The development of successful nursing practice objectives requires an effective understanding of existing theories and how they are integrated into current systems. These theories represent opportunities to develop and expand nursing practice in different ways to accomplish the desired efforts to improve patient care and wellbeing. It is important to recognize the work of these theorists and their contributions to nursing practice in order to facilitate successful outcomes for patients. One theorist that has had a tremendous impact on nursing practice is Sister Callista Roy, who developed a framework known as the Roy Adaptation Model in order to provide patients with a well-rounded approach to patient care and treatment through spiritual means that oversee system development (Boston College, 2013). This model establishes a standard for nursing that connects the spiritual nature of patient care with the development of complex and intricate systems to promote patient health and wellbeing (Boston College, 2013). Within this framework, there are a number of sub-segments that capture the spiritual nature of nursing and the care that is provided in order to effectively adapt to change and the needs of patients (Boston College, 2013). The following discussion will address the Roy Adaptation Model in greater detail and will emphasize the importance of this practice on patient health and wellbeing in modern nursing environments.
Sister Callista Roy was born in 1939 and earned Masters Degrees in pediatric nursing and sociology, in addition to a Doctoral Degree in Sociology (Nursing Theory, 2011). Sister Roy held many nursing and nursing faculty positions and gained experience in a variety of settings, while also supporting the development of several advanced nursing programs at different universities (Nursing Theory, 2011). Roy’s experiences enabled her to develop a greater understanding of the spiritual nature of healthcare and nursing practice and how patients are viewed in the context of these spiritual beliefs (Nursing Theory, 2011). The basic premise of the theory is as follows: “This model looks at the patient from a holistic perspective. The three concepts of her model are the human being, adaptation, and nursing. Under the concept of adaptation are four modes: physiological, self-concept, role function, and interdependence” (Nursing Theory, 2011).
Within the physiological framework, the more traditional nursing perspective is considered in the form of the physical being, while the self-concept perspective encourages the development of a personal state of mind, whereby individual patients perceive themselves in a specific manner in order to establish a level of mental stability to support physical wellbeing (Nursing Theory, 2011). In addition, the role function framework supports the ability of individuals to exist within their specific social settings and to effectively adapt to change as required (Nursing Theory, 2011). Finally, the interdependence framework addresses the importance of balancing relationships with other people through the use of social integration while also maintaining the independent state (Nursing Theory, 2011). Each of these frameworks work in conjunction with each other in order to provide patients with a comprehensive nursing experience that supports their overall health and wellbeing in different ways to accomplish the desired objectives (Nursing Theory, 2011).
From a nursing-based perspective, the Roy Adaptation Model represents a challenge to the status quo through the development of effective measures to support patient outcomes, noted as follows: “the goal of nursing is to promote adaptation of the patient during illness and health in all four of the modes. The nurse’s actions begin with assessment on two levels. First, the nurse makes a judgment as to the presence or absence of maladaptation. Second, the nurse focuses on the stimuli influencing the patient’s maladaptive behavior. The nurse then takes actions to promote adaptation by manipulating the environment, elements of the patient system, or both as part of their nursing care plan” (Nursing Theory, 2011). In this manner, it is important to recognize the value and contribution of nursing practice to this process and the continued development of effective nursing techniques and tools to enable nurses to effectively adapt to provide patients with the best possible outcomes for their condition (Nursing Theory, 2011).
The Roy Adaptation Model also represents a means of providing nurses with a framework for improving patient care and treatment by observing the whole self rather than individual parts (Current Nursing, 2012). This model demonstrates the impact of nursing care and treatment as it is represented through specific outcomes and expectations that will enable nurses to provide excellent patient care and treatment at all times (Current Nursing, 2012). By exploring the dimensions and boundaries of nursing care, it is possible to create an environment that embraces change and progress and that also supports the integration of existing tools to ensure that patient care is optimized at all times (Current Nursing, 2012).
In order to capture the essence of this model, nurses must accomplish a series of steps that are designed to view the whole self to make decisions regarding how to adapt to meet the specific needs of these patients (Current Nursing, 2012). This is best characterized by identifying patient needs in accordance with established practices, recognizing different stimuli that are indicative of the patient’s current condition, and making a definitive diagnosis that is based upon current health status as derived from data collection (Current Nursing, 2012). Upon review of the diagnosis, goals must be established that will support the framework for long term growth and improvement, and an intervention must be conducted to implement those goals into the care and treatment plan (Current Nursing, 2012). Finally, it is important to conduct a comprehensive evaluation regarding the patient that will determine if the intervention that has been chosen is in alignment with the goals that have been established (Current Nursing, 2012).
As a primary model for nursing practice, the Roy Adaptation model represents a challenge to engage nurses in the improved provision of patient care across a wide variety of settings. Nursing practice methods must continue to explore the dimensions of Roy’s model as a means of improving outcomes and promoting visibility in expanding change throughout nursing practice (DeLaune and Ladner, 2002). These efforts are important indicators of the ability of nurses to exercise sound and reasonable judgment in their nursing activities and to view patients from a different perspective that will better meet their current needs (DeLaune and Ladner, 2002). Nurses must recognize the value of these outcomes and integrate them into daily practice settings in order to accomplish greater objectives and an improve level of patient care quality for all (Roy and Zhan, 2005). In this manner, it is important to provide patients with a framework to promote their healing and recovery in a manner that considers the entire self, including the physical, spiritual, emotional, and psychological aspects of healthcare to promote patient wellbeing in different ways (Roy and Zhan, 2005).
There are a number of assumptions that are made under Roy’s Adaptation Model which must be clearly identified and understood. For example, it is assumed that this model will offer patients the most comprehensive evaluation because it considers the entire human being, including his or her emotional and psychological needs. However, many patients might not want to provide insight into their mental state and may find it difficult to confide in nurses in this manner. Therefore, patient observations might not be as effective as desired and could lead to difficulties in determining a diagnosis. Therefore, it is important to recognize that this model might not meet the goals and objectives of nurses when they are unable to obtain a clear picture of the entire being.
Roy’s Adaptation Model provides nurses with a useful tool in supporting the needs of patients beyond the traditional physical examination. In this manner, the model evaluates patients from a variety of perspectives in order to accomplish the desired objectives and influences to support patient care and wellbeing. These efforts are critical to the success of nursing practice and demonstrate the impact of expanding nursing assessments and diagnoses to include these objectives. It is important to recognize the value of Roy’s Adaptation Model because it enables nurses to evaluate their patients and provide them with the proper treatment plan to accomplish the desired objectives. At the same time, if this model is not used in its entirety and all phases are not utilized, its benefits will not be fully realized.
The efforts made by nurses to adopt the Roy Adaptation Model may not be effective in all settings because it may be difficult to obtain a comprehensive perspective of a patient under some conditions. In addition, some patients may have religious or cultural limitations that could prohibit this type of evaluation from taking place. The creation of an environment that embraces this model must provide patients with a well-rounded approach to their care and treatment that they are comfortable with at all times. Therefore, the model must be reflective of the commitment of nurses to offer an environment to their patients that supports their physical, spiritual, emotional, and psychological wellbeing.
The creation of a successful nursing practice environment and framework requires the development of specific models and approaches to ensure that patient care and treatment is optimized at all times. It is important to recognize the value of the Roy Adaptation Model throughout nursing practice as a means of evaluating patients from a comprehensive perspective. The ability to effectively adapt to specific circumstances requires nurses to evaluate patients on an individual basis and to reflect upon the nature of these circumstances to achieve greater patient outcomes. Patients who receive this type of evaluation are likely to benefit from this approach and will appreciate the evaluation that is conducted by nurses. At the same time, nurses must demonstrate their willingness to work with patients and adapt to their specific needs to promote greater health and wellbeing in an effective manner that captures the understanding of the patient and his or her entire self.
As a nurse, the ability to adapt to specific circumstances is one of the key benefits of this practice and provides greater insight into the developments associated with improvements in the quality of patient care. Therefore, it is necessary to determine how nurses must work collaboratively in their efforts to create environments that are conducive to successful outcomes. In this context, it is important to recognize how nurses provide patients with an evaluation effort that emphasizes the whole self rather than merely physical characteristics. This model reflects a necessity to evaluate patients from a variety of perspectives in order to demonstrate the importance of creating an environment that seeks the best possible outcomes for all patients. In this manner, the model identifies patient needs in order to establish a greater understanding of the patient and his or her specific concerns. In response to these concerns, nurses will promote adaptation in order to ensure that patients are provided with the appropriate level of care and treatment that will improve outcomes and will also expand their general health and wellbeing in different ways.
Boston College (2013). Sr. Callista Roy, Ph.D., RN, FAAN. Retrieved from http://www.bc.edu/schools/son/faculty/featured/theorist.html
Boston College (2013). The Roy Adaptation Model. Retrieved from http://www.bc.edu/schools/son/faculty/featured/theorist/Roy_Adaptation_Model.html
Current Nursing (2010). Application of Roys Adaptation Model. Retrieved from http://currentnursing.com/nursing_theory/application_Roy%27s_adaptation_model.html
DeLaune, S. C., & Ladner, P. K. (2002). Fundamentals of Nursing: Standards & Practice. (pp. 35-36). Clifton Park, NY: Delmar. Nursing Theory (2011). Sister Callista Roy. Retrieved from http://nursing-theory.org/nursing-theorists/Sister-Callista-Roy.php
Roy, S. C. & Zhan, L. (2005). Sister Callista Roy’s Adaptation Model and Its Applications. In Parker (Ed.), Nursing Theories and Nursing Practice. (pp. 268-279). Philadelphia, PA: F.A. Davis.