Introduction
Nursing models are theoretical models that are made up of concepts and theories. The nursing field is one of the fields which determine the survival of an individual depending on the patient care given by the nurses or caregiver. Theories and concepts of nursing assist the health care providers especially nurses to evaluate, plan and employ patient care through offering a structure within which to conduct their services. These theories apply to all patients despite their age, race, social status, economic or political status, color or financial status. The history of nursing theory is not clear. The date or year and place where nursing theory was developed is not known. The establishment of nursing theory has been in existence since the most fundamental of health interventions began to be practiced; thus, it is not a modern procedure. Nursing theory is a body of knowledge that is utilized to promote nursing practice and research. This knowledge might be obtained from either non-nursing materials, experimental learning or nursing research sources. Experimental learning involves the aspect of the nurses or nursing students carrying out practical activities within the hospital set up or health care institutions in order to effectively comprehend the theoretical part of the course or services. Non-nursing and nursing materials or resources can be obtained from printed materials or internet sources.
Before the use of nursing theories or models, nurses used to depend on other health care providers on how to carry out their responsibility. The establishment of a nursing theory which has been in existence since the most fundamental of health interventions began to be practiced; nurses have been more independent. Therefore, as a result, their services such as patient care have been effective and of good quality. They have become independent through the recognition of the importance of the developed nursing theories such as Callista Roy’s theory of nursing which is greatly used by most health care providers. In addition, nurses have become more independent through the exploration of professional borders. This clearly indicates that nurses have greatly developed by the aspect of wanting to know what the profession holds and what surrounds it that can be of benefit to them. From the above discussion regarding the nursing model as a framework of concepts and theories of nursing, the paper will examine one of the nursing theories called Roy’s theory of nursing that was established by Siste Callista Roy. The paper will later look at the implementation of the theory in the health setting and finally address the rationale of the theory in the Alzheimer’s unit.
Overview of Roy’s theory
Roy’s conceptual model was developed by Sister Callista Roy. She combined adaptation theory and general system theory to generate the Roy Adaptation theory or model. Roy’s model of nursing consists of the four major concepts of; nursing, person, environment and health. The model perceives a person as a biopsychological creature in constant association with an altering environment. The individual is an adaptive, open system that utilizes coping skills to manage stressors. The theory perceives the environment as the entire situations, influences, and circumstances that surround and impact the behavior and development of the person. In addition, it illustrates stressors as incentives and utilizes the phrase residual stimuli to illustrate those stressors whose effect on an individual or person is not understandable (Andrews & Roy, 1991, p. 23).
According to Roy’s theory, health and diseases are based on a continuum with several dissimilar degrees or states that are possible. Thus, health is the procedure of becoming and being a whole and an integrated person (Roy, 1980, p. 34). The goal of Roy’s model is to increase the adaptation promotion in each of the following four modes; interdependence, physiological, role function and self-concept; hence contributing to the health of a person and the quality of life.
Roy’s theory consists of a six-step process that is used in nursing practice. The steps include assessment, intervention, setting of goals, nursing diagnosis, evaluation of stimuli and evaluation of character. In the initial step, the behavior of a person in every mode is looked at. This personal character is later compared with rules and is considered either ineffective or adaptive. The second step focuses on the factors which affect behavior. Stimuli are grouped as residential, contextual or focal (Rambo, 1984, p. 54). The third step involves the nursing diagnosis which is a statement regarding inefficient characters along with the recognition of the possible cause. The fourth step is concerned with goal setting. The set goals should be specific, measurable, attainable, realistic and timely (SMART). Moreover, the goals are designed in collaboration with an individual or a person. Similarly, the fifth step is interested in intervention and this occurs during the manipulation of stimuli. It is also referred to as the doing phase. Lastly, the six-step is concerned with evaluation or assessment. The level of the alteration as confirmed by alteration in behavior is measured. Additionally, inefficient characters could be re-evaluated, and the interventions could be revised (Andrews & Roy, 1991, pp. 65-72).
Implementation of Roy’s theory
Roy’s theory can be implemented in several units within the healthcare setting. For instance, Roy’s theory is implemented in the area of the Alzheimer unit. The Alzheimer’s unit consists of patients who are suffering from Alzheimer’s disease, the most common type of dementia. The disease is terminal, incurable and degenerative. This disease is mostly known to attack old-aged people. The causes of the disease are not clearly known but some of the factors which are related to the disease are the impact of tangles and plaques in the brain. Symptoms associated with Alzheimer’s disease include; aggression, confusion, irritability, language breakdown, long-term loss of memory and mood swings. Exercise, feeding on a balanced diet, and mental stimulation are suggested as possible ways of managing and preventing the disease. Therefore, such patients need good care in order to adjust to the environment within the unit.
Roy’s theory of nursing is used within the Alzheimer’s unit where the chronically ill individuals are admitted since most of the relatives of the chronically ill individuals suffer from stress. Thus, there is then a need to assist them on how to take care of the patient safely and successfully. Eventually, its effects, particularly on an aging and aged community, more and more individuals, will suffer from stress (Fitzpatrick & Whall, 1996, p. 34).
Roy’s theory of nursing is implemented into nursing practice in various ways. These ways include; the terms of the clinical or medical conditions, terms of the nursing grounded or based on the development of a person, type of care needed, areas of practice and the type of health. In addition, it is implemented in terms of the nursing role or nursing interventions.
Patients suffering from Alzheimer’s disease (AD) are managed differently depending on the extent of the disease. An individual who is severely affected and the one who is not severely affected cannot receive similar services. Since AD is degenerative and incurable, the management of sick individuals is significant. The burden of taking care of such patients is taken up by the relatives. The disease gives great pressure ranging from economic, social, physical to psychological. The disease slowly destroys the thinking skills and memory and finally the ability to conduct the easiest activities or tasks. Therefore, individuals who are severely affected by the disease need close supervision or management since they cannot do anything for themselves. On the other hand, those who are not severely affected need also good management in order to improve their behaviors.
The rationale of Roy’s theory in the Alzheimer unit
Since Alzheimer’s disease is incurable, terminal and gradually renders individual’s incapable of carrying out their daily duties, caregiving is the best medication and should be managed carefully over the illness. Therefore, if the person is incapable of carrying out their duties in order to support him/herself and the family members, it is evident that such a person will entirely require some assistance in the following aspects; social, economic, physical and psychosocial. The essential way to help individuals in the Alzheimer unit is by the implementation of Roy’s theory.
During the moderate and early phases, adjustment to the lifestyle or personnel and living environment might raise the patient’s safety and minimize the burden of the caretaker. For instance, such modifications or changes include the observance of simplified routines, labeling of household equipment or commodities, and placing of secured locks in order to cue the individual suffering from the disorder. Personal adaptation can be can be achieved by ensuring that the caretaker minimizes the dangers within the environment and this will maximize independence. A safe surrounding is less restrictive where an individual with Alzheimer’s illness can easily experience more mobility and increased security.
Some patients may not be in a position to feed themselves and eat the food the way it is without it being broken into small particles. On the other hand, other patients are not in a position to do feed themselves or eat food without it being broken into small particles. In case the patient might be unable to feed themselves; hence, they require food to be put in pureed and smaller pieces. In addition, when swallowing food becomes difficult for them, the caretakers should utilize feeding tubes. In such situations, the medical ethics and efficacy of ongoing feeding is a significant consideration of the relatives and caretakers.
Moreover, Alzheimer’s disease gives the caregiver a great burden. Thus, the caregiver should be patient and ready to offer the necessary services. Relatives and the patient prefer home care rather than hospital care. The care is given to patient include; economic, social, physical and psychosocial care. Therefore, Roy’s theory helps the caregivers to learn disease-related behaviors such as memory loss due to impairment of the focal stimuli. Thus, Roy’s theory helps to promote adaptive reactions by manipulating the environment of the patient and contextual stimuli during patient care (Thornbury & King, 1992, p. 130).
Conclusion
In conclusion, Roy’s theory of nursing perceives a person as a group of combined systems, social, psychological and biological. The person attempts to sustain a balance between the outside world and each of the systems. Nevertheless, there is no complete extent of balance. According to Roy’s model of nursing, people struggle to thrive within the range where they could put up adequately. This range will be exceptional to a person. The level of adaptation is the extent of flexibility within which a person could handle new experiences effectively. In addition, the theory indicates that there are four major adaptation systems which are referred to as modes of adaptation. They include; the interdependency system, self-concept system, physical-physiological system and role mastery system.
Reference List
Andrews, H. & Roy, C. (1991). The Adaptation Model. Norwalk: Appleton & Lange.
Fitzpatrick, J. & Whall, A. (1996). Conceptual Model of Nursing: Analysis and Application
Rambo, B. (1984). Adaptive Nursing. Philadelphia: W.B. Saunders Company.
Roy, C. (1980). The adaptation model. Conceptual Models for Nursing Practice. Norwalk: Appleton, Century Crofts.
Thornbury, M. &King, D. (1992). The Roy Adaptation Model and Care of Persons with Alzheimer’s disease. Nursing Science Quarterly, Vol. 5, No. 3, 129-133. Web.