Sister Callista Roy's 'Adaptation Theory' - Book Report/Review Example

Critique on Sister Callista Roy's Adaptation Theory Introduction Sister Callista Roy is a highly respected nurse theorist, lecturer, researcher, and teacher. She defined nursing knowledge through her theory "Roy Adaptation Model" which is regarded as rich source of knowledge for clinical nursing. In this assignment, this theory will be critically analyzed to examine whether this theory has provided an expanded, value-based concept of adaptation. The Intent of the Theory Adaptation is a popular and long-standing term in nursing. It is used most frequently to capture a central concern of the discipline: an individual's adjustment to an illness, a disability, or health problem. People, both individually and in groups, according to this theory are viewed as holistic adaptive systems, with coping processes acting to maintain adaptation and to promote transformations at the personal and environmental levels. The coping processes are broadly described within the regulator and cognitive subsystems for the individual, and the stabilizer and innovator subsystems for groups. Through these coping processes, persons considered as holistic adaptive systems interact with the internal and external environment, transform the environment, and are transformed by it (Johnson & Webber, 2005, 207-233). Critique As evident from this theory, this model has been proposed in a simple manner that is easily comprehensible by any reader interested in nursing theories. The concepts are clear that flow through a process of reasoning. The components have been derived from both literature and clinical practice, and any practitioner identifies herself and her practice with the theory in no time. The modes and outcomes of adaptations were named by the classification of the incidents of behaviors of the patients as encountered in clinical practice. It seems that this adaptation theory provides a possible structural and conceptual framework for nursing that could possibly be used to develop more integrated curriculum, to serve as a theoretical basis for nursing practice, and to provide clues for improvement of patient care. It is clear that this theory presents a broad conception of human phenomena that helps the nursing profession to understand the biological, psychological, and social functioning of a human being in different changing contexts in health and disease (Johnson & Webber, 2005, 207-233). Adaptation is a term that has been used predominantly at the individual client level in nursing; it also has been employed at family and population levels and in the practice domain to address issues regarding the adaptability of nurses. According to Roy, the human system has the capacity to adjust and adapt effectively and efficiently to changes the environment and to change the environment according to the needs of adaptation. Thus, it can be viewed as a process where human biologic systems receive stimuli from the environment, and these inputs are internally processed through feedback mechanisms, and the results are either adaptive or ineffective behaviors. These lead to either effective or ineffective coping respectively ((Johnson & Webber, 2005, 151-154). Over years, it has been observed that the nursing science has evolved toward caring with an emphasis on the totality of the human being. These ideological changes in nursing practice indicate that health is considered as a state where individual react with environment continuously and consistently. If nursing is associated with human health, therefore, it needs to consider the environmental factors with due weightage. According to Roy, adaptation is influenced by integration of the person with the environment, and time influences the process of adaptation. These adaptations are related, in turn, to perception. From the propositions of this theory, the nursing assessment and intervention should identify and manage "input to adaptive system." This sets the stage for the goals of nursing interventions in all spheres, since if based on this theoretical model, the assessment and intervention process should focus on contextual and focal stimuli. If any deficit in adaptation is noted, the nurses can enter the prevalent human system in the client by using the nursing process, and then they can manage the incoming stimuli to promote adaptation, promote environmental change, and thus facilitate health. Therefore it is applicable and consistent with nursing practice in all dimensions and boundaries (Johnson & Webber, 2005, 151-154). It is to be admitted that although this theory has been developed through painstaking research, they propositions of this theory are free of jargons and easily understandable. Except in propositions 6 and 7, there are no jargons anywhere in this theory, and despite that since all these propositions can be easily correlated with nursing practice, these can be understood with very little effort. Concepts & Propositions of the Theory Roy proposed that the internal environment of a human being determines the adaptation level. According to her three possible conditions involving human life processes may modify the adaptive systems in the human being. The essence of human adaptation is the interrelationship between the pooled effects of all stimuli of the environment, which can be focal, contextual, and residual stimuli. Any person's ability to respond to a situation is actually the adaptation he attempts, and this also is a determinant. These all together interacts to manifest itself as human behavior to a changing condition and is known as coping. Behaviors as responses are either adaptive or ineffective in relation to whether they are promoting the person's integrity and the goals of adaptation. According to Roy, the human systems' goals of adaptation are survival, growth, reproduction, and mastery. Thus adaptation actually indicates immediate and short-term responses to changing environment (Colley, 2003). All the major concepts have therefore been identified and defined, so the reader does not have any problem understanding and analyzing the basic concepts and propositions of the theory. For example, the person is recognized as an integrated entity that has natural ways to adapt. It also defines clearly person, environment, health, and nursing. In this theoretical framework thus, a new conceptual definition of health arises with this nursing is related intimately, and this can then be defined as an outcome of adaptive process. This adaptive process can also then be defined as a pattern of being and becoming whole through integration with self and through adaptation with environment. However, it is to be remembered that Roy's theory developed over time with continuous corrections from inputs out of practice and better and deeper theoretical understanding of the proposed concepts. As a result, these basic definitions in the initial stage were not supported by ancillary propositions (Roy, Sr., 1977, 5060-A). However, these concepts actually stimulated the formulations of these propositions. The core concepts of this theory have actually stimulated formation of the propositions. Roy adaptation model states that acquired coping mechanisms are unique, and though this, the person recognizes the unique role of adaptation. These occur through the regulator or cognator processes and thus can affect an individual positively or negatively. The human being thus challenges the adaptive system, adjusts and modifies it in order to maintain and enhance the wellbeing. Deriving from this, health is nothing but manifestation of human interactions with regulator and cognator processes, and when the resultant may contribute to the goal of adaptation, the effective response may be termed as health. It is evident that these concepts are stimulating formulation of propositions (Roy, Sr., 1970, 43-45). Roy's propositions are related to meaning of theory. These propositions in a stepwise manner identify the influence of integration of the person through adaptation with the environment. From the conceptual point of view, these propositions are based on relationships that connect the synthesis of phenomena between the external and internal environment of the human being with goal to maintain balance and growth for primarily self and secondarily environment. The more the human can integrate with the environment, the more the adaptation will be health-friendly. Therefore, it can be stated that if nursing interventions are designed for human health, for improvement of human perceptions about human health, and for activities through a process to improve them, it should involve improvement of adaptation of human systems to environment. If it is called care or intervention, it should manage input to enhance adaptation. Since in this model this occurs through focal and or contextual stimuli, nursing should manage these stimuli also. As apparent, this is possible through a process that manages the interactive stimuli that would originate in the environment so human can easily adapt. Thus knowledge about this theory would help the nurses to identify and manage stimuli, through a process of explanation, prediction, and management of stimuli through interventions that are based on theories that determine patient outcomes. In this way the nursing intervention can very effectively manage the focal and contextual stimuli to improve adaptation to lead to a positive health (Colley, 2003). Theoretical knowledge provides the framework for understanding the human being holistically, which actually is a system of totality in continuous interaction of the environment. The excellence in nursing practice now is dependent on a better and through understanding of this process that will help nurses develop a framework for practice that would direct focus at person, environment, health, and coping. Thus strategies for intervention would facilitate human's own understanding and perceptions that is based on knowing the different parameters, and any successful nursing intervention would attempt to strengthen human coping with environmental changes, both internal and external. Since all these concepts are based on the basic tenets of Roy's theory, a better understanding of this would lead to a better design of this process and hence a more effective intervention (The Roy Adaptation Model, 2008). Reference List Colley, S. (2003) Nursing Theory: Its importance to practice. Nursing Standard, 17(46), 33. Johnson, B.M., & Webber, P.B. (2005). An Introduction to Theory and Reasoning. New York: Lippincott Williams & Wilkins, pp. 151-154 & pp. 207-233 Roy, Sr. C. (1970). Adaptation:Aconceptual framework for nursing. Nursing Outlook, 18(3), 43 45. Roy, Sr. C. (1977). Decision-making by the physically ill and adaptation during illness (Doctoral dissertation, University of California, Los Angeles, 1977). Dissertation Abstracts International, 38, 5060-A The Roy Adaptation Model (2008). Available from http://www.bc.edu/schools/son/faculty/theorist/Roy_Adaptation_Model.html Accessed on December 18, 2008 . Read More