Roy’s Adaptation Model and Neuman’s Systems Model

Subject: Nursing
Pages: 5
Words: 1267
Reading time:
5 min
Study level: Bachelor


The paper’s objective is to analyze the case of Sgt. Eddie Johns and apply Roy’s Adaptation Model and Neuman’s Systems Model to it.

These theories offer unique approaches to communicating with and treating patients. Studying the application of different approaches through cases is necessary to understand their effectiveness. Moreover, understanding ideas is essential for a more individualized approach to treating patients and achieving the best treatment outcomes.

Case Summary

After serving in Afghanistan, Sgt. Eddie Johns is an outpatient orthopedic clinic patient in the United States. He has a broken leg in several places and, according to doctors, has a traumatic brain injury, which the patient disagrees with. Sgt. Johns also has insomnia and can sleep for several hours only with alcohol.

He’s at home living with his mom, who can provide some care, and sees his girlfriend almost every day. However, the man is worried about his friend, who was more seriously injured and treated in another state. Eddie also has difficulty getting a job, as he is limited in movement due to a broken leg.

Roy’s Adaptation Model. Key Concepts

People as adaptive systems have four adaptative modes: physiological–physical, self-concept–group identity, role function, and interdependence. The environment is any circumstance, factor, or incentive affecting a person and group. Health is “(1) a process, (2) a state of being, and (3) becoming whole and integrated in a way that reflects individual and environment mutuality” (Smith & Parker, 2015, p. 159). The goal of nursing is to promote adaptation in all modes and thereby help achieve health.

Roy’s Adaptation Model. Adaptive modes

Physiological mode refers to the human physiological activity, for example, respiration, nutrition, and other processes. The self-concept mode depends on a person’s perception of self and directs behavior. Role function mode is determined by what position a person takes in society. Interdependence mode is a person’s relationship with loved ones.

Adaptive modes describe how a person interacts with the environment, responds to external stimuli, and adapts. When all adaptive modes work as a whole, people can satisfy their needs and will be healthier. For treatment, nurses evaluate behavior in all modes and the stimuli that affect them. They then set goals to achieve integrated adaptation – when all processes and functions in modes work as a whole to meet human needs. Interventions may include altering stimuli or strengthening a person’s coping capacity.

Roy’s Adaptation Model in Planning the Care for Sgt. Johns

When creating a care plan for Sgt. Johns, a nurse, can apply Roy’s Adaptation Model. Eddie will be seen as an adaptive system in such a case, and the nurse will have to assess his adaptive abilities and environmental stimuli affecting his health. In particular, influential factors in four modes are written on the slide. Based on the assessment, the nurse will establish the treatment goals together with the sergeant.

Roy’s Theory in Promoting Sgt. Johns Adjusted Self-concept

Physical self: Body image – the perception of an individual’s body – is how a person sees self physically. Physical sensations – how a person understands and can express their bodily feelings, such as symptoms.

Personal self: Self-consistency – is an understanding of oneself and personal qualities; it also includes the ability to self-organization. Self-ideal – who a person wants to be. Moral-ethical-spiritual self is personal values and beliefs.

When applying Roy’s Theory, the nurse should evaluate the elements described on the slide in the patient and focus on promoting integrity. In particular, it is crucial to help the sergeant understand the injuries and their consequences. For example, during recovery, he will not be able to do hard physical work and be as effective as before. The desire to return to the old job may indicate John’s misunderstanding of his condition.

Moreover, by applying this approach, after evaluating the sergeant as an individual, the nurse will understand his adaptive abilities and create a plan for the adaptation process.

Listening to Sgt. Johns’ “Story”

From the Roy Adaptation Model perspective, there are several vital reasons for listening carefully to the patient’s story in their own words.

By listening to patients, nurses can more accurately assess their adaptive modes and the extent of environmental impact. During a conversation with the patient, the nurse understands his needs and can more accurately identify existing problems and set treatment goals. The empathy shown by the nurse and the comfort provided contribute to greater disclosure and understanding of the patient, establishing trust for further collaborative work on treatment goals.

Nurses increase satisfaction with hospital services by listening to patients and actively communicating with them (Lotfi et al., 2019). Consequently, nurses provide additional positive environmental influences, which is a basic idea of Roy’s theory.

Neuman’s System Model. Overview

A person (client) is an open system influenced by external and internal stressors.

System influencers comprise an environment that can be internal, external, and created.

Health and illness are the opposite states of the system. Health is possible when the system is stable and has enough energy to maintain itself.

The task of nursing is to maintain the system’s stability through the assessment of stressors and assistance to the client in adjustments to them.

The client-client system consists of several protection lines against stressors and variables present in each circle in the system. The system is influenced by intrapersonal, interpersonal, and extrapersonal stressors.

Following the theory, prevention should be a critical intervention made by nurses. Neuman identified three types of prevention: primary – stress prevention; secondary – response to stress and strengthening of protection lines; tertiary – readaptation, reeducation, and support of the system’s stability.

Stressors for Sgt. Johns

Considering the situation of Sergeant Johns from the point of view of Neuman’s Systems Model, it is essential to determine which stressors affect him as a client. The most apparent stressors are that Eddie suffers from physical injuries – a broken leg and brain injury cause pain and inconvenience in everyday life. Insomnia is also a significant stressor, which does not allow the man to restore energy and keep his system at the required healthy level. The way the sergeant is trying to solve insomnia is a few cans of beer. Although this measure allows him to sleep for several hours, alcohol is an additional stressor for the body.

Other influential factors relate to sociocultural variables. Eddie is concerned about the health of his wounded friend and cannot visit him. Moreover, he is not able to return to work yet due to injuries.

While the case does not indicate any psychological symptoms due to the bomb explosion, distress, anxiety, and post-traumatic stress disorder are common among veterans. For this reason, the nurse must take into account the sergeant’s potential need for additional psychological assistance.

Care Plan for Sgt. Johns

According to Neuman Systems Model, the nursing process includes the following steps:

  • Collect all available data to determine stressors;
  • Validating data with the client;
  • Selecting nursing diagnoses and prioritizing them;
  • Setting goals together with the client and taking prevention as an intervention into account.

Based on the stressors that affect the sergeant, it is crucial to focus on their elimination, prevention, and strengthening of the sergeant’s resilience.


Nursing theories and models offer different approaches to treating patients. Their understanding and study encourage research and evidence-based practice.

The use of Roy’s Adaptation Model and Neuman’s Systems Model to analyze the case of Sgt. Eddie Johns made it possible to pay attention to factors other than physical ones that are also significant for health.

Focusing not only on physical injuries but also on the environment, patients’ feelings, and their unique position contribute to more successful treatment.


Lotfi, M., Zamanzadeh, V., Valizadeh, L., & Khajehgoodari, M. (2019). Assessment of nurse–patient communication and patient satisfaction from nursing care. Nursing open, 6(3), 1189-1196. Web.

Smith, M. C. & Parker, M.E. (2015). Nursing theories and nursing practice (4th ed.). FA Davis.