Sister Callista Roy’s Adaptation Model 1979 (USA)

Sister Callista Roy’s Adaptation Model 1979 (USA)
Sister Callista Roy was born on 1939, earned her B.S. in nursing from Los Angeles, M.S. in nursing and her doctorate in Sociology in 1977 from the University of California. She is the author, co author, professor and nurse theorist and known world wide for Roy Adaptation Model.  Her contributions to nursing are an Adaptation Model, Essentials of the Roy Adaptation Model, Theory Construction in Nursing, The Roy Adaptation Model: The Definitive Statement, Roy Adaptation Model Based Research, Twenty Five Years of Contributions to Nursing Science and Nursing Knowledge Development and Clinical Practice.
The Roy Adaptation Model has captured interest and respect since 1964 and she published her work in 1970 at the age of 31 years. She defined adaptation as ‘the process and outcome where by thinking and feeling persons, as individuals or in groups, use conscious awareness and choice to create human and environmental integration.’

The four major concepts of the RAM include:

1. Human as adaptive systems
2. The environment
3. Health
4. The goal of nursing

Human adaptive system
Roy conceptualizes the human system in a holistic perspective, which means the aspect of unified meaningfulness of human behavior in which the human system is greater the sum of individual parts.
Adaptation
The human adaptive system has input coming from the external environment as well as with in the system. Roy identifies inputs as stimuli and adaptation level. Stimuli are classified into three: focal, contextual and residual. The stimulus most immediately confronting the human system is the focal stimulus. Contextual stimuli are from the human systems internal and external world. Residual stimuli are those internal and external factors are unclear.
Adaptation level is the combining of stimuli that represents the condition of life process for the human adaptation system. The three levels defined by Roy are integrated, compensatory and compromised. Integrated process is present when the adaptation level is working as a whole to meet the needs of the human system. The compensatory process occur when the human’s response system have been activated and compromised process occur when the compensatory and integrated process are not providing for adaptation. 

Roy presents a unique nursing concept of control mechanisms:  the regulator and cognator.
The regulator subsystem has the components of input, internal process and output. Target organs and tissues under endocrine control produce regulator output response. Cognator control process is related to higher brain functions of perception, learning, judgment and emotion.

Roy categorizes family, group and collective system control mechanisms as the stabilizer and the innovator system. It suggests two goals: stabilization and change. Stabilizer process is those of established structure, values and daily activity where the work of the group is done and the group contributes to the general well being of society. The innovator subsystem identifies structure and processes that promotes change and growth. 

Four adaptive models
The coping processes, cognator-regulator and stabilizer-innovator promote adaptation in human adaptive system. Roy has identified four adaptive modes as categories for assessment of behavior resulting from cognator-regulator coping mechanisms in persons or stabilizer-innovator coping process in groups. These adaptive modes are

1. Physiological –physical
2. Self concept- group identity
3. Role function
4. Interdependence

Physiological –physical mode
The physiological mode represents the human system is physical responses and interaction with the environment. This is associated with fluid, electrolyte, elimination, nutrition, rest, neurologic function and endocrine function. The physical mode related to basic operating resources such as participants, physical facilities and fiscal resources.
Self concept- group identity mode
Self concept consists of a person’s beliefs about himself or herself at any given time. It has two components: physical self and personal self. Physical self includes body sensation and body image. Personal self includes self ideal, moral, ethical and spiritual belief. The group identity mode consists of interpersonal relationship, group self image, social milieu and culture.
Role function mode
It consists of a set of expectations of how a person in a particular position will behave in relation to a person who hold another position. It includes functions of the staff, decision making, initiative and delegation of the work to maintain in order to fulfill the expected responsibilities.
Interdependence mode
The mode focuses on the giving and receiving of love, respect and value with significant others and support systems. The underlying need of the mode is to nurture relationships.
Environment
She defined environment as all conditions that surround and affect the development and behavior of humans as adaptive systems, with particular consideration of person and earth resources.

The Roy Adaptation Model identifies the essential concepts relevant to nursing as the human adaptive system, the environment, health and nursing. The model suggests that nurses alter, increase, decrease, remove or maintain focal stimulus or if that is not possible, change the contextual stimuli so that the purposeful adaptation and transformation between the person and environment is promoted.