How would the use of the Roy Adaptation Model assist the nurse in planning the continuation of care for Sgt. Johns? Describe the influence of Roy’s Theory in guiding the nurse’s actions in promoting Sgt. Johns adjusted self-concept. From the perspective of the Roy Adaptation Model, why is it important for the nurse to listen to Sgt. Johns’ “story” in his own words and not just base her interactions on information from the chart, fellow colleagues, or his family? Based on Neuman Systems Model, identify at least 4 stressors from the case study. Create a plan of care based on Neuman Systems Model for Sgt. Johns.

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ROYAND NEUMAN'S ADAPTATIO NMODELS • T E R E S A S I M M O N S • A S P E N U N I V E R S I T Y • N U R 4 9 1 : C O N C E P T S A N D T H E O RY I N N U R S I N G • D R. D E N Y G O O Z E E , D N P , M S N , R N , C R R N • M AY 1 5 , 2 0 2 2

Objectives • Describe the use of Roy's adaptation model in the plan of care for Sgt. Johns • How will the nurse use Roy's Theory to guide actions that promote Sgt. Johns adjusted self-concept • Discuss the importance ofthe nurse to listening to Sgt. Johns in his own words while using the perspective of Roy's Adaptation Model • Create a plan of care • Identify four stressors using Neuman System's Model

Callista Roy • Callista Roy's Adaptation Model was developed in the 1970s •The Adaptation Model provides an extensive source of knowledge that improves nursing practice • In Roy's model, the person is seen as interrelated systems that maintains stability between multiple stimuli • Roy's work includes numerous publications such as books and nursing journals related to nursing theory and many other professional topics (Smith & Parker, 2015) This Photoby Unknown Author is licensed underCC BY-SA-N

Roy's 5 Major Concepts • Person • Human beings are holistic individuals who constantly interact with their environment. • Adaptation both innate and acquired are used to respond to environmental stimuli • Thinking and feeling is rooted in consciousness and humans adjust to changes in their environment • Environment •Environmental stimuli requires humans to adapt •Focal, internal and external • Circumstances and conditions that affect human development • Behavior is an adaptive system within the environment

Roy's 5 Major Concepts.... • Health • A state where individuals must continuously adjust various stimuli • Defined as a role where health and illness can coexist • The ability to cope with unhappiness, stress, disease and death • Nursing •Facilitators of adaptation •Promotes positive adaptation • Enhance positive environmental interactions and response to stimuli • Adaptation •Conscious and awareness when thinking and feeling • Human and environmental integration • Effective coping mechanisms (Gonzalo, 2021)

Internal Processes • Regulator subsystem • An individual's physiological coping mechanism • The body's attempt to adapt by using the endocrine and neurochemical systems • Cognator subsystem • Humans mental coping mechanism •Use of the brain to cope (Gonzalo, 2021)

Roy's Adaption Model: 4 adaptive modes • Physiological-Physical Mode • Physical and chemical processes • Functions and activities of humans • Basic needs of oxygen, nutrition, activity, rest, elimination and protection •Fluid and electrolyte balance, neurological and endocrine functions •Set in motion by the regulator subsystem •Self Concept • Sense of unity • Sense of purposefulness • Sense ofpersonal identity • Body image •Self ideals •Role Function Mode •Focuses on primary, secondary and tertiary roles •Position and involvement in society • An individual knowing where they stand in society • Interdependence Mode •Interactions between one another •Giving and receiving • Respect, love and value • Effective communication (Gonzalo, 2021)This Photoby Unknown Author is licensed underCC BY

3 Levels of Adaptation • Integrated Process •Meeting environmental demands • Involves stable processes such as realization, spiritual, breathing and meaningful relationships •Compensatory Process • Regulator and Cognator subsystems are challenged by environmental needs • Goals are aimed at meeting environmental needs ( new career, grief) •Compromised Process • Subsystems and modes are not meeting the needs of the environment (abusive relationship, unmanageable loss ) (Marudhar, 2019)

Roy's 6 step Nursing Process Assessment ofobserved behavior•Utilizing the adaptationmodel•Gathering information01Assessment ofstimuli•Focal, contextual andresidual •Internal and external 02Create a nursingdiagnosis •To develop plan of care03Goal setting•Created by use ofadaption model•Behavioral outcomes04Interventions•Actions that targetmanagement of stimuli• Determining how to assist the patient in achieving goals 05Evaluation • Have goals been met? • Judging effectiveness (Gonza

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