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DEVELOPMENTAL THEORY


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SISTER CALLISTA ROY

Adaptation Model

The changing

environment stimulates

the person to make

adaptive responses. For

human beings, life is

never the same


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BIOGRAPHY

Date of Birth: October 14, 1939


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EDUCATION

1963: BSN Mount St. Marys College, Los

Angeles

1966: Masters Degree in Pediatric Nursing University of California

1973: Masters Degree in Sociology

1977: PhD in Sociology


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WORK HISTORY

Entered the Sisters of Saint Joseph Carondelet

Professor and Nurse Theorist at Boston

College of Nursing

Fellow American Academy of Nursing

Member

Sigma Theta Tau North American Nursing Diagnosis Association

(NANDA)


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INFLUENCING FACTORS

Family

Education

Religious background Mentors

Clinical Experience


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METAPARADIGM IN NURSING

Person

A biopsychosocial being in constant interaction

with a changing environment

Is an open, adaptive system who uses coping skills

to deal with stressors


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Environment

Conditions, circumstances and influences that

surround and affect the development and

behavior of the person


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Health

Is the process of being and becoming an

integrated and whole person

Represented by a health-illness continuum


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Nursing

To promote adaptation for individuals and groups

in the four adaptive modes, thus contributing to

health, quality of life, and dying with dignity byassessing behaviors and factors that influence

adaptive abilities and by intervening to enhance

environmental interactions


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Person

Adaptive system has:

Cognator subsystems

Regulator subsystems

Adaptive system act to maintain adaptation to

four (4) adaptive modes:

Physiologic-physical Self-concept-group identity

Role function

Interdependence


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ROYS ADAPTATION MODEL

Person is an adaptive system in constant

interaction with an internal and external

environment


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Environment is the source of a variety of

stimuli that either threaten or promote the

persons unique wholeness


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Categories of environmental stimuli: Focal

Is the internal or external stimulus most immediately

challenging the persons adaptation

Is the phenomenon that attracts the most of ones

attentions

Contextual

All other stimuli existing in a situation that strengthen the

effect of the focal stimulus

Residual

Any other phenomena arising from a persons internal or

external environment that may affect the focal stimulus

but whose effects are unclear


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Persons Adaptation Level

Integrated

Compensatory

Compromised


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Categories of Coping Mechanisms:

Regulator subsystem

Occurs through neural, chemical, endocrine processes

Automatic response to stimuli

Cognator subsytem

Occurs through cognitive-emotive processes-perceptual

and information processing, learning, judgment, and

emotion


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Two Control Processes the Coincide With the

Subsystems:

Stabilizer subsystems

The established structures, values, and daily activitieswhereby participants accomplish the primary purpose

of the group and contribute to common purpose of

society

Innovator subsystems Refers to cognitive and emotional strategies that allow

a person to change to higher levels of potential


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Four Adaptive Modes:

Physiological

Self-concept

Role function

Interdependence


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Physiological Adaptive Mode

Refers to the way a person responds as a physical

being to stimuli from the environment

Goal: physiological integrity

5 physiological needs: 4 complex processes:

Oxygenation Senses

Nutrition Fluids and electrolytes

Elimination Acid-base balance

Activity and rest Neurologic function

Protection Endocrine function


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Self-Concept Adaptive Mode

Refers to psychological and spiritual characteristics

of the person

Goal: psychic integrity

Two components:

Physical self

Incorporates body sensation and body image Personal self

Incorporates self-consistency, self-ideal, and moral-ethical-

spiritual self


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Role Function Adaptive Mode

Refers to the primary, secondary or tertiary roles

the person performs in society

Goal: social integrity


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Interdependence Adaptive Mode

Refers to the coping mechanisms arising from

close relationship that result in the giving and

receiving of love, respect, and value

Goal: affectional adequacy


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Results of Coping Mechanisms:

Adaptive responses

Promotes integrity of the person and goals of

adaptation

Ineffective responses

Neither promote integrity nor contribute to the goals of

adaptation


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Adaptation

Responding positively to environmental changes


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NURSING PROCESS

Six Steps:

Assessment of behavior

Assessment of stimuli

Nursing Diagnosis

Goal Setting

Intervention

Evaluation


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NURSING PROCESS

ASSESSMENT OF BEHAVIOR

Adaptive Modes

Types:

Observable

Vital signs

Non-observable

Feelings experienced by the person (anxiety)


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NURSING PROCESS

ASSESSMENT OF STIMULI

Focal

Most immediately confronting the person

Contextual

All other stimuli present that are affecting the situation

Residual

Stimuli whose effect on the situation is unclear


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NURSING PROCESS

NURSING DIAGNOSIS

Formulation of statements that interpret the data

about the adaptation status of the person

The diagnostic statement indicates:

Actual

Potential problems


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NURSING PROCESS

GOAL SETTING

Involves the establishment of clear statements of

the behavioral outcomes for nursing care

Done together with the client

Includes:

Behavior

Change expected Time frame


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NURSING PROCESS

INTERVENTION

Management of stimuli

Alter

Increase

Decrease

Remove

Maintain


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NURSING PROCESS

EVALUATION

Observation of behaviors after interventions have

been completed to see if goals have been MET


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APPLICATION OF ROYS THEORY

Pages 147-151


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MADELEINE LEININGER

Transcultural Theory in

Nursing

Cultural Care Diversity

and UniversalityTheory

The purpose of transcultural

nursing is to discover and establish a

body of knowledge and skills

focused on transcultural care,health, and illness in order to assist

nurses giving culturally competent,

safe, and congruent care to people

of diverse culture worldwide


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BIOGRAPHY


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EDUCATION

1948: Diploma in Nursing St. Anthonys

School of Nursing, Denver

1950: BS Biological Science Benedictine

College, Atchinson, Kansas

1953: MSN Catholic University, Washington,

D.C. 1965: PhD in Anthropology University of

Seattle


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ACHIEVEMENTS

Offered 1st course in Transcultural Nursing at

University of Colorado

Major contributor to other schools in

transcultural nursing curriculum


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DEFINITION

Culture

Set of values, beliefs and traditions that are held

by a specific group of people and handed down

from generation to generation Beliefs, habits, likes, dislikes, customs, and rituals

learned from ones family


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DEFINITION

Religion

Set of belief in a divine or super human power to

be obeyed and worshipped as the creator and

ruler of the universe


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DEFINITION

Ethnicity

A consciousness of belonging to a group


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DEFINITION

Race

Classification of people according to shared

biologic characteristics, genetic markers, or

features


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DEFINITION

Cultural identity

The sense of being part of an ethnic group or

culture


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DEFINITION

Culture-universals

Commonalities of values, norms of behavior, and

life patterns that are similar among different

cultures


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DEFINITION

Culture-specifics

Values, beliefs and patterns of behavior that tend

to be unique to designate a culture


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DEFINITION

Material culture

Refers to objects (dress, art, religious artifacts)


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DEFINITION

Non-material culture

Refers to beliefs, customs, languages, social

institutions


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DEFINITION

Diversity

Fact or state of being different

Can occur between cultures and within a cultural

group


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DEFINITION

Cultural shock

State of being disoriented or unable to respond to

a different cultural environment because of its

sudden strangeness, unfamiliarity andincompatibility to the strangers culture

TRADITIONAL CONCEPTS OF HEALTH


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TRADITIONAL CONCEPTS OF HEALTH

AND DISEASE

Explanations for health and disease are

characterized by many traditional beliefs

about disease causation, treatment, and

general health practices


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Person

Is caring and capable of being concerned about

others


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Environment

Closely related to the concept of culture


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Health

Is culturally defined, valued and practiced

Is universal across all cultures yet defined differently by each

to reflect its specific values and beliefs

It is BOTH universal and diverse

Components

Health systems

Health care practices

Changing health patterns

Health promotions

Health maintenance


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Nursing

Has physical, psychocultural, and social

significance for those being assisted

Uses 3 modes of action to deliver care: Cultural care preservation or maintenance

Cultural care accommodation or negotiation

Cultural care repatterning/restructuring


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APPLICATION OF LEININGERS THEORY

Refer to page 159-161


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MARGARET JEAN WATSON

Philosophy and Science

of Caring

Caring in nursing

conveys physical acts,but embraces the mind-

body-spirit as it

reclaims the embodied

spirit as its focus ofattention


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EDUCATION

1964: BSN Boulder Campus, Univ. of

Colorado

1966: MS in Psychiatric-Mental Health

Nursing Health Sciences Campus,

Univ. of Colorado

1973: PhD in Educational Psychology andCounseling - Boulder Campus,

University of Colorado


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Person

Is a valued person in and of him to be cared for,

respected, nurtured, understood, and assisted


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Environment

Provides values that determine how one should

believe and what goals one should strive toward


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Health

Unity and harmony within the mind, body, and

soul

Three elements: High level of over-all physical, mental, and social

functioning

A general adaptive-maintenance level of daily

functioning

Absence of illness (or presence of efforts that lead to its

absence)


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Nursing

Human science of people and human health-

illness experiences that are mediated by

professional, personal, scientific, aesthetic, andethical human care transactions


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MAJOR ELEMENTS

1. The carative factors

Care with love

Originated from the word caritaswhich means

to cherish, appreciate and give special attention


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MAJOR ELEMENTS

Ten Carative Factors1. Formation of humanistic-altruistic system of

values

2. Instillation of faith-hope3. Cultivation of sensitivity to ones self and to

others

4. Development of a helping-trusting, human

caring relationship (pls refer to the next slide)5. Promotion and acceptance of the expression of

positive and negative feelings


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MAJOR ELEMENTS

Characteristics needed in the helping-trust

relationship

Congruence

Empathy

Warmth


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MAJOR ELEMENTS

Ten Carative Factors

6. Systematic use of a creative problem-solving caring

process

7. Promotion of transpersonal teaching-learning8. Provision of a supportive, protective, and corrective

mental, physical, societal, and spiritual environment

9. Assistance with gratification of human needs (please

refer to the next slide)

10. Allowance for existential-phenomenological-spiritual

forces


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MAJOR ELEMENTS

Watsons Ordering of Needs

Lower order needs (Biophysical Needs)

The need for ventilation

The need for food and fluid The need for elimination

Lower order needs (Psychosocial Needs)

The need for activity-inactivity

The need for sexuality


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MAJOR ELEMENTS

Watsons Ordering of Needs

Higher order needs (Psychosocial Needs)

The need for achievement

The need for affiliation

Higher order needs (Intrapersonal-interpersonal

Needs)

The need for self-actualization


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MAJOR ELEMENTS

2. Transpersonal Caring Relationship

Describes how the nurse goes beyond an

objective assessment, showing concerns toward

the persons subjective and deeper meaningregarding their own health care situation


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MAJOR ELEMENTS

3. Caring occasion / caring moment

The nurse and another person come together in

a such a way that an occasion for human caring is

created Not simply a goal for the cared-for, the nurse,

also needs to be aware of her own consciousness

and authentic presence of being in caring

moment with her patient


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APPLICATION OF WATSONS THEORY

Refer to page 166


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PATRICIA BENNER

From Novice to Expert

Nursing is a science

that studies the

relationships betweenmind, body, and human

worlds


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EDUCATION

1964: BSN Pasadena College

1970: MSN Univ. of California

1982: PhD Univ. of California


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ACHIEVEMENTS

Author of nine books

Internationally noted researcher and lecturer

on health, stress, and coping, skill acquisition

and ethics


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Nursing

Enabling condition of connection and concern


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Person

Self-interpreting being

Major aspects of understanding that the person

must deal with as: The role of the situation

The role of the body

The role of personal concerns

The role of temporality


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Health

What can be assessed

Not just the absence of disease and illness


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Environment

situation social environment


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SKILLS ACQUISITION IN NURSING

Novice

Stage where nursing students belong

Advance beginner

Newly graduated nurses

Competent

Proficient

Expert

SEVEN DOMAINS OF NURSING


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SEVEN DOMAINS OF NURSING

PRACTICE

Helping role

Teaching-coaching function

Diagnostic and patient-monitoring function

Effective management of rapidly changing

situations

Administering and monitoring therapeuticinterventions and regimens

Monitoring and ensuring the quality of health

care practices


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PHILIPPINE CONCEPTUAL MODELS


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Dr. LETTY G. KUAN

Has two MA Degree

Nursing

Education, major in Guidance and Counseling

Professor Emeritus UP College of Nursing

Former member of Board of Nursing

G


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Dr. LETTY G. KUAN

Dissertation: Retirement and Role

Discontinuities

D LETTY G KUAN


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Dr. LETTY G. KUAN

Concepts

Physiological age

Role

Change of life

Retiree

Coping approaches

D LETTY G KUAN


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Dr. LETTY G. KUAN

Determinants of positive perceptions inretirement:

Health status

Income

Work status

Family constellation

Self-preparation

CARMENCITA ABAQUIN


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CARMENCITA ABAQUIN

MAN and PhD UPCN

Expertise: MS (Oncologic Nursing)

Chairman of the BON

CARMENCITA ABAQUIN


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CARMENCITA ABAQUIN

Dissertation:

PREPARE ME Intervention and the Quality of

Life of Advance Progressive Cancer Patients

CARMENCITA ABAQUIN


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CARMENCITA ABAQUIN

Concepts

Presence

Reminisce therapy

Prayer

Relaxation-breathing

Meditation

Values clarification

CMO NO 14 S 2009


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CMO. NO. 14 S. 2009

POLICIES AND STANDARDS FOR BSN


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PROGRAM

Art. 1

Sec. 1. A person is a unique bio-psycho-socio-

cultural and spiritual being who is always in

constant interaction with the environment. Theseinteractions affects individuals, family, population

groups and societal health status



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PROGRAM

Art. 1

Sec. 1. Within the context of Philippine society,

nursing education, with caring as its foundation,

subscribes to the following CORE VALUES whichare vital components in the development of a

professional nurse and are therefore emphasized

in the BSN program:



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PROGRAM

Core Values

Love of God

Caring as the Core of Nursing

Compassion

Competence

Confidence

Conscience

Commitment (to a culture of excellence, discipline,

integrity, and professionalism)



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PROGRAM

Core Values

Love of People

Respect for the dignity of each person regardless of

creed, color, gender, and political affiliation) Love of Country

Patriotism (civic duty, social responsibility, and good

governance)

Preservation and enrichment of the environment andculture heritage


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PROGRAM

The following are the 11 Key Areas ofResponsibility for which the nurse should

demonstrate competence:

1. Safe and quality nursing care2. Management of resources and environment

3. Health education

4. Legal responsibility5. Ethico-moral responsibility



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PROGRAM

6. Personal and professional development

7. Quality improvement

8. Research

9. Record management10. Communication

11. Collaboration and teamwork

COMPETENCY STANDARDS


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END

GOODLUCK AND GOD BLESS

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