Callista Roy

Lifestyle change in type 2 diabetes a process model.

BackgroundIntegration is an emerging concept in the study of self-management and chronic illness, yet this process and how it occurs is not well understood. ObjectivesThis investigation, part of a triangulated study, focused on the experience of integrating type 2 diabetes treatment recommendations into an existing lifestyle while participating in a nurse-coaching intervention. MethodAn interpretive method elicited data from nurse-coaching sessions (4), field notes, and an interview in 9 women with type 2 diabetes. The process of data reduction and analysis (Miles & Huberman, 1994) was used to interpret data. ResultsThe core process of integrating lifestyle change in type 2 diabetes was multifaceted and complex. Challenges to the process of integrating lifestyle change included reconciling emotions, composing a structure, striving for satisfaction, exploring self and conflicts, discovering balance, and developing a new cadence to life. These challenges required acknowledgment in order for participants to progress toward integration. DiscussionBalance was an integral component to the experience of integration, between structure and flexibility, fear and hope, conflict and acceptance, diabetes and life. Conceptualizations identified with this investigation extend understanding of theories of integration and lifestyle change and invite the development and testing of nursing interventions.

A central unifying focus for the discipline: facilitating humanization, meaning, choice, quality of life, and healing in living and dying.

Nursing has a rich history of knowledge development, yet there remains ambiguity about what is a proper central unifying focus for the discipline. At this time in our history, it is imperative that we clearly define and articulate who we are and what we offer. Confusion about a central unifying focus is a significant problem for practice given the current healthcare environment and global problems affecting health and healing. The authors propose a central unifying focus for the discipline: facilitating humanization, meaning, choice, quality of life, and healing in living and dying. This focus will serve as a basis for our professional identity, strengthen our endeavors, and provide the ontological and epistemological basis for our continuing evolution as a practice profession.

Electric power plant emissions and public health

The generation of electric power is one important source of pollutants such as mercury, sulfur dioxide, nitrogen oxides, and fine particulate matter that can affect the respiratory, cardiovascular, and central nervous systems and cause pregnancy complications. But protecting people from environmental health hazards has become increasingly complex. Air pollutants are often invisible and travel many miles virtually undetected. Nurses can play a critical role in preventive strategies, as well as in the national debate on energy production and dependence on fossil fuels.

Roy Adaptation Model and Perspectives on the Family

multiperson situations, family and community. In D. Orem, Nursing: Concepts of practice (5th ed., pp. 348-380). St. Louis, MO: C. V. Mosby. Taylor, S. G., Renpenning, K. E., Geden, E. A., Neuman, B. M., & Hart, M. (2001). A theory of dependent-care: A corollary theory to Orem’s theory of self-care. Nursing Science Quarterly, 14, 39. Wallace, W. (1996). The modeling of nature. Washington, DC: Catholic University of America Press. Wang, C., & Fenske, M. M. (1996). Self-care of adults with noninsulin-dependent diabetes mellitus: Influence of family and friends. Diabetes Educator, 22, 465-470.

Research Based on the Roy Adaptation Model Last 25 Years

Two key events lead to the prominence of links among Roy’s grand theory, derived middle-range theories and the design of research. The author in this column describes this work in two formats. Essential details of two areas of research are presented in episodic form—the first is work on secondary analysis of Roy model-based research over 40 years and the author’s study of persons’ cognitive recovery from mild head injury. The second is a project on re-conceptualizing coping and adaptation processing in sequential detail within the context of work in the field and the significance of on-going work for nursing practice.

Extending the Roy Adaptation Model to Meet Changing Global Needs

The purpose of this article is to articulate how the Roy adaptation model has been extended as a conceptual framework to meet changing global needs. Nursing’s social mandate is described within the significant global changes of this century. The required synthesis of the individual and common good is predicated within the thinking of the model. Changes are described with specific examples of groups from the family to global society levels. The implications of this work for knowledge development are identified.

Developing Nursing Knowledge: Practice Issues Raised from Four Philosophical Perspectives

Analysis and comparison of emerging perspectives in nursing on some of the key issues of practice theory can create an enhanced vision of the discipline. Four philosophy-of-science perspectives — realism, relativism, interpretivism, and humanism — are catalysts for fruitful insights about practice. However, together they generate more questions than they answer, both from each perspective and from the intersection of the assumptions of the four philosophies about the nature of knowledge. The nature of knowledge for practice emerges from examining how the philosophical basis and the derived practice theories address such issues as the phenomena of the discipline, environment, teleology, and nursing theoretical frameworks. This is the time for good debate and collaborative knowledge-building among scholars of various persuasions within a milieu of ethos, pathos, and logic.

Instruments Used in Roy Adaptation Model-Based Research: Review, Critique, and Future Directions

The purpose of this secondary analysis is to identify and critique the instruments most frequently used to measure concepts of the Roy adaptation model. Of the 123 instruments used in 231 studies over 30 years, 20 instruments met the criteria for secondary analysis. Based on established criteria, 14 were judged to have high usefulness, three have moderate usefulness, one has limited usefulness, and two are not recommended for use with the model. Recommendations include locating and developing instruments in key content areas including adaptation in groups, and particularly developing measurement strategies consistent with the philosophical assumptions of the model and multiple ways of knowing.

Profession at the crossroads: A dialog concerning the preparation of nursing scholars and leaders

The purpose of a practice disciplines terminal degree is to develop wise scholars to guide the profession in anticipating and meeting the health-related needs of those served via philosophical, conceptual/theoretical, and empirical inquiry on behalf of professional practice. Each of these dimensions is important for the disciplines ability to meet its obligations to society. However, contemporary circumstances have created a context within which the maturation of the profession may be threatened by an imbalance among the three dimensions of PhD education. Specifically, we discuss the possibility of a tilt toward the empirical at the expense of the other two. Yet, the philosophical and conceptual/theoretical dimensions are those that have permitted core disciplinary knowledge to be developed. We aim to create a dialog about current challenges and the responsibilities of the disciplines scholars for stewardship of the discipline and offer some strategies to ensure balance among the three equally important dimensions.

The visible and invisible fields that shape the future of the nursing care system.

Nursing care systems, past and future, are shaped by issues, trends, and visions that are both visible and invisible. The founding of Nursing Administration Quarterly twenty-five years ago was a visionary response to identify contemporary issues and predict future trends effectively. The vision stemmed from the deep values and commitment about the role of nursing administration in the health care system. Likewise nurse administrators of the 21st century face the challenge of shaping continuity and change within a unique set of issues and trends that call for new visions. The issues and trends are only part of the fields, or nonphysical forces, that nurse administrators use to shape the future of nursing care systems. The focus of this article is to examine both visible and invisible forces for determining the future. Key issues and trends are looked at from the perspective of personal and professional values and commitments. The purpose of exploring this perspective is to stimulate thinking about strategies to create possible and plausible futures.