NURSING THEORIES: ROY AND LEININGER 6
NursingTheories: Royand Leininger
CallistaRoy’s Adaptation Model of Nursing
TheAdaptation Model of Nursing is a nursing care theory that wasdeveloped by Sister Callista Roy. According to the theory, anindividual is viewed as a combination of systems that areinterrelated to operate as one person. These systems encompass thebiological, the social and the psychological aspects of a humanbeing. The theory holds that an individual is a bio-psycho-socialbeing who has a constant interaction with the environment (Roy,2009). The environment is a changing element that constitutes achanging world. According to Wilkinsonand Treas (2010), aperson copes with the dynamic environment as per the theory by makingchoices that adapt to health or illness. People make these choicesusing both acquired and innate mechanisms that originate from thethree elements of a human being the social, biological andpsychological aspects.
Callistaasserts that health and illness are unavoidable in the environment,therefore a person must respond positively to the environment byadapting to it. To do this, a person has four main modes of adapting,which are interdependence, self-concept, role function andpsychological needs(Sitzman& Wright, 2011).Therefore,the role of nursing is to promote the adaption of a person to theenvironment in every of these modes.
Theadaptation model of nursing addresses various concepts that relate tothe nursing discipline. The theory addresses nursing as the practicethat facilitates people to adapt to the environment in the fouradaptive modes. According to Roy (2009), this facilitationcontributes to health and quality life, as well as giving people careto die with dignity. Nursing achieves this by influencing adaptiveabilities of people through the procedure of intervening in theirinteraction with the environment.
Thetheory addresses health as the process and state of becoming wholeand integrated in the environment. According to Roy (2009), health isan inevitable aspect of the life of an individual. Therefore, thetheory addresses illness as the state that contravenes the wholenessand the integration that reflects a healthy state. This means thatillness is a state of having imbalances in the interaction with theenvironment as it relates to the four adaptive modes.
Themodel addresses the person as a bio-psycho-social being that is inconstant interaction with the environment and uses acquired andinnate mechanisms to adapt. According to the theory, a person is anadaptive system that is made up of several parts that function inunison for some purpose (Roy, 2009). The theory addresses theenvironment as the internal or external space that confronts aperson. This conceptually includes all the stimuli that are presentin any situation that contributes to the effect that a person feelscoming from the surrounding. This means that the environment includesall the circumstances, all the conditions, and the influences thatsurround people and affect the development of their behavior.
Theadaptive model of nursing as developed by Callista Roy is applicableto the practice today as it gives a multiple view of situations inrelation to multi-faceted humans. The theory is applied in theprocess of observing people by enriching the interviewing skills,especially when carrying out individualized assessment. In addition,Roy’s Adaptation Model is applicable in the development of thenursing processes such as patient assessment, diagnosis and otherhealth intervention tasks(Sitzman& Wright, 2011).Throughresearch, the model provides guide to explore more variables foreducational development of the discipline. Therefore, the theoryprovides a basis for the development of a curricular for nursinginstitutions.
Regardedas the pioneer of transcultural nursing, MadeleineLeiningerdeveloped the transcultural theory of nursing to focus on comparativecultural values. The transcultural nursing studies the cultures andunderstands their similarities as well as the differences across thehuman groups(Sitzman& Wright, 2011).Thetheory of transcultural nursing states that different culturesprovide different set of beliefs, values and practices that dictatethe direction of care that the nursing should take. The theory rangesthe direction of care in three main aspects. One of the aspects iscultural care, preservation that influences nursing to maintainhealth and help people to recover from illnesses. The second is thecultural care accommodation where nursing is meant to help peoplenegotiate their way to better health status. The third is culturalcare re-patterning which diverts nursing to help in changing thelifestyles of people to adapt to culturally meaningful and healthyways.
Leininger’stransculturalnursing addresses nursing as a practice that is meant to provide carethat is in line with the cultural beliefs, practices and values. Thetheory focuses on delivering knowledge that influences nursing toprovide care that preserves health accommodates cultural factors andre-patterns, lifestyles according to culture(Wilkinson& Treas, 2010). Transculturalnursing addresses a person as part of the society that is practicedcertain cultural values. A person is deemed to live in congruencewith the demands of the society in terms of cultural practices,beliefs and values. At the same time, people are considered to becaring beings who are concerned with the issues of others.
Thetransculturalnursing addresses the environment as an element of the larger worldthat Leiningerterns as a worldview. Worldwide is the way that people look at theenvironment and creates a picture or a set of values based on theperception (Sitzman& Wright, 2011).According to Leininger,the environment is the societal structure that provides the contextthrough which people practice care to others. The environmentalcontext dictates the cultural practices that people should becongruent with as they care for others.
Leininger’stransculturalnursing addresses health as a state of being, which is defined,valued and practiced culturally. This state reflects the ability ofpeople to perform their tasks and activities in life through waysthat are beneficial and culturally expressed(Wilkinson& Treas, 2010). Thestate of being healthy also reflects the ability to live according tothe values, beliefs and practices of the society, which forms thebasis of defining the environmental context. The transculturalnursing therefore addresses illness as the state of being unable toperform the expectations of the cultural context. According toWilkinsonand Treas (2010),the transcultural nursing views illness and wellbeing as aspects thatare shaped by factors that relate to an individual’s perception andsocial level.
MadeleineLeininger’stransculturalnursing is applicable in the modern practice in the appreciation ofdiversity and individuality. The theory is applicable in developingthe respect and understanding of various cultural values, beliefs andspirituality as they relate to health and illness(Wilkinson& Treas, 2010). Throughsuch understanding, trans-cultural nursing is applicable in thedevelopment and maintenance of physical spiritual and emotional carethrough therapies. This theory is also applicable in the provision ofhealth care to culturally diverse societies by providing a way ofunderstanding the health needs of people through the culturalcontext. As a result, Leininger’stransculturalnursing is applicable in translating nursing as a transculturalcaring profession that is purposed to serve human beings worldwide byunderstanding their social contexts.
Roy,C. (2009). "Assessment and the Roy Adaptation Model," TheJapanese Nursing Journal,29(11), 5-7.
Sitzman,K., Wright, E. L.(2011). Understandingthe Work of Nurse Theorists: A Creative Beginning (2nd ed.).Burlington, Ma: Jones and Bartlett Publishers
Wilkinson,J.M., & Treas, L.S. (2010). Fundamentalsof Nursing – Volume 1: Theory, Concepts, and Applications.Philadelphia: F.A. Davis