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adapt [2021/10/16 20:06] – [Integral Eye Movement Therapy (IEMT) - An Adaptive Model] andrewtaustinadapt [2023/03/06 10:11] (current) – Remove socialite tom
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 +{{tag>IEMT Model Adaptation reframe Nursing}} 
 ==== Integral Eye Movement Therapy (IEMT) - An Adaptive Model ==== ==== Integral Eye Movement Therapy (IEMT) - An Adaptive Model ====
 **Based on Sr. Callista Roy’s (1970) Adaptation Model** **Based on Sr. Callista Roy’s (1970) Adaptation Model**
  
-Nursing theories frame, explain or define the practice and delivery of nursing care. There are a number of prominent models in common use, and different models may be used according to the organisational needs and the provisional requirements of the patient group served.  +Sister Callista Roy[(Callista_Roy>Callista Roy[[https://en.wikipedia.org/wiki/Callista_Roy|Wikipedia]])]  is an influential figure in the modern nursing profession. After graduating from Mount St. Mary’s College with a Bachelor of Science in Nursing and Sociology, she went on to pursue her Master's and Doctorate degrees at the University of California, Los Angeles. She contributed greatly to the field of nursing science with her research into Adaptation Model[( :harvard:Riehl1980>> 
 +authors   : C. Riehl 
 +title     : Conceptual Models for Nursing Practice (Archive.org Online Library) 
 +published : 1980 
 +publisher : Century Crofts 
 +url       : https://archive.org/details/conceptualmodels0000rieh 
 +)] [( :harvard:Roy1980>> 
 +authors   : H. Andrews, C. Roy 
 +title     : The Adaptation Model (Archive.org Online Library) 
 +published : 1991 
 +publisher : Appleton & Lange 
 +url       : https://archive.org/details/royadaptationmod0000andr 
 +)] of Nursing, which includes assessing patient health issues through understanding their adaptation patterns for better, more informed care. 
  
-Sister Callista Roy developed the Adaptation Model of Nursing which quickly became regarded as a major nursing theory worldwide, especially in rehabilitation environments.  Roy's model sees the individual as a set of interrelated biological, psychological and social systems. Whilst the individual strives to maintain a balance between these systems and the pressures of the outside world, an ideal level of balance is rarely found, thus the need for continual adaptation. +Her concept has been cited by various scholars and forms the basis for many current approaches to health evaluation and assistance. Moreover, her Adaptive Model has been expanded overseas, providing the opportunity for research collaboration between nurses around the world. Sister Callista Roy’s exceptional scientific contributions have set new precedents in holistic nursing assessment, making her an esteemed professional in both American and international healthcare communities.
  
-=== Overview of the theory === +Nursing theories frame, explain or define the practice and delivery of nursing care. There are a number of [[nursing_models|prominent models in common use]], and different models may be used according to the organisational needs and the provisional requirements of the patient group served.  
-NEEDS REWRITING TO AVOID PLAGIARISM+
  
-This model comprises the four domain concepts of person, health, environment, and nursing; it also involves a six-step nursing process. Andrews & Roy (1991) state that the person can be a representation of an individual or a group of individuals.[1] Roy's model sees the person as "a biopsychosocial being in constant interaction with a changing environment".[2] The person is an open, adaptive system who uses coping skills to deal with stressors. Roy sees the environment as "all conditions, circumstances and influences that surround and affect the development and behaviour of the person".[1] Roy describes stressors as stimuli and uses the term residual stimuli to describe those stressors whose influence on the person is not clear.[1] Originally, Roy wrote that health and illness are on a continuum with many different states or degrees possible.[2] More recently, she states that health is the process of being and becoming an integrated and whole person.[1] Roy's goal for nursing is "the promotion of adaptation in each of the four modes, thereby contributing to the person's health, quality of life and dying with dignity".[1] These four modes are physiological, self-concept, role function and interdependence.+Sister Callista Roy developed the Adaptation Model of Nursing[(Adaptation_model_of_nursing>Adaptation model of nursing[[https://en.wikipedia.org/wiki/Adaptation_model_of_nursing|Wikipedia]])] 
 + which quickly became regarded as a major nursing theory worldwide, especially in rehabilitation environments.  Roy's model sees the individual as a set of interrelated biological, psychological and social systems. Whilst the individual strives to maintain a balance between these systems and the pressures of the outside world, an ideal level of balance is rarely found, thus the need for continual adaptation. 
  
-Roy employs a six-step nursing process: assessment of behaviour; assessment of stimuli; nursing diagnosis; goal setting; intervention and evaluation. In the first step, the person's behaviour in each of the four modes is observed. This behaviour is compared with norms and is deemed either adaptive or ineffective. The second step is concerned with factors that influence behaviour. Stimuli are classified as focal, contextual or residual.[2] The nursing diagnosis is the statement of the ineffective behaviours along with the identification of the probable cause. This is typically stated as the nursing problem related to the focal stimuli, forming a direct relationship. In the fourth step, goal setting is the focus. Goals need to be realistic and attainable and are set in collaboration with the person.[1] There are usually both short term and long term goals that the nurse sets for the patient. Intervention occurs as the fifth step, and this is when the stimuli are manipulated. It is also called the 'doing phase' .[2] In the final stage, evaluation takes place. The degree of change as evidenced by change in behaviour, is determined. Ineffective behaviours would be reassessed, and the interventions would be revised.[1]+The [[orders_of_adaptation|Adaptation]] Model has been used in neurological rehabilitation units in a number of ways. Some examples[(application_Roys_adaptation_model>Application of Roy's Adaptation Model (RAM)[[https://currentnursing.com/nursing_theory/application_Roy%27s_adaptation_model.html|currentnursing.com]])] include:
  
-The model had its inception in 1964 when Roy was a graduate student. She was challenged by nursing faculty member Dorothy E. Johnson to develop a conceptual model for nursing practice. Roy's model drew heavily on the work of Harry Helson, a physiologic psychologist.[3] The Roy adaptation model is generally considered a "systems" model; however, it also includes elements of an "interactional" model. The model was developed specifically for the individual client, but it can be adapted to families and to communities (Roy, 1983)[full citation needed]. Roy states (Clements and Roberts, 1983)[full citation needed] that "just as the person as an adaptive system has input, output. and internal processes so too the family can be described from this perspective."+  * **Assessing the impact of neurological injuries** or conditions on an individual's physical, psychological, and social functioning.
  
-Basic to Roy's model are three concepts: the human being, adaptation, and nursing. The human being is viewed as a biopsychosocial being who is continually interacting with the environment. The human being's goal through this interaction is adaptation. According to Roy and Roberts (1981, p. 43)[full citation needed], ‘The person has two major internal processing subsystems, the regulator and the cognator." These subsystems are the mechanisms used by human beings to cope with stimuli from the internal and external environment. The regulator mechanism works primarily through the autonomic nervous system and includes endocrine, neural, and perception pathways. This mechanism prepares the individual for coping with environmental stimuli. The cognator mechanism includes emotions, perceptual/information processing, learning, and judgment. The process of perception bridges the two mechanisms (Roy and Roberts, 1981)+  * **Developing treatment plans** that address the unique needs and strengths of each individual, taking into account their personal goals and priorities.
  
 +  * **Evaluating the effectiveness of rehabilitation interventions** by tracking changes in an individual's adaptation level over time.
 +
 +  * **Providing a framework for collaborative care**, where multiple healthcare professionals can work together to support the individual's adaptation and recovery.
 +
 +  * **Educating individuals and their families about the impact of neurological injuries** or conditions on their lives, and helping them develop coping strategies to manage any challenges they may face.
 +
 +<blockquote center>
 +Health is not freedom from the inevitability of death, disease, unhappiness or stress, but rather is the ability to cope with them in a competent way.
 +
 +<cite>Ivan Illich</cite>
 +</blockquote>
 +
 +
 +<blockquote center>
 +We now act as if we really believe that disease, aging, and death are unnatural acts and all things are remediable. All we have to do, we think, is know enough (or spend enough), and disease and death can be prevented or fixed.
 +
 +<cite>Faith T. Fitzgerald</cite>
 +</blockquote>
 +
 +==== Overview of the theory ====
 +
 +The Adaptation model has four domain concepts of: (i) person, (ii) health, (iii) environment, and (iv) nursing; 
 +
 +The model views the person as "//a biopsychosocial being in constant interaction with a changing environment//".
 +
 +As in systems theory, a person is an open and adaptive system that uses internal coping skills to deal with environmental stressors. The environment is defined as "all conditions, circumstances and influences that surround and affect the development and behaviour of the person".
 +
 +Stressors are defined as stimuli and the model uses the term //residual stimuli// to describe those stressors whose influence on the person is not immediately clear. Many life experiences and events that are long over may continue to exert residual stress upon the individual.
 +
 +Health is defined as the process of "being and becoming an integrated and whole person" and Callista Roy's goal for the delivery of nursing care is "//the promotion of adaptation in each of the four modes*, thereby contributing to the person's health, quality of life and dying with dignity//".
 +
 +*//The four modes referred to are: (i) physiological, (ii) self-concept, (iii) role function and (iv) interdependence.//
  
----- 
  
 +==== Adaptive Model and IEMT ====
  
-Embedded within the operating mechanism of IEMT is a fundamental assumption that holds a person as a dynamic being who is in constant interaction with the ever-changing environment. Human beings are an intricate design of biological, social and psychological factors, both internal and external. +Embedded within the operating mechanism of [[iemt_wiki|IEMT]] is a fundamental assumption that holds a person as a dynamic being who is in constant interaction with the ever-changing environment. Human beings are an intricate design of biological, social and psychological factors, both internal and external. 
  
 Every environment offers the individual resources, challenges, struggles and stressors of different forms and variable degrees thereby resulting in all consequential effects being subjective and occurring on a spectrum.  Every environment offers the individual resources, challenges, struggles and stressors of different forms and variable degrees thereby resulting in all consequential effects being subjective and occurring on a spectrum. 
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 An important aspect of IEMT is an increase in resilience in order to get the client more effective to face, handle and adapt to the current environment. IEMT attempts to increase adaptability and maturity on part of the individual in order to manage life and its' ongoing complexities.  An important aspect of IEMT is an increase in resilience in order to get the client more effective to face, handle and adapt to the current environment. IEMT attempts to increase adaptability and maturity on part of the individual in order to manage life and its' ongoing complexities. 
  
-Being an “adaptive system”, a person has input from the environment, which is subject to internal processing, eventually leading to an output. Our model presumes that the individual uses both innate and acquired (learned) mechanisms to adapt. Some of these adaptations may bring about unintended negative consequences and may be termed maladaptive.+Being an “[[orders_of_adaptation|adaptive system]]”, a person has input from the environment, which is subject to internal processing, eventually leading to an output. Our model presumes that the individual uses both innate and acquired (learned) mechanisms to adapt. Some of these adaptations may bring about unintended negative consequences and may be termed maladaptive.
  
 The environmental stimuli that present as a resource, challenge, stressor or any combination of these may have its’ origin in the historical biography of an individual. This, in turn, can exert an effect in the present through its psychological, physiological, emotional, social and/or environmental nature. The environmental stimuli that present as a resource, challenge, stressor or any combination of these may have its’ origin in the historical biography of an individual. This, in turn, can exert an effect in the present through its psychological, physiological, emotional, social and/or environmental nature.
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 {{:adaptive_1_.png?600|}} {{:adaptive_1_.png?600|}}
  
-==== The environment has four components: ====+==== Environmental stressors have four components: ====
  
-  - **Focal** - current and specific stresses (extraneous pressures, intrinsic health issues) applied to the individual present in many or all contexts; +  - **Focal** - current and specific stresses (extraneous pressures, intrinsic health issues) applied to the individual present in many or all contexts. The focal stimuli are those which attract the most attention from individuals (injury, divorce, debt, etc) or communities (such as a bombing, kidnap, environmental disaster, etc); 
   - **Contextual** - all context-dependent stimuli, that is, those present in the background, and frame the situations that exacerbate the consequences of the focal stresses;   - **Contextual** - all context-dependent stimuli, that is, those present in the background, and frame the situations that exacerbate the consequences of the focal stresses;
-  - **Residual** - historical stresses whose after-effects continue into the current situation and affect the individual’s well-being. This may include attitudes, beliefs and strong influences in the form of either people or experiences.  +  - **Residual** - historical stresses whose after-effects continue into the current situation and affect the individual’s well-being. This may include attitudes, beliefs, and strong influences in the form of either people or experiences.  
-  - **Prospective Stresses** - can reasonably be known, anticipated and expected prior to their occurrence. +  - **Prospective Stresses** - can reasonably be known, anticipated, and expected prior to their occurrence. 
  
 With the IEMT model, well-being is affected when an individual’s adaptation fails to de-potentiate residual negative states resulting from historical environmental interactions and pressures. This in turn leads to specific maladaptive patterns, The Patterns of Chronicity, which inadvertently serve to maintain the residual negative state. With the IEMT model, well-being is affected when an individual’s adaptation fails to de-potentiate residual negative states resulting from historical environmental interactions and pressures. This in turn leads to specific maladaptive patterns, The Patterns of Chronicity, which inadvertently serve to maintain the residual negative state.
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   - **Residual** - past events and traumas that leave a residual kinaesthetic that affects well-being and behaviour in the present moment    - **Residual** - past events and traumas that leave a residual kinaesthetic that affects well-being and behaviour in the present moment 
   - **Prospective** - habitual responses to “routine” triggers   - **Prospective** - habitual responses to “routine” triggers
 +
 +==== Adaptation ====
 +
 +The Adaptation model proposes 3 levels of adaptation
 +
 +1. Adaptive (systemic reorganisation)
 +2. Compensatory (part-system reorganisiton)
 +3. Maladaptive (failure to reorganise)
  
 {{ :coping_processes.png|}} {{ :coping_processes.png|}}
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 {{:image-3.jpg?800|}} {{:image-3.jpg?800|}}
 +
 +===== See also =====
 +
 +  * [[nursing_models|Additional nursing models]]
 +  * [[orders_of_adaptation|]]
 +  * [[orders_of_change|]]
 +
 + 
  • Last modified: 2021/10/16 19:06
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