NURSING CONCEPTUAL MODELS: MODELS OF ROY, OREM AND LEVINE

Sister Callista Roy

Adaptation Model of Nursing

Roy’s definition of Health

Not merely a static state but a dynamic process of integration and holistic well-being, involving continual adaptation and mutual interactions between the individual and the environment. Reflects the interaction between individuals and their environment, promoting physiological, psychological, and social integrity. The ability to cope competently with the inevitabilities of death, disease, unhappiness, and stress.

Roy’s definition of Environment

Encompasses all conditions, circumstances, and influences surrounding individuals or groups, considering the interdependence of person and earth resources, including focal, contextual, and residual stimuli.

Roy’s definition of Nursing

A health care profession that concentrates on understanding human life processes and patterns while emphasizing health promotion for individuals, families, groups, and society at large. The science and practice that expands adaptive abilities and enhances a person and environment. The promotion of adaptation in each of the four adaptive modes, contributing to health, quality of life, and dignified dying.

Adaptation

process and outcome whereby thinking and feeling persons as individuals or in groups use conscious awareness and choice to create human and environmental integration.

Adaptation Level

Represents the dynamic condition of life processes categorized as integrated, compensatory, and compromised.

Adaptation Problems

Broad concerns related to adaptation; areas of focus for nurses in relation to individuals or groups.

Coping Processes

Involves innate and acquired coping mechanisms; these are ways individuals interact with their changing environment.

regulator subsystem

involves coping processes related to neural, chemical, and endocrine systems

cognator subsystem

includes cognitive-emotive channels like perception, judgment, and emotion

Adaptive Modes

how the regulator and cognator mechanisms are manifested; in other words, they are the external expressions of the internal processes.

Physiological-Physical Mode

- This mode’s basic need is composed of the needs associated with oxygenation, nutrition, elimination, activity and rest, and protection.

- This model’s complex processes are associated with the senses, fluid and electrolytes, neurologic function, and endocrine function.

Self-Concept Group Identity Mode

In this mode, the goal of coping is to have a sense of unity, meaning the purposefulness in the universe, and a sense of identity integrity. This includes body image and self-ideals.

Role Function Mode

This mode focuses on the primary, secondary, and tertiary roles that a person occupies in society and knowing where they stand as a member of society

Interdependence Mode

This mode focuses on attaining relational integrity through the giving and receiving of love, respect and value. This is achieved with effective communication and relations.

Dorothea Orem

Self-Care Deficit Theory of Nursing

Myra Estrin Levine

Conservation Model

Self-Care Deficit Theory of Nursing

explains how nurses can help individuals maintain or regain their health by supporting their ability to care for themselves. It is one of the most widely used grand nursing theories and emphasizes patient independence and self-care responsibility

Adaptation Model of Nursing

a prominent nursing theory aiming to explain or define the provision of nursing science. sees the individual as a set of interrelated systems that maintain a balance between these various stimuli. grounded on humanism with the belief that a person has his own creative power and has coping abilities to enhance wellness.

Orem’s definition of Person

Humans are defined as “men, women, and children cared for either singly or as social units” and are the “material object” of nurses and others who provide direct care.

Orem’s definition of Health

An external source of influence in the internal interaction of a person’s different aspects. “being structurally and functionally whole or sound.” a state that encompasses both the health of individuals and groups

human health

the ability to reflect on oneself, symbolize experience, and communicate with others.

Orem’s definition of Environment

An external source of influence in the internal interaction of a person’s different aspects. has physical, chemical, and biological features. It includes the family, culture, and community.

Orem’s definition of Nursing

an art through which the practitioner of nursing gives specialized assistance to persons with disabilities, making more than ordinary assistance necessary to meet self-care needs.

Theory of Self-Care

Explains why and how individuals care for themselves

Theory of Dependent-Care

Describes how family or friends provide care for dependents.

Theory of Self-Care Deficit

Explains why nursing is needed when people cannot meet their own care needs

Theory of Nursing Systems

Describes the relationships and structures necessary to deliver effective nursing care.

Self-Care Agency

acquired ability or power to engage in self-care. is affected by basic conditioning factors (age, gender, developmental state, health state, socio-cultural, health care system, family system, patterns of living, environmental and resource adequacy and availability)

Self-Care Requisites

Universal, Developmental, Health Deviation. The reasons for which self-care is undertaken. Express the intended or desired results.

Universal Self-Care Requisites

Universal goals are met through self- or dependent-care and are based on validated knowledge of human structure and function across all life stages

eight

how many common self-care requisites are identified

Developmental Self-Care Requisites

Actions to be undertaken that will provide developmental growth

Health Deviation Self-Care Requisites

required in illness or injury or because of medical tests or treatments to correct a condition. Apply to those with illness, injury, or disability. Involve meeting care needs arising from health deviations and treatment measures.

Helping methods

nursing actions used to overcome or compensate for individuals’ health-related limitations in self-care or dependent-care. Nurses select and combine methods based on each patient’s needs and limitations.

Nursing Agency

complex property or attribute of people educated and trained as nurses that enable them to act, to know, and to help others meet their therapeutic self-care demands by exercising or developing their own self-care agency.

Nursing Systems

Series and sequences of deliberate practical actions of nurses performed at times in coordination with the actions of their patients

Basic conditioning factors

condition or affect the value of the therapeutic self-care demand and/or the self-care agency of an individual at times and under specific circumstances

ten

how many basic conditioning factors have been identified

Levine’s definition of Person

A holistic being with a sense of identity and self-worth. Differ in their needs, wants, and goal. Continually adapting in their interactions with their environment. Constantly strives to preserve wholeness and integrity

Wholeness (Holism)

sound, organic, progressive mutuality between diversified functions and parts within an entirety, the boundaries of which are open and fluent

Integrity

oneness of the individual, emphasizing that they respond in an integrated, singular fashion to environmental challenges

Levine’s definition of Health

is socially determined by the ability to function in a reasonably normal manner. is not just an absence of pathological conditions. is a return to self; individuals are free and able to pursue their own interests within the context of their own resources. “A wholeness and successful adaptation”

Levine’s definition of environment

The context in which individuals live their lives, and not just a passive backdrop. The individual actively participates. Completes the wholeness of the individual. Consists of both the internal and external.

INTERNAL ENVIRONMENT

Consists of the physiological and pathophysiological aspects.

Operational environment

consists of the undetected natural forces that affect an individual.

Perceptual environment

consists of information that is interpreted by the sensory organs.

Conceptual environment

influenced by language, culture, spirituality, ideas, symbols, concepts, inventions, and cognition

Levine’s definition of Nursing

Viewed as a “human interaction” and as both a a profession and scientific discipline. The goal is accomplished using the conservation principles when performing nursing interventions: energy, structure, personal, and social integrity. Therapeutic nursing care

trophicognosis

refers to the use of the scientific method to develop nursing care judgment

conservation

Natural law, which describes the way complex systems can continue to function even when severely challenged. A product of adaptation.Through this, individuals can confront challenges, adapt, and maintain their uniqueness.

Adaptation

A life process by which people maintain their wholeness or integrity as they respond to environmental challenges

Historicity

patterned responses passed on both through genetics and through the patterns of life experiences

Specificity

unique adaptive responses to specific environmental challenges

Redundancy

availability of multiple adaptive responses

Principle of Conservation of Energy

Involves balancing the patient's energy output and energy input to avoid excessive fatigue. Includes adequate rest, nutrition, and exercise

Principle of Conservation of Structural Integrity

Focusing attention on healing by maintaining or restoring structural and functional integrity through conservation in defense of wholeness. Preventing breakdown and promoting healing

Principle of Conservation of Personal Integrity

Maintaining or restoring the individual patient's sense of identity, self-worth. Recognizes the individual as one who strives for recognition, respect, self-awareness, selfhood, and self-determination.

Principle of Conservation of Social Integrity

Acknowledging patients as social beings. Social integrity is reflected in the dynamic relationships among human beings. Health is socially determined, and the family is considered a critical social unit. Exists when a patient is recognized as someone who resides within a family, a community, a religious group, an ethnic group, a political system, and a nation.