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Four women smiling with a black and white filterThe Roy Adaptation Model for Nursing had its beginning when Sr. Callista Roy entered the masters program in pediatric nursing at University of California Los Angeles in 1964. Her advisor and seminar faculty was Dorothy E. Johnson who was writing and speaking on the need to define the goal of nursing as a way of focusing the development of knowledge for practice. Dr. Roy had read a little about the concept of adaptation and was impressed with the resiliency of children she had cared for in pediatrics.

At the first seminar in pediatric nursing, she proposed that the goal of nursing was promoting patient adaptation. Throughout her course work in the master's program Dorothy Johnson encouraged her to develop her concept of adaptation as a framework for nursing. The use of systems theory as defined by von Bertalanffy was an important early concept of the model, as was the work of Helson. Helson defined adaptation as a process of responding positively to environmental changes and described three types of stimuli, focal, contextual and residual. Dr. Roy made appropriate derivations of these concepts for use in describing situations of people in health and illness. Other authors that influenced the early development of the central concepts of the model included Dohrenwend, Lazarus, Mechanic, and Selye. The view of the person as an adaptive system took shape from this early work with the cognator and regulator being added as the major internal processes of the adapting person.

Development of the RAM – Early and Today

The Adaptive Modes

There are four adaptive modes: 

  • Individual Application
    • Relational integrity, the feeling of security in nurturing relations
    • Includes interactions of giving and receiving love, respect, and value
  • Group Application
    • The social context in which a group operates, relational, developmental, and resource adequacy
    • Includes context, infrastructure, and member capability

  • Individual Application: Physiologic
    • Five basic needs: oxygenation; nutrition; elimination; activity and rest; and protection
    • Four complex processes: senses; fluid, electrolyte and acid-base balance; neurologic function; and endocrine function
  • Group Application: Physical
    • Resource adequacy, are the needs of the group being met
    • Example: if a community continues to permit pollution of its rivers from industries in the environment, the physical health of community members will be affected

  • Individual Application
    • The need to know who one is in relation to others so that one can act
  • Group Application
    • Roles within a group are the vehicle through which the goals of the social system are accomplished
    • Includes the functions of administrators and staff, the management of information, and systems for decision-making and maintaining order

  • Individual Application: Self-Concept
    • An individual’s physic and spiritual integrity; the need to know who one is so that one can be or exist with a sense of unity
    • Example: A nurse can have a self-concept seeing himself/herself as physically capable of the work involved.
  • Group Application: Group Identity
    • Identity integrity; interpersonal relationships, group self-image, social milieu, culture and shared responsibility of the group
    • Example: There is a social environment experienced by the nurses, administrators, and other staff that is reflected by those who are part of the nursing care group. The group feels shared values and counts on one another.

Roy Adaptation Model Terms

Adaptation: the process and outcome whereby thinking and feeling persons, as individuals and groups, use conscious awareness and choice to create human and environmental integration

Adaptation Level: adaptation level represents the condition of the life processes described on three levels as integrated, compensatory, and compromised

Adaptation Processes: activity of subsystems for coping of individuals and relational persons

Adaptive Modes: ways of manifesting adaptive processes

Cognator Subsystem: for individuals, a major coping process involving four cognitive-emotive channels: perceptual and information processing, learning, judgment and emotion.

Common Purposefulness: all persons and earth have both unity and diversity; are united in a common destiny; find meaning in mutual relations with each other, the treated world, and a God-figure

Compensatory Adaptation Level: cognator and regulator or stabilizer and innovator are activated by a challenge to the integrated life processes

Compromised Adaptation Level: results from inadequate integrated and compensatory life processes; an adaptation problem

Contextual Stimuli: all other stimuli present in the situation that contribute to the effect of the focal stimulus

Coping Processes: Innate or acquired ways of responding to the changing environment

Cosmic Unity: a philosophic view of reality which stresses the principle that people and earth have common patterns and integral relationships

Focal Stimulus: the internal or external stimulus most immediately confronting the human adaptive system

Holism: descriptive of individual and relational adaptive systems; stems from philosophical assumptions of person functioning as wholes in a unified expression of meaningful human behavior; includes common purposefulness and cosmic unity

Humanism: The broad movement in philosophy and psychology that recognized the person and subjective dimensions of the human experience as central to knowing and valuing (Roy, 1988); includes the development of specific schools of thought such as secular, atheistic or Christian humanism.

Innovator Subsystem: pertaining to humans in a group, the internal subsystem that involves structures and processes for change and growth

Integrated Adaptation Level: structures and functions of the life processes are working as a whole to meet human needs

Interdependence: the close relationships of people aimed at satisfying needs for affection, development of relationships, and resources to achieve relational integrity

Regulator Subsystem: for individuals, a major coping process involving the neural, chemical, and endocrine systems

Relational Persons: individuals relating in groups such as families, organizations, communities, and society as a whole; use stabilizer and innovator coping processes; with four adaptive modes of physical, groups identity, role function and interdependence (Hanna & Roy, 2001)

Relativity: refers to the belief that there is no way to determine objective truth or objective morality; subjectivity is emphasized and the truth becomes what is meaningful or significant within a given context, while good means pleasurable or satisfying; person's own thoughts and feelings are final guide to action (Roy, 2000)

Residual Stimulus: an environmental factor within or outside the human system with affects in the current situation that are unclear

Role: the function unit of society; each role exits in relation to another

Self-concept: the composite of beliefs and feelings that is held about oneself at a given time, formed from the internal perception and perceptions of others' reactions

Stabilizer Subsystem: for groups, the subsystem associated with system maintenance and involving established structures, values, and daily activities whereby participants accomplish the purpose of the social system

Stimulus: that which provokes a response, or more generally, the point of interactions of the human system and environment

Veritivity: principle of human nature that affirms a common purposefulness of human existence; components include a) purposefulness of human existence, b) unity of purpose in humankind, c) activity and creativity for the common good, d) value and meaning of life; the richness of rootedness in absolute truth

Coping and Adaptation Processing Scale (CAPS)

Published in 2015, Sr. Callista Roy is pleased to share with you the latest 15-item Coping and Adaptation Processing Scale (CAPS). This short form has been proven equally valid and reliable as the long form, but is far more efficient for researchers. All of the original 47 items included in the CAPS long form are reflected in the new 15 item short form.

CAPS Form   CAPS User Manual   CAPS Spanish Form

Two nursing students practicing on a mannequin

Spanish Teaching Tool

Roy Adaptation Model

We are thrilled to provide a new teaching tool for educators. Completed in 2015, this project was completed thanks to the hard work of Martha Velasco-Whetsell, PhD, RN and Sr. Callista Roy, RN, PhD, FAAN. This series of PowerPoints are intended to serve as teaching guidelines for Spanish speaking instructors. We hope you enjoy using it.

*The contents of this work may not be changed or reproduced in any form without permission from Roy Adaptation Association.

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