Roy theory

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Roy theory

  1. 1. Tehran University of Medical Sciences School of Nursing & Midwifery Preparation by: Ahmed waheed mezban MS medical surgical nursing The supervision of: Dr.SHAHSAVARI Tuesday, November 10, 2015 Sister Callista Roy - Nursing Theorist And Dorothy Johnson - Nursing Theorist
  2. 2. Roy's Adaptation Model •Introduction: •Sr.Callista Roy- nurse theorist, writer, lecturer, researcher and teacher •Professor and Nurse Theorist at the Boston College of Nursing in Chestnut Hill •Born at Los Angeles on October 14, 1939. •Bachelor of Arts with a major in nursing - Mount St. Mary's College, Los Angeles in 1963. •Master's degree program in pediatric nursing - University of California ,Los Angeles in 1966. •Master’s and PhD in Sociology in 1973 and 1977. •Worked with Dorothy E. Johnson •Worked as f faculty of Mount St. Mary's College in 1966. •Organized course content according to a view of person and family as adaptive systems. •RAM as a basis of curriculum i at Mount St. Mary’s College •1970-The model was implemented in Mount St. Mary’s school •1971- she was made chair of the nursing department at the college
  3. 3. Assumptions Explicit assumptions •The person is a bio-psycho-social being. •The person is in constant interaction with a changing environment. •To cope with a changing world, person uses both innate and acquired mechanisms which are biological, psychological and social in origin. •Health and illness are inevitable dimensions of the person’s life. •To respond positively to environmental changes, the person must adapt. •The person’s adaptation is a function of the stimulus he is exposed to and his adaptation level •The person’s adaptation level is such that it comprises a zone indicating the range of stimulation that will lead to a positive response. •The person has 4 modes of adaptation: physiologic needs, self- concept, role function and inter-dependence.
  4. 4. • "Nursing accepts the humanistic approach of valuing other persons’ opinions, and view points" Interpersonal relations are an integral part of nursing •There is a dynamic objective for existence with ultimate goal of achieving dignity and integrity. Implicit assumptions: •A person can be reduced to parts for study and care. •Nursing is based on causality. •Patient’s values and opinions are to be considered and respected. •A state of adaptation frees an individual’s energy to respond to other stimuli.
  5. 5. Major Concepts •Adaptation -- goal of nursing •Person -- adaptive system •Environment -- stimuli •Health -- outcome of adaptation •Nursing- promoting adaptation and health •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
  6. 6. 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. 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 •All conditions, circumstances, and influences surrounding and affecting the development and behavior of persons and groups with particular consideration of mutuality of person and earth resources, including focal, contextual and residual stimuli
  7. 7. 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 Nursing: •To promote adaptation in the four adaptive modes •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
  8. 8. Four Adaptive Modes: •Physiologic Needs •Self Concept •Role Function •Interdependence THEORY DEVELOPMENT Philosophical Assumptions: •Persons have mutual relationships with the world and God •Human meaning is rooted in an omega point convergence of the universe •God is intimately revealed in the diversity of creation and is the common destiny of creation •Persons use human creative abilities of awareness, enlightenment, and faith •Persons are accountable for the processes of deriving, sustaining, and transforming the universe
  9. 9. Adaptation and Groups: •Includes relating persons, partners, families, organizations, communities, nations, and society as a whole. Adaptive Modes A. Persons •Physiologic •Self Concept •Role Function •Interdependence B. Groups Physical Group Identity Role Function Interdependence
  10. 10. Adaptation Level • A zone within which stimulation will lead to a positive or adaptive response • Adaptive mode processes described on three levels • Integrated • Compensatory • Compromised Integrated Life Processes: • Adaptation level where the structures and functions of the life processes work to meet needs •Examples of Integrated Adaptation •Stable process of breathing and ventilation •Effective processes for moral-ethical-spiritual growth
  11. 11. Compensatory Processes: • Adaptation level where the cognator and regulator are activated by a challenge to the life processes •Compensatory Adaptation Examples: •Grieving as a growth process, higher levels of adaptation and transcendence •Role transition, growth in a new role Compromised Processes: •Adaptation level resulting from inadequate integrated and compensatory life processes •Adaptation problem •Compromised Adaptation Examples •Hypoxia •Unresolved Loss •Stigma •Abusive Relationships
  12. 12. THE NURSING PROCESS: •RAM offers guidelines to nurse in developing the nursing process. •The elements : •First level assessment •Second level assessment •Diagnosis •Goal setting •Intervention •evaluation
  13. 13. Introduction: Dorothy E. Johnson was born on August 21, 1919 in Savannah, Georgia. She earned her Bachelor of Science in Nursing in 1942 from Vanderbilt University in Nashville, Tennessee. In 1948, she received her Master's degree from Harvard University. During her career, Johnson was an assistant professor of pediatric nursing, an associate professor of nursing, and a professor of nursing at the University of California in Los Angeles. She retired in 1978
  14. 14. Dorothy Johnson-Behavioral Systems Model • The person is a behavioral system comprised of a set of organized, interactive, interdependent, and integrated subsystems • Constancy is maintained through biological, psychological, and sociological factors. • A steady state is maintained through adjusting and adapting to internal and external forces.
  15. 15. Johnson’s 7 Subsystems •Affiliative subsystem - social bonds •Dependency - helping or nurturing •Digestive - food intake •Eliminative - excretion •Sexual - procreation and gratification •Aggressive - self-protection and preservation •Achievement - efforts to gain mastery and control
  16. 16. Johnson’s Concepts 1. Person •A behavioral system comprised of subsystems constantly trying to maintain a steady state 2. Environment •Not specifically defined but does say there is an internal and external environment 3. Health •Balance and stability. 4. Nursing •External regulatory force that is indicated only when there is instability
  17. 17. There are four assumptions about system in the model: • There is "organization, interaction, interdependency and integration of the parts and elements of behaviors that go to make up the system." • A system "tends to achieve a balance among the various forces operating within and upon it, and that man strive continually to maintain a behavioral system balance and steady state by more or less automatic adjustments and adaptations to the natural forces occurring on him." • A behavioral system, which requires and results in some degree of regularity and constancy in behavior, is essential to man. It is functionally significant because it serves a useful purpose in social life as well as for the individual. • "System balance reflects adjustments and adaptations that are successful in some way and to some degree."
  18. 18. The four assumptions about structure and function are that • "from the form the behavior takes and the consequences it achieves can be inferred what 'drive' has been stimulated or what 'goal' is being sought." • Each individual person has a "predisposition to act with reference to the goal, in certain ways rather than the other ways." This predisposition is called a "set." • Each subsystem has a repertoire of choices called a "scope of action." • The individual patient's behavior produces an outcome that can be observed.

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