1. Roy’s Adaptation Model with Spinal Cord Injuries

2. Roy’s Adaptation Model
In RAM the individuals adapt to stimuli through regulator and cognator coping mechanisms.
The environment is a common source of focal, contextual, and residual stimuli.

3. RAM
3 reasons for use of RAM with research on the meaning of living with a spinal cord injury.
Original research was done by Roy
Adaptive modes can be easily applied to the families
Extension to previous research done on living with spinal cord injury

4. Adaptation
“the process and outcome whereby thinking and feeling persons, as individuals or in groups, use conscious awareness and choice to create human and environmental integration.”(DeSanto, 2006)

5. RAM with Spinal Cord Injury
Multiple challenges with adapting to environment, physical needs, and psychological needs with spinal cord injury for patient and families.
Roy’s model is used to identify 3 stimuli’s that reflect the meaning of living with spinal cord injury for the family.

6. Focal Stimuli
Involves internal and external factors that will affect the person or families immediately.

7. Contextual Stimuli
Environmental factors that present to the person and how they deal with the focal stimulus.

8. Residual Stimuli
Environmental factors within or without the human system and the effects seem to be unclear.

9. 4 Modes of Adaptation Used
Physiological Mode
Self-Concept Mode
Role Function
Interdependence Mode

10. Physiological Mode There are 3 themes to this mode:
Looking for understanding to a life that is unknown
Stumbling along an unlit path
Being chained to the injury

11. Physiological Mode
The knowledge and understanding of the families is an important requirement to achieve the goals of adaptation.
The families need to be able to understand the physical condition of the individual with a spinal cord injury as they age.
This focuses on the physical complications of the spinal cord injury.

12. Self-Concept Mode
There are 5 themes addressed in the self-concept mode:
Stumbling along an unlit path
Viewing self through a stained glass window
Moving forward in a new way of life
Reaching normalcy
Being chained to the injury

13. Self-Concept Mode
This mode reflects the psychic integrity of knowing oneself and being able to live with a sense of meaning and purpose.
Being able to accept the body image however it may be.
Have self ideals to what they would like to do or is capable of doing.

14. Role Function There are 4 themes to the Role Function mode:
Looking for understanding to a life that is unknown
Challenging the bonds of love
Reaching normalcy
Being chained to the injury

15. Role Function
This mode involves role transitioning in response to living with a spinal cord injury.
The tertiary role in this mode are roles that are freely chosen by a person and are temporary.
This also involves having role clarity to be able to understand and commit to the various roles of the injury and their ability.
Emphasizes the ways that a patient and families redefine the abilities of the patient to be able to perform their preinjury activities.

16. Interdependence Mode There are 4 themes to the interdependence mode:
Viewing self through a stained glass window
Challenging the bonds of love
Moving forward in a new way of life
Being chained to the injury

17. Interdependence Mode
This mode reflects the support systems, relational integrity, resource adequacy, and interdependent relationships with others.
The interdependence mode focuses on the way the patient and their families give and receive social support.

18. Significance to Nursing Care
Nurses are able to assist the patient and the families to be able to develop strategies to enhance their self perception on their life and abilities.
Educate society on awareness and adapting spinal cord injury patients into society.
Educate the patient and families on how to adapt to the changes in the patient to be able to reach their maximum potential for the years to come.

19. References DeSanto-Madeya, Susan. (July, 2006)
References DeSanto-Madeya, Susan. (July, 2006). A Secondary Analysis of the Meaning of Living With Spinal Cord Injury Using Roy’s Adaptation Model. Nursing Science Quarterly. Vol. 19,3, pgs DOI: /