ARTÍCULO ORIGINAL / ORIGINAL ARTICLE/ ARTIGO ORIGINAL

Theory generation: from evidence to practice

Generando teoría: de la evidencia a la práctica

Equipo organizador del Primer Congreso Internacional de Enfermería

The Faculty of Nursing at Universidad de Antioquia, designated as Chapter by the Roy Adaptation Association to boost knowledge and development of the theory in the practice, held the First International Congress on Nursing: Theory generation: from evidence to practice, this took place on March 8 and 9, 2013. This event was attended by Doctor Callista Roy, who is one of the biggest nursing theorists in the world. This academic meeting was an important opportunity to discuss possibilities for the development and academic consolidation of our discipline seeking to care for humans with ethical and social pertinence criteria, which are currently a priority.

The Roy Adaptation model is a reference for academia and for service due to its holistic vision of the human being and because of its capacity to adapt to the demands and determinants of the cultural, economic, political, and social contexts. The challenge of integrating the theory onto the nursing practice, besides being an ethical imperative, is a philosophical and scientific base that results in the professional autonomy. This form of caring for patients has contributed to nursing care, as well as to medical and interdisciplinary treatments taking place in healthcare institutions.

Nursing care is in the midst of change and innovation. Many countries in the world have implemented diverse models or theories to assess, plan, and execute care for people who are in optimal health conditions and for those who are most vulnerable. The Roy model emerged during the 1970s as a response to the crisis within the profession due to the subordination of nurses to the medical action, which led them to ponder on how to change their work. Her model arises from professional experience in pediatric services where she was impressed by the adaptation capacity of children; she set out to define a goal for nursing whose reference framework were adaptation, understood as the use of conscience to integrate onto the context, using as theoretical bases the Systems Theory and the Evolutionary Theory.

The moments of the model contemplate inputs, processes, and outputs; in which nursing care moves within the process. The inputs are the stimuli that provoke the first reaction in people and the outputs are the adaptive or ineffective responses, which can become inputs, given that the Nursing Care Process (NCP) is dynamic. The model's objectives are aimed at guiding the care giving practice, prioritizing the nursing work, systematizing tasks, defining roles, and avoiding reprocesses.

The Roy Adaptation model defines three concepts: the person, health, and nursing. The person is seen as a bio-psychosocial being in constant relation with a changing environment; it is a complex biological system, which tries to adapt to four areas: a) physiology: to respond to the needs of circulation, bodily temperature, oxygen, organic liquids, sleep, activity, feeding and elimination, b) self perception to respond to changes of the environment, c) role domain, because each person fulfills a distinct role in society, as mother, child, father, patient, retiree; which sometimes changes as is the case when a person retires and must adapt to the new role; and d) interdependence, because the self perception and the social role domain of each individual interacts with the people around them, exerting and receiving influence; this creates relations of interdependence that can be modified by changes in the environment.

Health within the model is seen as a process of adaptation in maintaining physiological, psychological, and social integrity. Nursing is defined as a system of theoretical knowledge that perceives an analysis and action process, related to caring for the actually or potentially sick individual. Roy differentiates nursing as science and as practice, meaning that the latter is focused with the purpose of offering individuals services that positively promote their health.

For individuals to adapt within the four previous areas, nurses must carry out two types of actions: evaluation, whose purpose is to define the patient's situation in health - disease; and the direct intervention on the patient, actions are conducted within the NCP, which comprises the Assessment, Planning, Acting, and Evaluation phases.

Due to this, within the framework of the Congress, Universidad de Antioquia made an honorable mention of doctor Sister Callista Roy, recognizing and exalting her life and research work, which have generated theoretical development and have enlightened the nursing practice throughout with an 'Adaptation Model' that postulates that humans adapt to changes in the environment, thus, contributing to health, quality of life, and to death with dignity. Also, the City Council of Medellín highlighted the importance of nursing in improving the health of the population and publicly recognized Sister Callista Roy for her contribution to the development of nursing in our department and throughout the nation.