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Sister Callista Roy Theory

Dr. Callista Roy is a widely acclaimed nursing theorist as well as an educator, researcher, speaker and author. She developed her Adaptation Model of Nursing while she was in graduate school at the University of California, Los Angeles (UCLA), and a first draft was published in Nursing Outlook in 1970. Over the years, she has continually refined and updated the theory that is now a part of the associate to doctoral level curricula in many nursing schools.

While at UCLA, Sister Callista Roy studied with Dr. Dorothy Johnson who had developed the Behavior System Model of Nursing. Dr. Johnson urged Sister Roy to develop her concept of adaptation and refine it into a theory to define the goal of nursing. Roy's colleagues at Mount St. Mary's College were very supportive of her work. The completed model, Introduction to Nursing: An Adaptation Model, was published in 1976 and has been updated numerous times. In 1991, she formed the Boston Based Adaptation Research in Nursing Society (BBARNS) to further her work. It was later named the Roy Adaptation Association.

The adaptation model addresses the focus of nursing care, the target of nursing care and the need for nursing care. Dr. Roy's viewpoint of the patient is holistic. She states that patients are constantly adapting and the goal of nursing is to promote that adaptation in both sickness and health.

Explicit Assumptions

  • People are holistic beings.
  • People are constantly interacting with their changing environment.
  • People cope with changes by using inborn and learned coping skills that are biological, psychological and social.
  • Health and illness are a part of everyone's life.
  • To adapt, people must have positive responses to changes in their environment.
  • Adaptation depends on people's adaptation levels and the stimuli to which they are exposed.
  • Adaptation levels refer to the amount of stimulation that lead to positive responses.
  • The four forms of adaptation are biologic, concept of self, role development and interaction with others.
  • Nursing values other people's opinions and points of view. Interaction with others is an essential part of nursing.
  • The ultimate goal of existence is to reach dignity and wholeness.

Implied Assumptions

  • People can be separated into parts for care and study.
  • Nursing is based on cause and effect.
  • Nursing needs to consider and respect a person's opinions and values.
  • When a person adapts, he or she is free to respond to additional stimuli.

Nursing Process

  • Assessment of a patient's behavior
  • Assessment of a patient's stimuli
  • Nursing diagnosis
  • Goal setting
  • Nursing interventions to meet goals
  • Evaluation
In the late 1990s, Dr. Roy revised her theory for the 21st century. She drew on her knowledge of philosophy, spirituality and scientific research. She saw people as defined by their physical and social environments and cited nursing scholars who developed a discipline that served to enhance the well-being of people and the earth. Dr. Roy used the term cosmic unity to show that people and the earth have common characteristics. She feels that people are responsible for understanding, maintaining and transforming the universe. These thoughts are contained in a 1997 publication and also in the 1999 revision of her book that was co-authored by Dr. Heather Andrews.

Other changes in the 1999 edition included expanding adaptive criteria to include groups as well as individuals and explaining adaptation on three levels of life processes. The three process levels are integrated, compensatory and compromised. She also described the structure for the development of nursing knowledge based on her theory and gave examples of research that validated this framework.

Dr. Roy's nursing theory is constantly evolving. Her research interests at this time are in the neuroscience field and are focused on cognitive problems of people with mild head injuries. Her findings add to the broad base of nursing knowledge and outcomes of nursing practice.

Publications related to the Adaptation Model of Nursing

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