an individual’s adaptation occurs in four different modes. This also holds true for families (Hanson, 1984). These include the physiologic mode, the self-concept mode, the role function mode, and the interdependence mode (Roy, 1980).
The individual’s regulator mechanism is involved primarily with the physiologic mode, whereas the cognator mechanism is involved in all four modes (Roy and Roberts, 1981). The family goals correspond to the model’s modes of adaptation: survival = physiologic mode; growth = self-concept mode; continuity = role function mode. Transactional patterns fall into the interdependence mode (Clements and Roberts, 1983).
In the physiologic mode, adaptation Involves the maintenance of physical integrity. Basic human needs such as nutrition, oxygen, fluids, and temperature regulation are identified with this mode (Fawcett, 1984). In assessing a family, the nurse would ask how the family provides for the physical and survival needs of the family members. A function of the self-concept mode is the need for maintenance of psychic integrity. Perceptions of one’s physical and personal self are included in this mode.
Families also have concepts of themselves as a family unit. Assessment of the family in this mode would include the amount of understanding provided to the family members, the solidarity of the family. the values of the family, the amount of companionship provided to the members, and the orientation (present or future) of the family (Hanson, 1984).
The need for social integrity is emphasized in the role function mode. When human beings adapt to various role changes that occur throughout a lifetime, they are adapting in this mode. According to Hanson (1984), the family’s role can be assessed by observing the communication patterns in the family.
Assessment should include how decisions are reached, the roles and communication patterns of the members, how role changes are tolerated, and the effectiveness of communication (Hanson, 1984). For example, when a couple adjusts their lifestyle appropriately following retirement from full-time employment, they are adapting in this mode.
The need for social integrity is also emphasized in the interdependence mode. Interdependence involves maintaining a balance between independence and dependence in one’s relationships with others. Dependent behaviors include affection seeking, help seeking, and attention seeking. Independent behaviors include mastery of obstacles and initiative taking.
According to Hanson (1984), when assessing this mode in families, the nurse tries to determine how successfully the family lives within a given community. The nurse would assess the interactions of the family with the neighbors and other community groups, the support systems of the family, and the significant others (Hanson, 1984).
The goal of nursing is to promote adaptation of the client during both health and illness in all four of the modes. Actions of the nurse begin with the assessment process, The family is assessed on two levels.
First, the nurse makes a judgment with regard to the presence or absence of maladaptation. Then, the nurse focuses the assessment on the stimuli influencing the family’s maladaptive behaviors. The nurse may need to manipulate the environment, an element or elements of the client system, or both in order to promote adaptation (Roy, 1980).
Many nurses, as well as schools
of nursing, have adopted the Roy adaptation model as a framework for nursing practice. The model views the client in a holistic manner and contributes significantly to nursing knowledge. The model continues to undergo clarification and development by the author.