Brockton, Massachusetts: Use of the Adaptation Model, Nursing Process and Guidelines for a Comprehensive Community Assessment
This work in writing will utilize the Adaptation Model, nursing process and guidelines to complete a community assessment, analyze gathered data for implications for health care, formulate a nursing diagnosis for the community, and incorporate findings into the nursing process and formulate a care plan for a specific community problem.
According to the Public Health Nursing: Leadership Guide and Resource Manual" published by the Massachusetts Association of Public Health Nurses (2005) nurses employed in public health nursing are constantly conducting assessments of the community's needs and resources both those available to the individual and groups. Public health nurses are focused on organization and working with a diverse network in promoting ensuring and strengthening the well-being and health in the community with goals for high standards of health care for the population. Public health is the systematic approach in the preservation, protection and improvement of the entire population's health enabled by "prevention and control of communicable disease, injury and prevention of disability" while promoting health status excellence for everyone in the community. This is inclusive of the prevention of epidemics and disease spread while protecting against hazards that are environmental in nature as well as response to disaster and community recovery inclusive of health care services access combined with promotion of healthy lifestyles.
Adaptation Model
The Adaptation model is a conceptual framework with a focus on the patient as "an adaptive system, one in which nursing intervention is required when a deficit develops in the patient's ability to cope with the internal and external demands of the environment." (Mosby's Medical Dictionary, 8th edition, 2009) These demands have been divided into four categories including those of:
(1) physiologic needs;
(2) the need for a positive self-concept,
(3) the need to perform social roles and (4) the need to balance dependence and independence." (Mosby's Medical Dictionary, 8th edition, 2009)
The maladaptive response of the patient is assessed by the nurse and utilizes this response to identify the type of demand creating the conflict. Nursing care is then planned around promotion of adaptive responses for successful coping with the effect that present stress places on the well-being of the patient. This is a model that was proposed by Sister Callista Roy.
A changing environment requires that the patient respond successfully and it was proposed by Sister Callista Roy that the environment must be considered in terms of the internal and external stimuli that affect the group or individual. Environmental stimuli is reported to be inclusive of "the conditions, circumstances, and influences that surround and affect the development and behavior of an individual or group.' (Mosby's Medical Dictionary, 8th edition, 2009)
Health is described as "a state being and a process of becoming an integrated and whole person. " (Mosby's Medical Dictionary, 8th edition, 2009)
Adaptive behavior takes place in four modes:
(1) physiological;
(2) self-concept;
(3) role function; and (4) interdependence. (Mosby's Medical Dictionary, 8th edition, 2009)
All of these four modes are collectively termed as 'wellness'. (Mosby's Medical Dictionary, 8th Edition, 2009)
The adaptation model is conceptualized as shown in the following illustration.
Figure 1
Adaptation Model
Illness is reported to be "ineffective adaptation in one or more of these modes. Nursing is a theoretical system of knowledge that prescribes a systematic process related to the care of the ill or potentially ill person." (Mosby's Medical Dictionary, 8th edition, 2009) Stated as the goal of nursing is the promotion of all four adaptive modes during wellness and illness." (Mosby's Medical Dictionary, 8th edition, 2009)
Six Steps in Nursing Process of Adaptation Model
There are six steps in the nursing process of the adaptation model including the following:
(1) assessment of behaviors, data regarding the client's physiological, self-concept, role function, and interdependence behaviors are collected. Once the data have been collected, the nurse must judge whether the behaviors are adaptive or ineffective. Thus the primary question is: To what extent is the person adapting to environmental stimuli?
(2) assessment of influencing factors, priorities are set for further assessment and identification of the environmental stimuli that influence the client's behavior and so contribute to the adaptive or ineffective responses.
(3) nursing diagnosis, involves a behavioral description of the client's adaptive or ineffective responses and identification of the most relevant influencing factors, as well as establishment...
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