Calista Roy Adaptation Model

Calista Roy’s Adaptation Model

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Calista Roy’s Adaptation Model

Sister Calista Roy is a luminary in the field of nursing who has a unique perspective on many issues. When it comes to nursing, medicine, and society as a whole, Sister Roy has been an enormously influential figure. Roy has been honored with numerous accolades for her work. She has been referred to as a living legend by her colleagues. Sister Roy began her career as a nurse but evolved into so much more throughout the course of her life. Throughout her life, this nursing theorist persisted to seek her education and her desire to learn. She was born on the 14th of October in Los Angeles on a sister named Roy. She belonged to the Carondelet Sisters of St. Joseph; a religious order founded by her. After graduating from Mount Saint Mary's of Los Angeles with a bachelor's degree in nursing in 1963, she began her career as a registered nurse. After that, she worked as a pediatric nurse while pursuing a master's degree in nursing at the University of California (Barone, 2012). Over the years she has expanded to include not just one person but groups of people, such as, families (Dobratz, 2014). 

RAM stated that health may coincide with adaptation. If one reaches adaptation, they maintain health. However, if one has ineffective adaptation, their health may be compromised (Yu et al., 2021). I think of this concept when relating to stress or anxiety. If the environmental stimuli cause, increase anxiety or stress and one has poor coping mechanisms, then they may experience a decline in health. Some symptoms may be headaches, insomnia, muscle pain, & stomach discomfort (Mayo Clinic, 2019). Those of us on the front lines have had to dig deep into those coping skills files. Some already experiencing PTSD. Even at home, our kids have had to adapt to circumstances that have never happened in history. As a mom, I have always focused on building coping mechanisms for life’s challenges and drilling that we can’t control our environment, but we can control how we respond to it. Some days we have adapted well and others have been a struggle.

  The concepts of this theory are ones I use daily at work. Working on a labor and delivery unit, I help eliminate the environmental stimuli during the labor process to help the patients have a memorable experience. Post-partum, I help the “new” parents adapt to their new roles as parents. I generally, look at the patient as a whole and not just the effected part. The RAM theory fits well, as I am dealing with the family as a unit. This past year I have also had to help eliminate stressors and environmental changes for my staff. Our organization was acquired by a corporation and just 2 weeks later, COVID hit. “Change” was a daily event. I think we could call 2020 the year of adaptation. 

Calista Roy’s Adaptation Model (RAM) is based on the fact that a person is a bio-psycho-social being in a constant interaction with a changing environment (DeStigter et al., 2021). The model states that health is an inevitable dimension of a person’s life and is represented by a health-illness continuum (DeStigter et al. 2021). Health promotion is actively taking part in being well including physical, mental, spiritual, emotion, and social well-being (Louis, 2019). In nursing, health promotion looks different depending on the setting however, it always involves the patient, education, and adaptation on what it is they are going through. The RAM model states that “nursing is aimed at helping patients foster healthy coping mechanisms to adapt to both internal and external stimuli through four factors: interdependence, self-concept, physiological physical, and role function” (Louis, 2019). This model best reflects my thinking on health promotion. The biggest role we have as nurses is education and this model is about teaching the patient to adapt in order to be well. Every patient is different, and it is important to consider what they are going through and teach them not only about their illness/disease, but also help and support them to adapt in order to have the best quality of life possible. 

As a post-operative nurse, this theory is reflected in my everyday practice. Patients who I care for just had surgery to remove a cancerous tumor from their pancreas and require a lot of health promotion teaching. This is teaching not only about what life looks like for them now but also helping them adapt to their new life. Each of the four effectors of this model are used when applying this model to the patient. Physiological physical mode is used when teaching the patient about their nutritional changes and insulin administration. It is also used when promoting incentive spirometry use and when making recommendations to increase his mobility after surgery. The self-concept mode is used when we teach the patient self-care. Exploring spiritual beliefs that are important to the patient is an important part of recovery and these beliefs must be taken care of as part of the patient’s care. The role function is used when exploring the perception that the patient has of the surgery and what it means for their everyday life. The discussions about recovery and what it looks like for the patient including who is caring for them and what services they may need are important aspects of this mode. Lastly, the interdependence mode is used to focus on interactions and relationships of the patient that can give them support, both informational and emotional, to assist in their recovery (Louis, 2019).

 Adapting will improve their quality of life and allow them to learn their “new normal”. Nurses assist with this process by examining the patient’s current condition and place emphasis on the interventions that will help address the needs of the patient. Nursing interventions should be aimed at helping the patient adapt to the changes (Louis, 2019). The RAM theory will continue to be applied to my nursing practice as patients continue to have surgery and their recovery is filled with anxiety and stress. As a nurse using the RAM model, I can help the patient adapt and thrive in their new regime making them physically, spiritually, psychologically, and socially prepared for life post-op.

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References

Barone, S. H. (2012). Coping and adaptation in adults living with spinal cord injury. Journal of Neuroscience Nursing, 44(5), 271-283.

DeStigter, A., Hiebner, A., & Post, J. (2021). Non-Pharmacological Interventions for Terminal Restlessness in End-of-Life Care.

 Dobratz, M. C. (2014). Life closure with the Roy adaptation model. Nursing science quarterly, 27(1), 51-56.

LOUIS, J. K. (2019). Application of Roy's adaptation model to the management of a patient with Pancreatic Ductal Adenocarcinoma. Singapore Nursing Journal, 46(1).

Mayo Clinic. (2019). Stress symptoms: Effects on your body and behavior. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stresssymptoms/art-20050987

Yu, S., & Song, J. E. (2021). Essential Role of Theory in Nursing Research for Advancement of Nursing Science. Journal of Korean Academy of Nursing, 51(4), 391-394.