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

The Roy Adaptation Model

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

The Roy Adaptation Model is an approach that sees a person as a bio psychosocial individual who is consistent in interaction with a changing environment (Jennings, 2017). The theoretical approach uses five leading components. These components include

Person

It is a biopsychosocial being in continuous interaction with an environment constantly changing. The person uses both the acquired and innate mechanisms as their adaptation mechanism (Papathanasiou et al., 2013). This component also includes people as groups, families, communities, and society.

Nursing activities, 

Plays the role of promoting adaptation for groups and individuals in adaptive models. Therefore, it contributes to health, life quality and a patient dying with dignity. It does this by assessing and intervening factors and behaviors that impact adaptive abilities to enhance environmental interactions.

Adaptation 

It is the outcome and process of groups and people who use self-reflection, conscious awareness and choices to create environmental integration. The adaptation component entails a person responding positively to various environmental changes.

The environment

Includes all the circumstances, conditions and influences affecting and surrounding personal or group development.

• Focal- Consists of all the internal or external that confront a person.
• Contextual- all the present stimuli in the situation that causes focal stimuli effect.
• Residual- a factor with a current unclear situation.

Health.

It is a state of becoming or being whole and integrated. The illness-health continuum often represents health.

Identify specific research approaches appropriate for use with the theoretical model or framework and how they fit your intended project.

The specific research approach appropriate for use with Roy Adaptation Model would be the descriptive study. The descriptive approach tries to identify the leading characteristics of a problem via its description. This occurs because it may be impossible for a patient to describe a problem in detail. Through descriptive study, one gets a glimpse of the given problem, giving them a greater understanding of the case. Therefore, a physician can use the achieved information with what he already knows to understand the patient’s problem.

My intended project deals with depression cases in the elderly. Older adults have decreased cognitive abilities, and therefore, their problem description may not be sufficient for one to understand what is going on with them. My project also uses the PHQ-2 depression screen to determine the severity of the condition to enable its control and prevention within six months. Since the depression screen also monitors the patient progress, it can be easily applied to the descriptive study as it shows how well the patients are adapting to the medication and what more needs to be done (Huijbregts et al., 2013). When the two are combined, the patients will likely get the best care from the given facility.

Does the model lend itself to quantitative or qualitative methods or both? 

The method is often considered qualitative. It is so because it gives deeper information that can play vital roles in a patient’s life. The information is applicable because it enables the care providers to assess the patient’s adaptation behaviors and promote positive adaptations within the care providing environment.

What kind of quantitative/qualitative methods would be most appropriate? (Focus groups, interviews, pre/post-tests, record review, survey, etc.)

The theory mainly aims at interconnecting holistic persons with the interactions they have with the environment. The model is a qualitative method (Kahle, 2013). The most suitable methods would be interviews and surveys. Surveys are vital in the collection of data because they offer high representativeness. They provide a high general capability level where larger populations are represented. With this, the most commonly asked questions may include

How do you feel emotionally and physically after realizing that you may receive help regarding your current condition?

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 work well, and what aspects do not?

The Roy Adaptation Model may play a vital role in the lives of these patients (Frank et al., 2017). Even though the patients are aged, using this approach will increase life expectancy and compliance. This is because the approach works by evaluating the physiologic mode of the patients and their self-concept mode. When the nurses providing care meet all these requirements, they will likely provide holistic care to the patients.

The approach is divided into five leading components, with each component having a vital role in the lives of the patients. The patients in my case are depressed elderly patients who need more care than any other type of patient. When patients age, their cognitive abilities decline, and the care they require is more intense. In my case, these are elderly patients battling depression, making their case way worse than if they were battling dementia alone. Therefore, by understanding all the model components, the care provider gets a picture of what needs to be done to the patient. For instance, when understanding the environment, the model gives all the internal and external aspects

References

Frank, C. A., Schroeter, K., & Shaw, C. (2017). Addressing traumatic stress in the acute traumatically injured patient. Journal of Trauma Nursing, 24(2), 78-84.

Huijbregts, K. M., de Jong, F. J., van Marwijk, H. W., Beekman, A. T., Adèr, H. J., Hakkaart-van Roijen, L., … & van der Feltz-Cornelis, C. M. (2013). A target-driven collaborative care model for Major Depressive Disorder is effective in primary care in the Netherlands. A randomized clinical trial from the depression initiative. Journal of Affective Disorders, 146(3), 328-337.

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.

Kahle, L. R. (2013). Attitudes & social adaptation: A person-situation interaction approach (Vol. 8). Elsevier.

Papathanasiou, I., Sklavou, M., & Kourkouta, L. (2013). Holistic nursing care: theories and perspectives. American Journal of Nursing Science, 2(1), 1-5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294442/

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