Roy's Adaptation Model

1. 02/09/17 ROY'S ADAPTATION MODEL 1

2. GROUND RULES  Be attentive  Please switch off your laptops  Don’t talk & leave the room during presentation  Ask questions without any hesitation at the end of presentation 02/09/17 ROY'S ADAPTATION MODEL 2

3. ROY’S ADAPTAION MODEL Presented By: N/C Sana Sultan Faculty: Maj. Shagufta Parveen 02/09/17 ROY'S ADAPTATION MODEL 3

4. Objectives At the end of this presentation learner will be able to: Introduction Describe biographical sketch of Callista Roy Explain evolution of theory Explain assumptions of the theory Describe Roy’s Adaptation Model (RAM) Explain metaparadigm of RAM Describe types of stimuli 02/09/17 ROY'S ADAPTATION MODEL 4

5. Objectives Contd…  Explain coping mechanism  Describe adaptive modes of RAM  Elaborate application of RAM  Identify strength & weaknesses of RAM  Describe application of theory in practice / education & research  Elaborate the implementation of RAM in Rheumatoid Artritis 02/09/17 ROY'S ADAPTATION MODEL 5

6. Introduction  Nursing is establishing itself as a scientific discipline  The nursing models provide the basis for selecting knowledge to be transmitted in nursing education  It is the framework for nursing practice and the direction for nursing research 02/09/17 ROY'S ADAPTATION MODEL 6

7. Biographical Sketch Of Callista Roy  Born on 14th Oct ,1939  Bachelors of arts in nursing  Masters of science in nursing from University of California, LosAngeles1966  Masters of arts(M.A) in sociology  Associate professor and chairperson of the department of nursing at mount Saint Mary’s college until 1982 02/09/17 ROY'S ADAPTATION MODEL 7

8. Biographical Sketch Of Callista Roy Cont…  1983-1985 she was Post Doctoral fellow at Robert Wood Johnson at University of California, as a clinical nurse scholar in neuroscience. 02/09/17 ROY'S ADAPTATION MODEL 8

9. Evolution Of Theory  Concept of the theory was developed when Roy was graduate student  Challenged by another nurse theorist Dorothy E.Johnson to develop a theory of nursing  Operationalizing in 1968  Literature debut in 1970  Model presentation in 1977 02/09/17 ROY'S ADAPTATION MODEL 9

10. Assumptions  Scientific assumptions  Philosophical assumptions  Assumptions from humanism  Assumptions based on veritivity 02/09/17 ROY'S ADAPTATION MODEL 10

11. Assumptions Contd… Scientific assumptions: Systems of matter and energy Self and environmental awareness Human decisions Thinking and feeling System relationships Persons and the earth relationships. Person and environment transformations Integration of human and environment 02/09/17 ROY'S ADAPTATION MODEL 11

12. Assumptions Contd… Philosophical assumptions: Mutual relationships Human meaning God is intimately revealed in the diversity of creation Persons use human creative abilities Persons are accountable for sustaining and transforming the universe 02/09/17 ROY'S ADAPTATION MODEL 12

13. Assumptions Contd… Assumptions from humanism: Creativity Purposefulness Holism Interpersonal process 02/09/17 ROY'S ADAPTATION MODEL 13

14. Assumptions Contd… Assumptions based on veritivity: Purposefulness of human existence Unity of purpose of humankind Activity & creativity for common goods Values & meaning of life 02/09/17 ROY'S ADAPTATION MODEL 14

15. Roy’s Adaptation Model (RAM) “Nursing is to help the person adapt to change in physiological needs, self-concepts, role function and interdependent relations during health and illness” 02/09/17 ROY'S ADAPTATION MODEL 15

17. Metaparadigm Of RAM  Human being  Environment  Health  Nursing 02/09/17 ROY'S ADAPTATION MODEL 17

18. Metaparadigm Of RAM Contd… Human being:  The Person viewed as a adaptive system, their health, and their environment  Interchanging with the environment  Person also refers to families, groups, communities and the whole society 02/09/17 ROY'S ADAPTATION MODEL 18

19. Metaparadigm Of RAM Contd… Environment:  All conditions, circumstances and influences that surround and affect the development and behavior of the person  A change acts as a stimulating and causes adaptive responses. 02/09/17 ROY'S ADAPTATION MODEL 19

20. Metaparadigm Of RAM Contd… Health:  It is a process where he or she is striving to achieve their maximum potential Nursing:  Nursing acts to enhance the interaction of the person with the environment to promote adaptation. 02/09/17 ROY'S ADAPTATION MODEL 20

21. Types Of Stimuli Focal Stimuli: Immediately confront the individual in a particular situation. Focal stimuli for a family include needs and changes within the family members, among the environment. Contextual Stimuli: Are those other stimuli that influence the situation 02/09/17 ROY'S ADAPTATION MODEL 21

22. Types Of Stimuli Contd… Residual Stimuli: Include the individual’s beliefs or attitudes that may influence the situation. Contextual and residual stimuli for a family system include nurturance, socialization, and support. 02/09/17 ROY'S ADAPTATION MODEL 22

23. Types Of Stimuli Contd… Example: Smoking Focal:  Nicotine addiction Contextual:  Belief that smoking is enjoyable, relaxing, part of routine Residual stimuli:  Beliefs about body image, and weight gain with smoking cessation 02/09/17 ROY'S ADAPTATION MODEL 23

24. Coping Machanism Regulator: Primarily used as a mechanism to cope with physiological stimuli Cognator: used mainly as mechanism to cope with psychological stimuli dealing primarily in area of cognition, judgment and emotion 02/09/17 ROY'S ADAPTATION MODEL 24

25. Adaptive Modes Of RAM  Physiological Mode  Self concept mode  Role function mode  Interdependent mode 02/09/17 ROY'S ADAPTATION MODEL 25

26. Adaptive Modes Of RAM Contd… Physiological: Oxygenation, nutrition, elimination, activity, rest, and protection Self Concept: Psychological and spiritual elements Role Function: primary, secondary, and tertiary roles the person performs in society 02/09/17 ROY'S ADAPTATION MODEL 26

27. Adaptive Modes Of RAM Contd… Interdependence: coping mechanisms arising from close relationships 02/09/17 ROY'S ADAPTATION MODEL 27

30. Application Of RAM To Promote Behavior:  Served as a guide to assess each member's level of adaptation  Identify actual or potential adaptation problems  examining the stimuli that influence those problems  management of stimuli to promote adaptation 02/09/17 ROY'S ADAPTATION MODEL 30

31. Application Of RAM Contd... In Education:  Nursing education  Geriatric Nurse-Practitioner Program  University of Ottawa School of Nursing  Mount Saint Mary’s College, Los Angeles 02/09/17 ROY'S ADAPTATION MODEL 31

32. Application Of RAM Contd... In Administration:  A Nursing Philosophy  Mission Statements  Standards of Practice  Job Descriptions  Planning and Appraisal  Quality Monitoring 02/09/17 ROY'S ADAPTATION MODEL 32

33. Strength Of RAM  Use to analyze diverse health care related issues  Analyzes the individual from a broad perspective  Identify the factors affecting the individual and his community  Provide opportunity to understand whole human being  Includes the spiritual aspect of nursing assessment 02/09/17 ROY'S ADAPTATION MODEL 33

34. Weaknesses Of RAM  Inadequate definition of concepts and terms  Complete implementation of the model is perceived as time consuming 02/09/17 ROY'S ADAPTATION MODEL 34

35. Areas Of Practice In Term Of Medical Condition  Cancer patients  Amputations  AIDS management  Alzheimer disease  Anxiety  Chronic pain  Cardiomyopathy  Chronic sorrow  Critical care 02/09/17 ROY'S ADAPTATION MODEL 35

36. Areas Of Practice In Term Of Medical Condition Contd…  Hypernatremia  Intensive care  Postpartum  Leukemia  Osteoporosis  Pediatric  Preoperative  Polio survivor 02/09/17 ROY'S ADAPTATION MODEL 36

37. Areas Of Practice In Term Of Human Development  Adolescents  Caregiver stress  Cesarean section  Emergency  Gerontology  Mental health  Neonates  Nursing administration 02/09/17 ROY'S ADAPTATION MODEL 37

38. Areas Of Practice In Term Of Human Development Contd…  Nursing children  Nursing community  Nursing families  Nursing infants  Palliative care  Pregnancy  Rehabilitation 02/09/17 ROY'S ADAPTATION MODEL 38

39. Areas Of Practice In Term Of Nursing Intervention Condt…  Breastfeeding  Group therapy  Nutrition  Parenting  Spiritual intervention 02/09/17 ROY'S ADAPTATION MODEL 39

40. Implementation of RAM in Rheumatoid Arthritis Ms. F was a patient suffering from Rheumatoid arthritis for the past six years. Nursing assessment using RAM based assessment tool , began during her first visit to Rheumatology polyclinic of sultan Qaboos Hospital , Salalah Omans. 02/09/17 ROY'S ADAPTATION MODEL 40

41. Implementation of RAM in Rheumatoid Arthritis Cont… Initial Assessment Of Physiological Response Mode:  Pain  Poor appetite  Difficulty in swallowing  Difficult to arise in the morning due to joint pain that lasts for 30 minutes 02/09/17 ROY'S ADAPTATION MODEL 41

42. Implementation of RAM in Rheumatoid Arthritis Contd… Initial Assessment Of Physiological Response Mode:  Felt extremely tired after daily activity  Rated her pain on 10 point pain scale as 9  Feel depressed and helpless sometime  Difficult to carryout daily routine 02/09/17 ROY'S ADAPTATION MODEL 42

43. Implementation of RAM in Rheumatoid Arthritis Contd… Assessment of role function mode behavior:  She was working in an insurance office  In beginning changed her shift morning to evening  Resigned because of activity intolerance  Currently unemployed 02/09/17 ROY'S ADAPTATION MODEL 43

44. Implementation of RAM in Rheumatoid Arthritis Contd… Assessment of interdependence mode behavior:  Good relationships with family and friends initially  Later she felt her self as burden on her family 02/09/17 ROY'S ADAPTATION MODEL 44

45. Implementation of RAM in Rheumatoid Arthritis Contd… Initial assessment of self-concept response mode:  Limited activity  Bothered about her loss and upper extremity deformities  Think that other people took him a stranger  Do not want to marry 02/09/17 ROY'S ADAPTATION MODEL 45

46. Implementation of RAM in Rheumatoid Arthritis Contd… Assessment of stimuli: Focal:  disease it self (Rheumatoid Arthritis) Contextual:  Difficulty in swallowing , fatigue , in ability to do daily work Residual:  Personal belief , current health status 02/09/17 ROY'S ADAPTATION MODEL 46

47. Modes Nursing Diagnosis Physiological Response Chronic pain r/t joint inflammation as evidenced by facial expression and verbalization Self-care Body image disturbance r/t chronic disease , long term treatment & dependency as evidenced by social isolation Role function Altered role performance r/t fatigue , pain as evidenced by resigned to her jod interdependence Social withdrawal & isolation r/t altered body image as evidenced by unemployed status 02/09/17 ROY'S ADAPTATION MODEL 47

48. Conclusion RAM identifies essential concepts relevant to the nursing profession. The human adaptive system is constantly interacting with internal and external stimuli which affect individual’s health. It is the responsibilities of nurses to manipulate specific stimuli so as to help patient achieve optimal health. it is useful in analyzing groups, individuals and societies. It is the responsibility of nurses to facilitate adaptation of groups and persons so as to enhance their welfare wand well being. • 02/09/17 ROY'S ADAPTATION MODEL 48

51. Refrences  Retrieved from https://sites.google.com/site/roysadaptationmodel/ho on 25th Jan, 2017  Retrieved from https://sites.google.com/site/culpepperram/ on 25th Jan , 2017  Retrieved from http://www.bc.edu/sites/nurse-theorist/the_roy_adapt on 28th jan 2017 02/09/17 ROY'S ADAPTATION MODEL 51

52. Refrences Contd…  Retrieved from https://en.wikipedia.org/wiki/Adaptation_model_of_nu on 30th Jan , 2017  Retrieved from http://customwritingtips.com/component/k2/item/2118 on 30th Jan , 2017  Radhamaniamma Jayasree. Nursing care of patient with rheumatoid Arthritis – An application of Roy’s Adaptation model. journal of 02/09/17 ROY'S ADAPTATION MODEL 52

53. Refrences Contd… Pharmaceutical & Biomedical sciences (J. pharma biomed sci.)2013,27(27): 482-492. Article No. 11 02/09/17 ROY'S ADAPTATION MODEL 53

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