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CHAPTER 17 Sister Callista Roy 309

and by intervening to promote adaptive abilities
Adaptation and to enhance environment interactions (Roy &
Roy has further defined adaptation for use in the Andrews, 1999).
twenty-first century (Roy & Andrews, 1999). According
to Roy, adaptation refers to “the process and outcome Person
whereby thinking and feeling persons, as individuals or According to Roy, humans are holistic, adaptive sys-
in groups, use conscious awareness and choice to create tems. “As an adaptive system, the human system is
human and environmental integration” (Roy & described as a whole with parts that function as unity
Andrews, 1999, p. 30). Rather than being a human sys- for some purpose. Human systems include people as
tem that simply strives to respond to environmental individuals or in groups, including families, organiza-
stimuli to maintain integrity, every human life is pur- tions, communities, and society as a whole” (Roy &
poseful in a universe that is creative, and persons are Andrews, 1999, p. 31). Despite their great diversity,
inseparable from their environment. all persons are united in a common destiny (Roy &
Andrews, 1999). “Human systems have thinking and
feeling capacities, rooted in consciousness and mean-
Nursing ing, by which they adjust effectively to changes in the
Roy defines nursing broadly as a “health care profession environment and, in turn, affect the environment”
that focuses on human life processes and patterns and (Roy & Andrews, 1999, p. 36). Persons and the earth
emphasizes promotion of health for individuals, fami- have common patterns and mutuality of relations and
lies, groups, and society as a whole” (Roy & Andrews, meaning (Roy & Andrews, 1999). Roy (Roy &
1999, p. 4). Specifically, Roy defines nursing according Andrews, 1999) defined the person as the main focus
to her model as the science and practice that expands of nursing, the recipient of nursing care, a living,
adaptive abilities and enhances person and environ- complex, adaptive system with internal processes
mental transformation. She identifies nursing activities (cognator and regulator) acting to maintain adapta-
as the assessment of behavior and the stimuli that influ- tion in the four adaptive modes (physiological, self-
ence adaptation. Nursing judgments are based on this concept, role function, and interdependence).
assessment, and interventions are planned to manage
the stimuli (Roy & Andrews, 1999). Roy differentiates Health
nursing as a science from nursing as a practice disci- “Health is a state and a process of being and becoming
pline. Nursing science is… “a developing system of integrated and a whole person. It is a reflection of
knowledge about persons that observes, classifies, and adaptation, that is, the interaction of the person and
relates the processes by which persons positively affect the environment” (Andrews & Roy, 1991, p. 21). Roy
their health status” (Roy, 1984, pp. 3–4). Nursing as a (1984) derived this definition from the thought that
practice discipline is “nursing’s scientific body adaptation is a process of promoting physiological,
of knowledge used for the purpose of providing an psychological, and social integrity, and that integrity
essential service to people, that is, promoting ability to implies an unimpaired condition leading to com-
affect health positively” (Roy, 1984, pp. 3–4). “Nursing pleteness or unity. In her earlier work, Roy viewed
acts to enhance the interaction of the person with the health along a continuum flowing from death and
environment—to promote adaptation” (Andrews & extreme poor health to high-level and peak wellness
Roy, 1991, p. 20). (Brower & Baker, 1976). During the late 1990s, Roy’s
Roy’s goal of nursing is “the promotion of adapta- writings focused more on health as a process in which
tion for individuals and groups in each of the four health and illness can coexist (Roy & Andrews, 1999).
adaptive modes, thus contributing to health, quality Drawing on the writings of Illich (1974, 1976), Roy
of life, and dying with dignity” (Roy & Andrews, 1999, wrote, “health is not freedom from the inevitability of
p. 19). Nursing fills a unique role as a facilitator of death, disease, unhappiness, and stress, but the ability
adaptation by assessing behavior in each of these four to cope with them in a competent way” (Roy &
adaptive modes and factors influencing adaptation Andrews, 1999, p. 52).