First, consider the concept of a system as applied to an individual. Roy conceptualizes the person in a holistic perspective. Individual aspects of parts act together to form a unified being. Additionally, as living systems, persons are in constant interaction with their environments. Between the system and the environment occurs an exchange of information, matter, and energy. Characteristics of a system include inputs, outputs, controls, and feedback.
Major Concepts
Environment
Conditions, circumstances and influences that… affect the development and behavior of humans as adaptive systems.
Health
A state and process of being and becoming integrated and whole.
Person
“The human adaptive system” and defined as “a whole with parts that function as a unity for some purpose. Human systems include people… groups… organizations, communities, and society as a whole.” (Roy & Andrews, 1999)
Goal of nursing
The “promotion of adaptation in each of the four modes.”
Adaptation
The “process and outcome whereby thinking and feeling persons as individuals or in groups use conscious awareness and choice to create human and environmental integration.”
Four Adaptive Modes
1. Physiologic-physical mode: physical and chemical processes involved in the function and activities of living organisms; the underlying need is physiologic integrity as seen in the degree of wholeness achieved through adaptation to changes in needs. In groups, this is the manner in which human systems manifest adaptation relative to basic operating resources. The basic need of this mode is composed of the needs associated with oxygenation, nutrition, elimination, activity and rest, and protection. The complex processes of this mode are associated with the senses, fluid and electrolytes, neurologic function, and endocrine function.
2. Self-concept-group identity mode: focuses on psychological and spiritual integrity and a sense of unity, meaning, purposefulness in the universe.
3. Role function mode: refers to the roles that individuals occupy in society fulfilling the need for social integrity; it is knowing who one is, in relation to others.
4. Interdependence mode: the close relationships of people and their purpose, structure and development individually and in groups and the adaptation potential of these relationships.
Subconcepts
Adaptive responses are those that promote the integrity of the person. The person’s integrity, or wholeness, is behaviorally demonstrated when the person is able to meet the goals in terms of survival, growth, reproduction and mastery. Ineffective responses do not support these goals. (Roy & Andrews, 1991)
Coping mechanisms describe the control processes of the person as an adaptive system. Some coping mechanisms are inherited or genetic, such as white blood cell defense mechanism against bacteria that seek to invade the body. Other mechanisms are learned, such as the use of antiseptics to cleanse a wound.
Two Coping Subsytems
A. Cognator subsystem
“A major coping process involving four cognitive-emotive channels: perceptual and information processing, learning, judgment, and emotion.”
B. Regulator subsystem
A basic type of adaptive process that responds automatically through neural, chemical, and endocrine coping channels.
Focal stimuli
Those stimuli that are the proximate causes of the situation.
Contextual stimuli
All other stimuli in the internal or external environment, which may or may not affect the situation.
Residual stimuli
Those immeasurable and unknowable stimuli that also exist and may affect the situation.
Assumptions
Scientific Assumptions
- Systems of matter and energy progress to higher levels of complex self-organization.
- Consciousness and meaning are constructive of person and environment integration.
- Awareness of self and environment is rooted in thinking and feeling.
- Humans by their decisions are accountable for the integration of creative processes.
- Thinking and feeling mediate human action.
- System relationships include acceptance, protection, and fostering of interdependence.
- Persons and the earth have common patterns and integral relationships.
- Persons and environment transformations are created in human consciousness.
- Integration of human and environment meanings results in adaptation.
Philosophical Assumptions
- Persons have mutual relationships with the world and God.
- Human meaning is rooted in the omega point convergence of the universe.
- God is intimately revealed in the diversity of creation and is the common destiny of creation.
- Persons use human creative abilities of awareness, enlightenment, and faith.
- Persons are accountable for the processes of deriving, sustaining, and transforming the universe.
Strengths:
The theory suggests the influence of multiple causes in a situation, which is strength when dealing with multi-faceted human beings.
The sequence of concepts in Roy’s model follows logically. In the presentation of each of the key concepts there is the recurring idea of adaptation to maintain integrity. Every concept was operationally defined.
The concepts of Roy’s model are stated in relatively simple terms.
A major strength of the model is that it guides nurses to use observation and interviewing skills in doing an individualized assessment of each person.
The concepts of Roy’s model are applicable within many practice settings of nursing.
Weaknesses:
Painstaking application of the model requires significant input of time and effort.
Roy’s model has many elements, systems, structures and multiple concepts.
Analysis
As one of the weaknesses of the theory that application of it is time-consuming, application of the model to emergency situations requiring quick action is difficult to complete. The individual might have completed the whole adaptation process without the benefit of having a complete assessment for thorough nursing interventions.
Adaptive responses may vary in every individual and may take longer time compared to others. Thus, the span of control of nurses may be impeded by the time of the discharge of the patient.
Unlike Levine, although the latter tackled on adaptation, Roy gave much focus on the whole adaptive system itself. Each concept was linked with the coping mechanisms of every individual in the process of adapting.
The nurses’ roles when an individual presents an ineffective response during his or her adaptation process were not clearly discussed. The main point of the concept was to promote adaptation but none were stated on how to prevent and resolve maladaptation.
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