DEPRESSION IN ELDERLY AND ROY’S ADAPTATION MODEL

PICOT formatted Clinical Project Question
P: In the home health setting of patients aged range 60-to 75 with depression symptoms.
I: Does the PHQ-2 depression screen assist in the early identification of symptom severity and monitor for symptom changes for clinical depression.
C: Using the GDS-15 screening tool.
O: To improve the identification of clinical depression in the elderly by 100%.
T: In the initial office visit and over 6 months?

Select the specific theoretical framework that you will use with your project (education, leadership or FNP). Describe how the theory that you chose aligns with your capstone project. Include the following information:

Describe the key features of the selected theoretical framework/model. What are its major components?

Identify specific research approaches appropriate for use with the theoretical model or framework and how it fits with your intended project.
Does the model lend itself to quantitative or qualitative methods or both?
What kind of quantitative/qualitative methods would be most appropriate? (Focus groups, interviews, pre/post-tests, record review, survey, etc.)
Describe how the theoretical framework might be used to evaluate the program/project and critique how well the model fits the program or project.
What aspects of the model works well and what aspects do not?
Why?

ANSWER

Depression in Elderly and Roy Adaptation Model

Roy Adaptation Model

Models in nursing enable nurses to center on the nursing role and its application instead of medical practice. The model facilitates purposeful, effective, controlled, and systematic patient care (Ursavaş, Karayurt, & İşeri, 2014). The Roy Adaptation Model is applicable in achieving goals nursing. As per the Roy Adaptation Model, nursing aims at increasing life expectancy and compliance.The model assesses patients in self-concept, physiological, interdependence, and role function modes to offer holistic care (Ursavaş, Karayurt, & İşeri, 2014). In this regard, this paper describes the utilization of the Roy Adaptation Model when caring for patients diagnosed with elderly depression.

According to Roy, nursing is the humanistic and scientific profession, emphasizing the need for specialized knowledge in providing health care (Ursavaş, Karayurt, & İşeri, 2014). The Roy Adaptation Model metaparadigm concepts are environment, person, nursing, and health. From the model, a person is biopsychosocial, in continued interaction with the changing environment. The individual is a whole adaptive system defined by parts functioning with a unity of purpose (Jennings, 2017). On the other hand, the environment consist of residual, contextual, and focal stimuli. The focal stimulus refers to confronting a person’s external and internal environment.

Individuals instantly resist external and internal stimuli (Ursavaş, Karayurt, & İşeri, 2014). In addition, the environment also refers to the conditions, influences, and circumstances surrounding and affecting humans’ behavior and development. Behavior and development are adaptive systems having particular earth and human resources considerations (Jennings, 2017). Health refers to the process and state of being whole and integrated. Nursing aims at managing focal stimuli followed by contextual stimuli. The nursing goal is to enhance life processes for adaptation (Jennings, 2017). Adaptation is the outcome and process of feeling and thinking people who utilize conscious choice and awareness to create environmental and human integration. The Roy Adaptation Model has six steps: first assessment, second assessment level, diagnosis, setting of patients’ health goals, intervention, and evaluation (Jennings, 2017).

Research Approach

The appropriate research approach for the intended research project is the exploratory study. The exploratory study approach will help in knowledge development and enhance theory-based practice. Besides, the Roy adaptation model will facilitate comprehension of people’s experiences with elderly clinical depression. An exploratory study will help explore the effectiveness of PHQ-2 depression screens utilizing the GDS-15 screening tool to enhance early clinical depression identification. The research setting is home health with patients aged 60-75 years. The study will consider the initial visit and more than six months. Further, the research will use an exploratory research design to evaluate interventions’ effectiveness.

Nature of the Roy Adaptation Model

The Roy Adaptation Model lends itself to both the qualitative and quantitative methods. The model can be applicable to guide quantitative open-ended questions content analysis, and qualitative approaches. For the quantitative approach, the responses may be either ineffective or adaptive within the interdependence, role function, self-concept, and physiological adaptation modes, followed by tallying to obtain the adaptation score.

Qualitative Methods

The most appropriate qualitative methods would be pre/post-tests and interviews. Patients diagnosed with elderly clinical depression over the last six months should be interviewed and answer pre/post-tests during their treatment. Verbal informed consent is requisite from these patients before interviews. With patients’ clinical and demographic data, the patients should be assessed in the interdependence, role function, self-concept, and physiologic modes.

Evaluating the Research Project using Roy Adaptation Model

The Roy Adaptation Model will help evaluate the project by observing people’s responses to changes in the environment. Adaptation happens when individuals respond to changes in the environment positively. Thus, people should utilize self-reflection, choice, and conscious awareness to create environmental and human integration (Ursavaş, Karayurt, & İşeri, 2014). With the Roy Adaptation Model, nursing will manage focal stimuli and contextual stimuli. Nursing will focus on enhancing life processes, for promoting individuals adaptation.

The Roy theoretical framework enables nurses to view their profession as of humanistic and scientific nature, emphasizing the requirement for specialized knowledge in health care provision (Ursavaş, Karayurt, & İşeri, 2014). The aspects of interdependence, role function, self-concept, and physiologic modes work well. For the physiological mode behavior is manifested in all organs, tissues, cells, and systems physiological activity. Self-concept focuses on spiritual and psychological integrity, unity sense, purposefulness, and meaning in life. Besides, the role function refers to individuals’ roles in society for social integrity. The interdependence mode entails people’s close relationships, their purpose, development, and structure individually and groups (Ursavaş, Karayurt, & İşeri, 2014). The four modes work well for realizing high-quality and patient-centered health care.

The aspects of the model that do not work well include the assumption that individuals are bio-psycho-social and interact with a dynamic environment. Besides, coping with the dynamic environment utilizes acquired and innate coping mechanisms. The model also assumes that illnesses are part of life (Jennings, 2017). Finally, the model assumes that people must respond positively to changes in the environment to adapt.

References

Jennings K. M. (2017). The Roy Adaptation Model: A theoretical framework for nurses

providing care to individuals with Anorexia Nervosa. ANS. Advances in nursing science, 40(4), 370–383. https://doi.org/10.1097/ANS.0000000000000175

Ursavaş, F. E., Karayurt, Ö., & İşeri, Ö. (2014). Nursing approach based on Roy Adaptation

Model in a patient undergoing breast conserving surgery for breast cancer. The journal of breast health, 10(3), 134–140. https://doi.org/10.5152/tjbh.2014.1910