CALLISTA ROY ADAPTATION THEORY The model was first put forward the concept of adaptation by Sister Callista

Roy (1969). The concept was developed from the concept of the individual and the adaptation process as described below. The basic assumption is Roy adaptation model: 1. Man is the whole of the social biopsychologist and constantly interact with the environment. 2. Man uses defense mechanisms to cope with the changes biopsychosocial. 3. Everyone understands how individuals have the ability to adapt to the limit. Basically, human beings respond to all stimuli, both positive and negative. 4. Human adaptability vary from one another, if one can adjust to the changes it has the ability to deal with both positive and negative stimuli. 5. Healthy and the sick were is a matter that can not be avoided from human life. In nursing care, according to Roy (1984) as recipients of nursing care are individuals, families, groups, society is seen as a "Holistic adaptive system" in all aspects of a single entity. A system is a unity which connect because of its function as a unit for some purpose, and the interdependence of each of its parts. System consists of the input process, output, control and feedback (Roy, 1991), with the following explanation: 1. Input Roy identifies the input as a stimulus, a unity of information, materials or energy from the environment which may cause the response, which is divided into three levels, namely stimulus focal, contextual and residual stimuli. a. Focal stimulus is a stimulus that directly deal with a person, the effect is immediate, such as infection. b. Contextual stimuli are all other stimuli experienced by a person both

internal and external influence and the situation can be observed, measured and subjectively reported. Stimuli appear simultaneously which may cause a negative response to the focal stimulus such as anemia, social isolation. c. Stimulus residuals are additional features available and relevant to the situation but it is difficult to observe include the belief, attitude, develop according to the individual nature of past experience, it gives the process of learning to tolerance. For example, the experience of pain in the waist there is a tolerance but there is not. 2. Control Process control by reason Roy is a form of coping mechanisms in use. This control mechanism is divided into regulator and kognatoryang a subsystem. a) Subsystem regulator. Subsystem regulator has these components: input-and output processes. Input internal or external stimulus. The transmitter regulators are chemical systems, neural or endocrine. Autonomic reflex is the response of neural systems and brain and spinal cord which passed the behavioral output of the regulator system. Many physiological processes that can be considered as a behavioral regulator subsystem. b) Subsystem kognator. Stimulus for kognator subsystem can be external or internal. The behavior of the regulator output subsystems can be stimulus for kognator feedback subsystem. Kognator process control-related brain function in information processing, judgment and emotions. Perception or process information related to the internal process in selecting attention, noting and remembering. Learning correlated with the process of imitation, reinforcement (reinforcement) and insight (insight). Problem solving and decision making is internal processes associated with assessment or analysis. Emotion is the defense to seek waivers, use judgment and compassion. 3. Output.

The output of a system is the observed behavior DAPT, can be measured or subjectively reported both from within and from outside. This behavior is a feedback to the system. Roy output categorize the system as an adaptive response or a response that is not mal-adaptive. Adaptive response can improve the overall integrity of the person that can be seen when a person is able to carry out the objectives with regard to survival, development, reproduction and excellence. While the mall adaptive response behaviors that do not support this goal. Roy has used a form of coping mechanism to describe someone as an adaptive process control system. Some coping mechanisms inherited or genetically inherited (eg white blood cells) as a defense system against bacteria that invade the body. Another mechanism that can be studied such as the use of antiseptic to clean the wound. Roy introduced the unique concept of nursing science is the control mechanism called Regulator and Kognator and mechanisms are part sub-system adaptation. In understanding the concept of this model, put forward the concept Callista Roy adaptation model of nursing that have multiple views or beliefs, and its values are: 1. 2. 3. Human beings as biological, psychological, and social factors always interact with their environment. To achieve a homeostatic or integrated, one must adapt accordingly to the changes. There are three levels of adaptation to humans raised by Roy, among others: a. Focal stimulation is a direct stimulus to adapt to a person and will have a strong influence on an individual. b. Contextual stimulus, a stimulus experienced by someone else, and both internal and external stimuli, which may affect, then do observations, measured subjectively. c. Residual stimulus, a stimulus that are the characteristics of the existing or additional in accordance with the situation in the process of adjustment to a difficult environment observations.

4.

System adaptation has four modes of adaptation are:

First, the physiological function, adaptation is a system component that physiological adaptations such as oxygenation, nutrition, elimination, activity and rest, skin integrity, senses, fluids and electrolytes, neurological function and endocrine function. Second, the concept of self that had understanding of how a person familiar with the patterns of social interaction in dealing with others. Third, the function of the role is a process of adjustment that relates to how a person's role in identifying patterns of social interaction in dealing with others Fourth, a person's ability to recognize interdependent patterns of compassion, which is done through interpersonal relationships at individual and group levels. 5. In the process of adjustment of the individual must increase the energy to be able to implement the objectives of the sustainability, development, reproduction and advantages that this process has the goal of improving the adaptation response. Sister Callista Roy's adaptation theory memeandang client as an adaptive system. In accordance with Roy's model, the goal of nursing is to help a person to adapt to changing physiological needs, self-concept, role function, and interdependence for healthy relationships and illness (Marriner-Tomery, 1994). The need for nursing care arises when the client can not adapt to the needs of internal and external environment. All individuals must adapt to the needs of the following: 1. Fulfillment of basic physiological needs 2. The development of a positive self-concept 3. Appearances social role 4. Achieving dependence a balance between independence and

Nurses determine the above requirements cause problems for the client and assess how the client to adapt to it. Then the nursing care given in order to help clients adapt. According to Roy, there are four main objects in the science of nursing, namely: 1) Humans (individuals who receive nursing care) Roy stated that the recipients of nursing care services of individuals, families, groups, communities or social. Each performed by a nurse as a holistic system adaptation and open. System opens the impact of constant changes to information, events, energy between system and environment. Constant interaction between the individual and the environment are characterized by internal and external changes. With this change individuals must maintain the integrity of his, in which individuals are kontunyu adapt. Roy argued that man as an adaptive system. As an adaptive system, humans can be described as a holistic entity that has input, control, output and feedback process. Process control is a coping mechanism that is manifested by means of adaptation. More specifically human is defined as an adaptive system with kognator activity and regulators to maintain adaptation in four ways, namely adaptation: physiological function, self-concept, role function and interdependence. In the adaptation model of nursing, man described as a living system, open and adaptive to experience the power and substance to the changing environment. As the human adaptive system can be described in terms of the characteristics of the system, so the man seen as the unity of interconnected between overall functional unit or several functional units for multiple purposes. Input in humans as an adaptation system is to receive input from the outside environment and the inside of individuals themselves. Input or stimulus including opposing standard variable feedback can be compared. This is a standard variable internal stimuli that have this level of adaptability and represent the range of stimuli that can be tolerated by human

efforts are wont to do. The process of human control as an adaptive system is coping mechanism. Two coping mechanisms have been identified, namely: regulator subsystems and subsystem kognator. Regulators and kognator described as an act in relation to the four effector or ways of adaptation, namely: physiological function, selfconcept, role function and interdependence. The four function modes developed by Roy consist of: a) Physiological. 1) Oxygenation: describe the patterns related to the use of oxygen respiration and circulation. 2) Nutrition: describing patterns of nutrient utilization to improve the condition of the body and development. 3) Elimination: describing patterns of elimination. 4) Activity and rest: describes patterns of activity, exercise, rest and sleep. 5) Skin Integrity: describing patterns of physiological functions of the skin. 6) Taste / senses: Describe the functions related to sensory perceptual senses 7) Fluids and electrolytes: describes the usage patterns of physiological fluids and electrolytes 8) Neurologic Function: describing patterns of neurologic control, regulation and intellectual 9) Endocrine Function: describing patterns of control and regulation, including stress responses and reproductive system b) Self-concept (Psychic) This concept model to identify patterns of values, beliefs and emotions associated with the idea yourself. Attention is paid to the fact about the state of the physical self, the individual, and moralethical

c) Role Function (Social) The function of the role of identifying patterns of social interaction a person relates to others due to the dual role. d) Interdependent Interdependent identify patterns of human values, warmth, love and belonging. This process occurs through interpersonal relationships of individuals and groups. 2) Nursing; Nursing is a form of professional services in the form of basic needs and administered to both healthy and sick individuals who experience physical, psychological and social in order to achieve optimal health. Roy defines the purpose of nursing is to improve adaptation responses associated with four modes of adaptation responses. Internal and external changes and input stimulus depends on individual coping conditions. The condition or state of a person coping coping someone is someone adaptation level. Person's level of adaptation will be determined by the focal stimulus, contextual, and residual. Focal is a recipient of direct response to the threat / incoming input. The use of focal generally dependent level changes that affect someone. Stimulus contextual stimuli are all other internal and external one that affects the situation and can be observed, measured, and the opinion submitted by the individual. Stimulus residuals are characteristics / history of one existing and arising releva with the situation but it is difficult to measure objectively. 3) The concept of healthy; Roy defines healthy as a continuum of the dead to the highest level of health. He stressed that health is a state and processes in an effort to make himself terintegrasisecara and overall, physically, mentally and socially. The integrity of individual adaptation manifested by an

individual's ability to meet the objectives of maintaining growth and reproduction. Pain is a condition of inability of the individual to adapt to stimuli originating from within and outside the individual. Very healthy and diseased individuals perceived by the individual. Person's ability to adapt (coping) depending on the individual's background in interpreting and perceiving the healthy-sick, such as level of education, occupation, age, culture and others. 4) The concept of the environment; Roy defines environment as all conditions from internal and external, that influence and has led to the development of individual and group behavior. Externally the neighborhood can be physical, psychological or individual received and perceived as a threat. While the internal environment is the mental state of the individual's body (such as experience, ability emosioanal, personality) and the biological stressor (cells or molecules) derived from the body individu.manifestasi which appears to be reflected in the behavior of individuals as a response. With a good understanding of the environment will assist nurses in improving adaptation to change and reduce the risk resulting from the surrounding environment. Roy adaptation model provides guidance for nurses in developing the nursing process. Elements of the nursing process in accordance with Roy include first and second stage assessment, diagnosis, goals, interventions, and evaluation, the steps are similar to the nursing process in general. a) Assessment Roy recommends assessment is divided into two parts, namely the assessment of phase I and phase II studies. The first assessment includes gathering data about the client's behavior as an adaptive system associated with each mode of adaptation: physiological, self-concept, role function and

dependability. Therefore, the first assessment is defined as the study of behavior, namely the assessment of each client's mode of adaptation in a systematic and holistic. After the first assessment, the nurse analyze patterns of behavioral change in the client about the ineffectiveness of response or an adaptive response that nurses need support. If there are deficiencies response (mal-adaptive), nurses undertaking the second phase. At this stage, the nurse collects data on stimulus focal, contextual and residual impact on the client. According to Martinez, the factors that influence the adaptive responses include: genetic; gender, stage of development, drugs, alcohol, smoking, self-concept, role function, interdependence, patterns of social interaction; mechanisms and coping style, physical and emotional Strea; culture; and physical environment. b) Formulation of nursing diagnoses Roy defines three methods to formulate nursing diagnoses: (1) Using the typology developed by Roy diagnosis and is associated with 4 adaptive modes. in applying this diagnosis, diagnosis kasusTn. Smith is "hypoxia". (2) Using a diagnosis by a statement / observation of behavior that looks and influential tehadap stimulus. By using this method of diagnosis is the diagnosis is "chest pain caused by lack of oxygen to the heart muscle associated with the hot weather". (3) Conclude the behavior of one or more adaptive modes associated

with the same stimulus, which relate for example if a farmer experiencing chest pain, which he worked out in the hot weather. In this case, the appropriate diagnosis was "a failure related to the role of physical limitations (myocardial) to work in the hot weather".

c) Nursing Interventions Nursing interventions is a plan with the goal of changing stimulus ataumemanipulasi focal, contextual, and residual. Implementation is also addressed to the client's ability in coping widely, so that the overall stimulus can occur on the client, so that the total stimulus is reduced and increased adaptability. Nursing interventions aim is the achievement of optimal conditions, using constructive coping. The long term goal should be to describe the adaptive problem solving and availability of energy to meet those needs (maintain, growth, reproduction). Short-term goal to identify expectations of the client's behavior after stimulus manipulation focal, contextual and residual. d) Implementation Implementation of nursing is planned with the aim of changing or manipulating focal, kontextual and residual stimuli and also expand the capabilities of one's coping on adaptation zone is reduced so that the total stimuli and increased adaptability. e) Evaluation Recent assessment of the nursing process based on defined goals nursing. Determination of the success of a nursing care based on changes in the behavior of the expected outcomes are defined, ie the adaptation of the individual.