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CHAPTER 17 Sister Callista Roy 313

The Roy Adaptation Model is useful in guiding Samarel, Tulman, and Fawcett (2002) examined
nursing practice in institutional settings. It has been the effects of two types of social support (telephone
implemented in a neonatal intensive care unit, an and group social support) and education on adapta-
acute surgical ward, a rehabilitation unit, two general tion to early-stage breast cancer in a sample of 125
hospital units, an orthopedic hospital, a neurosurgical women. Women in the experimental group received
unit, and a 145-bed hospital, among others (Roy & both types of social support and education (n 5 34);
Andrews, 1999). women in the first control group received only tele-
Weiland (2010) described use of the Roy Adapta- phone support and education, and women in the
tion Model in the critical care setting by advanced second control group received only education. Mood
practice nurses to incorporate spiritual care into nurs- disturbance and loneliness were reduced significantly
ing care of patients and families. Spiritual care is an for the experimental group and for the first control
important, but often overlooked, aspect of nursing group but were not reduced for the second control
care for patients in the critical care setting. group. No differences were observed among the groups
The Roy Adaptation Model has been applied to in terms of cancer-related worry or well-being. This
the nursing care of individual groups of patients. study provides an excellent example of how the Roy
Examples of the wide range of applications of the Roy Adaptation Model can be used to guide the conceptu-
Adaptation Model are found in the literature. Villar- alization, literature review, theory construction, and
eal (2003) applied the Roy Adaptation Model to the development of an intervention.
care of young women who were contemplating smok- Zeigler, Smith, and Fawcett (2004) described the use
ing cessation. The author provides a comprehensive of the Roy Adaptation Model to develop a community-
discussion of the use of Roy’s six-step nursing pro- based breast cancer support group, the Common Jour-
cess to guide nursing care for women in their mid- ney Breast Cancer Support Group. A qualitative study
twenties who smoked and were members of a closed design was used to evaluate the program from both
support group. The researcher performed a two-level participant and facilitator perspectives. Responses
assessment. In the first level, stimuli were identified from participants were categorized using the Roy
for each of the four adaptive modes. In the second Adaptation Model. Findings from this study showed
level, the nurse made a judgment about the focal that the program was effective in providing support for
(nicotine addiction), contextual (belief that smoking women with various stages of breast cancer.
is enjoyable, makes them feel good, relaxes them, Newman (1997a) applied the Roy Adaptation Model
brings them a sense of comfort, and is part of their to caregivers of chronically ill family members. With a
routine), and residual stimuli (beliefs and attitudes thorough review of the literature, Newman demon-
about their body image and that smoking cessation strated how the Roy Adaptation Model was used to
causes weight gain). The nurse made the nursing provide care for this population. Newman views the
diagnosis that for this group, a lack of motivation to chronically ill family member as the focal stimulus. Con-
quit smoking was related to dependency. The women textual stimuli include the caregiver’s age, gender, and
in the support group and the nurse mutually estab- relationship to the chronically ill family member. The
lished short-term goals to change behaviors, rather caregiver’s physical health status is a manifestation of the
than the long-term goal of smoking cessation. The physiological adaptive mode. The caregiver’s emotional
intervention focused on discussion of the effects of responses to caregiving (i.e., shock, fear, anger, guilt,
smoking on the body, reasons and beliefs about increased anxiety) are effective or ineffective responses
smoking and smoking cessation, stress management, of the self-concept mode. Relationships with significant
nutrition, physical activity, and self-esteem. During others and support indicate adaptive responses in the
the evaluation phase, it was determined that the interdependence mode. Caregivers’ primary, secondary,
women had moved from pre-contemplation to the and tertiary roles are strained by the addition of the
contemplation phase of smoking cessation. The author caregiving role. Practice and research implications illu-
concluded that the Roy Adaptation Model provided a minate the applicability of the Roy Adaptation Model for
useful framework for providing care to women who providing care to caregivers of chronically ill family
smoke. members.