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322 UNIT III Nursing Conceptual Models

TABLE 17-1 Overview of the Adaptive Modes—cont’d

Subsystem Adaptive Mode Coping Need
Cognator Self-Concept Physical Self
The self-concept adaptive mode refers Body sensation: To maintain a positive feeling about
to the psychological and spiritual one’s physical being (i.e., physical functioning,
characteristics of a person. sexuality, or health)
The self-concept consists of the Body image: To maintain a positive view of one’s
composite of a person’s feelings about physical body and physical appearance
himself or herself at any given time. Personal Self
The self-concept is formed from internal Self-consistency: To maintain consistent self-organization
perceptions and the perceptions of and to avoid dysequilibrium
others’ reactions. Self-ideal or self-expectancy: To maintain a positive
The self-concept has two major or hopeful view of what one is, what one expects
dimensions: the physical self and the to be, and what one hopes to do
personal self. Moral-spiritual-ethical self: To maintain a positive
Basic need: Psychic and spiritual integrity evaluation of who one is
Interdependence To maintain close, nurturing relationships with people
Basic need: Relational integrity or who are willing to give and receive love, respect,
security in nurturing relationships and value
Role Function To know who one is and what society’s expectations
Basic need: Social integrity are so that one can act appropriately within society

The goal of nursing is to promote adaptive
responses. This is accomplished through a six-step CASE STUDY
nursing process: assessment of behavior, assessment of A 23-year-old male patient is admitted with a
stimuli, nursing diagnosis, goal setting, intervention, fracture of C6 and C7 that has resulted in quad-
and evaluation. Nursing interventions focus on man- riplegia. He was injured during a football game at
aging environmental stimuli by “altering, increasing, the university where he is currently a senior. His
decreasing, removing, or maintaining them” (Roy & career as a quarterback had been very promising.
Andrews, 1999, p. 86). At the time of the injury, contract negotiations
Meleis (1985) proposed that the focus of nursing were in progress with a leading professional foot-
theorist works as the following three types: ball team.
1. Those who focus on needs 1. Use Roy’s criteria to identify focal and con-
2. Those who focus on interaction textual stimuli for each of the four adaptive
3. Those who focus on outcome modes.
Meleis (1985, 2007) classifies the Roy Adaptation 2. Consider what adaptations would be necessary
Model as an outcome theory. In applying the concepts in each of the following four adaptive modes:
of sy’stem and adaptation to person as the patient of (1) physiological, (2) self-concept, (3) interde-
nursing, Roy has presented her articulation of the pendence, and (4) role function.
person for nurses to use as a tool in practice, educa- 3. Create a nursing intervention for each of the
tion, and research. Her conceptions of person and of adaptive modes to promote adaptation.
the nursing process contribute to the science and the
art of nursing. The Roy Adaptation Model deserves
further study and development by nurse educators,
researchers, and practitioners.