HI STORI CAL EVOLUTI ON OF THE CONCEPT ENVI RONMENT
PROPOSED I N THE ROY ADAPTATI ON MODEL
Mar cos Venícios de Oliv eir a Lopes1 Lor it a Mar lena Fr eit ag Pagliuca2 Thelm a Leit e de Ar auj o1
Lopes MVO, Pagliu ca LMF, Arau j o TL. Hist or ical ev olu t ion of t h e con cept en v ir on m en t pr oposed in t h e Roy adapt at ion m odel. Rev Lat ino- am Enfer m agem 2006 m ar ço- abr il; 14( 2) : 259- 65.
The concern for t he developm ent of concept s becom es even m ore im port ant when we report t o it s use in Nur sing t heor ies, in w hich som e concept s ar e consider ed cent r al, such as per son, env ir onm ent , healt h and nursing. This st udy aim s t o discuss t he hist orical evolut ion of t he environm ent concept used in t he Roy Adapt at ion Model. The m et hod of analysis t he st udy w as based on is t he evolut ionar y concept ual analysis of t he concept Environm ent of t he Roy Adapt at ion Model. According t o t he research result s, Environm ent is int roduced as t he second m aj or concept in t he Roy Adapt at ion Model. I n t his t heor ist ’s int er pr et at ion of t he env ir onm ent , w e not ice her int er est in sur passing t he m echanist ic point of v iew upon w hich t he fir st v er sion of t he m odel w as b ased . Th e ap p r o ach o f t h e co n cep t o f i n t er act i o n b et w een p eo p l e an d g r o u p s seem s t o r ep r esen t an im pr ov em ent , influenced by t he cur r ent t hought s t hat ar e pr eem inent in nur sing.
DESCRI PTORS: adapt at ion; nur sing t heor y ; concept for m at ion
EVOLUCI ÓN HI STÓRI CA DEL CONCEPTO ENTORNO PROPUESTO
EN EL MODELO DE LA ADAPTACI ÓN DE ROY
La pr eocu pación con el desar r ollo de con cept os se v u elv e m ás im por t an t e cu an do n os r epor t am os par a su u so en t eor ías de En f er m er ía. En ellas, algu n os con cept os son con sider ados cen t r ales, t ales com o per son a, am bien t e, salu d y en f er m er ía. Est e ar t ícu lo v isa ex am in ar la ev olu ción h ist ór ica del con cept o de am bient e ut ilizado en el Modelo de Adapt ación de Roy. El m ét odo de análisis en que el est udio fue basado es el análisis concept ual ev olucionar io del concept o Am bient e del Modelo de Adapt ación de Roy . De acuer do con los result ados del est udio, Am bient e es int roducido com o el segundo concept o m ás im port ant e en el Modelo de Adapt ación de Roy. En la int erpret ación que la t eórica hace del am bient e, not am os su int erés en ult rapasar el punt o de vist a m ecanicist a en que la pr im er a ver sión del m odelo er a basada. La pr opuest a de int er acción del concept o am bient e con per sonas y gr upos par ece r epr esent ar una m ej or ía, influenciada por los pensam ient os cor r ient es que son pr edom inant es en la enfer m er ía.
DESCRI PTORES: adapt ación; t eor ía de enfer m er ía; for m ación de concept o
EVOLUÇÃO HI STÓRI CA DO CONCEI TO AMBI ENTE
PROPOSTO NO MODELO DA ADAPTAÇÃO DE ROY
A pr eocupação com o desenvolvim ent o de conceit os t or na- se m ais im por t ant e quando nos r epor t am os par a seu u so em t eor ias de En fer m agem . Nelas, algu n s con ceit os são con sider ados cen t r ais, com o pessoa, am b ien t e, saú d e e en f er m ag em . Est e ar t ig o v isa ex am in ar a ev olu ção h ist ór ica d o con ceit o d e am b ien t e u t ilizado n o Modelo de Adapt ação de Roy . O m ét odo de an álise em qu e o est u do f oi baseado é a an álise conceit ual ev olucionár ia do conceit o Am bient e do Modelo de Adapt ação de Roy . De acor do com os r esult ados do est udo, Am bient e é int roduzido com o o segundo conceit o m ais im port ant e no Modelo de Adapt ação de Roy. Na in t er p r et ação q u e a t eór ica f az d o am b ien t e, n ot am os seu in t er esse em u lt r ap assar o p on t o d e v ist a m ecanicist a em que a pr im eir a ver são do m odelo er a baseada. A pr opost a de int er ação do conceit o am bient e com pessoas e gr upos par ece r epr esent ar um a m elhor ia, influenciada pelos pensam ent os cor r ent es que são pr edom in an t es n a en f er m agem .
DESCRI TORES: adapt ação; t eor ia de enfer m agem ; for m ação de conceit o
1
I NTRODUCTI ON
N
u r s i n g k n o w l e d g e h a s d e v e l o p e d t hroughout t he years wit h a not able search t o est ablisha r an ge of con cept u alizat ion s t h at can ch ar act er ize
and define nur sing science. I n t his r espect , em pir ical
t heory is a m anifest at ion of t he em pirical st andard of
knowledge, which can be viewed as knowledge derived
from t radit ional ideas on science, observed in realit y,
and v er ifiable by ot her s( 1).
How ev er, em p ir ical k n ow led g e in v olv es t h e
search for a solid concept ual and philosophical basis,
w h i c h a i m s a t s u b s i d i z i n g d e s c r i p t i o n a n d
underst anding of phenom ena associat ed t o t hat range
of knowledge. Therefore, t he developm ent of concept s
in Nu r sin g is a p oin t of g r eat r elev an ce in cu r r en t
d eb at es.
However, t here are st ill differences in t he way
concept s are underst ood. For som e aut hors, concept s
can be viewed as som et hing cont inuous t hat goes from
t h e m ost con cr et e t o t h e m ost abst r act( 1 ). I n ot h er
cases, t hey are considered as abst ract ions t hat reflect
phenom ena( 2). What can be considered com m on about
t hose view s is t hat concept s ar e m ent al for m ulat ions
of an exist ence t hat can be m or e or less com plex.
I n Nu r sin g , w e h av e f aced sit u at ion s t h at
in t er f er e w it h t h e dev elopm en t of con cept s f or t h e
p r o f e ssi o n . Am o n g t h e co m m o n e st o f t h e se a r e :
usage of vague t erm inology, am biguit y in t he definit ion
of im por t ant concept s for Nur sing, and inconsist ency
am ong t heories. Many concept s are w idely used w it h
d iv er sif ied d ef in it ion s, t h u s d elay in g t h e scien t i f i c
dev elopm ent of t he pr ofession( 3).
The views of Nursing on concept s reflect t he
diversit y of ways t o approach t his issue. These visions
i n cl u d e : f o cu s o n r e l a t i o n s a m o n g co n ce p t s a n d
em pirical or rem arkable realit y, arguing t hat concept s
ar e essent ially sy m bols for obj ect iv e elem ent s in t he
world; em phasis on hum an m ind and t hought ; relat ion
bet w een a concept and a specific w or d( 3).
I n t h e pr ocess of an aly sis of con cept s, t w o
m ain t hought s can be ident ified: t he essent ialist and
t he evolut ionary. I n t he first , t he purpose of analysis
is t o d ef in e t h e con cep t of in t er est in t er m s of it s
c r i t i c a l a t t r i b u t e s o r “ e s s e n c e ” , w h e r e a s i n t h e
evolut ionary t hought , one considers concept s as being
dy nam ic, “ indist inct ” r at her t han finit e, absolut e and
“ clear cryst al”, dependent on t he cont ext , and having
pr agm at ic u sefu ln ess or pu r pose.
The concern for t he developm ent of concept s
becom es even m ore im port ant w hen w e report t o it s
use in Nur sing t heor ies. I n t hem , som e concept s ar e
co n si d er ed cen t r al , su ch as p er so n , en v i r o n m en t ,
h e a l t h a n d n u r si n g . Acco r d i n g t o w h a t h a s b e e n
pr ev iously ex posed, t hese concept s suffer v ar iat ions
in t heir definit ions according t o t he view of t he t heorist .
Specifically w it h r egar ds t o t he env ir onm ent
co n cep t , Ro y asser t s t h at t h er e ar e at l east f o u r
different ways t hrough which it is exam ined in Nursing
st u dies. I n t h e fir st appr oach , t h e con cept is called
u n d er sp eci f i ed m et a- p ar ad i g m co n st r u ct , w h i ch i s
co m p a t i b l e w i t h t h e n o t i o n o f e n v i r o n m e n t a s a
m e d i a t i n g p r e s e n c e . Th e s e c o n d v i e w s e e s
env ir onm ent as t he com m unicat iv e cont ex t , t hat is,
t h e ph en om en a u n der st u dy ex ist in t h e social an d
h ist or ical p osit ion of t h e p er son . Th e t h ir d w ay t o
concept ualize t he environm ent is t o define it as social
posit ion s of an open field, w h er e t h e n u r se’s social
p o si t i o n can b e seen as p o si t i v e w h en r el at ed t o
pat ient s and negat ive for t he profession’s inst it ut ional
subor dinat ion t o m edicine. Last ly, t he envir onm ent is
st ill con cep t u alized as a su r v ey list of ex t r an eou s
v ar iables, w her e effect s t hat m odify t he v ar iables of
a hypot hesis dim inish t he generalizat ion of t heories( 4).
Roy is t he aut hor of one of t he m ost diffused
Nur sing concept ual m odels. The dev elopm ent of her
concept ual m odel began when she was st ill a graduat e
s t u d e n t i n t h e 6 0 ’ s u n d e r D o r o t h y Jo h n s o n ’ s
or ient at ion, in a t im e w hen nur sing w as st ar t ing it s
sear ch t o incr ease it s k now ledge base, alt hough st ill
u n d e r t h e i n f l u e n c e o f t h e o r e t i c a l t h i n k i n g b y
ph ilosoph er s an d psy ch ologist s.
Or i g i n a t e d f r o m h u m a n i sm a n d sy st e m ’ s
t h eor y, Roy st ar t ed t h e dev elopm en t of h er m odel,
by present ing it s base w hile undergoing her m ast er’s
d eg r ee co u r se. At t h e b eg i n n i n g o f t h e 7 0 ’s, sh e
published ar t icles in w hich she show ed t he bases of
her m odel for nursing pract ice. I n 1976, she launched
her fir st book cont aining t he descr ipt ion of t he basic
con cept s ( per son , en v ir on m en t , h ealt h an d n u r sin g
g o al ) . I n ad d i t i o n , t h e p u b l i cat i o n i n t r o d u ced t h e
specific concept s of her proposal ( adapt at ion, st im uli,
b eh a v i o r a n d a d a p t i v e m o d es) . Ro y co n t i n u ed t o
im prove her m odel by launching books in 1981, 1984,
1 9 8 6 , 1 9 9 1 an d 1 9 9 9 . Ad d it ion ally, p u b licat ion s in
v a r i o u s j o u r n a l s s o u g h t t o c o n t r i b u t e t o t h e
This ar t icle w as dev eloped st ar t ing fr om t he
pr ev ious k now ledge on Roy ’s Adapt at ion Model, and
discussed t he hist or ical ev olut ion of t he env ir onm ent
co n cep t u sed i n t h e m en t i o n ed m o d el , a i m i n g a t
co n t r i b u t i n g t o t h e d ev el o p m en t a n d a p p r o p r i a t e
applicat ion of it in our pr ofessional r ealit y.
METHODS
Th e s t u d y i s b a s e d o n t h e e v o l u t i o n a r y
concept ual analy sis m et hod. Accor ding t o t his v ision,
a concept is consider ed t o be an abst r act ion t hat is
ex pr essed in som e w ay. Su ch con cept s ar e f or m ed
by t he ident ificat ion of com m on char act er ist ics of a
group of obj ect s or phenom ena, and by t he abst ract ion
and grouping of t hose charact erist ics w it h t heir w ays
of ex pr ession( 2- 3).
Th e m e t h o d o f e v o l u t i o n a r y a n a l y s i s o f
con cep t s in v olv es t h e f ollow in g p r im ar y act iv it ies:
id en t if y in g t h e con cep t of in t er est an d ex p r ession s
associat ed wit h it ; ident ifying and select ing a field for
dat a collect ion, w hich can be cognit iv e, pr ofessional
or ev en polit ical; collect ing r elev ant dat a t o ident ify
bot h t he at t ribut es of t he concept and t he cont ext ual
basis of t he concept , including int erdisciplinary, social,
cult ural and t im e variat ions; analyzing dat a which are
m ost r elat ed t o t h e ch ar act er ist ics of t h e con cep t ;
iden t if y in g a sam ple of t h e con cept , if appr opr iat e;
ident ify ing out com es and hy pot heses t o pr om ot e t he
developm ent of t he concept . Many of t hose act ivit ies
occu r si m u l t an eou sl y an d ar e com p l em en t ar y an d
int er dependent . I n t his w or k w e lim it ed our selv es t o
d e v e l o p o u r a n a l y si s o n t h e f o u r f i r st a ct i v i t i e s
m en t ion ed( 3 ).
I n t he collect ion and m anagem ent of dat a one
e m p h a s i z e s i n d u c t i o n , a i m i n g a t d i s c o v e r i n g
appr oaches focused on t he ident ificat ion of r elev ant
a sp e ct s o f t h e co n ce p t . I n t h i s p h a se , t h e d a t a
considered include t he sit uat ion, t im e, social, cult ural
an d d iscip lin ar y con t ex t f or t h e ap p licat ion of t h e
concept . The focus on t he ex plor at ion of cont ex t ual
a s p e c t s o f t h e c o n c e p t s e e k s t o a c h i e v e a n
u n der st an din g of sit u at ion s in w h ich t h e con cept is
used, t he use of t he concept in varied sit uat ions, and
it s use by people wit h pot ent ially diverse perspect ives.
Th e c o n c e p t o f i n t e r e s t c h o s e n w a s
e n v i r o n m e n t , c o n s i d e r e d o n e o f t h e f o u r m a i n
concept s t o be defined in Nur sing t heor y. The r ealm
for dat a collect ion w as Roy ’s Adapt at ion Model. The
m ain w or k s p u b lish ed b y t h e au t h or on t h e m od el
were verified, including all books and t he m ain art icles
published in j ournals. The reading and careful analysis
o f e a ch o f t h e w o r k s a l l o w e d u s t o ca p t u r e t h e
h i st o r i ca l e v o l u t i o n o f t h e e n v i r o n m e n t co n ce p t ,
specifically it s t im e and social and cult ural variat ions.
RESULTS AND DI SCUSSI ON
The Roy adapt at ion m odel
Th is d escr ip t ion of Roy ’s Ad ap t at ion Mod el
was based on t he second edit ion of t he work ent it led
The Roy adapt at ion m odel by Roy and Andr ew s, t he
lat est book published by t he t heorist on her m odel up
t o t h e m o m e n t w e w r o t e t h i s p a p e r( 1 5 ). A s t h e
a d a p t a t i o n co n ce p t h a s a l r e a d y b e e n p r e v i o u sl y
defin ed, w e pr oceed t o descr ibe t h e ot h er con cept s
pr esent ed by t he aut hor s.
Fo r t h e m , a d a p t a t i o n l e v e l r e p r e s e n t s
con dit ion s of lif e pr ocesses, w h ich ar e descr ibed at
t h r ee lev els: t h e in t egr at ed, t h e com pen sat or y an d
t h e com p r om ised . Con cer n in g t h e in t eg r at ed lev el,
st ruct ures and funct ions of life processes are working
t oget h er in or der t o m eet h u m an n eeds. Abou t t h e
co m p en sa t o r y l ev el , r eg u l a t o r a n d co g n a t o r su b
-syst em s are act ivat ed t o search for t he int egrat ion of
l i f e p r o c e s s e s . A t t h e c o m p r o m i s e d l e v e l , l i f e
p r o c e s s e s p r e s e n t i n a d e q u a t e i n t e g r a t i o n ,
char act er izing an adapt at ion pr oblem .
The person is seen as a holist ic and adapt ive
syst em , as a whole wit h part s t hat funct ion as a unit
f or som e en ds. Th is sy st em in clu d es in div idu als or
g r o u p s ( f a m i l y, o r g a n i z a t i o n s, co m m u n i t i e s a n d
societ ies) . When v iew ed as a sy st em , t he per son is
consider ed as being in cont act w it h t he env ir onm ent
f r o m w h i c h h e r e c e i v e s s t i m u l i t h a t d e m a n d
r esponses, w hich can be visualized t hr ough behavior.
S t i m u l i a r e d e f i n e d a s e v e r y t h i n g t h a t
p r o v o k e s r e sp o n se . Th e y a r e d i v i d e d i n t o t h r e e
cat egories: focal, which im m ediat ely faces t he hum an
syst em ; cont ext ual, w hich involves st im uli pr esent in
t h e sit u at ion t h at con t r ib u t e t o t h e ef f ect of f ocal
st im u lu s; an d r esid u al, w h ich is an en v ir on m en t al
fact or t hat is present or not in hum an syst em s, whose
effect s in t he current sit uat ion are not clear.
Th e en v ir on m en t , in t u r n , is v iew ed as all
condit ions, circum st ances and influences t hat surround
adapt iv e sy st em , consider ing par t icular ly t he per son
and ear t h r esour ces. The r esponses pr oduced by t he
in t er act ion of t h e h u m an adapt iv e sy st em w it h t h e
environm ent are divided int o t wo cat egories: adapt ive
r esponses, w hich pr om ot e int egr it y in t er m s of goals
o f t h e h u m an sy st em ; an d i n ef f ect i v e r esp o n ses,
w h ich do n ot con t r ibu t e t o t h e in t egr it y m en t ion ed
p r ev iou sly.
Th e s e r e s p o n s e s a r e s h o w n t h r o u g h
b eh av ior s t h at in d icat e in t er n al or ex t er n al act ion s
a n d r e a ct i o n s i n a sp e ci f i c ci r cu m st a n ce . Th e se
behaviors result from t he st im uli process of t he hum an
sy st em t h r ou g h t w o su b - sy st em s: t h e r eg u lat or /
st abilizer and t he cognat or / innovat or. The regulat or
su b - sy st e m i s t h e co n f r o n t i n g p r o ce ss ( u se d b y
i n d i v i d u a l s) t h a t i n v o l v e s n e r v o u s, ch e m i ca l a n d
e n d o c r i n e c h a n n e l s . Th e s t a b i l i z e r s u b - s y s t e m
cor r esponds t o t he r egulat or com ponent , how ever, it
r e l a t e s t o g r o u p s , a n d i s a s s o c i a t e d w i t h t h e
m a i n t e n a n c e a n d i n v o l v e m e n t o f e s t a b l i s h e d
st r u ct u r es, v alu es an d act iv it ies per for m ed daily by
part icipant s in order t o reach social syst em purposes.
The cognat or sub- syst em is a process of cont rol used
b y i n d i v i d u a l s t h a t u ses f o u r co g n i t i v e- em o t i o n a l
ch an n el s: p er cep t u al an d i n f o r m at i o n p r o cessi n g ,
learning, j udgem ent and em ot ion. The innovat or
sub-sy st em i s t h e g r o u p f a ci n g p r o cess t h a t i n v o l v es
s t r u c t u r e s a n d p r o c e s s e s f o r c h a n g e a n d
im p r ov em en t .
Roy and Andrews st at e t hat it is not possible
t o obser ve how t hese sub- sy st em s funct ion dir ect ly.
Th e i r e v a l u a t i o n i s i n d i r e ct l y m a d e t h r o u g h t h e
b e h a v i o r s m e n t i o n e d t h a t a r e d i v i d e d i n t o f o u r
adapt iv e m odes: phy sical- phy siological, self- concept
/ gr oup ident it y, r ole funct ion and int er dependence.
I n t he first m ode, t he physiological part refers t o t he
w a y t h e i n d i v i d u a l p h y si ca l l y i n t e r a ct s w i t h t h e
e n v i r o n m e n t t h r o u g h h i s o r g a n s a n d o r g a n i c
com pon en t s. Th e ph y sical m ode cor r espon ds t o t h e
w a y a co l l e ct i v i t y sh o w s i t s a d a p t a t i o n t o b a si c
oper at ional r esour ces ( par t icipant s, phy sical facilit ies
a n d f i sca l r e so u r ce s) . Th e se l f - co n ce p t m o d e i s
com posed of belief s an d f eelin gs t h at an in div idu al
has about him self at a cert ain m om ent . Group ident it y
in v olv es in t er p er son al r elat ion s, g r ou p self - im ag e,
so ci al en v i r o n m en t an d cu l t u r e. Th e r o l e f u n ct i o n
m odel inv olv es t he r oles t hat an indiv idual per for m s
i n s o c i e t y o r t h e a c t i o n s a s s o c i a t e d w i t h t h e
in f r ast r u ct u r e of a g r ou p . I n t er d ep en d en ce f ocu ses
on int er act ions r elat ed t o lov e giv ing and r eceiv ing,
r espect and v alue am ong indiv iduals, and public and
privat e cont act s of a group( 14).
I n t he Roy Adapt at ion Model, healt h is defined
a s a st a t e a n d p r o ce ss o f b e i n g a n d b e co m i n g ,
int egr at ed and t ot al, and t he goal of nur sing is t he
pr om ot ion of adapt at ion in each of t he four adapt ive
m o d es.
Hist or ical ev olut ion of t he concept env ir onm ent
The hist or ical dev elopm ent of t he m odel led
t o sev er al changes in t he w ay Roy saw pr ofessional
p r act ice. I n t h is w ay, con cep t s an d in t er - r elat ion s
am ong t hem w er e alt er ed in t he sear ch t o im pr ov e
t he m odel. Specifically, t he envir onm ent concept w as
r e v i s e d s e v e r a l t i m e s s i n c e t h e a u t h o r ’ s f i r s t
publicat ion in 1970, w hen it w as not addr essed as a
p a r t i cu l a r co n ce p t b u t w a s ch a r a ct e r i ze d a s t h e
environm ent in which t he individual was insert ed. This
can be at t est ed in t he follow ing passage: “ Man, as a
bio- psy chosocial being, is int er act ing const ant ly w it h
his changing environm ent . To cope wit h t he changing
world, he uses bot h innat e and acquired m echanism s
( . . . ) . Th r ou gh t h ese m ech an ism s, m an at t em pt s t o
respond t o t he dem ands m ade on him by t he changing
en v ir on m en t ”( 5 ).
I n t h ose f ir st essay s, t h e en v ir on m en t w as
r est r ict ed t o t he not ion of place, not consider ing t he
pr ocesses in h er en t t o t h e body of t h e per son as a
possible environm ent . The insert ion of t his not ion st art s
as t he m odel is applied and st udied. Soon in 1 9 7 1 ,
Roy discret ely developed t he concept of environm ent ,
say i n g t h at : “ Ad ap t at i o n t h eo r y v i ew s m an as an
or g an ism in con st an t in t er act ion w it h h is ch an g in g
environm ent . He has innat e and acquired m echanism s
t hat help him cope w it h t he const ant env ir onm ent al
changes. ( ...) I n ot her words, t he body adapt s t o t he
ex t er nal env ir onm ent al change. Sim ilar m echanism s
oper at e on t he psy chosocial lev el: for ex am ple, t he
ego defense of denial or sublim at ion”( 6).
I n t h i s sen se, t h er e i s a n a d m i ssi o n t h a t
e x t e r n a l c h a n g e s a s s o c i a t e d t o a n i n t e r n a l
env ir onm ent , her e defined as t he psy chosocial lev el
t hat alt ers and dem ands a response from t he person
aim in g at adapt at ion . Alt h ou gh n ot discu ssed m or e
direct ly, t he int ernal environm ent st art ed t o be not iced
w h ile bear in g in m in d t h at psy ch osocial alt er at ion s
are neit her t ouchable nor direct ly not iced by observing
t h e e x t e r n a l e n v i r o n m e n t i n w h i ch t h e p e r so n i s
Ro y l a u n ch e d a m o r e co n ci se d e f i n i t i o n ,
sim ilar t o t hat of 1971, in her first book published in
1976. This definit ion say s t hat m an int er act s w it h a
con st an t ly ch an gin g en v ir on m en t an d, t o cope w it h
h i s ch an g i n g , h e h as cer t ai n i n n at e an d acq u i r ed
m ech an ism s. We n ot ice in Roy ’s w r it in g s t h at t h e
concept environm ent was m inim ally addressed, t o t he
d e t r i m e n t o f o t h e r co n ce p t s. Th e r e w a s g r e a t e r
co n ce r n i n d e f i n i n g t h e a p p l i ca t i o n o f t h e m o d e l
t hrough t he adapt ive m odels, rat her t han showing t he
t heor y ’s m aj or concept s in a m or e consist ent w ay( 7).
Ther efor e, w e can say t hat , in t he 70’s, t he
co n cep t en v i r o n m en t i s p r esen t ed a s a n o t i o n o f
p l a ce . I n 1 9 7 1 , Ro y p r e se n t e d a d e f i n i t i o n t h a t
e s t a b l i s h e d a n o t i o n o f i n t e r n a l e n v i r o n m e n t
( psy ch osocial lev el) . Nev er t h eless, it w as lim it ed t o
t he concept of place.
Af t er t h e ap p licat ion an d ev alu at ion of t h e
m odel by t he t heorist as well as by her collaborat ors
and gr aduat ion st udent s, concept s w er e clar ified and
m ade adequ at e t o t h e pr oposed f r am ew or k . I n t h e
80’s, t he definit ion of env ir onm ent pr esent ed in t he
m o d e l s t a r t e d t o i n c l u d e p h y s i c a l , s o c i a l a n d
psychological aspect s. The aut hor clarifies t he concept
environm ent in 1980 when she assert s t hat t he person
confr ont s const ant phy sical, social and psy chological
c h a n g e s i n h i s e n v i r o n m e n t a n d i s c o n t i n u a l l y
int er act ing w it h t hese. At t im es, lear ned or acquir ed
m ech a n i sm s a r e u sed t o co p e w i t h t h e ch a n g i n g
w or ld( 8).
The publicat ion in 1980, however, refers t o a
su m m ar ized ch ap t er on t h e ad ap t at ion m od el an d
consequent ly does not det ail it s concept s. I n t he book
on t he m odel published in 1981, on t he ot her hand,
Roy present s a m ore developed definit ion and includes
t he environm ent concept am ong it s great er concept s.
I n t hat work, t he aut hor assert s t hat , by environm ent
we m ean sim ply what t he dict ionary says, t hat is, all
t h e c o n d i t i o n s , c i r c u m s t a n c e s , a n d i n f l u e n c e s
su r r ou n d in g , an d af f ect in g t h e d ev elop m en t of an
organism or group of organism s( 9). Roy also says t hat
f u r t h er clar if icat ion of en v ir on m en t as dist in ct f r om
int er nal st im uli aw ait s addit ional t heor et ical w or k in
h er con cept u al f r am ew or k .
I t is im port ant t o not ice t hat , at t he beginning
of t he 80’s, t he aut hor st art s t o adopt a definit ion t hat
is very close t o t he one t hat would be used up t o t he
begin n in g of t h e 9 0 ’s. Nev er t h eless, t h er e w as n ot
y et a clear d if f er en ce b et w een in t er n al st im u li an d
int ernal environm ent . The aut hor did not relat e direct ly
t h e r an g e of st im u li an d t h e en v ir on m en t con cep t .
Th er e is a v er y clear sep ar at ion b et w een t h e t w o
c o n c e p t s . Th e s t i m u l i a r e t r e a t e d a s o r d i n a r y
com p on en t s of t h e en v ir on m en t , w it h ou t h av in g a
m or e com plex v iew about t hem . I t is int er est ing t o
say t hat t he ot her t wo works launched by t he aut hor
i n 1 9 8 4 a n d 1 9 8 6 s h o w e d a m o r e s u m m a r i z e d
env ir onm ent concept . I n t hose book s, t he concept is
p r esen t ed t h e sam e w ay, t h at is, t h e en v ir on m en t
i n c l u d e d a l l t h e c o n d i t i o n s , c i r c u m s t a n c e s a n d
influences surrounding and affect ing t he developm ent
and behavior of t he person( 10- 11).
I n 1991, Roy gav e a m or e pr ecise definit ion
o f w h a t s h e c o n s i d e r e d a s b e i n g e n v i r o n m e n t :
“ En v ir on m en t in clu des all con dit ion s, cir cu m st an ces
a n d i n f l u e n c e s t h a t s u r r o u n d a n d a f f e c t t h e
d e v e l o p m e n t a n d b e h a v i o r o f t h e p e r so n . Th e se
influencing fact ors are cat egorized as focal, cont ext ual
and residual st im uli.”( 12) I n t his cont ext , t he exist ence
of int ernal and ext ernal alt erat ions is est ablished and
consequent ly t he environm ent st art s t o be focused in
t hat w ay. By confir m ing t his not ion, t he t heor ist , in
t h e sam e y ear, pr oposes t h at “ a collect iv e t er m for
all in t er n al an d ex t er n al st im u li is en v ir on m en t ”( 1 2 ).
This classificat ion of int er nal and ex t er nal st im uli is
t hen ext ended t o t he environm ent concept , having in
m ind t hat it would represent t he collect ivit y of st im uli
t o w h i ch t h e p er so n i s ex p o sed . Th i s a sso ci a t i o n
bet w een t he envir onm ent and st im uli is confir m ed in
t he w or k published by Roy and Cor liss, in w hich t he
aut hors assert t hat t he environm ent cont ains input t o
t he person or group, and includes int ernal and ext ernal
st im uli( 13). I t is im port ant t o say t hat , in t his chapt er,
Roy int roduces her first definit ions of group and aim s
at r e- adj ust ing her m odel t o t his new per spect iv e.
I n 1 9 9 7 , Ro y s u r p r i s e s t h e r e a d e r s b y
p r e s e n t i n g n e w c o n c e p t s b a s e d o n n u r s i n g
n eu r oscien ce, on Qu an t u m Ph y sics an d on t h e n ew
Cosm ology. I n t h is ar t icle, t h e au t h or def en ds t h at
t he syst em s of m at t er and energy progress t o higher
levels of com plex self- organizat ion. I n t his search for
self- organizat ion, consciousness and m eaning assum e
fu n dam en t al im por t an ce an d ar e con st it u t iv e of t h e
per son and env ir onm ent al int egr at ion. Aw ar eness of
self and environm ent is root ed in t hinking and feeling,
and t hey, in t urn, m ediat e hum an act ion. The person
a n d e n v i r o n m e n t t r a n sf o r m a t i o n s a r e cr e a t e d i n
hum an consciousness, and t he int egr at ion of hum an
I t i s i n t e r e s t i n g t o n o t e t h a t t h e w o r k
published in 1997 consolidat es t he aut hor ’s int ent ion
t o in t egr at e t h e per son an d en v ir on m en t con cept s,
w h i ch h a v e b e e n l e a d i n g h e r w o r k f o r so l o n g ,
however, wit hout a link as direct as t he one present ed
in t his w or k . A r em ar k able fact is t hat , in t he book
launched in 1999, t his link is not as pronounced as in
t he pr ev ious ar t icle.
I n t h e e a r l i e r w o r k , Ro y d e f i n e s t h e
en v ir on m en t as an in t er n al w or ld an d su r r ou n d in g
m an as an ad ap t iv e sy st em . I n a clear er w ay, t h e
con cep t m en t ion ed is sh ow n j u st lik e in t h e 1 9 9 1
ed i t i o n o f t h e b o o k , w i t h sp eci al co n si d er at i o n o f
p er son an d ear t h r esou r ces. Th e au t h or com p let es
her idea by saying t hat : “ an evolving universe is t he
d e scr i p t i o n o f t h e e n v i r o n m e n t a s a b i o p h y si ca l
c o m m u n i t y o f b e i n g s w i t h c o m p l e x p a t t e r n s o f
i n t e r a c t i o n , f e e d b a c k , g r o w t h , a n d t h e d e c l i n e ,
const it ut ing per iodic and long t er m r hy t hm s”( 15).
I n t h i s l ast d ef i n i t i o n , w e n o t i ce a st r o n g
in f lu en ce of p ost - m od er n it y t h ou g h t s, r ep r esen t ed
esp ecially b y t h e id ea of n on - lin ear it y an d b y t h e
cu r r en t con cep t of h ol i sm . Her con cep t su r p asses
space and body r eact ions. The env ir onm ent is close
t o t he not ion of t he com plex it y of t he hum an being
a n d t o i n t e r p e r s o n a l i n t e r a c t i o n s . I n a n a r t i c l e
p u b lish ed in 2 0 0 0 , Roy r easser t s h er in t en t ion t o
cont inue w or k ing w it h concept s of Quant um Phy sics
and Cosm ology. She im prov es her view on adapt at ion
as a consequence of t he int er- relat ion am ong person,
env ir onm ent and conscience( 16).
I n t his lat est work, Roy assert s t hat creat ive
pr ocesses ar e f u n dam en t al t o pr edict an d plan t h e
f u t u r e, an d t h em co m p o se h u m an co n sci o u sn ess,
con sciou sn ess on h im self an d on t h e en v ir on m en t ,
as w ell as t he m an- env ir onm ent int egr at ion. For t he
aut hor, consciousness is defined as consciousness on
int er nal and ex t er nal env ir onm ent( 16). Hopefully, Roy
w i l l co n t i n u e h er ef f o r t s t o r ef i n e t h e co n cep t o f
env ir onm ent in fut ur e publicat ions.
FI NAL CONSI DERATI ONS
En v i r o n m e n t i s i n t r o d u ce d a s t h e se co n d
m aj or con cept in t h e Roy Adapt at ion Model( 1 7 ). Th e
a sso ci a t i o n o f t h i s co n ce p t w i t h t h e p r i n ci p l e o f
a d a p t a t i o n i s w e l l d e f i n e d , s i n c e a d a p t a t i o n i s
described by t he aut hor as a conscious choice of hum an
and env ir onm ent al int egr at ion, sur passing t he not ion
of p h y sical ch an g e an d of en v ir on m en t as a m er e
p lace w h er e r elat ion s t ak e p lace. Th e p r in cip le of
adapt at ion suggest ed by t he aut hor ex pands t o t he
i n t er - r el a t i o n f i el d , em p h a si zi n g i t a s p a r t o f t h e
en v ir on m en t .
I n t he int er pr et at ion t hat t he t heor ist m akes
o f t h e e n v i r o n m e n t , w e n o t i c e h e r i n t e r e s t i n
sur passing t he m echanist ic point of v iew upon w hich
t he first version of t he m odel was based. The approach
of t h e con cep t of i n t er act i on b et w een p eop l e an d
g r o u p s s e e m s t o r e p r e s e n t a n i m p r o v e m e n t ,
influenced by t he current t hought s t hat are preem inent
in nur sing.
The logist ic m et hod t hat t he t heorist uses t o
ex p lain h er m od el, n ev er t h eless, g oes ag ain st t h e
oper at ion of t he concept . This happens because, by
separ at ing and br eak ing dow n t he m odel in differ ent
p a r t s, w h i l e d i d a ct i ca l l y o r g a n i zed , t h e n o t i o n o f
in t eg r at ion an d t h e com p lex it y of t h e en v ir on m en t
becom e difficult t o visualize in t he holist ic perspect ive.
Aft er being divided, t he re- organizat ion of t he several
con cept s an d t h e in t er - r elat ion s am on g t h em leads
t o a fr agm ent ed v iew of t he pr ocess.
I n t he cour se of t he ent ir e w or k, t he aut hor
cert ainly proposed t o be coherent in her way of seeing
r ealit y an d pr of ession al pr act ice. Th e m aj or f act or s
underpinning t he evolut ionary process can be not iced
in t he explanat ions of her great er concept s. However,
w e believ e t hat , in or der t o hav e t r ue appr opr iat ion
of t h e p ost - m od er n t h ou g h t s t h e au t h or say s sh e
adopt s, it will be necessary t o re- evaluat e t he syst em ic
basis on w hich her m odel is based.
The crit ical analysis of a t heoret ical m odel is
an ex haust ing t ask and dem ands deep t hink ing. The
st u d y o f t h e co n ce p t e n v i r o n m e n t a l l o w e d u s t o
u n d er st an d i t s h i st o r i cal an d st r u ct u r al ev o l u t i o n ,
t hereby widening t he not ion of t he need for cont inuous
r ev ision of it s pr act ice and t hink ing.
The cr ucial point s addr essed in t his analy sis
w er e: t he Roy adapt at ion m odel has been gr adually
evolving, accom panying t he t rends of t he profession;
t he const ant obser v at ion of pr ofessional pr act ice has
been im por t an t in t h e r ev ision of t h e con cept s t h e
m odel defends; t he syst em ic basis suggest ed by Roy
needs a r ev ision since, in som e m om ent s, her post
-m od er n id eas see-m n ot t o associat e ap p r op r iat ely
wit h Helson’s ideas; it is necessary t o keep a const ant
r ev ision of t he m odel and of it s applicat ion as w ell,
e s p e c i a l l y f o r t h e n e w c o n c e p t u a l c h a n g e s
I t is unquest ionable t hat t he ideas t aken from
quant um physics and fr om cosm ology w ill pr om ot e a
change of paradigm s t hat will affect t he basic st ruct ure
of t he t heory, which up t o t he m iddle of t he 90’s st ill
pr esent ed an or ganizat ion based on sy st em s t heor y
and a st r ong influence of posit iv ist par adigm .
REFERENCES
1. Chinn PL, Kr am er MK. Theor y and nur sing: a sy st em at ic appr oach. 4t h ed. St . Louis: Mosby ; 1995.
2 . King I M, Faw cet t J. The language of nur sing t heor y and m et at h eo r y. I n d i an ap o l i s: Si g m a Th et a Tau I n t er n at i o n al Honor Societ y of Nur sing; 1 9 9 7 .
3. Rodger s BL, Knafl K. A. Concept developm ent in nur sing: Foundat ions, t echniques, and applicat ions. Philadelphia: W. B. Sau n d er s; 2 0 0 0 .
4 . Roy C. Dev elop in g n u r sin g k n ow led g e: p r act ice issu es raised from four philosophical perspect ives. Nurs Sci Q 1995; 8 ( 5 ) : 7 9 - 8 5 .
5 . Roy C. Adapt at ion: a concept ual fr am ew or k for nur sing. Nu r s Ou t look 1 9 7 0 ; 1 8 ( 3 ) : 4 2 - 5 .
6 . Ro y C. Ad ap t at i o n : a b asi s f o r n u r si n g p r act i ce. Nu r s Ou t l o o k 1 9 7 1 ; 1 9 ( 4 ) : 2 5 4 - 7 .
7 . Ro y C. I n t r o d u ct i o n t o n u r si n g : an ad ap t at i o n m o d el . En g lew ood Clif f s: Pr en t ice- Hall; 1 9 7 6 .
8 . Roy C. Th e Roy adapt at ion Model. I n : Rieh l, JP, Roy C. Concept ual m odels for nursing pract ice. 2nd ed. Norw alk ( CT) : Ap p let on - Cen t u r y - Cr of t s; 1 9 8 0 . p . 1 7 9 - 8 8 .
9 . Roy C, Rob er t s SL. Th eor y con st r u ct ion in n u r sin g : an adapt at ion m odel. En glew ood Cliffs: Pr en t ice– Hall; 1 9 8 1 . 10. Roy C. I nt roduct ion t o nursing: an adapt at ion m odel. 2nd ed. En glew ood Clif f s: Pr en t ice- Hall; 1 9 8 4 .
1 1 . An d r ew s HA, Roy C. Essen t ials of t h e Roy ad ap t at ion m odel. Nor w alk ( CT) : Applet on - Cen t u r y - Cr of t s; 1 9 8 6 . 1 2 . Ro y C, An d r ew s HA. Th e Ro y ad ap t at i o n m o d el : t h e definit ive st at em ent . Norw alk ( CT) : Applet on e Lange; 1991. 13. Roy C, Corliss CP. The Roy adapt at ion m odel: t heoret ical updat e and knowledge for pract ice. I n: Parker M. Pat t erns of nur sing t heor ies in pr act ice. New Yor k : Nat ional League for Nu r sin g; 1 9 9 3 . p. 2 1 5 - 2 9 .
1 4 . Roy C. Fu t u r e of t h e Roy Model: ch allen ge t o r edefin e adapt at ion . Nu r s Sci Q 1 9 9 7 ; 1 0 ( 1 ) : 4 2 - 8 .
15. Roy C, Andrews H A. The Roy adapt at ion m odel. 2nd ed. St am for d ( CT) : Applet on e Lange; 1999.
1 6 . Roy C. A t h eor ist en v ision s t h e f u t u r e an d sp eak s t o n u r sin g adm in ist r at or s. Nu r s Adm in Q. 2 0 0 0 ; 2 4 ( 2 ) : 1 - 1 2 . 17. Lopes MVO, Araúj o TL, Rodrigues DP. A relação ent re os m odos adapt at ivos de Roy e a t axonom ia de diagnóst icos de en fer m agem da NANDA. Rev Lat in o- am En fer m agem . 1 9 9 9 ou t u b r o; 7 ( 4 ) : 9 7 - 1 0 4 .
