Sister Callista Roy was named after Saint Callistus, a pope and martyr, from the Roman calendar on the day of her birth, October 14, 1939 at the Los Angeles Country General Hospital to a big family, which was deeply devoted to God and the service of others (Office of the Nurse Theorist 2002). Her mother was a nurse who lived and taught the values of faith, hope and love to her children, so that at 14, Sister Callista herself worked at a large general hospital as a pantry girl, as a maid and then as a nurse's aid. She entered the convent and became one of the sisters of Saint Joseph of Carondolet for 40 years. During that time, she earned a bachelor's degree, major in Nursing, at Mount St. Mary's College in Los Angeles (Office of the Nurse Theorist). As a young nun and nurse, she worked in hospitals administered by her congregation, which enabled her to demonstrate her love and concern especially to hospitalized children. This led her to enroll in a master's degree program in pediatric nursing at the University of California at Los Angeles in 1964 during which she received instruction from mentors, including Dorothy e. Johnson, Ruth Wu, Connie Robinson and Barbara Smith Moran (Office of the Nurse Theorist).
During her first seminar under mentor Dorothy Johnson, Sister Callista proposed that the goal of nursing was patient adaptation and this became her framework (Gray 2003). Her framework was first influenced by von Bertalanffy and Helson who delved into the three types of stimuli involved in adaptation, namely, focal, contextual and residual, and she used these stimuli in describing the conditions of the healthy and the sick. Her first write-up on her derived model was published in May 1970 and. By 1987, at least 100,000 nurses throughout the world took programs that used Roy's adaptation model (Gray).
Sister Callista Roy's theory has been applied to health teaching about osteoporosis and breastfeeding and emphasizes the significance of adapting to environmental conditions to promote and facilitate healing and recovery (Shaner 2004). While it made sense in many cases, critics felt that adaptation was not always the best method of responding to the environment, such as in conditions of poor air quality or toxic substances. Doing so could, instead, lead to diseased conditions, such as cancer or asthma, rather than promote or facilitate healing. Florence Nightingale advocated that nurses adjusted environmental conditions to which patients were subjected, rather than the patients adapting to these conditions in the environment (Gray). There were times when the best option was precisely to leave the situation alone, if it cannot be changed or a nurse to intervene in order to change the condition or situation in the environment.
In light of these observations and developments, Sister Callista modified her model by redefining adaptation and adjusting her philosophy into one that viewed persons as extensions of their physical and social environments (Gray 2003). She updated her model to include relationships and to expand adaptation into the three levels of integrated life, compensatory and compromised processes. And she continues to upgrade it as developments unfold and the nursing profession responds to these developments (Gray).
Sister Callista's scientific assumptions (Gray 2003) consist of: systems of matter and energy that progress to higher levels of complex self-organization; a person's consciousness and meaning that coexist and integrate with the environment; self-awareness and awareness of the environment that derive from thought and feeling; the integration of these processes from the free choices that individuals make; thought and feeling as mediating human action; acceptance, protection and the fostering of independence as occurring in system relationships; universal and integral relationship between individuals and the earth; individual and environmental transformations as occurring and crafted in human consciousness; and the integration of human and environmental meanings as resulting in adaptation (Gray). Her philosophical assumptions derive from the mutual relationships that the individual has with the world and God, human meaning is rooted on a converging point of the universe; God is intimately revealed in the diversity of creation as the common destiny of all in it; the creative use of awareness, enlightenment and faith enables the individual; and human accountability for the deriving, sustaining and changing the universe (Gray).
Her concept of persons and relationships with other persons encompass an adaptive system with coping processes and a composite whole; an inclusive collection of individuals from families, organizations, communities, nations and the human society as a whole; and an adaptive system that inherently possesses subsystems that recognize and regulate acting in order to support adaptation in the physiologic-physical, self-concept-group identity, role function, and interdependent adaptive modes (Gray 2003). The physiologic-physical mode includes needs for oxygen, nourishment, elimination, activity and rest, and protection. The group mode consists of participants, capacities, physical facilities and fiscal resources as well as shared relations and shared responsibility for the accomplishment or attainment of shared goals (Gray). The self-concept-group-identity mode requires psychic and spiritual integrity for unity, meaning and purposefulness in the universe. And in the performance of role function, the individual requires social integrity in confronting and deliberating over complex options and positions. The group must perceive its role clearly and to understand tasks it is expected to perform (Gray).
Sister Callista's model establishes the environment as the cumulative conditions, circumstances, and influences surrounding and affecting individual development and behavior, and constituting the three types of stimuli, i.e., focal, contextual and residual (Gray 2003). In the case of human adaptation, the significant stimuli include the stages of human development, family and culture.
Her adaptation model defines health as a state and process of being, integrating or becoming whole of the individual with his environment (Gray 2003). It perceives adaptation as the process and outcome of conscious awareness and choice, whether individual or group, towards integration with the environment. According to Sister Callista, adaptive responses promote integrity in the direction of survival, growth, reproduction, mastery and personal and environmental transformation (Gray). She clarifies that responses are inadequate or ineffective if they fail to contribute to the stated goals of the human system and that adaptation levels represent and signify the condition of life processes at the three different levels earlier mentioned (Gray).
In her view, nursing is that science and practice that expands adaptive capabilities and enhances the transformation of the individual and the environment and that its proper goals are to enable the individual or the group to adapt by contributing to heath, quality of life and dying with dignity (Gray 2003). Nursing begins with an evaluation of behavior and the factors that influence the capability to adapt and is complemented by intervention measures that can expand the capability and enhance environmental interactions. As a whole, nursing or the nursing process is a problem-solving approach that consists of gathering information, identifying the capabilities and needs of the affected individual, the selection and performance of a select and appropriate intervention measure, and the evaluation of the outcome in taking this measure (Gray). Sister Callista's adaptation model has been incorporated into the nursing curriculum, especially in the UK and is seen as replacing other models as the nursing profession evolves.
As was first published as a 1970 Nursing Outlook article, "Adaptation: a Conceptual Framework for Nursing," Sister Callista views the individual as a combined biological and social organism in constant interaction with a continuously changing environment through four modes of adaptation (Stein 2000). These modes are physiologic, self-concept, role function and interdependence. As internal and external stimuli occur, the individual needs to adapt and constant adaptation incurs and results in deficits and excesses. In order to protect or maintain his or her physiologic, psychic, and social integrity or equilibrium, the individual applies coping mechanisms in order to restore the satisfaction of needs or achieve it (Stein). This is adaptation.
Sister Callista's model also describes a zone that figures as a variable. Stimuli that occur within this zone will yield positive response or adaptation. Otherwise, the response is negative or mal-adaptation (Stein 2000). She identifies two coping mechanisms in the process and these are the cognator and the regulator. The cognator relates to perception, learning, judgment and emotion primarily through the autonomic nervous system in making physiologic adjustments.
According to her model, the individual uses both, but separately, the cognator and regulator mechanisms in responding to or adapting to the changing internal or external environment and in preserving his integrity as an organism (Stein 2000). The outcome is perceived as positive if the adaptation achieves or restores integrity, otherwise, it is negative or mal-adaptation.
Sister Callista frames the goal of nursing precisely as one that promotes positive adaptation in every one of the four adaptive modes of the person (Stein 2000), including the prevention of illness and the maintenance of health by enabling the individual and by widening his or her zone of adaptation. She posits the individual as in a dynamic relationship with the internal and external environment that constantly changes. Stimuli from both types of environment influence…