Nursing Theories 2

Roy's Adaptation Model
Sr.Callista Roy
THEORY DESCRIPTION
The central questions of Roys theory are:
Who is the focus of nursing care? What is the target of nursing care? When is nursing care indicated?
ROY ADAPTATION MODEL CONCEPTS

Adaptation -- goal of nursing Person -- adaptive system Environment -- stimuli Health -- outcome of adaptation Nursing -- promoting adaptation and health
Concepts-Adaptation
Responding positively to environmental changes. The process and outcome of individuals and groups who use conscious awareness, self reflection and choice to create human and environmental integration
Concepts-Person
Bio-psycho-social being in constant interaction with a changing environment Uses innate and acquired mechanisms to adapt An adaptive system described as a whole comprised of parts Functions as a unity for some purpose
Includes people as individuals or in groups-families, organizations, communities, and society as
a whole.
Concepts-Environment
Focal - internal or external and immediately confronting the person Contextual- all stimuli present in the situation that contribute to effect of focal stimulus Residual-a factor whose effects in the current situation are unclear
Concepts-Health
Inevitable dimension of person's life Represented by a health-illness continuum A state and a process of being and becoming integrated and whole
Concepts-Nursing
To promote adaptation for individuals and groups in the four adaptive modes, thus contributing to health, quality of life, and dying with dignity by assessing behaviors and factors that influence adaptive abilities and by intervening to enhance environmental interactions
Concepts-Subsystems
Cognator subsystem A major coping process involving 4 cognitive-emotive channels(perceptual and information processing, learning, judgment, and emotion) Regulator subsystem a basic type of adaptive process that responds automatically through neural, chemical, and endocrine coping channels
Four Adaptive Modes
Physiologic Needs Self Concept Role Function Interdependence
Adaptation and Groups
Includes relating persons, partners, families, organizations, communities, nations, and society as a whole
Adaptation Level
A zone within which stimulation will lead to a positive or adaptive response Three levels 1. Integrated 2. Compensatory 3. Compromised
Integrated Life Processes

Adaptation level where the structures and functions of the life processes work to meet needs
Stable process of breathing and ventilation
Compensatory Processes
Adaptation level where the cognator and regulator are activated by a challenge to the life processes
Role transition, growth in a new role
Compromised Processes
Adaptation level resulting from inadequate integrated and compensatory life processes
Hypoxia
Unresolved Loss
Usefulness of Adaptation Model

Scientific knowledge for practice Clinical assessment and intervention Research variables To guide nursing practice To organize nursing education Curricular frame work for various nursing colleges
Jean Watson's Philosophy of Nursing
The seven assumptions

1. Caring can be effectively demonstrated and practiced only interpersonally. 2. Caring consists of carative factors that result in the satisfaction of certain human needs. 3. Effective caring promotes health and individual or family growth. 4. Caring responses accept person not only as he or she is now but as what he or she may become.
The seven assumptions

5.Caring is more healthogenic than is curing. A science of caring is complementary to the science of curing. 6. The practice of caring is central to nursing. 7. A caring environment is one that offers the development of potential while allowing the person to choose the best action for himself or herself at a given point in time.
The ten primary carative factors

1. The formation of a humanistic- altruistic system of values.
2. The installation of faith-hope. 3. The cultivation of sensitivity to ones self and to others. 4. The development of a helping-trust relationship 5. The promotion and acceptance of the expression of positive and negative feelings.
The ten primary carative factors

6. The systematic use of the scientific problem-solving method for decision making 7. The promotion of interpersonal teaching-learning. 8. The provision for a supportive, protective and /or corrective mental, physical, socio-cultural and spiritual environment. 9. Assistance with the gratification of human needs.
10. The allowance for existential-phenomenological forces.
Watsons ordering of needs

* Lower order needs (biophysical needs) o The need for food and fluid o The need for elimination o The need for ventilation
* Lower order needs (psychophysical needs) o The need for activity-inactivity o The need for sexuality
* Higher order needs (psychosocial needs) o The need for achievement o The need for affiliation o Higher order need (intrapersonalinterpersonal need) o The need for self-actualization
Watsons theory and the four major concepts

Human being refers to .. a valued person in and of him or herself to be cared for, respected, nurtured, understood and assisted; in general a philosophical view of a person as a fully functional integrated self. He, human is viewed as greater than and different from, the sum of his or her parts.
Health
A high level of overall physical, mental and social functioning A general adaptive-maintenance level of daily functioning The absence of illness (or the presence of efforts that leads its absence)
Environment/society
* Caring (and nursing) has existed in every society. * A caring attitude is not transmitted from generation to generation. * It is transmitted by the culture of the profession as a unique way of coping with its environment.
Nursing
* Nursing is concerned with promoting health, preventing illness, caring for the sick and restoring health.
Nursing
It focuses on health promotion and treatment of disease. She believes that holistic health care is central to the practice of caring in nursing
Nursing
She defines nursing as:
a human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic and ethical human transactions.
From Novice to Expert Patricia E. Benner
LEVELS OF NURSING EXPERIENCE

1. 2. 3. 4. 5. Novice Advanced beginner Competent Proficient Expert
Novice
Beginner with no experience Taught general rules to help perform tasks Rules are: context-free, independent of specific cases, and applied universally Rule-governed behavior is limited and inflexible
Ex. Tell me what I need to do and Ill do it.
Advanced Beginner
Demonstrates acceptable performance Has gained prior experience in actual situations to recognize recurring meaningful components Principles, based on experiences, begin to be formulated to guide actions
Competent
Demonstrates acceptable performance Has gained prior experience in actual situations to recognize recurring meaningful components Principles, based on experiences, begin to be formulated to guide actions
Competent
Gains perspective from planning own actions based on conscious, abstract, and analytical thinking and helps to achieve greater efficiency and organization
typically a nurse with 2-3 years experience on the job in the same area or in similar day-to-day situations
Proficient
Perceives and understands situations as whole parts More holistic understanding improves decisionmaking Learns from experiences what to expect in certain situations and how to modify plans
Expert
No longer relies on principles, rules, or guidelines to connect situations and determine actions Much more background of experience Has intuitive grasp of clinical situations Performance is now fluid, flexible, and highlyproficient

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Roy's Adaptation Model

ROY ADAPTATION MODEL CONCEPTS

Four Adaptive Modes

Physiologic Needs Self Concept Role Function Interdependence

Adaptation and Groups

Integrated Life Processes

Stable process of breathing and ventilation

Usefulness of Adaptation Model

Jean Watson's Philosophy of Nursing

The seven assumptions

The seven assumptions

The ten primary carative factors

The ten primary carative factors

10. The allowance for existential-phenomenological forces.

Watsons ordering of needs

Watsons theory and the four major concepts

From Novice to Expert Patricia E. Benner

LEVELS OF NURSING EXPERIENCE

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