches in the Development of George can better adapt to the environment. This
Adaptation Research Instruments, in the might include facilitating a discussion group with
Development of Middle-Range Theories other youth with Type 1 diabetes, or teaching self-
of Adaptation. management strategies.
 The researchers aspire nurses to apply
these practices in helping patients cope
and adapt to the world that is always
constantly changing.

APPLICATION OF THE THEORY

Your patient is a 13-year-old boy named George.

George was diagnosed with insulin-dependent
diabetes mellitus, or Type 1 diabetes, when he was
6 years old. He was admitted to hospital with
ketoacidosis. As his nurse, you would like to
assess, then address his needs according to Sister
Callista Roy’s Adaptation Model.

1. What are the stimuli affecting George?

2. At what level of adaptation is George?

3. What intervention can you provide for

George,based on the Adaptation Model?

DATA ANALYSIS:

- Diabetes ketoacidosis is a serious complication of

diabetes. Since George was admitted to the hospital
with ketoacidosis, he stays inside of the room most
of the time, has high blood sugar level, and
possibly experiences weakness, nausea, stomach
pain, and other symptoms that is caused by his
disease.

ASSESSMENT OF STIMULI:

A. Focal Stimuli: George is containing to try to

cope with the diagnosis of Type 1 diabetes because
it is a dynamic process as George grows, the
diagnosis continues to be the focal stimuli

B. Contextual stimuli: desire to be a normal

teenager, desire to be independent, ability to
tolerate stress, perception of diabetes

C. Residual stimuli: beliefs about body image and

identity

NURSING DIAGNOSIS

Since George was admitted with ketoacidosis, it

means that he is not managing his diabetes well.
Therefore, he is operating at a compromised level
of adaptation