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1、卡丽斯塔 罗伊的适应模式,The Roy Adaptation Model,logo,王惠婷 华筱娟 俞晓莲,2,3,理论家简介,4,目前主要研究方向,脑部损伤病人的护理,慢性神经损伤病人的适应过程,神经学护理,5,5,罗伊著作,罗伊适应模式,罗伊适应模式,6,6,人处于对环境变化不断反应的状态，人与环境整合的结果就是适应,为了达到生存、成长、繁衍、自主和自我实现，人必须适应,个人所能承受或应对的刺激源的范围与强度构成了人的适应水平,适应水平具有个体差异性和动态变化性,人际关系对于适应具有非常重要的意义,7,适应水平,适应水平,无效反应,适应性反应,S S S,S S,S S,S S S,适应
2、水平适应范围示意图（S刺激）,刺激与适应水平,8,适应模式理论构架,8,人是一个整体性适应系统,9,1.Adaptation,the process and outcome where by thinking and feeling persons,as individuals and groups,use concious awareness and choice to create human and environmental integration,人本存在主义（1960-至今）每个人都有独特性及完整性、主观能动性、选择权及自主权,10,stimuli,all other enviro
3、nmental stimuli present,those beliefs,attitudes,traits and experiences that have an indeterminate effect on the presenting situation,the degree of change immediately confronting the person,11,11,5,Adaptation levels,three levels,12,2,应对机制（应对机转）,13,调节者亚系统,The regulator mechanism operates essentially t
4、hrough the autonomic nervous system which establishes reflex action for coping with stimuli by approach,attack or flight.Observable symptoms of undue regulator activity include tachycardia,tension,excitement and appetite loss.,14,认知适应过程,15,举例,16,认知者亚系统,consciously thought and decision,unconsciously
5、defense mechanisms,17,群体应对机制,stabilizer subsystem,innovator subsytem,18,对护理启示,关注患者所处的家庭、社区环境，充 分调动群体应对系统，利用外环境中 各种促进健康的变量，协调和稳定个 体内环境的适应和稳定，从而推动个 体适应性行为和提高个体适应水平。,19,护士在群体应对系统中的作用,The family can be studied in clinicalobservations or in structured studies to identify which processes promote the stabi
6、lity of the family and which lead to the forward movement of growth and transformation.Based on understanding of these processes,the nurse can help families enhance these processes,20,Physiologic Mode,Five needsoxygenation nutrition elimination activity rest protectionFour complex processes senses f
7、luid,electrolyte,acid-base balance neurologic function endocrine function,21,自我概念,个体：精神、心理完整态 躯体心像 自我一致性,22,角色功能分为三级,初级与生长发育有关,二级角色来源于一级角色,三级角色由二级角色衍生而来,23,Role function,role set the complex of positions individual holds,Interdependence,Individual Persons,affectional adequacy,Relational Person,under
8、standing and committing to fulfill expected tasks so group can achieve common goals,developmental and resource adequacy,24,输出,适应反应：保持人的完整性，生存、成长、繁衍、自我 实现无效反应：阻碍和威胁作用特殊：某种情境或成长阶段，适当的个反应会阻断群体系统的连续性,25,罗伊对护理四个概念的阐述,26,Roy believes health-illness occurs along a continuum that includes:,peak wellnessHigh-level wellnessGood healthNormal healthPoor healthExtreme poor healthDeath,适应模式与护理程序,一级评估,二级评估,28,理论的应用,CAPS量表,SF-CAPS量表,Antenatal AssessmentInstrument,29,理论的分析与评判,Thank you!,
