How Do I Start a Nursing Diagnosis Using the Roy Adaptation Model?


Assess physiological behavior. Based on Maslow's "Hierarchy of Needs," learn whether the patient is satisfying basic needs such as oxygenation, nutrition, elimination, activity and rest. Evaluate more complex processes such as electrolytic balance, fluid intake and neurological and endocrine functions. Investigate how the patient functions. Is he or she able to function independently? Can he or she bath alone? Does he or she shop and cook for themselves? Does he or she maintain a clean and safe living environment?


Assess the patient's spiritual or psychological state. Ask how he or she sees himself or herself in terms of the universe, family, community and spiritual connection. Sense if he or she feels needed and whether he or she thinks life is meaningful and with purpose. According to Roy, feeling needed is part of the "group identity integrity," when one feels a sense of ownership with others.


Need is "social integrity," knowing who one is in relation to others. Knowing oneself is connected to knowing where one fits in a social hierarchy, family and community. Assess how much responsibility the patient holds, how he or she balances interactions, and whether he or she shies away or embraces interaction. Note how he or she approaches goals, how he or she satisfies them, whether he or she completes them and how he or she feels if goals aren't met.


How interdependent is the patient on others for love, affection and value. According to Roy, there is an inherent need to achieve "relational integrity" using a process of "affectional" adequacy. A patient should demonstrate some degree of relational integrity using developmental and resource adequacy. This means that he or she learned how to obtain food, shelter, health and security through interdependence with others.

Tips and Warnings

  • After assessing behavior, the nursing professional should assess stimuli that might affect behavior. This is when a tentative nursing diagnosis can be formulated.
  • The Roy Adaptation Model is a problem-solving approach that was developed by Sister Callista Roy. It is partly based on Abraham Maslow's "Hierarchy of Needs" and "Need Satisfaction Models" and Dorothy Johnson's "Behavior System Model." Roy's model focuses on how a patient uses adaptive coping methods to protect his or her physiological, psychic and social integrity to restore "need satisfaction." In nursing, data is gathered on a patient's ability to cope and adapt. A nursing care approach is implemented and outcomes of care are evaluated. Before developing a diagnosis, nursing professionals first must assess a patient's behavior.