Theory Assignment

Running head: THEORY ANALYSIS PAPER 1

Theory Analysis Paper

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Nursing Theory and Advanced Practice 502-B01

Liberty University

THEORY ANALYSIS PAPER 2

Theory Analysis Paper

Theory analysis is a process used to guide the examination of a theory that can create new

insights on the theory studied (McEwen & Wills, 2011). The grand theory to be analyzed in this

paper is the Roy Adaption Model (RAM). The approach used to analyze the RAM is Chinn and

Kramer’s Theory Description and Critical reflection. There are six concepts that comprise Chinn

and Kramer’s Theory description which include, purpose, concepts, definitions, relationships,

structure, and assumptions (McEwen & Wills, 2011). Critical reflection occurs after theory

description and examines the sematic and structural clarity and consistency, simplicity or

complexity, generality, accessibility and importance of the theory to practice (McEwen & Wills,

2011). The purpose of this paper is to analyze the RAM using Chinn and Kramer’s method of

theory description and critical reflection.

Theory Description

Purpose

The purpose of Roy’s Adaption model is to evaluate how a person adapts to physiological

and psychological changes in their internal and external environment (McEwen & Wills, 2011).

This model serves to assist nurses in understanding how a person adapts to change and identifies

areas that nurses need to intervene to assist the client with effective adaption (McEwen & Wills,

2011).

Concepts

There are numerous concepts identified and defined in the RAM. Key concepts of the

RAM are the concepts of the nursing metaparadigm which include the concepts of person,

health, environment, and nursing (McEwen & Wills, 2011). Other pertinent concepts include

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adaption, the goal of nursing, focal stimuli, contextual stimuli, residual stimuli, cognator and

regulator subsystems (McEwen & Wills, 2011).

Definitions

Definitions pertinent to discuss regarding the RAM include those concepts of the

metaparadigm, adaption, and the goal of nursing. Other concepts of the stimuli and subsystems

will also be defined and further discussed in this paper. The components of the nursing

metaparadigm and adaption are essential to understanding the RAM and are defined below.

Person is defined as “an adaptive system with internal processes for coping with change”

(Barone, Roy, & Frederickson, 2008, p.353). A person is not exclusively an individual; it could

also include a group, population, or society (McEwen & Wills, 2011). Environment is defined as

all influences, situations, and stimuli that affect how a person or group responds using their

adaptive systems (McEwen & Wills, 2011). Health is defined as “a state and process of being

and becoming integrated and whole” (Barone et al., 2008, p.354). Nursing would be defined as

the practice and science that aides the person by enhancing their adaptive abilities ultimately

leading to the goal of nursing (Barone et al., 2008). Adaption is defined as a process that is used

by an individual or group with awareness of their thoughts and feelings to choose to integrate

with their environment (McEwen & Wills, 2011). The goal of nursing is defined by Roy which

expresses that the nurse should “…promote adaption for individuals and groups in the four

adaptive mode thus contributing to health, quality of life and dying with dignity” (Barone et al.,

2008, p.354).

Other concepts that must be defined to understand the relationships and structure of the

RAM are the three types of stimuli and subsystems. There are three types of stimuli identified in

the RAM which include the focal stimuli, contextual stimuli and the residual stimuli. A focal

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stimulus is defined as a stimulus that is the root cause of a situation (McEwen & Wills, 2011). A

contextual stimulus encompasses all other stimuli in the environment that may or may not affect

a situation (McEwen & Wills, 2011). A residual stimulus is defined as a stimuli that is not yet

identified or unknown that may affect a situation (McEwen & Wills, 2011).

The two subsystems identified by Roy include the cognator and the regulator subsystems

for individual coping processes (Barone et al., 2008). The cognator subsystem is defined as “a

major coping process that involves four cognitive-emotive channels: perceptual and information

processing, learning, judgment, and emotion” (McEwen & Wills, 2011, p. 171). The regulator

subsystem is defined as the most basic automatic adaptive process that occurs through “…neural,

chemical, and endocrine coping channels” (McEwen & Wills, 2011, p. 171).

Relationships

The RAM is comprised of four adaptive modes that create the framework of the model

(Roy, 2011). These four modes include the physiologic-physical, self-concept-group identity,

role function, and interdependence (McEwen & Wills, 2011). The physiologic-physical mode

includes the basic human physiologic and physical needs of a living being (McEwen & Wills,

2011). Self-concept-group identity mode recognizes the spirituality and behaviors with regards to

how a person or group views their meaning and purpose of existence (McEwen & Wills, 2011).

Role function mode reflects personal knowing and identity of who an individual is and the role

or roles a person holds in society (McEwen & Wills, 2011). Interdependence mode identifies the

importance of close personal relationships and how they affect a person’s development, purpose,

and structure (McEwen & Wills, 2011). In addition to the four adaptive modes the person is

influenced by their coping process which Roy also identified as the regulator and cognator

subsystems (Barone et al., 2008).

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Structure

The RAM begins with focal, residual and/or contextual stimuli affecting a person’s

environment. The person then uses the four overlapping adaptive modes to react and interact

with their environment (McEwen & Wills, 2011). There are also two subsystems, the regulator

and innovator, which are coping systems that affect a person’s adaption. The coping systems

overlap the connection between all four adaptive modes. Nurses observe and assess the person’s

behaviors in four adaptive modes and in the two subsystems to identify how effectively a person

is adapting to their internal and external environment. Nursing interventions are individualized

with the goal of promoting adaption within the four adaptive modes and ultimately health of the

person.

Assumptions

Assumptions of the RAM are explicitly stated. There are three groups of assumptions in

the RAM which include philosophical, scientific, and cultural (McEwen & Wills, 2011). Several

philosophical assumptions are made about a person’s relationship with the universe and with

God (McEwen & Wills, 2011). There are many scientific assumptions about the person and their

relationships and interactions with their environment (McEwen & Wills, 2011). Cultural

assumptions include those about how cultural experiences and cultural expressions all can

influence how the RAM is expressed (McEwen & Wills, 2011).

Critical Reflection

Sematic Clarity and Consistency

Numerous concepts are defined in the RAM. Each concept gives meaning to the RAM

and enhances a nurse’s ability to understand and potentially utilize the model. The RAM uses

concepts specific to nursing, including those of the metaparadigm. Since the model has

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overlapping and interconnecting concepts, the concepts are consistently used. An example of this

is the concept of a person is defined as “an adaptive system with internal processes for coping

with change” (Barone et al., 2008, p.353). This definition expresses how change, or the

environment, can cause a person to use the four adaptive modes and coping mechanisms

identified by the RAM as the regulator and cognator subsystems to achieve adaption or health.

This definition exemplifies the interconnectedness of the concepts of the RAM and how they are

used consistently in the model. Roy’s concepts are consistent with their definition and support

the adaption model.

Structural Clarity and Consistency

Concepts are clearly defined in the RAM, allowing for relationships to be easily

identified and organized. Relationships between metaparadigm concepts, adaption, the four

adaptive modes and coping mechanisms are apparent in the RAM. McEwen and Wills (2011)

present a diagrammatic representation of the RAM structure that enhances understanding of the

interconnected relationships between the concepts. This model illustrates that the RAM is logical

but rather complex. The structure of the theory is consistent in its form because it shows the

interconnected concepts and how their relationships affect a person’s adaption.

Complexity

The RAM is a complex theory. Although the RAM theory is a comprehensive theory and

the concepts are clearly defined, it is complex because of the multiple interconnecting modes,

numerous concepts, influences of subsystems, and stimuli (McEwen & Wills, 2011). The

diagrammatic representation of the theory enhances understanding of the theory but it also

illustrates the complexities of the RAM. The complexity of the RAM can make full application

and utilization rather tedious (McEwen & Wills, 2011).

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Generality

The RAM is versatile and can be applied to either an individual or a group and to a

variety of populations. This is because in nursing the person or group is constantly being affected

by their environment which may stress coping mechanisms and inhibit adaption. The four

adaptive modes of the RAM are valid among all individuals and groups enhancing the ability of

the RAM to be applied in a wide variety of nursing practice settings and situations.

Accessibility

The concepts used in the RAM are empirically and operationally defined. This allows for

research and testing of a concept identified or the entire theory. The nursing metaparadigm is an

identifiable phenomena utilized in the RAM. The goal of the RAM is effective adaption which

can be achieved using the defined empirical concepts along with assessment of the four adaptive

modes and subsystems.

Importance

The RAM guides nurses by providing a framework for which nurses can aide a person or

group in adaption. Focus is placed on creating individualized nursing interventions based off of

the nurse’s observation and assessment of the person. The RAM has been proven to guide

nursing research, practice and education (McEwen & Wills, 2011). The RAM is testable and

applicable to a variety of nursing settings. This theory has stood the test of time and continues to

impact current nursing practice.

Conclusion

In this paper the RAM was analyzed using Chinn and Kramer’s theory description and

critical reflection. The theory description summarized and identified essential components of the

RAM. The critical reflection section analyzed the RAM focusing on the structure and usefulness

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of the theory. Ultimately, this paper summarized and analyzed the RAM and found it to be a

comprehensive and detailed framework that is useful in a variety of nursing settings, populations,

and cultures.

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References

Barone, S., Roy, C., & Frederickson, K. (2008). Instruments used in Roy adaption model-based

research: Review, critique, and future directions. Nurse Science Quarterly, 21(4), 353-

362. doi: 10.1177/0894318498323491

McEwen, M., & Wills, E. (2011). Grand nursing theories based on interactive process.

Theoretical basis for nursing (3 rd

ed., pp. 148-182). Philadelphia, PA: Lippincott,

Williams & Wilkins.

Roy, C. (2011). Research based on the Roy adaption model: Last 25 years. Nurse Science

Quarterly, 24(4), 312-320. doi: 10.1177/089431841149218