Roy’s Adaptation Model in Nursing


Roy’s Adaptation Model (RAM) was created to assist nurses in the process of caregiving for patients. The model’s concepts provide a model for evaluating focal points in a patient’s environment that influence the health of an individual. Using this evaluation, a nurse can create a set of goals to improve the situation. Roy’s model is a useful framework that offers an effective way of giving patients quality care.

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Background and Main Concepts of Roy’s Adaptation Model

The main idea of the Roy Adaptation model is that the surroundings have the impact on the recovery process. The model operates under the assumption that adaptation should be the center of nursing and uses the concept from Helson’s research to define three main categories of stimuli (as cited in Alligood, 2014). Focal is a factor that attracts most of the attention of a patient. The second one is contextual, which is everything that strengthens the focal stimuli. The last one is residual, which includes factors from the internal and external environment (Alligood, 2014). Roy distinguishes four adaptive systems of an individual. They are the physiological, self-concept, interdependence, and role function model (Alligood, 2014). The connection between the stimuli and models is the fact that each of the factors influences every model.

From the moment it was created, the RAM gained popularity and was used in the healthcare sector. Roy and Andrews used the already existing concepts “from both systems theory and adaptation-level theory” to support the model. (as cited in Alligood, 2014, p. 21). The theory was influenced by Roy’s fascination with children’s phycology, as she was involved in pediatrics. The additional stimulus was for the work was a challenge from her professor. To develop the theory, Roy summarized the theoretical knowledge, made an assumption and tested the evidence by applying the research in the practice of Saint Mary’s College Department (Alligood, 2017). This approach was used further, as Roy’s has updated her work several times.

Usefulness and Research of the Theory

The model is used in the nursing practice to evaluate patient’s condition and ways to improve it. It is useful because it is based on a combination of the research from other fields. Additionally, it offers an easy to understand a way of assessing the criteria of the factors that influence one’s wellbeing. Since the theory was created for being utilized in the healthcare industry, it is both practical and helpful to nursing.

The framework includes the process of evaluating the adaptation as an outcome of the nursing care. Therefore, it is useful for understanding and predicting the consequences of the caregiving. Alligood (2014) provides an example of a patient’s case, as a proof that the model is adequate. Debbie was a twenty-nine years old woman, admitted to the nursing unit. She had a surgery after which she was experiencing issues with urinary bladder. She would have to perform intermittent self-catheterization upon her return to home. The patient was afraid of the procedure. Therefore there was a risk of her not utilizing the method. The nursing unit has performed an evaluation using Roy’s Adaptation Model and assessed the central stimuli of the environment (Alligood, 2014). Next, the nursing diagnoses were in place which helped set the goals for this patient. Finally, the evaluation and intervention process was performed to explain the importance of the procedure and how to implement it correctly in the environment (Alligood, 2014). RAM has helped the nursing unit to evaluate patient’s environment and stimuli and effectively set goals for health improvement.

The RAM theory has generated research aimed at identifying the usefulness of the model in practice. Hemmati Maslakpak, Maghsoodi, and Sheikhi (2015) studied the effect of RAM implementation in the nursing homes for the elderly. The proposition for this study was the positive influence on the quality of life of the given model. According to the results, after the implementation of the model, the quality of life for people in question has improved significantly (Hemmati Maslakpak et al., 2014).

Evaluation of the Model

The model is easy to understand and implement, as it offers a list of specific steps to evaluate the patient’s environment and stimuli. The strengths of the model are that it is easy to comprehend, and there is a process that allows determining the effectiveness. The weaknesses are the fact that it is based on the observable and non-observable factors (Alligood, 2014). The non-observable factors have to be considered using the patient’s description, which can be misleading at times. In my advanced practice, I would use RAM as the effectiveness of it was proven by research, it is easy to use and implement, and it gives a clear understanding of the factors that influence the health condition of the patient.

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Overall, the RAM is a useful framework for patient caregiving. In the model, concepts from other scientific fields are used, and it was proven to be effective by research. The main assumption of the frameworks is that adaptation is the central area of concern for patients care. The model is adopted by many nursing units and is effectively used to influence the environment of the patients and their health conditions.


Alligood, M. (2017). Nursing theorists and their work (9th ed.). St. Louis, MI: Elsevier Health Sciences.

Alligood, M. (2014). Nursing theory: Utilization & application (5th ed.). St Louis, MI: Elsevier.

Hemmati Maslakpak, M., Maghsoodi, E., & Sheikhi, S. (2015). The effects of a care program based on the Roy adaptation model on nursing home residents’ quality of life. Modern Care Journal, 12(4). Web.

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