THEORY SISTER CALLISTA ROY

DISUSUN OLEH:
KELOMPOK 9

ANGGOTA:
1. Davina Putri Prakasanjaya
2. Paramitha Tyara Hapsari
3. Salman Joan Rajendra
1. HISTORY

Sister Callista L. Roy (born October 14, 1939) is a renowned

nursing theorist, professor, and author. She is recognized for her
groundbreaking work in developing the Nursing Adaptation
Model. Roy earned a Bachelor of Arts with a major in Nursing
from Mount Saint Mary’s College in Los Angeles in 1963,
followed by a master's degree in nursing from the University of
California in 1966.

After obtaining her nursing degree, she pursued studies in

sociology, receiving a master's degree in 1973 and a doctorate in
1977. As a pediatric nurse, Roy observed the remarkable
resilience and adaptability of children to significant physical and
psychological changes.

Inspired by these observations, she worked towards creating an

appropriate conceptual framework for nursing, developing the
fundamental concepts of her model while a graduate student at
the University of California between 1964 and 1966.

Since 1987, Roy has held a position as a resident nurse theorist

at Boston College School of Nursing, where she teaches
students at the doctoral, master's, and undergraduate levels. In
1991, she founded the Boston Based Adaptation Research in
Nursing Society (BBARNS), later renamed the Roy Adaptation
Association.

Her scholarly work includes conceptualizing and measuring

coping mechanisms and establishing the philosophical
foundation for the adaptation model and nursing epistemology.
The Nursing Adaptation Model, developed by Sister Callista
Roy in 1976, is a prominent theory aimed at explaining and
defining the delivery of nursing care. The model views
individuals as sets of interrelated systems that maintain balance
among various stimuli.
2. THEORY THAT FOCUS ON UNDERSTANDING
Roy defined nursing as a scientific and humanistic profession, and
emphasized the importance of their specialized knowledge in contributing
health needs and well-being of the community. According to RAM, the
purpose of nursing is to increase compliance and life expectancy.

The metaparadigm concepts of Roy Adaptation Model are person,

environment, health and nursing (4). The Roy Adaptation Model sees the
person as a biopsychosocial being in continuous interaction with a
changing environment. The environment includes focal, contextual and
residual stimuli. A focal stimulus is the confrontation with one’s internal
and external environment.

The four modes of adaptation defined in Roy Adaptation Model are

physiologic, self-concept, role function and interdependence modes.
Nurses help to meet the needs of individuals in these modes of adaptation
(3, 13).

- The Physiologic Mode

The physiologic mode is associated with the physical answers of the

person, given to stimuli from the environment (14). It includes the physical
and chemical processes within an individual’s life and activities.
Physiologic mode requirements are based on physiologic integrity. This
mode consists of nine basic physiologic requirements: 1) Oxygenation, 2)
nutrition, 3) Elimination, 4) activity and rest, 5) Protection, 6) Senses, 7)
Fluid-electrolyte and acid-base balance, 8) Neurologic function and 9)
Endocrine function.

- The Self Concept Mode

The self-concept mode is defined as the individual’s mixture of beliefs and

feelings about himself or others at a certain time. The self-concept mode
consists of the physical self and personal identity. Physical self contains
body image and body sense. Personal identity is formed by their thoughts,
moral-ethics and spirituality.

- The Role Function Mode

 The role function mode covers the individual’s role in society for social
integrity. The roles described herein are divided in three: 1. primary roles;
the role of gender (female, male), 2. secondary roles; different roles
(mother, father, teacher, etc.), and 3. tertiary roles (president of an
association, etc.) (3). The basic requirement for role function mode is
defined as social integrity (14). Role function mode applies to both
individuals and groups at all levels. It includes designated and informal
roles

- The Interdependence Mode

The behavior and mutual relations of individuals and groups are explained
by interdependence in RAM. The interdependence mode includes
relationships with others that are meaningful to the person, and support
systems. For the individual, this mode focuses on interactions related to
love, respect, giving and receiving value. The basic requirement of this area
is the creation of a sense of confidence by relationship integrity and
improvement of relationships

3. EXPLAINATION OF THEORY AND HOW IT WORKS

As a basis for carrying out the nursing process, Roy believes
that the patient must be viewed as a complete human being (view
comprehensive) both from biological, psychological and spiritual aspects.
Besides that
The patient must also be viewed as a system that can live through
constant interaction with its environment. Roy's adaptation model offers
standards for developing or implementing the nursing process through
Roy's elements include:
A. Stage I: Nursing Assessment
1. Behavioral assessment
This is a stage of the nursing process that aims to collect
data and deciding whether the client is adaptive or maladaptive. Included
in
This model shows whether basic human needs can be influenced
by deficiency or excess, for example too little oxygen, too
high blood sugar or too much dependence. Nurse
using interviews, observation and measurement to study
Current client behavior in each mode. Based on this study
the nurse analyzes whether this behavior is adaptive, maladaptive or
maladaptive potential.
2. Study of influencing factors
This stage includes an assessment of significant stimuli
changes in a person's behavior, namely focal, contextual and stimuli
residuals.
a. Identify focal stimuli
Focal stimuli are changes in behavior that can be observed.
Nurses can carry out assessments using
behavioral assessment, namely: observation skills,
carry out measurements and interviews.
b. Identify contextual stimuli
These contextual stimuli contribute to the cause of the occurrence
behavior or precipitation by a focal stimulus. For example, children
those who are hospitalized have ineffective behavioral roles
that is, not learning. The focal stimulus that can be identified is
the fact that children miss school schedules. Stimulus
contextual factors that can be identified are internal factors
the child suffers from illness and the external factor is that the child is
isolated.
Contextual stimulation can be identified by nurses through
observation, measurement, interview and validation.
According to Martinez, 1976 in Roy 1989, contextual factors are
influencing the adaptive mode are genetics, sex, stage
development, drugs, alcohol, tobacco, self-concept, role function,
interdependence, social interaction patterns, coping mechanisms, stress
emotional and physical religion, and the physical environment.
c. Identify residual stimuli
At this stage what influences is past experience.
Helson in Roy, 1989 explains that several factors from
Past experiences are relevant in explaining how things are now
This. Attitude, culture, character are residual factors that are difficult to
measure
and have an effect on the current situation.
B. Nursing diagnosis
Nursing diagnoses according to Roy's adaptation theory are defined as
an outcome of the decision-making process related to
lack of ability to adapt. Nursing diagnoses are formulated with
observing client behavior regarding environmental influences.

I. Observe the most prominent client response in one adaptive mode,

for example ; sub-physiological mode of fluid requirements.
 Case example for diarrhea: intake: 1200 ml, output: 3500 ml, complaints
thirst (+), inelastic turgor, eyelids appear sunken. From the response
This patient can be concluded that the patient's nursing diagnosis
According to Roy, it is a fluid volume deficit.
II. Summarizes the client's response from one or more of the adaptive
modes
associated with the same stimulus. For example, the disturbed mode is
Physiological modes, self-concept and interdependence.
Sample case ; The client complained that he didn't want to eat, he only
finished eating ¼
portion, BB dropped 2 kg from normal. From this data the client
experiences
impaired nutritional needs: nutrition less than requirements (mode
physiological). Because the client lacks nutrition resulting in poor posture
looking thin, this makes the client experience Body Image problems
(Self-Concept Mode), this condition also results in the client being unable
to
fulfill their daily needs (Interdependence Mode)
C. Goal Determination
Roy (1984) said that in general the aim of intervention
Nursing is to maintain and enhance behavior
adaptive and changing ineffective behavior to adaptive. Goal setting
divided into long-term goals and short-term goals. Term goals
The length to be achieved includes: Life, growth, reproduction and
power. Short-term goals include achieving desired behavior
expected that after manipulation of the focal stimulus,
contextual and residual.
D. Intervention
Nursing interventions are carried out with the aim of changing or
manipulating focal, contextual and residual stimuli, is also focused on
individual coping or adaptation zone, so that all stimuli are appropriate
with the individual's ability to adapt.
Nursing actions try to help the stimulus lead to behavior
adaptive. This re-emphasizes the importance of identifying causes
during the phase II assessment.

4. APPROACH
nursing approach
Roy (1984) said that in general the aim of nursing intervention is to
maintain and enhance adaptive behavior and change ineffective behavior
to adaptive. Goal setting is divided into long-term goals and short-term
goals. Long-term goals to be achieved include: Life, growth, reproduction
and
power. Short-term goals include achieving desired behavior
expected after manipulation of focal, contextual and residual stimuli.

In this theory, humans are considered as holistic creatures who interact with
the environment as an adaptive system. This theory also emphasizes the
psychosocial and spiritual aspects of humans.

The following are several things related to the nursing approach according
to Sister Callista Roy's theory:

- Main elements
The four main elements of Roy's theory are humans, environmental
concepts, healthy concepts, and nursing. These four elements influence
each other.

- Roy employs a six-step nursing process: assessment of behavior;

assessment of stimuli; nursing diagnosis; goal setting; intervention and
evaluation. In the first step, the person's behavior in each of the four modes
is observed. This behavior is compared with norms and is deemed either
adaptive or ineffective.

- Nursing goals
The goal of nursing is to increase compliance and life expectancy.

- Roy's adaptation model

Roy's Adaptation Model (RAM) relates behavioral responses to three
stimuli, namely focal, contextual, and residual.