Nursing Theory Analysis Paper

Sample Answer

Nursing theories play an important role in guiding nursing practice. Nursing theories act as frameworks for knowledge development that is utilized in making health-related decisions for the patients.

The theories also provide a better understanding of the human experiences with illnesses as well as health in an institution of healthcare. Nursing theories also guide nursing research. Nurses use concepts from nursing theories as the underpinnings of their research. Nursing researches evaluate the effectiveness of nursing interventions based on whether the goals stated in a theory have been achieved or not.

Furthermore, knowledge from nursing theories elicit more issues in nursing that can be solved and understood better utilizing concepts from the theory. Therefore, this research paper examines the adaptation theory of nursing by Sister Callista Roy. The paper examines the background of the theory, describes it, its evaluation, and application to nursing.

Theory Background

Sister Callista Roy developed the adaptation theory in 1976. Born in 1939, Roy studied a bachelor’s degree in nursing from Mount Saint Mary’s College in 1963. She also got a master’s degree in nursing in 1966 from the University of California. She proceeded to get a doctoral degree in nursing from the same university in 1977.

Roy developed her theory of adaptation after working with Dorothy Johnsons when she was developing her conceptual model for nursing. Roy identified from her experience as a pediatric nurse that children demonstrated significant resilience in care despite the challenges due to their health problems (Spraga-Spencer, 2020).

Roy developed the concepts of her model between 1964 and 1966 when she was at the University of California. Roy operationalized the model in 1968 where it was adopted for use as a philosophical foundation for the nursing curriculum in Mount Saint Mary’s College of nursing.

Roy has extensive experience as a professional nurse. She worked as an associated professor as well as chairperson for the nursing department at Mount Saint Mary’s College. She also worked as a profession at University of Portland and Mount Saint Mary’s College. She was the clinical nurse scholar for neuroscience in the University of California between 1983 and 1985 (Zerwekh & Garneau, 2020).

The other professional contributions of Roy to nursing includes the development of the coping and philosophical underpinnings of the adaptation model for use in nursing epistemology and founding of the Boston Based Adaptation Research in Nursing Society. Since inception of the Roy’s adaptation model, its use has gained significant relevance and need in the modern nursing practice and research.

Roy’s adaptation theory mainly aims at assisting the vulnerable populations such as the patients to build the resilience they need in overcoming a disease. Roy’s model strives to ensure that patients have the abilities and power to achieve their optimum level of functioning (Smith, 2019).  As a result, successful adaptation to an illness is perceived to a critical determinant of health and wellbeing in Roy’s model of adaptation.

Concepts of Roy’s Model of Adaptation

The model of adaptation by Calista Roy has five concepts that relate to nursing. The concepts include adaptation, person, environment, health, and nursing. According to Roy, adaptation is the process in which an individual responds positively to environmental changes. According to her, people live in environments that constantly change.

The constant environmental changes demands that human beings respond positively to promote their optimum health. The ability of the human beings to adapt to their environment depends on factors such as self-reflection, conscious awareness, and the choice to integrate the needs of their environments into their daily lives.

perceived that conscious awareness is important in human life because it enables individuals to select the decisions or behaviors that minimize their exposure to circumstances that affect health adversely. Roy also considered adaptation to be a product of self-reflection. Accordingly, the individual’s experiences form part of the events that influence their adaptation (Peate, 2019).

Roy further identified that successful adaptation requires individuals to identify ways in which they can successfully integrate the constant environmental changes into their lives. The second concept in the adaptation model by Roy is the person. According to Roy’s model, the person is an adaptive system that responds to environmental changes. In this case, Roy perceived human beings to be in constant interaction with their environments.

The environmental conditions change in a constant manner, which increases the need for the person to respond to them effectively. Roy’s model identified that the person uses acquired as well as innate mechanisms to respond to the constant changes in the environment. The innate mechanisms are that are inborn. The innate mechanisms include immunity and the influence of genetics.

On the other hand, acquired mechanisms encompass those that individuals acquire from their environment or previous encounters with new conditions in their environment. For example, a persistent exposure to cold weather or influenza builds new immunity that enables individuals to overcome the health effects of the constant environmental changes.

The model of adaptation further identifies that the concept of person is an adaptive being that uses regulate and cognator sub-systems to remain adaptive to the environmental needs. The cognator sub-system responds to environmental demands using the cognitive and emotional channels. The channels include information processing, judgment, emotion, and learning. The regulator sub-system utilizes the chemical, neural, and endocrine channels to respond to environmental stimuli. Optimum health therefore depends on the effective functioning of the cognator and regulator subsystems of adaptation.

Roy further considered the concept of person to include individuals, groups such as families, communities, organizations, and the society in its entirety. The Roy adaptation model also considered the person to comprise of parts that work together to ensure unity for a purpose in responding to environmental changes (Browning, 2020). As a result, the person becomes the focus of nursing care, as it receives the planned care interventions by nurses.

The third concept in Roy’s adaptation model is environment. According to Roy’s model, environment comprises of the internal and external environments. The environment confronts the person, forcing the need for successful adjustment to the environmental needs. Roy also considered the environment contextual in nature.

In this case, environment refers to all the stimuli that contribute to focal stimuli. The stimuli can be either internal or external environmental stimuli. Roy asserted that the environmental stimuli affect human behaviors and development. The effect on behavior and development also extends to groups, organizations, and communities responding to the environmental needs (Gibson, 2020).

Therefore, as seen from Roy’s model of adaptation, individuals, groups, organizations, or communities should demonstrate positive response to the environmental stimuli for them to achieve their optimum health needs.
The other concept in Roy’s adaptation model is health. Roy perceived health as a critical dimension in the life of an individual.

Accordingly, health-illness continuum represents the health and life of the person. Roy also considered health to be a process and state of becoming and being integrated in a system of wholeness. Accordingly, the successful integration of the person and the existence of mutually co-existing relationship between the person and environment influences health.

Roy however considered health also unrealistic in nature, as seen from the lack of a predetermined continuum of the relationship between illness and health. Due to this, Roy considered illness and health to co-exist. Roy also considered health to be the ability of the person to adapt with their environment. According to her, health occurs when an individual successfully adjusts or responds to both internal and external environmental stimuli (Ellis, 2017).

However, ineffective response to the environmental stimuli leads to ill health, hence, the nature of the relationship between health, person, and environment.
The last concept in the model of adaptation by Roy is nursing. According to Roy, nursing is a profession that aims at assisting the person to achieve successful adaptation in their environments.

Roy’s model perceived nursing to focus on the processes that influence human life and patterns of people’s behavior that promote health and full-potential for families, individuals, communities, and groups. Roy further perceived nursing as a practice and science. Accordingly, nursing utilizes science of understanding the interrelation between the different adaptive modes that promote adaptation.

Roy therefore considered the goal of nursing to be to promote individual and group adaptation in the different adaptive modes, as a way of contributing to quality of life, health and dignified death. Roy also identified that nurses assist the adaptation of the person using adaptive modes that include physiological, self-concept, role functioning, and interdependence modes (Zerwekh & Garneau, 2020).

Consequently, the role of nursing in Roy’s model of adaptation is to promote successful adaptation of the person to their environment for the desired quality of life, health, and dignified death, hence, the interrelationship between the concepts.

Assumptions of Roy’s Model of Adaptation

The use of Roy’s model of adaptation relies on a number of assumptions. The assumptions in the model are classifiable into three classes that include scientific, cultural, and philosophic assumptions.

Philosophic Assumptions

One of the philosophic assumptions of the adaptation model by Roy is the fact that there exist a mutual relationship between the person, God-figure and the world. The existence of this relationship implies that the provision of nursing care should incorporate the worldview of the patient into the care process.

The second philosophic assumption of the theory is that the meaning of the person is rooted in the omega convergence of the world. This assumption implies that human beings make meaning of their lives and health based on their understanding of the universe. The other assumption is that God is the creator of diversity and a destiny for all the world creations.

As a result, human beings hold God as the highest supernatural being in the universe. The other philosophic assumption is the fact that human beings use their enlightenment, faith, and awareness to influence their decisions (Peterson & Bredow, 2020). Consequently, humans have the ability to use their creative abilities to adapt to their environments.

Scientific Assumptions

One of the scientific assumptions of the adaptation model by Roy is that human beings are accountable for their creative processes and integration. The implication for this assumption is that human beings are rational in nature. They use their feelings and thinking to mediate their actions.

The second scientific assumption of the adaptation model by Roy is that environmental awareness of self is deeply rooted in feeling and thinking. The implication of this assumption is that human behavior and response to environmental changes depend on their interpretation of their experiences.

The other scientific assumption of the model is that meaning and consciousness comprise the environmental integration and thinking of the person. The other scientific assumption of the adaptation model is that human actions are dependent on thinking and feeling, energy and systems matter progress to the highest levels of human complex self-organization, and adaptation arises from successful integration of the person into the environment (Fawcett, 2016).

Cultural Assumptions

One of the cultural assumptions of the adaptation model by Roy is that the experiences in a given culture influence the expression of the elements in the adaptation model by Roy. This assumption implies that the cultural values and practices of a group influence the effectiveness and use of the concepts of care in the adaptation model by Roy.

The second cultural assumption of Roy’s model is that each culture may have a concept that is critical in determining the manner in which the concepts of Roy’s model are used in practice. The third cultural assumption of the model is that the use the adaptation model may vary based on the cultural values and practices that contribute to the evolution of the model’s use in practice (Thomas, 2016).

Metaparadigms

From the above analysis, the four main concepts of the adaptation by Roy include health, person, nursing, and environment. The concepts constitute the metaparadigms of the adaptation model by Roy. Each of these metaparadigm components has a unique definition in their use in nursing practice.

According to Roy’s model of adaptation, the person is an adaptive system that has regulator and cognator subsystems that ensure successful adaptation in the above-identified adaptive modes. Roy defined the environment as the conditions, influences, and circumstances that affect and surround the development as well as behavior of the person.

Roy defined health as the process and state of becoming and being integrated into a system of wholeness that reflects environment and person mutuality. Lastly, Roy defined nursing as a profession that promotes the adaption of the person in the four modes of adaptation with the aim of promoting quality of life, health, and dignified death (Smith, 2019).

Application of Roy’s Adaptation Model to Nursing

The model of adaptation by Roy has considerable applications to nursing practice, administration and research. One of the applications of the model to nursing practice is assessment. Nurses can use the model to assess the ability of the patients to adapt to their changes in health status.

Nurses can use cues to changes in health that can be either observable or non-observable. During the assessment of the patient, the nurse determines the behaviors of the patient from the four adaptive modes and the patient’s response to stimuli. The nurse then uses the assessment data to develop nursing diagnoses that match the behaviors and response of the patients to the stimuli (Spraga-Spencer, 2020).

Roy’s model of adaptation is also applicable to the planning stage of nursing care. The nurse uses the data from the assessment to develop care goals that will promote adaptation. The setting of goals encompasses the development of statements that reflect the behavioral outcomes that must be met for adaptation to be possible.

The adaptation model by Roy can also be applied to the implementation of nursing care plan. In this case, the nurse determines the most effective ways in which the pre-developed goals of care can be achieved to ensure that patients attain their adaptation to environmental stimuli. The selection of the interventions for use to achieve adaptation takes into consideration the type of the stimuli to change as a way of promoting optimum outcomes of care (Fawcett, 2016).

The adaptation model by Roy can also be applied to the evaluation of nursing care. Nurses use the model to determine the effectiveness of the adopted interventions in promoting adaptation. The nurse evaluates the patient’s response to the stimuli based on the interventions that were used in the care process (Peterson & Bredow, 2020). Nurses often use strategies such as observation, interviewing, and measurement to determine whether the selected interventions were effective in facilitating effective adaptation in their patients.

Roy’s model of adaptation can also be used in research. The model can act as a theoretical framework for studies that aim at promoting behavioral change in populations. The theory provides the assumptions and concepts that are used for evaluating the effectiveness of interventions in a research. An example of a study that used Roy adaptation model is the one conducted by Jennings (2017). \

The study by Jennings (2017) investigated the use of the model of adaptation by Roy in the management anorexia nervosa. The study revealed that the use of the adaptation model was effective in guiding knowledge development, inter-disciplinary education, and provision of case specific care to patients with anorexia nervosa. The study also revealed that the theory by Roy could be used to evaluate the effectiveness of interventions utilized to manage anorexia nervosa. In this case, subjective assessment of the changes in symptoms of anorexia nervosa was done to determine the effectiveness of the adopted interventions.

Nurse administrators can also use the model of adaptation by Roy to facilitate change in their organizations. In this case, nurse administrators can use the model to understand the experiences of their staffs with new change agents in their practice. This understanding is important for the development of the interventions to increase the practice use of the change (Thomas, 2016). For example, the model enables the identification of the perceived barriers to change from the nurses and the need for interventions such as training to enhance the adoption of the change in an institution of healthcare.

Conclusion

In conclusion, Roy model of adaptation is a theory that can be used to inform nursing practice, research, and administration. The theory provides an understanding of the relationship between concepts of nursing practice that include health, nursing, person, and environment.

The adaptation model also provides assumptions that guide nursing practice. The above analysis has shown that Roy model of adaptation has practice, research, and nursing administration uses. The theory can be used for the purposes of assessment, planning, implementation, and evaluation of care.

The theory is also effective for use in nursing researches that investigate the effectiveness of interventions that aim at promoting adaptation and behavioral changes. The adaptation theory by Roy also has uses in nursing administration. Nurse administrators can use the theory to implement new initiatives that transform behaviors, quality of care, and health outcomes for patients. Consequently, nurses should explore the ways of making an effective use of the theory in their practice.

References

• Browning, A. M. (2020). Application of the Roy Adaptation Theory to a care program for nurses. Applied Nursing Research, 151340. https //doi.org/10.1016/j.apnr.2020.151340
• Ellis, P. (2017). Understanding Ethics for Nursing Students. Learning Matters.
  Fawcett, J. (2016). Applying Conceptual Models of Nursing Quality Improvement, Research, and Practice. Springer Publishing Company.
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  Jennings, K. M. (2017). The Roy Adaptation Model A Theoretical Framework for Nurses Providing Care to Individuals with Anorexia Nervosa. ANS. Advances in Nursing Science, 40(4), 370–383. https //doi.org/10.1097/ANS.0000000000000175
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