INSTITUTE OF HEALTH

FACULTY OF HEALTH SCEINCE

SCHOOL OF NURSING

INDIVIDUAL ASSIGNMENT ON CRITICUE OF ROY ADAPTATION

MODEL

PREPARED BY: SERKALEM ASCHALEW (MSc IN PEDIATRICS

AND CHILD HEALTH NURSING STUDENT)

SUBMITTED TO: Dr ASRESASH DEMISSIE

DATE OF SUBMISSION: JANUARY, 2022

JIMMA, ETHIOPIA
Acknowledgment:
First and foremost, I would like to express my gratitude to our Teacher, Dr. Asresash Demissie,
for allowing me to evaluate this model and improve my critique skills.

Second, I would like to express my gratitude to the librarians at Jimma University Post Graduate
for lending me a book and allowing me to use their internet access.

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Table of Contents
Acknowledgment:.......................................................................................................................................I
1.1. Introduction..........................................................................................................................................1
1.2. Objective..............................................................................................................................................2
1. 3.Major Assumption................................................................................................................................2
1.3.1. Scientific assumptions...................................................................................................................2
1.3.2. Philosophical assumptions.............................................................................................................2
1.3.3. Cultural assumption.......................................................................................................................2
1.4. Major concept Roy adaptation model...................................................................................................3
1. 4.1.Person:...........................................................................................................................................3
1.4.2. Environment:.................................................................................................................................3
1.4.3. Health:...........................................................................................................................................4
1.4. 4. Nursing:........................................................................................................................................4
1.5. Four adaptive modes.............................................................................................................................5
1.5.1. Physiological-Physical modes.......................................................................................................5
1.5.2. Self-Concept Group Identity Mode................................................................................................5
1.5.3. Role Function Mode......................................................................................................................5
1.5.4. Interdependence Mode...................................................................................................................5
1.6. Levels of Adaptation............................................................................................................................7
1.6.1. Integrated process..........................................................................................................................7
1.6.2. Compensatory Process...................................................................................................................7
1.6.3. Compromised Process...................................................................................................................7
1.7. Six-Step Nursing Process.....................................................................................................................8
1.8. Critique.................................................................................................................................................8
1.9. Strength and Weaknesses of theory....................................................................................................10
1.10. Conclusion........................................................................................................................................11
1.11. Preference........................................................................................................................................12

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1.1. Introduction
Sister Callista Roy

Sr.callista Roy was a prominent nurse theorist, writer, lecturer researcher and teacher professor
and nurse theorist at the Boston College of Nursing in Chestnut Hill. She was born at Los
Angeles on October 14, 1939 as the 2 nd child of Mr. and Mrs. Fabian Roy she earned a bachelor
of arts with a major in Nursing from Mount St. Mary’s College, Los Angeles in 1963. A master’s
degree program in pediatrics nursing at the University of California, Los Angeles in 1966.she
also earned a master’s and PHD in Sociology in 1973 and 1977, respectively
(Phillips,2010,p.335).

Roy Developed the basic concepts of her model while she was graduated student at the
University of California Los Angele after begin challenged by Dorothy E Johnson in seminar to
develop a conceptual model of nursing. The Roy adaptation model was first published in 1970.

Since that time, Roy has published many books and article and presented Nemours lecture
focusing on model it is use in nursing practice. She has also continued to refine and redefine the
model (Roy, 2009; Roy and Andrews, 1991, 1999) and has been awarded many honors for her
contribution to nursing theory, practice, research and education (Phillips, 2010).

Roy credits harry helson’s adaptation theory for playing a key role in her early thinking and
developments of her own model .she also credits rapopor’s definition system as well as concepts
from Lazarus and selye (Roy and Roberts, 1981). The main task human system is to maintain
integrity in the face of environmental stimuli (Phillips, 2010).

According to Roy and Andrew (1999), Adaptation refers to “the process and outcome thereby
thinking and feeling persons as individual or in a groups use conscious awareness and choice to
create human and environmental integration(p,54).Adaptation lead to optimal health and
wellbeing to quality life and to death with dignity(Andrews and Roy,1991).an integrated
compensatory and compromise life process , which attempt to reestablish adaptation .if the
compensatory processes are not adequate compromised processes result(Roy, 2009.p.33).

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1.2. Objective
 Know the Goal of Roy adaptation theory
 List Assumptions of Roy adaptation theory
 Identify major Concepts of Roy adaptation theory
 Discuss Meta-paradigm of Roy adaptation theory
 Critique of Roy adaptation theory
 Strength and weakness of Roy adaptation model

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1. 3.Major Assumption
1.3.1. Scientific assumptions
 Integration of human and environmental meanings results in adaptation(Roy,2009,P.31)
 Awareness of self and environment is rooted in thinking and feeling.
 Thinking and feeling mediate human action.
 System of matter and energy progress to higher levels of complex self-organization.
 Consciousness and meaning are constructive of person and Environment integration.
 Human by decision are accountable for the integration of creative processes.
 Person and environment transformations are created in human consciousness.
 Person and the earth have common patterns and integral relationship.

1.3.2. Philosophical assumptions

 Persons have mutual relationships with the world and God.
 Persons are accountable for the processes of deriving, sustaining, and transforming the
universe (Roy, 2009, P.31).
 Human meaning is rooted in the omega point convergence of the universe.
 God is intimately revealed in the diversity of creation and is the common destiny of
creation.
 Person use human creative ability of awareness, enlightenment and faith.

1.3.3. Cultural assumption

 Integration of cross cultural experience
 Cultural needs and necessity to eliminate culture-bound analysis of key concepts.
 A concept central to the culture may influence the Roy adaptation model to some extent.
 Cultural expressions of the Roy adaptation model may lead to changes in practice
activities such as nursing assessment.

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1.4. Major concept Roy adaptation model

1. 4.1.Person:
According to the Roy adaptation model humans are holistic and adaptive system “The human
system Describe as the whole with parts that function as unity for some purpose. Human system
include people individual, or in a groups, including family, organizations, communities and
society as a whole (Roy and Andrews, 1999, p.31). The Person specifically defined as “an
adaptive system with cognator and regulator subsystems acting to maintain adaption in the four
adaptive models” (Roy, 2009, p.12). Humans are holistic beings that are in constant interaction
with their environment Bio psycho social. Humans use a system of adaptation, both innate and
acquired, to respond to the environmental stimuli they experience.

1.4.2. Environment:
Environment is the second major concept of the model.it is understood as the world within and
around humans as adaptive systems. (Roy, 2009, p.46). The Environment refers to “all condition,
circumstances and influences surrounding and affecting the development and behavior of the
persons and groups, with particular consideration of a mutuality of a person and earth
resource.”(p.12).it is the changing environment that stimulates the person to make adaptive
responses (Andrews and Roy,1991,p,18).Factor in the environment that affect person are
categorized as focal, contextual, residual stimuli(Phillips,2010,p.343).

The Three environmental stimuli

Focal stimuli:- refer to the stimuli that are most immediately confronting a person.  

Contextual stimuli: - are all other stimuli that might have a positive or negative influence on the
situation. 

Residual stimuli:-are internal and external factors that may be affecting the individual or group.

1.4.3. Health:
Health is “a state and process of being and becoming integrated and whole that reflects person
and environment mutually” (Roy, 2009, p.12).in her early writings, Roy about health as existing
along a continuum; she now view this conceptualization of health as “simplistic and unrealistic

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since it does not accommodate the coexistence wellness and illness and includes individuals
chronic disabilities or terminal illness who in spite of their condition are dealing effectively with
life changes”(p.46-47). During the 1999 Roy’s writings began focus to on health as a process on
which health and illness coexist (Roy and Andrews,1999;Phillips,2010,p.342).in either
conceptualization health is viewed as a reflection of adaptation(Roy and Andrew,1991,p.21).

1.4. 4. Nursing:
Roy defines nursing as a “health care profession that focus on human life processes and pattern
of people with a commitment to promote health and full life potential for individuals ,families
,groups and the global society” (Roy,2009,p.3).she defines nursing as the science and practice .
The goal of nursing is” to promotion of adaptation for individuals and groups in four adaptive
models, thus contributes to health ,quality of life and dying with dignity by assessing behavior
and factors that influence adaptive abilities to enhance environmental factors” (Roy,2009,p.12)

Internal process

Regulator
The regulator subsystem is works primarily through the use of the autonomic nervous system in
making physiologic adjustments (Roy, 1976). Stimuli from internal and external environment act
as through the sense to the nervous system thereby affecting the fluid, electrolyte and acid base
balance as well as the endocrine system.

Cognator
The cognator subsystem processes that are related to brain functions such as Perception,
judgment, learning, and emotion. The behavior view inputs of the human system and take of
either adaptive response and ineffective response the response serves as feedback to the system
with human system using this information to decide whether they increase or decrease its effort
to cope with the stimuli (Roy, 2009,p.34)

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1.5. Four adaptive modes

1.5.1. Physiological-Physical modes

Physical and chemical processes are involved in the function and activities of living organisms.
These are the actual processes put in motion by the regulator subsystem.

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.

1.5.2. Self-Concept Group Identity Mode

In this mode, the goal of coping is to have a sense of unity, meaning the purposefulness in the
universe, and a sense of identity integrity. This includes body image and self-ideals.

1.5.3. Role Function Mode

Refers to the roles that individuals occupy in society fulfilling the need for social integrity, it
knows who one is, in relation to others.

1.5.4. Interdependence Mode

This mode focuses on attaining relational integrity through the giving and receiving of love,
respect and value. This is achieved with effective communication and relations.

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 1.6. Levels of Adaptation

1.6.1. Integrated process

The various modes and subsystems meet the needs of the environment. These are usually stable
processes (e.g., breathing, spiritual realization, successful relationship).

1.6.2. Compensatory Process

The cognator and regulator are challenged by the environment’s needs but are working to meet
the needs (e.g., grief, starting with a new job, compensatory breathing).

1.6.3. Compromised Process

The modes and subsystems are not adequately meeting the environmental challenge (e.g.,
hypoxia, unresolved loss, abusive relationships).

Person as adaptive system

Effectors
Control
process Physiologic
Input Out-put
Self-concept
stimuli Regulator
or coginator Role-function Adaptive or
Iinterdependence
ineffective

Feed back
Adaptation level

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1.7. Six-Step Nursing Process
In the Adaptation Model, a nurse's job is to manipulate stimuli by eliminating, decreasing,
increasing, or altering them such that the patient feels better

1. Assess the behaviors manifested from the four adaptive modes.

2. Assess the stimuli; categorize them as focal, contextual, or residual.
3. Make a statement or nursing diagnosis of the person’s adaptive state.
4. Set a goal to promote adaptation.
5. Implement interventions aimed at managing the stimuli.
6. Evaluate whether the adaptive goal has been met.

1.8. Critique
Purpose

The Roy adaptive model's goal is to make it easier for a patient to recover through adaptation by
describing the four adaptive modes and their associated stimuli, and then sketching an
intervention, which involves assessing the patient's overall well-being and identifying potential
dangers.

Concept

Because each adaptive mode is defined and requires its own intervention, the theory's concept is
broad and a little difficult to comprehend and apply. Nursing activities, commonly referred to as
the nursing process, are a central element in the Roy Adaptation Model. The concepts can be
defined in the text in a list of definitions or narrative forms, but because they are not labeled as
definitions, they are difficult to find and contain information that is not directly relevant to the
concept's definition. The met paradigm concepts are included in the Roy Adaptation model,
which contains a large number of defined concepts. Roy Adaptation explains five major nursing
concepts: person, goal, health, and safety.

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Definitions

Definitions stated in the Roy adaptive theory are clear and every single word that needs special
definitions are defined well.

Structure

The Roy adaptive model's structure is difficult to comprehend without a thorough

comprehension of the concept. It is also difficult to analyze without a thorough understanding of
the concept. It is suggested that the concept of a person as an adaptive system overlaps. If the
adaptive modes are balanced, effective adaptation can be obtained. However, the entire
adaptation process appears to be linear, with an ill or unwell person being influenced by the input
(stimuli and adaptation level). As a coping strategy, the control process (regulator and cognator)
must be activated in response to the input, which impacts the effectors (four adaptive modes) and
resulting in output (adaptive or ineffective response).

Relationships-

The relationships in the theory are both accurate and simple to comprehend. The links between
concepts are well-presented and well-established in the vast majority of cases. Some concepts are
connected, although they are generally distinct. Roy organized the frameworks in a way that
made the principles clear. The model presents all possible links between variables in a
methodical manner, resulting in a plethora of theoretical hypotheses. Earlier research
investigations, on the other hand, focused on the well-understood physiological occurrence rather
than a nursing phenomenon. To meet evolving global needs, it eventually evolved in a
concentration on group identity's behaviors toward internal and environmental stimuli. Roy
wants the model's relationships to be nonlinear and multivariate, rather than linear.

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Clarity:

The basic concepts, subsystems, and four modalities of adaptation are all well-defined and
understandable. However, a more comprehensive description of primitive analogues is required.
Her model's concept arrangement is reasonable; but, in comparison to her original format, the
growth of definitions in her model is inadequate. Furthermore, terms and concepts acquired from
other fields are not limited to the nursing profession. contains clearly-defined concepts as well as
a logical structure that may be followed.

Simplicity- a complex theory is densely packed with useful information, but properly
comprehending it needs a great amount of effort and rereading. Because it contains several major
concepts, sub-concepts, structures, and other numerous relationship claims, the Roy adaption
model is not sparse. It's comprehensive, and it tries to clarify the clients' realities so that nursing
treatments can be tailored to their individual requirements.

Generality-

It covers a wide range of nursing scenarios that can be used in case studies and nursing
phenomenon. A theory with broad concepts will encompass more ideas in fewer words than one
with confined notions. Roy's model can be used in a variety of therapeutic settings, including
both inpatient and outpatient settings, but it is limited in breadth because it primarily tackles the
concept of person-environment adaptation and concentrates on the patient.

Accessibility - putting the theory into practice in everyday practical nursing encounters is
difficult, if not impossible.

Importance - Critical since it provides unique viewpoint on nursing as a whole and has aided in
the development of numerous middle- range theories.

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1.9. Strength and Weaknesses of theory
1.9.1. Strength

 Every concept was well-defined in terms of how it will work in practice.

 The concepts were logically sorted in their sequence.
 Roy's model's concepts are laid forth in a straightforward manner.
 It instructs nurses on how to conduct an individual assessment of each person using
observation and interviewing skills.
 Her idea could be used in a variety of nursing practice contexts.

1.9.2. Weakness
 It took a long time to figure out what was going on in theory.
 It's difficult to use in an emergency situation where you need to react quickly.
 The person may have gone through the entire adaption process without the benefit of a
comprehensive assessment that would have allowed for comprehensive nursing
interventions.
 Individual adaptive responses may differ and take longer in some cases than in others.
 As a result, the time of the patient's release may limit the nurses' scope of oversight.
 The nurses' roles were not explicitly stated when an individual exhibits an ineffective
response during the adaption phase.
 The concept's major goal was to encourage adaptation, but there was no mention of how
to prevent and resolve maladaptation.

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1.10. Conclusion
The Use of Roy Adaptation theory in nursing provide nurses to focus on the role of nursing and
its applications rather than medical practice .The theory helps patient care to be systematic,
purposeful, controlled and effective. The aim of this theory is to increase compliance and life
expectancy. Roy adaptation theory evaluates the patient in physiologic, self-concept, role
function and interdependence modes aiming to provide holistic care.

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1.11. Preference
1. Phillips K.D (2010) Sr. callista Roy: Adaptation model in A.M Tomey & M.R Alligood (Eds).
Nursing theory and their work (7th edd.,pp.335-365). Mary land heights M.O: Mosby.

2. Andrew, H.A. and Roy, C. (1991). Overview of the physiologic mode. In George, J.
(Ed.). Nursing theories: the base for professional nursing practice. Norwalk, Connecticut:
Appleton & Lange

3. Roy, C. and Adrews, H. A. (1999) The Roy adaptation mode. l (2nd ed). In McEwen, M. and
Wills, E. (Ed.). Theoretical basis for nursing. USA: Lippincott Williams & Wilkins

4. Roy,Sr.C..(2009).Roy Adaptation model (3rd ed.).upper saddle, river NJ: Pearson.

5. Roy, Sr.C,& Robert, S.(1981).Theory constriction in nursing :an adaptation model.

Englewood cliff, NJ.prentice-hall.

6. Roy, Sr. C and Adrews,H.A(1991),The Roy Adaptation model:the definitive statement

Norwalk, CT, Appleton & lange.

7. Wills M. Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing. Philadelphia.

Lippincott Williams & Wilkins

8. Andrew, H.A. and Roy, C. (1991).Essentials of the Roy Adaptation model. In Sr. C .Roy &
H.A Andrews(Eds), The Roy adaptation mode: definitive statement (pp,2-25),Norwalk, CT:
Appleton & lange.

9. Roy, C. and McLeod, D. (1981) The person’s theory as an adaptive system. In George, J.
(Ed.). Nursing theories: the base for professional nursing practice. Norwalk, Connecticut:
Appleton & Lange.

10. Wills M. Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing. Philadelphia.

Lippincott Williams & Wilkins

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