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320 UNIT III Nursing Conceptual Models

for deriving middle-range theories for testing in stud- nursing care that addresses the holistic needs of the
ies of smaller ranges of phenomena (Reynolds, 1971). patient. The model is also capable of generating new
Roy’s model (Roy & Corliss, 1993) is generalizable to information through the testing of hypotheses that have
all settings in nursing practice but is limited in scope, been derived from it (Roy, 2011a; Roy & Corliss, 1993;
as it primarily addresses the person-environment Smith, Garvis, & Martinson, 1983).
adaptation of the patient, and information about the
nurse is implied.
SUMMARY
Accessibility The Roy Adaptation Model has greatly influenced the
Roy’s broad concepts stem from theory in physiological profession of nursing. It is one of the most frequently
psychology, psychology, sociology, and nursing; empiri- used models to guide nursing research, education,
cal data indicate that this general theory base has sub- and practice. The model is taught as part of the cur-
stance. Roy’s model offers direction for researchers who riculum of most baccalaureate, master’s, and doctoral
want to incorporate physiological phenomena in their programs of nursing. The influence of the Roy Adap-
studies. Roy (1980) studied and analyzed 500 samples of tation Model on nursing research is evidenced by the
patient behaviors collected by nursing students. From vast number of qualitative and quantitative research
this analysis, Roy proposed her four adaptive modes in studies it has guided. The Roy Adaptation Model
humans. has inspired the development of many middle-range
Roy (Roy & McLeod, 1981; Roy & Roberts, 1981) nursing theories and of adaptation instruments. Sister
has identified many propositions in relation to the Callista Roy continues to refine the adaptation model
regulator and cognator mechanisms and the self- for nursing research, education, and practice.
concept, role function, and interdependence modes. According to Roy, persons are holistic adaptive
These propositions have received varying degrees of systems and the focus of nursing. The internal and
support from general theory and empirical data. Most external environment consists of all phenomena that
of the propositions are relational statements and can surround the human adaptive system and affect their
be tested (Tiedeman, 1983). Over the years, many development and behavior. Persons are in constant
testable hypotheses have been derived from the model interaction with the environment and exchange infor-
(Hill & Roberts, 1981). mation, matter, and energy; that is, persons affect and
In spite of the progress made over the last 25 years, are affected by the environment. The environment is
the greatest need to increase the empirical precision the source of stimuli that either threaten or promote a
of the Roy Adaptation Model is for researchers to person’s existence. For survival, the human adaptive
develop middle-range theory based on the Roy Adap- system must respond positively to environmental
tation Model with empirical referents specifically stimuli. Humans make effective or ineffective adap-
designed to measure concepts proposed in the derived tive responses to environmental stimuli. Adaptation
theory. Roy has explicated a significant number of promotes survival, growth, reproduction, mastery,
propositions, theorems, and axioms to serve in the and transformation of persons and the environment.
development of middle-range theory. The holistic Roy defines health as a state of becoming an inte-
nature of the model serves nurse researchers world- grated and whole human being.
wide who are interested in the complex nature of Three types of environmental stimuli are described
physiological and psychosocial adaptive processes in the Roy Adaptation Model. The focal stimulus is
(Roy, 2011a; 2011b). that which most immediately confronts the individual
and demands the most attention and adaptive energy.
Importance Contextual stimuli are all other stimuli present in the
The Roy Adaptation Model has a clearly defined nurs- situation that contribute positively or negatively to the
ing process and is useful in guiding clinical practice. strength of the focal stimulus. Residual stimuli affect
The utility of the model has been demonstrated globally the focal stimulus, but their effects are not readily
by nurses. This model provides direction for quality known. These three types of stimuli together form the