response to peer DQ3
Number of replies: 1
This discussion piece looks at Roy’s Adaptation Model in both and individual and group roles as well as looks into different stimuli and adaptation levels. It also looks at how to apply the model into everyday practice as future advanced practitioners.
Difference in Adaptive Modes
When looking at Roy’s Adaptation Model there is the individual and the group within the holistic adaptive system (Smith, 2019). When assessing the individual there are four modes; physiological, self-concept, role function, and interdependence (Smith, 2019). The physiological mode looks at the basic needs of the individual and further breaks it into nine components (Smith, 2019). These components include; oxygenation, nutrition, elimination, activity/rest, protection, senses, fluid electrolyte and acid-base balance, neurological function, and endocrine function (Smith, 2019). The self-concept mode looks at how the person views themselves spiritually, morally, ethically, body sensation, body image, self-ideal, self-consistency, and self-worth (Smith, 2019). Self-concept allows one to see how a person composites beliefs and feelings regarding themselves at a given moment (Smith, 2019). Role function looks at the individual’s role within their community and how a person might interact in their current role towards a person in an opposing role (Smith, 2019). Interdependence focuses on the interactions related to the giving and receiving of love, respect, and value (Smith, 2019). It looks further into the person’s support systems that contribute to the interspersed needs (Smith, 2019).
In Roy’s Adaptation Model, the group looks at multiple modes; physical, group identity, and role clarity (Smith, 2019). The physical mode of the group looks into the fiscal resources, physical facilities, and the participants (Smith, 2019). Group identity looks into interpersonal relationships, group self-image, social milieu, and culture (Smith, 2019). Role clarity is the need to understand a commitment to fulfilling expected tasks and to achieve common goals (Smith, 2019). This looks into reciprocating roles, expectations, and integrating roles within a group (Smith, 2019).
Focal, Residual, and Contextual Stimuli
Roy’s Adaptation Model also looks into three types of stimuli that affect an individual and environmental interactions that can affect an individual’s or group’s adaptive system (Smith, 2019). These three stimuli are; focal, contextual, and residual (Smith, 2019). Focal stimuli are the most immediate stimuli, either internal or external, that confront the human system (Smith, 2019). An example of this would be a broken arm. Contextual stimuli contain all the other stimuli present at the time the situation occurred that contribute to the effect of the focal stimuli (Smith, 2019). An example of this would be icy conditions while walking outside. Lastly, residual stimuli contain environmental factors within or without the human system with effects in the current situation that may be unclear (Smith, 2019). An example of this would be a history of osteoporosis affecting healing time in the patient’s broken arm.
Four Questions
As an advanced practitioner during an evaluation of a patient one might ask the following four questions to better understand the patient being cared for while applying Roy’s Adaptation Model. Open-ended questions allow providers a better insight into the mindset and environment that the patient is currently dealing with. The four questions that I would ask in an emergency room setting are as follows:
What brings you into the department today?
Do you feel safe at home and what are your current living conditions?
What are your current healthcare goals and goals for this visit today?
Upon discharge do you have to care for anyone at home and do you have someone to care for you and the person you may be caring for?
The reason one might as these four questions is to gain insight into the self-concept mode, physiological mode, interdependence mode, and role function mode in Roy’s Adaptation Model (Smith, 2019). The first question allows for the patient to set the tone of the visit and allows for the provider to hear what the patient needs and is currently dealing with that may have brought them in seeking care. The second question is something asked during every triage in the emergency department. It allows for both the nurse and the provider to understand the type of environment that the patient will go home to once they leave the department. The third question allows for the provider to create a health care plan for that patient so that they have a high chance of achieving their health care goals. The last question allows the provider to see the patient’s current roles within their home environment and allows the provider to see what support the patient currently has available to them.
Integrated, Compensatory and Compromised Levels of Adaptation
- In Roy’s Adaptation Model, there are three levels of adaptation responses; integrated, compensatory, and compromised level (Smith, 2019). The integrated level “occurs when the structures and functions of the adaptive modes are successfully working as a whole to meet human needs” (Smith, 2019). The compensatory level “occurs when cognator and regulator or stabilizer and innovator are activated by a challenge” (Smith, 2019). The last level is the comprised level which “occurs when integrated and compensatory processes are inadequate creating an adaptation problem” (Smith, 2019). One study that was conducted looked at the overall nurses’ well-being during COVID-19 while applying Roy’s Adaptation Model (Callis, 2020). When looking at the integrated level of the nurses it looked at their effective coping strategies through available resources from the hospital (Callis, 2020). In the compensatory level, some of the nurses struggled with physiological discomfort or pain due to the stressors they were faced with (Callis, 2020). The compromised level only occurred when the nurses as a whole suffered from low morale due to the mental and physical exhaustion they experienced leading them to eventually level the nursing profession (Callis, 2020).
- Overall, Roy’s Adaptation Model allows for advanced practice nurses to better evaluate a patient’s or group’s self-concept mode, physiological mode, interdependence mode, and role function mode. It also provides a more holistic view of the systems of the patient.
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