Sister Callista Roy developed the Adaptation Model of Nursing in the 1960s based on her observations of how individuals adapt to changes in their environment. The model views people as adaptive systems that interact with stimuli from the environment. There are four modes of adaptation: physiological, self-concept, role function, and interdependence. The goal of nursing according to the model is to promote positive adaptation by increasing adaptive responses and decreasing ineffective responses. The model has been widely applied in nursing research, education, and practice to understand how patients cope with illness or adversity.
Martha Rogers’s Science of Unitary Human Beings...simplified...with a case sc...Karen V. Duhamel
This PowerPoint is a comprehensive overview of Martha Rogers's abstract conceptual model of the Science of Unitary Human Beings, with a simplified description of her model, including a case scenario illustrating key conceptual principles.
Martha Rogers’s Science of Unitary Human Beings...simplified...with a case sc...Karen V. Duhamel
This PowerPoint is a comprehensive overview of Martha Rogers's abstract conceptual model of the Science of Unitary Human Beings, with a simplified description of her model, including a case scenario illustrating key conceptual principles.
Orlando's theory is a interrelate concepts. Many various theorist have describe different classification of this theory. It is a Middle Range Nursing Theory However all have shown it is an interactive type of theory
1. To be able to differentiate, apply and identify the various models of nursing theories and approaches in all phases of life.
2. To know the essential value of formal nursing conceptual models and understand the provision of a shared view of the metaparadigm concepts (person, environment, health and nursing).
3. Be able to focus on nursing's role: to work with patients to manage their health problems/life processes.
Madeleine Leininger’s Culture Care: Diversity and Universality TheoryBankye
“A substantive area of study and practice focused on comparative cultural care (caring) values, beliefs, and practices of individuals or groups of similar or different cultures with the goal of providing culture-specific and universal nursing care practices in promoting health or well-being or to help people to face unfavorable human conditions, illness, or death in culturally meaningful ways.”(P.58)
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Orlando's theory is a interrelate concepts. Many various theorist have describe different classification of this theory. It is a Middle Range Nursing Theory However all have shown it is an interactive type of theory
1. To be able to differentiate, apply and identify the various models of nursing theories and approaches in all phases of life.
2. To know the essential value of formal nursing conceptual models and understand the provision of a shared view of the metaparadigm concepts (person, environment, health and nursing).
3. Be able to focus on nursing's role: to work with patients to manage their health problems/life processes.
Madeleine Leininger’s Culture Care: Diversity and Universality TheoryBankye
“A substantive area of study and practice focused on comparative cultural care (caring) values, beliefs, and practices of individuals or groups of similar or different cultures with the goal of providing culture-specific and universal nursing care practices in promoting health or well-being or to help people to face unfavorable human conditions, illness, or death in culturally meaningful ways.”(P.58)
Grant, Pay for college, government grant
How to get a $25,000 FREE cash grant http://bit.ly/35YY2X1
Nursing Simulation Reflection Paper
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Nursing Admission Essay Sample
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My personal philosophy on nursing. Every nurse views the profession as something different based on their own personal philosophies, so I'm glad I can share this!
Running Head PERSONAL PHILOSOPHY OF NURSINGPERSONAL PHILOSOPHY .docxgemaherd
Running Head: PERSONAL PHILOSOPHY OF NURSING
PERSONAL PHILOSOPHY OF NURSING
Personal Philosophy of Nursing
Personal Philosophy of Nursing
Keeping in mind the end goal to compose a philosophy of nursing, I trust that initial one must choose what philosophy intends to nurse practitioners. I think Meehan, (2012) expressed it best when she stated that philosophy is an approach toward life and realism that advances from every nurse practitioner convictions. This explanation gives me the opportunity to apply my own convictions. I don't need to acknowledge what another person has chosen. Scientists have been debating for quite a long time whether nursing is an art or a science. For what reason would it be able to not be both? I trust that to be a successful nurse practitioner someone must have the capacity to give the "art" of caring, and have the ambition to proceed to achieve and use the knowledge of "science" all through nursing profession. According to Jasmine (2009), nursing can be recognized as both science and art, in which caring formulates the nursing’s theoretical framework. Nursing and caring are based on a relational unity, understanding, and association between the patient and professional nursing. This idea is also echoed by Rose and Whitman (2003) in their article Using Art to Express a Personal Philosophy of Nursing. Whitman and Rose (2003) argue that one approach of isolating the influential and sensitive parts of nursing is to manage caring as the art of nursing. Without caring, the nurses and nurse practitioners can't unite with the patient. On the off chance that the practitioner can't unite, confidence won't develop. Without this faith in connection, helpful nursing won't occur. In this manner caring is at the focal point of all-effective nursing experiences. This isn't to make light of the worth of science. A proficient medical practitioner must have the capacity to utilize technical means accessible. The nursing practitioner ought to know about the life structures and physiology of the human body, pathology and recent rules for pharmacological treatment. This is a consistently changing body on learning. Science likewise incorporates the ability required to perform specialized undertakings. Nurse Educator model clarifies the science behind proficiency achievement. As medical practitioners we are all on a field to accomplish "expertise" in to each of the seven domains of skills.
As a nurse, I should first consider the idea of individuals. A man is substantially more than a person made through genomic technology and environmental impacts. They are considerably more prominent than the whole of his or her parts. They are a portion of the family, philosophy and society. I trust that adopting a patient focused strategy enables all people to be tended to, regarded and urged to achieve their maximum capacity. It is fundamental that the nurse practitioner perceive culture assorted range and racial variations, endeavoring to tre ...
UNIT-IV M.Sc I year THEORIES APPLIED IN COMMUNITY HEALTH NURSING.pptxanjalatchi
What are theories and models of nursing?
Image result for community health nursing theories and models
Four major concepts are frequently interrelated and fundamental to nursing theory: person, environment, health, and nursing. These four are collectively referred to as metaparadigm for nursing. Person, Nursing, Environment, and Health – the four main concepts that make up the nursing metaparadigm.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. Sister Callista Roy Born 1939-present Member of the Sisters of Saint Joseph of Carondelet BSN, MSN, Masters and Doctorate of Sociology Professor, clinical nurse scholar, nurse theorist, author
3. Becoming of the Model While working on masters, was mentored by Dorothy Johnson Challenged to develop a conceptual model Roy noticed the resiliency of children and change Intrigued by adaptation becoming the eventual framework
4. Becoming of the Model cont 1968: Operationalization 1970: Literature debut 1977: Model presentation
5. Basis of Adaptation Model Harry Helson Rapoportdefinition Combination became definition of a person as an adaptive system Dohrenwend, Lazarus, Mechanic, and Selye Biological, and behavioral sciences Underpinnings Johnson’s behavioral model
6. Statement of theory “The goal of nursing is to promote adaptation for individuals and groups in each of the four adaptive modes, thus contributing to health quality of life, and dignity with dying” (Roy 1999, p. 19)
7. Main premise of theory “When push comes to a shove, we will seldom disappoint ourselves. We all harbour greater stores of strength than we think. Adversity brings the opportunity to test our mettle and discover for ourselves the stuff of which we are made.Do not underestimate the power of a person to cope. He may be dependent now but deep within him lies the energy to adapt” http://nursingtheories.blogspot.com/2008/07/sister-callista-roy-adaptation-theory.html
8. My view of the RAM I believe the adaptation model as a framework used to see a person who is constantlyinfluenced by their environment; people have the chance to positively respond to their environment and adapt, or fail at adapting. It is the nurse who guides us in the succession of adaptation.
14. Main concepts Two internal mechanisms for adaptation Regulator Cognator Four adaptive modes physiological-physical needs self concept group identity role function interdependence
17. Nursing Implications Goal is directed to establishing adaptation Contribute to health, quality of life and dying with dignity Roy Adaptation Model Nursing Process Assessment of behavior Assessment of stimuli Nursing diagnosis Goal setting Nursing intervention Evaluation
20. Tools/Instruments Used to measure perceptions of powerlessness in decision making Health care outcomes for cancer patients Framework for adult survivors of multiple traumas Describe relationship between nursing intervention and interpretation of results Used as a basis for checklist for problematic behavior prediction
21. Application of theory to practice Middle range theory areas Caregiver well being Coping with pain Coping with chronicity
22. Practice reflection/problem This is not the first situation that came to mind as I was reflecting this question, but this is the most appropriate situation, I believe for this exercise. There was a woman in her 40s who presented to the ED with a c/c of assault. She was pregnant, had been vomiting, and was assumed to have taken some type of psychoactive medication due to her erratic behavior. She was uncooperative with her nurse and was yelling, crying, refusing to take her medication, and refusing a urine specimen. After about one hour of trying to coerce compliance with the woman, my colleague desperately came to me and asked if I could “try to talk some sense into this lady”. “Therapeutic communication is not my strong point Marian, you know that”, was my response. However, we have a very tight nit bond of nurses in our department, and I felt my obligation to help. I proceeded into the room with a plan to place myself in an inferior position as to elicit a feeling of safety and comfort. I said nothing as I entered the room and immediately turned the lights taking a blanket from the shelf for her. I sat down in the chair next to her and said absolutely nothing for what felt like an eternity. Finally, I asked her how I could help her. She did not respond and I sat there for yet another eternity. When I stood up to walk out she told me to sit back down. Finally she began to talk, and might I add, for a VERY long time agreeing to comply with the treatment plan. I was thoroughly convinced that I was not going to be able to help this woman, but I was determined to try. I believe that all patients, even the most difficult ones, want help. Some people have great difficulty relinquishing control and giving trust to others. Therefore, I believe that by turning the lights off, I created a safety ground for her because she did not have to look at me. With the blanket, I showed compassion and offered her comfort. With my silence, I offered a willingness to help without saying so. By sitting in the chair, I made myself an equal instead of a superior. This was one of “proud” moments in my nursing career. I touched someone that was untouchable by others. And my fellow nurses were so shocked when I came back to the nursing station with a urine specimen they thought I voided in the cup myself! Although this was a difficult situation for the both the patient and I, I would have wanted the nurse to treat my mother or my sister just as I had treated her. I slept quite well that night.
23. Practice reflection/problem Moreno, M., Duran, M., & Hernandez, A. (2009). Nursing care for adaptation. Nursing science quarterly. Jan, 67-73.
24. Research articles Wright, P., Holcombe, J., Foote, A., & Piazza, D (1993). The Roy adaptation model used as a guide for the nursing care of an 8 year old child with leukemia. Journal of Pediatric Oncology 10(2), 68-74. Sercekus, P. & Mete, S. (2009). Effects of antenatal education on maternal prenatal and postpartum adaptation. Journal of Advanced Nursing Dec, 999-1010.
25. Conclusion RAM is a complex theory RAM lends many applications to education and research RAM theorizes that people are adaptive systems constantly influenced by stimuli Nursing is used to increase adaptive behaviors Nursing is used to decrease maladaptive behaviors
26. References Alligood, M, & Tomey, A. (2010). Nursing theorists and their work: 7th ed. Maryland Heights MO: Mosby. Meleis, A. (2007). Theoretical nursing:4th ed.. Philadelphia: Lippincott William & Wilkins. Moreno, M, Duran, M, & Hernandez, A. (2009). Nursing care for adaptation. Nursing Science Quarterly, 22(1), 67-73. Peterson, S, & Bredow, T. (2009). Middle range theories application to nursing research: 2nd ed. Philadelphia: Lippincott William & Wilkins. Roy, C, & Andrews, H. (1999). Roy adaptation model. Stanford CT: Appleton & Lange. Roy, S.C. (1988). An Explication of the philosophical assumptions of the roy adaptation model. Nursing Science Quarterly, 1(26), 26-34. Sercekus, P, & Mete, S. (2009). Effects of antenatal education on maternal prenatal and postnatal adaptation. Journal of Advanced Nursing, Dec, 999-1010. Sister callistaroy. (2008, July). Retrieved June 1, 2010 from http://nursingtheories.blogspot.com/2008/07/sister-callista-roy-adaptation-theory.html Wright, P, Holcombe, J, Foote, A, & Piazza, D. (1993). The Roy adaptation model used as a guide for the nursing care of an 8 year old child with leukemia. Journal of Pediatric Oncology Nursing, 10(2), 68-74.
Editor's Notes
-Sister Callista Roy was born in October 1939 in California-She is a member of the Sisters of Saint Joseph of CarondeletShe received undergraduate degrees in nursing, has both a masters and doctorate in sociology-She held professor status at Mount St Mary’s College and was a postdoctoral fellow at University of California-Roy has authored many books and articles and has received numerous personal and professional achievement recognitions
- Roy was challenged by Johnson to create a model for nursing; Roy, a pediatric nurse at the time, had great interest in children and their ability to adapt especially in the face of great physical and psychological changes
First operationalizedat Mount St Mary’s college as foundation of nursing school; 1977 model was presented Nurse Educator Conference
Roy used HerryHelson’s adaptation theory as a basis for her her own model, which statrs that an adaptive response is a function of stimuli; he further defines a stimulus as anything that can elicit a response; this may be internal or external; his work defined the “adaptation zone” which defines whether the response is perceived with a positive or negative outcome; if it is a positive outcome, the person is considered to have adapted to the stimulusWith Helson’s work and Rapoport’s definition of system, the person is now considered an “adaptive system”Dohrenwend, Lazarus, Mechanic and Syle further outline self integrityOther sciences were cited to help to understand persons
Roy’s theory states that a person is constantly interacting with a changing environment; when he or she cannot respond effectively, nursing is needed; when nursing has allowed the person to respond effectively, and therefore has adapted, nursing is no longer needed.
I would like to take this opportunity to reflect on my practice problem from earlier in the semester. I believe the RAM fits this situation quite well. My problem was a patient who presented to the ED with a c/o of assault and had been previously uncooperative and noncompliant with the recommended treatment plan. It was through my nursing care and interventions, that I was able to help her realize that I was, in fact, aiding her to comply with the treatment plan to help her. The RAM states that nursing is used to help the patient change maladaptive behaviors into positive adaptation.
Person is an adaptive system made of parts; Environment is internal or externalHealth is the process of becoming wholeNursing is a function to achieve adaptation
-environment refers to all conditions and circumstances that affect the behavior of people-stimuli may be focal, contextual or residual-health is a state/process of becoming wholeAdaptation- positive response to stimuli which creates integration of human and environmentIneffective responses- negative response to stiumuli which do not contribute to the goals of peopleAdaptation level- integrated, compensatory, compromisedNursing- practice which aids in expanding adaptive abilities; goal of nursing is to help in achieving the 4 adaptive modes
-According to Alligood, human systems are complex and adapt to many different stimuli to achieve adaptation; furthermore, these systems work together to achieve a purposeA few of the scientific assumptions believe that awareness of self and environment is based on thinking and feeling which go on to mediate hman action. Acceptance, protection and independence are system relationships, and that the integration of human and environment result in adaptationPhilosophical assumptions believe that we have relationships with God and others; God is the creator, and that we as humans are responsible for the universe.Implicit assumption believes that people can be reduced to parts for study and care, nursing is based on causality and that people’s opinions and values should be respected; A quote from Roy “Individual persons, their perceptions and their experiences are the starting point of nursing”Humanism states that people are essential to knowing- the principles include holism, purposefulness, activity and activityAlligood text states that veritivity “affirms in the belief of the purpose, value and meaning of all human life” According to Roy, (2008) her own meaning of veritivity “refers to the principle of human nature that affirms a common purposefulness of human existance”.
-Regulator mechanism is recognized as the autonomic nervous system to respond to stimuli and the environment; this includes the nervous and hormonal systems; mechanical responses are a result of the input of stimuli-Cognator system- applies a meaning to the stimuli to attach feeling to a behavior; parts of the cognator mechanism inclue coding, memory, learning, judgement, and emotion. Because these concepts cannot be measured directly, the resultant behaviors are evaluated. These are then classified into one of the four adaptive modes. -Input is sent through the internal mechanisms and produces an expected response
Physiological mode includes the basic necessities to maintain the physical integrity of a being; includes nutrition, elimination, activity rest, protection, fluid/electrolytes-Self concept- beliefs and feelings about oneself; the underlying needs are spiritual; self is broken into the physical self and the personal self; physical self includes concepts such as appearance ,attributes and sexuality; personal self includes values, worth and the moral-ethical-spiritual self. -Role function- social integrity and the need to know how to act-Interdependence- need to feel secure in nurturing relationships.
Circular diagram of the RAM. On the left hand side, you see the incoming stimuli. The stimuli are affecting the physiologic, selfconcept, interdepedence, or role function modes. Each of these modes are interrelated and share similar circles. The coping process is superimposed on the mode circles. Pointed outward from the coping process is the behavior which has been processed and ends in the adaptation circle. The fact that the diagram is circular and not linear represents, the constant fluid and dynamic movement of incoming stimuli and resultant behaviors.
Roys’ six step nursing process is similar to the 5 step nursing process we are familiar with; an added exception to the assessment of stimuli which is affecting the particular behaviorBehavior- is judged as being adaptive or ineffective; Stimuli- nurse identifies the stimuli and the eliciting response of the effect on the behavior. Based on the assessment, nursing diagnoses are made and goals are set. It is through the intervention step that the stimuli are manipulated. In the evaluation stage, ineffective or maladaptive behaviors are reassessed in an attempt to reach a common goal of adaptive behavior. According to Roy (2008) the processes of each adaptive mode is viewed as the middle range theories that make up the knowledge of how integration takes place.
Internal criticism according to Peterson and Bedrow concerns the fit of the internal components of the theory and their relationship to each other.Royswork is a conceptual model which describes the theory that the person is an adaptive system; it is an abstract model.-Adequacy: systematic model which is synthesized from other models in different disciplines; Clarity: Roy clearly defines the metaparadigm concepts and the four adaptive modes; philosophical concepts are difficult to understand; Consistency: physiological mode is concrete which lacks congruency from the other three modes; Logical Development- central concept of adaptation is shown to be true; however the philosophical assumptions that the model is based upon does launch into unproven territoryLevel of Theory Development- Meleis describes it as being “exemplary” and has been used to develop middle and situation specific theories. Has been used as a framework to describe adaptation and nursing interventions in achieving adaptation.
External criticism according to Peterson and Bedrow “considers the fit between the theory and external criteria”; the evaluation of these concepts is dependent on the perceptions of the person evaluating the theoryRoy’s adaptation model is a grand theory model and is quite complex which includes several concepts, sub-concepts and four modes; because there are many different concepts and modes, it is a complex and difficult theory to understand.Complexity- this is a complex grand theory and according to Meleis, the complexity of the theory has slowed the operationalization of the theory for research project but lends itself well to education.Discrimination- Roy adaptation model is unique as it uses both scientific and philosphical assumptions to predict adaptive or ineffective behaviorsPragmatic- RAM is used and operationalized in the description of adaptation of chronic pain and caregiver effectiveness; it has been applied to the realm of pediatrics, oncology and psychology; has been used in the construction of checklists Scope- RAM is a broad range theory with a wide level of abstractness that can be applied to a number of settingsSignificance- the research has definite impact on nursing and interventions and can provide a framework for predicting adaptive or maladaptive behaviors and guide nursing interventions to assist the patient in achieving their maximum potentialUtility- has been used to describe phenomena such as functional return after delivery, healthcare outcomes for cancer patients, planning care for surgical patients;
Roy’s theory has been used in two main areas to include caregiver effectiveness and well being and coping with pain and chronicity; it has been used to develop and describe the adaptation to chronic pain; ; the theory has been translated and supported in different cultures.
This was my submission to the practice reflection/problem earlier in the semester. As I re-read my problem I realized that the RAM was appropriate to describe my nursing situation. I will give a few moments to reflect the reading.
Practice reflection dealing with the nursing situation narrated earlier. Through the Duran et al (2009) article, the RAM outlines the necessity for the nurse to make an effort to become familiar with the patient’s lives. Attention to their context allows the person to be recognized as an individual. The RAM asserts that each nurse-patient interaction is individualized and unrepeatable. The nurse knows that in order to achieve adaptation the patient must recognize and be an active participant in their own environment. By “reducing” myself to the patients level (sitting in a chair silently) I recognized key facts outlined by Moreno et al : the power in the nurse-patient relationship is mutual, each recognize the influence each has on the other, and decision making is shared.
The RAM uses as a guide for the nursing care of an 8 year old, specifically utilizes the framework of the RAM to guide nursing care for an 8 year old with leukemia. Using the 6 step nursing process, the RAM was able to correctly identify maladaptive behaviors in the child as well as the causative stimuli, use nursing interventions to aid in correcting the behaviors and manipulating the stimuli thereby adjusting the child’s behavior of loneliness to positive adaptive behaviors regarding hospitalization. Effects of antenatal education on maternal prenatal and postpartum adaptation used the RAM to hypothesize that manipulating the stimuli (education) would predict more effective postpartum behaviors (i.e. adaptation) in the education group vs the control group./