Nursing Theory II

1. Roy’s Adaptation Model

Sister Callista Roy defines ADAPTATION as the “process and outcome whereby the thinking and feeling person uses conscious awareness”. She creates human and environmental are integration. The theory focuses on increasing complexity of person and environment; Self-organization; Relationship between and among persons. This theory also focuses on the individual as biopsychosocial adaptive system. Roy believes that creation spirituality- view that “persons and the earth are one and that they are in God and of God” and Universe and supreme being.

Theory employs feedback cycle of the input (stimuli); Throughout (control processes) and Output (behavioral and adaptive response). Both individual and environment are sources of stimuli requiring modification to promote adaptation and ongoing purposive response. The process she defined as being and becoming integrated is the adaptive responses contribute to health; Ineffective and maladaptive responses do not contribute to health and each person’s adaptation is unique and constantly changing.

Individual respond to needs (stimuli) are in four modes:

1. Physiologic mode involves the body’s basic physiologic needs and ways of adapting with regards to fluid and electrolytes, activity, rest, circulation, oxygen, nutrition, elimination, protection, senses neurologic and endocrine function. Behaviour pertaining to the physical aspect of the human system; Physical and chemical processes.
2. Self-concept has 2 components, which are physical self-involving sensation and body image and personal self (self-ideal) self-consistency and the moral –ethical self. The composite of beliefs and feelings held about oneself at a given time. It focusses on the psychological and spiritual aspects of the human system.
3. The role of function is determined by the need for social integrity and performance of duties based on the given position in society.
4. Interdependence mode is one’s relation with significant others and support system that provide help, affection and attention.

The goal of Callista’s Roy model is to enhance life processes through adaptation in four adaptive modes. Behaviour pertaining to interdependent relationships of individuals and group where each relationship exists for some reason.

2. King’s Goal Attainment Theory

King’s conceptual framework for nursing consists of three dynamic interacting system:

• Relationship of operational systems (individual’s)
• Interpersonal system (groups)
• Social system (educational or health care system).

The theory selected 15 concepts from nursing

• Self-role
• Perception
• Communication
• Interaction
• Transaction
• Growth and development
• Stress
• Time
• Personal space
• Organization
• Status
• Power
• Authority
• Decision making
• Essential knowledge

In the transaction model design, it describes the nature of and standard of nurse-patient interaction (goal-attainment) where nurse purposely interact and mutually set, explore and agree to means to achieve goals. So, goal-attainment represent outcomes. For examples, recorded information in the patient record, represent evidence-based practice; Provides insights into nurse’s interaction with the individual or groups. It highlights the importance of client’s participation in decisions that influence care and focuses on nurse-client interaction and outcomes of care.