Effect of community management based on Roy′s adaptation model in patients with chronic obstructive pulmonary disease / 中华健康管理学杂志

Objective:To determine the effect of community management based on the Roy′s adaptation model (RAM) in patients with chronic obstructive pulmonary disease (COPD).Methods:This study was a cluster randomized controlled study, with the community as the cluster unit, and selected 805 COPD patients from 8 communities in Xuzhou City who had completed community registration before June 2019. A total of 735 patients actually completed follow-up and participated in intervention evaluation. They were randomly divided into control group (362 cases) and intervention group (373 cases) by random number table method. The control group received routine follow-up, while the intervention group received RAM intervention for 6 months. The forced expiratory volume in 1 second (FEV1)/forced volume vital capacity (FVC) ratio (FEV 1/FVC) and the modified British medical research council (mMRC) were used to assess the pulmonary function. The hospital anxiety and depression scales (HADS) were used to evaluate the mental health. The Chinese version of the Short Form Coping and Adaption Processing Scale (CAP-15) was used to assess the adaptive capacity. And the St. George′s Respiratory Questionnaire (SGRQ) was used to evaluate the quality of life in COPD patients. The t test or χ 2 test was used for pre-intervention comparisons between groups, and the repetitive measure analysis of variance (ANOVA) was used for post-intervention comparisons between groups. Results:After 6 months intervention, there were no significant differences in FEV 1/FVC radio between the two groups [(0.61±0.11) vs (0.62±0.12)] ( P=0.172). The scores of mMRC [(2.04±0.33) vs (2.77±0.31) points], HAD-A [(5.28±4.28) vs (6.99±4.41) points], HAD-D [(5.82±5.12) vs (7.27±4.93) points] and SGRQ [(40.17±9.30) vs (53.69±9.77) points] were all lower in the intervention group than those in the control group (all P<0.001). The CAPS-15 score was higher in the intervention group than that in the control group [(35.87±3.62) vs (26.1±3.47)] ( P<0.001). Conclusion:RAM could be used in community management of COPD patients, which could improve their dyspnea symptoms and psychological and physiological functions, also improve their adaptability and quality of life.

Application of Roy's Adaptation Model in understanding content saturation in nursing education

Background@#Significant changes in healthcare and society prompted constant revisions in the nursing curriculum that resulted in content saturation in nursing education and challenged the delivery of effective instruction. Various factors contributed to content saturation in nursing education, which has produced adverse individual and institutional outcomes. Alack of literature on a theoretical framework limited understanding of this phenomenon. This article addressed this gap in the literature.@*Purpose@#This article aims to describe the applicability of the Roy Adaptation Model (RAM) as a theoretical framework for understanding content saturation in nursing education.@*Methods@#A literature review of published articles from the 1980s to 2020s on using RAM in nursing education was conducted. Walker and Avant's (2011) concept theory and derivation techniques were used to propose a new conceptual model based on RAM.@*Results@#RAM is widely used in nursing research, practice, and education. However, it has not been used to describe content saturation in nursing education. The Content Saturation in Nursing Education Model (CSNEM) is proposed to explain this phenomenon.@*Conclusion@#RAM provides a theoretical lens for understanding content saturation in nursing education. The CSNEM can be a new framework to describe this phenomenon, contributing to knowledge development in nursing education.

Environmental Influence on Adolescent Resilience Development in Medellin Colombia / Influencia del ambiente en el desarrollo de la resiliencia en adolescentes de Medellín, Colombia / Influência do ambiente no desenvolvimento da resiliência em adolescentes de Medellín, Colômbia

ABSTRACT Objective: To know the influence of the environment (family functionality, social support and neighbourhood and school environment) on the development of adolescent resilience. Methods: Descriptive, correlational design. A total of 184 adolescents from six schools in the Aranjuez district of Medellín participated. Probabilistic, two-stage sampling. Five scales were used to collect data: 1) The child and youth resilience measurement scale; 2) The neighbourhood environment questionnaire; 3) The family cohesion and adaptability assessment scale; 4) The multidimensional scale of perceived social support; and 5) The school environment questionnaire. Data were analysed though SPSS 24v software. Results: a relationship was found between resilience and neighbourhood environment (rs= .324, p = .000), family functionality (rs= .380, p = .000), social support (rs= .456, p = .000) and school environment (rs= .353, p = .000). In addition, resilience was explained in 35.8 % by the neighbourhood environment (β= .20; p = .012), family functionality (β = .13; p = .090), social support (β= .30; p = .000) and school environment (β = .15; p = .064). Conclusion: Adolescent resilient behaviour is influenced by social support, family functioning, and school and neighbourhood environment, all external factors fostering self-regulation, as mentioned by Roy's Nursing model.

RESUMEN Objetivo: conocer la influencia del ambiente (funcionalidad familiar, apoyo social y ambiente barrial y escolar) en el desarrollo de la resiliencia de los adolescentes. Métodos: diseño descriptivo, correlacional. Participaron 184 adolescentes de seis colegios de la comuna Aranjuez de Medellín. Muestreo probabilístico, bietápico. Para recolectar los datos, se aplicaron cinco escalas: 1) la escala child and youth resilience measure; 2) el cuestionario de ambiente barrial; 3) la escala de evaluación de cohesión y adaptabilidad familiar; 4) la escala multidimensional de apoyo social percibido; y 5) el cuestionario de ambiente escolar. Los datos se procesaron con el software SPSS 24v. Resultados: se encontró una relación entre la resiliencia y el ambiente barrial (rs = .324, p = .000), funcionalidad familiar (rs = .380, p = .000), apoyo social (rs = .456, p = .000) y ambiente escolar (rs = .353, p = .000). Además, la resiliencia fue explicada en un 35,8 % por el ambiente barrial (β=.20; p =.012), la funcionalidad familiar (β=.13; p =.090), el apoyo social (β=.30; p =.000) y el ambiente escolar (β=.15; p = .064). Conclusión: la conducta resiliente de los adolescentes es influenciada por el apoyo social, la funcionalidad familiar y el ambiente escolar y barrial, factores externos que favorecen la autorregulación, como lo menciona Roy en su modelo de enfermería.

RESUMO Objetivo: availar a influência do ambiente (funcionalidade familiar, apoio social e ambiente de bairro e escolar) no desenvolvimento da resiliência dos adolescentes. Métodos: desenho descritivo, correlacional. Participaram 184 adolescentes de seis colégios da comunidade Aranjuez, Medellín, Colômbia. Amostragem probabilística, bietápica. Para coletar os dados, foram aplicados cinco instrumentos: 1) a escala child and youth resilience measure; 2) o questionário de ambiente de bairro; 3) a escala de avaliação de coesão e adaptabilidade familiar; 4) a escala multidimensional de apoio social percebido; 5) o questionário de ambiente escolar. Os dados foram processados com o software SPSS 24v. Resultados: verificou-se relação entre a resiliência e o ambiente de bairro (rs = .324, p = .000), funcionalidade familiar (rs = .380, p = .000), apoio social (rs = .456, p = .000) e ambiente escolar (rs = .353, p = .000). Além disso, a resiliência foi explicada em 35,8 % pelo contexto de bairro (β =.20; p =.012), pela funcionalidade familiar (β =.13; p =.090), pelo apoio social (β =.30; p =.000) e pelo ambiente escolar (β =.15; p = .064). Conclusões: o comportamento resiliente dos adolescentes é influenciado pelo apoio social, pela funcionalidade familiar e pelo ambiente escolar e de bairro, fatores externos que favorecem a autorregulação, como mencionado por Roy no seu modelo de enfermagem.

A study on Development and Implementation of the Psychophysiological Well-being Assessment Tool based on Roy’s Adaptation Model for breast cancer patients

Breast cancer is a major health burden among Indian females in their young age. As the females came to know the disease isalready in advance stage. To get rid from the complications they have to undergo for mastectomy and after mastectomy they havedisturbed Psychophysiological Wellbeing. In the present methodological study researcher has developed PsychophysiologicalWellbeing Assessment Tool (PWAT) based on Roy's Adaptation Model after three rounds of item analysis and Delphi surveywith experts of different fields of nursing to assess their Psychophysiological wellbeing. After the finalization of PWAT it wasimplemented on 200 post mastectomy breast cancer patients who were under radiation therapy or chemotherapy and selected byNon- probability purposive sampling technique, in Rajinra Hospital Patiala. Data was collected and analyzed by using descriptiveand inferential statistics. Common consensus of experts was obtained from 72 pooled items to final version of PWAT with 38items. The reliability of instrument was estimated by using split half Chronbachs alpha which was r=0.87. Statistically all theitems of PWAT were found inter correlated and were compatible to each other. The mean score range of physiological well-beingwas 57.40 as compared to mean score range of the psychological well-being of breast cancer patients was 83.17.There waspositive correlation (0.347) between physiological wellbeing and psychological wellbeing at the level of 0.001. Thus it wasstatistically evident that if physiological well-being score increased then psychological wellbeing score also increased. Thus itmay be concluded that if the nurses would be equipped with PWAT, they will do quick assessment of psychophysiologicalwellbeing of post mastectomy breast cancer patients. Their timely intervention will help in decreasing re-hospitalizations ofpatients and help in cost containment for the health care industry which is the essence of quality care management.

Adaptation to High-Risk Childbearing: A Preliminary Situation-Specific Theory / Adaptación a la maternidad de alto riesgo: una teoría preliminar específica de la situación / Adaptação à maternidade de alto risco: uma teoria preliminar específica da situação

ABSTRACT The purpose of this paper is to present a discussion of a preliminary situation-specific theory of adaptation to high-risk childbearing for expectant and new mothers and fathers. Roy's Adaptation Model guided the design and conduct of the pilot study of correlates of maternal and paternal functional status from which the theory was derived. The conceptual-theoretical-empirical structure for the study is displayed in a diagram. The concepts of the theory-functional status, physical symptoms, physical energy, psychological symptoms, and relationship quality--are identified and defined, and their linkages are identified. Implications for testing and potential use of the theory in nursing practice are discussed.

RESUMEN El propósito de este artículo es presentar una discusión sobre una teoría preliminar específica, de la situación de la adaptación a la maternidad de alto riesgo, para las futuras madres y los nuevos padres. El modelo de adaptación de Roy sirvió de guía para el diseño y la realización del estudio piloto de correlatos del estado funcional materno y paterno del cual se derivó la teoría. La estructura conceptual-teórico-empírica para el estudio se muestra en un diagrama. Se identifican y definen los conceptos de la teoría: estado funcional, síntomas físicos, energía física, síntomas psicológicos y calidad de la relación, y se identifican sus vínculos. Se discuten las implicaciones para las pruebas y el uso potencial de la teoría en la práctica de enfermería.

RESUMO O objetivo deste artigo é apresentar uma discussão de uma teoria preliminar específica da situação de adaptação à maternidade de alto risco para as futuras mães e os novos pais. O modelo de adaptação de Roy serviu como um guia para desenho e implementação do estudo piloto de correlatos do estado funcional materno e paterno do qual a teoria foi derivada. A estrutura conceitual-teórico-empírica para o estudo é mostrada em um diagrama. Os conceitos da teoria são identificados e definidos: estado funcional, sintomas físicos, energia física, sintomas psicológicos e qualidade da relação, e seus elos são identificados. As implicações para o teste e o uso potencial da teoria na prática de enfermagem são discutidas.

A phenomenological study on working experience of nonlocal nurses in Shanghai / 中国实用护理杂志

Objective To explore the feelings of nonlocal nurses working in shanghai in order to provide effective and reliable basis for the nursing managers to develop humanistic management. Methods 12 nonlocal nurses were interviewed with open-ended questions. The data collected from the interviews were analyzed thematically. Results There are seven themes of nonlocal nurses′ working experience: the pursuit of a better personal development, physical needs are not met, the affected self-concept, the role strain,lack of good interpersonal support,achieve their self-worth and look forward to humanistic management modes. Conclusions It is showed that there are various types of maladjustment problems on nonlocal nurses. All above suggest that nursing managers should be concerned about the physical and mental health status of nonlocal nurses, and improve the guarantee mechanism. Using motivation mechanisms to mobilize the enthusiasm of nonlocal nurses, with a view to maximize their potential power.

Application status and enlightenment of the Roy adaptation model in nursing care of patients with cancer / 中国实用护理杂志

This paper summarizes the application status of the Roy adaptation model in the process of nursing patients with cancer, during the perioperative phase, radiotherapy or chemotherapy period and the care phase of extending from hospital to the community. Through the analysis of existing problems, put forward corresponding countermeasures to provide reference for the application and improvement of this model.

Proceso enfermero a recién nacido con hiperbilirrubinemia basado en el modelo de adaptación de Roy / Roy's adaptation model based nursing process on the attention to the newborn with hyperbilirubinemia / Processo enfermeiro a recém-nascido com hiperbilirrubinemia baseado no modelo de adaptação de Roy

Posterior al nacimiento el recién nacido cursa por un periodo de transición para ajustarse a los cambios fisiológicos que implican el estar fuera del vientre materno. Durante este periodo es común la aparición de complicaciones como la ictericia neonatal, padecimiento común a nivel mundial, que se define como la coloración amarilla de la piel resultado de los altos niveles circulantes de bilirrubina. Representa una de las principales causas de morbilidad, tanto en recién nacidos de término como en pretérmino. Su etiología se encuentra relacionada con distintos factores de riesgo maternos y/o neonatales y, aunque sus índices de mortalidad son bajos, el retraso en su diagnóstico y tratamiento conlleva severas complicaciones, como el kernicterus . Dentro de los factores de riesgo maternos la hiperbilirrubinemia por incompatibilidad sanguínea entre la madre y el recién nacido, como en el presente caso, requiere de la inmediata y oportuna atención del profesional de enfermería que labora dentro de los servicios de cuidados neonatales, con el objetivo de limitar el daño, favorecer la pronta recuperación, la reunión del binomio y la posterior integración del recién nacido a la dinámica familiar. El presente estudio de caso fue elaborado bajo el marco conceptual del modelo de adaptación de Roy, y a través del proceso enfermero, como herramienta metodológica para priorizar el cuidado. Aunque no fue posible documentar una disminución considerable en los niveles de bilirrubina, los resultados obtenidos se consideraron satisfactorios, ya que se logró mejorar el nivel de adaptación del recién nacido en el modo adaptativo fisiológico.

After being born, the baby goes through a period of transition of physiological changes and adjustments. During this period, the newly born can experience neonatal jaundice, an imbalance characterized by the yellow pigmentation of the skin as the result of the high levels of circulating bilirubin. This problem is one of the main causes of both on-term and pre-term neonatal mortality. There are different maternal and neonatal risk factors involved in the issue and, although its mortality rates are low, a delay in diagnosing and treating neonatal jaundice leads to severe complications such as kernicterus. A hyperbilirubinemia due to blood incompatibility between the mother and the baby, like in this particular case, requires immediate attention from the neonatal-care nursing professional in order to limit the damage, and to favor a prompt recovery, the reunion of the mother and her baby, and the integration of the baby into other family dynamics. This study was conducted within the conceptual frame of the Roy's Adaptation Model and through the nursing process. Although, a considerable decrease in the bilirubin level was not achieved, the obtained results were considered satisfactory since the level of physiological adaptation of the newborn improved significantly.

Posterior ao nascimento, o recém-nascido mantém um período de transição para se ajustar aos câmbios fisiológicos que implicam estar fora do ventre materno. Durante este período, é comum a aparição de complicações como a icterícia neonatal, padecimento comum a nível mundial, que se define como a coloração amarela da pele, resultado dos altos níveis circulantes de bilirrubina. Representa uma das principais causas de morbidade tanto em recém-nascidos de término e pré-término. A sua etiologia encontra-se relacionada a distintos fatores de risco maternos e/ou neonatais e, ainda que seus índices de morbidade seja baixos, o retraso no seu diagnóstico e tratamento envolve severas complicações, como o kernicterus. Dentro dos fatores de risco maternos, a hiperbilirrubina por incompatibilidade sanguínea entre a mãe e o recém-nascido, como no presente caso, requer da imediata e oportuna atenção do profissional de enfermagem que trabalha dentro dos serviços de cuidados neonatais, com o objetivo de limitar o dano, favorecendo a rápida recuperação, a reunião do binômio e a posterior integração do recém-nascido à dinâmica familiar. O presente estudo de caso foi elaborado sob o marco conceitual do Modelo de Adaptação de Roy e através do Processo Enfermeiro, como ferramenta metodológica para priorizar o cuidado. Ainda que não foi possível documentar uma diminuição considerável nos níveis de bilirrubina, os resultados obtidos consideraram-se satisfatórios, já que conseguiu melhorar o nível de adaptação do recém-nascido no modo adaptativo fisiológico.

Application of Roy adaptation model in patients with adolescent insanity / 现代临床护理

Objective To investigate the effect of Roy Adaptation Model(RAM)in patients with adolescent insanity.Methods One hundred patients with adolescent insanity during October 2011 to March 2012 were randomized in equal number into two groups by random digit table:the study group and the control group.The former were intervened with RAM and the latter received routine care and health education.Seven weeks after intervention,Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Scale(HAMA) and Observation Scale(NOSIE)were used for the assessment. Results After intervention,the scores on HAMD and HAMA in the study group were significantly lower,compared to the control group(P<0.01).The scores on social function,social interest,subjective support and use of social support were all significantly higher than those of the control group(all P<0.01). Conclusions RAM can improve their ability of the patients with adolescent insanity to adapt to the environment.It may improve their mental state and their quality of life.

Estimulación multisensorial auditiva, tactil, vestibular y visual (atvv) para la capacidad de adaptación según roy en la eficiencia de la alimentación del recien nacido pretérmino / Multisensory stimulation, auditory, tactile, vestibular and visual (ATVV) for adaptability as Roy in the efficiency of feeding preterm

Introducción: De todos los nacidos vivos en Colombia, aproximadamente el 16% son prematuros y de estos el 80% requieren ser hospitalizados. Aunque los avances en la tecnología han mejorado las tasas de supervivencia del recién nacido pretérmino (RNPT), han fracasado en disminuir los costos médicos y la estancia hospitalaria. Una de las principales causas es la demora en la alimentación oral exitosa. En consecuencia, los esfuerzos de la investigación deben enfocarse en la búsqueda de intervenciones de enfermería que ayuden al desarrollo de las habilidades para la alimentación por succión. En este caso la ciencia de enfermería con el Modelo de Adaptación de Roy sirvió de guía para estudiar el proceso del logro de la alimentación oral en el RNPT. Este modelo considera que la base del conocimiento de enfermería se fundamenta en el entendimiento de la adaptación de la persona dentro de su situación de vida. Y desde la perspectiva de la adaptación, la alimentación del recién nacido, es un proceso tanto biológico como social, que considera los diversos subsistemas, tanto del recién nacido como del medio ambiente y del cuidador, los cuales interactúan junto con el efecto del desarrollo de las habilidades para la alimentación oral. Este desarrollo se puede observar a través de la transición entre el inicio de la vía oral por succión y el logro de la vía oral total, la estabilización hemodinámica durante la alimentación (medida a través de los episodios de bradicardia y desaturación), la cantidad y tiempo gastado durante la alimentación y el número de succiones en cada toma, además otro aspecto relacionado con el logro de la alimentación oral es la ganancia de peso durante esa transición. Un estímulo contextual que puede ayudar al RNPT al logro de la alimentación en una forma exitosa y que puede ser aplicado por la enfermera es el aplicado a través de la intervención-"Estimulación multisensorial auditiva,táctil,vestibular y visual (ATVV) el cual se aplica antes de la alimentación. Objetivo: Determinar la eficacia de la aplicación en mayor dosis del estímulo contextual: "Estimulación multisensorial ATVV", en el modo adaptativo fisiológico relacionado con la alimentación del recién nacido pretérmino, en términos de la transición desde el inicio de la vía oral a la vía oral total. Métodos: Se realizo un Ensayo Clínico Controlado, con 58 RNPT entre las 29 y 32 semanas de edad gestacional, hemodinamicamente estables. Se hizo una asignación aleatoria de los participantes, el grupo experimental recibió la intervención 3 veces al día y el grupo control recibió la intervención una vez al día. Se compararon los grupos mediante análisis de supervivencia con regresión de cox, el cálculo del número necesario a tratar, la prueba de wilcoxon y la prueba t de student. Resultados: Las características de los recién nacidos en los dos grupos fueron similares. Los hallazgos indican que la aplicación del estímulo contextual a través de la estimulación multisensorial ATVV tiene un efecto estadísticamente significativo en el logro de la alimentación por vía oral y en la ganancia de peso. Se encontró una diferencia de dos días entre los dos grupos en el número de días en llegar a la vía oral total por succión(p=.005) y una diferencia promedio de ganancia de peso de 7 gramos (p=.04). Los resultados sugieren que no hay diferencia en la presentación de episodios de bradicardia (p=.608) y episodios de desaturación (p=.896), es decir que la aplicación de la intervención tres veces al día no influye en los cambios en estos parámetros. En las habilidades de la alimentación, los resultados muestran, mayor número de succiones (p=.0100), aumento en la cantidad tomada (p=.0207) y una corta duración de la alimentación (p=.0104) en los recién nacidos a quienes de les aplico la intervención tres veces al día. La diferencia promedio entre los dos grupos en la estancia hospitalaria fue de 3 días pero no fue estadísticamente significativa (p=.229). Conclusión: La aplicación del estímulo contextual a través de la intervención estimulación multisensorial ATVV aplicada tres veces al día redujo el número de días en llegar a la vía oral total por succión y aumento la ganancia de peso. Y aunque en menor consideración disminuyo los eventos de bradicardia y desaturación durante la alimentación, ayudo a mejorar las habilidades de la alimentación en cuanto a número de succiones, cantidad y tiempo gastado en tomar la alimentación y disminuyó la estancia hospitalaria. No se evidenciaron efectos secundarios en la administración de alguna de las dos dosis. Es pertinente continuar la evaluación de las habilidades de la alimentación realizando un seguimiento más prolongado para poder determinar los cambios específicos en la misma y a su vez mirar otros desenlaces relacionados con el establecimiento del vínculo afectivo padres-hijos.

Introduction: Of all live births in Colombia, approximately 16% are premature and of these 80% require hospitalization. While advances in technology have improved survival rates of preterm newborns (PN), have failed to curb medical costs and hospital stay. A major cause is the delay in successful oral feeding. Consequently, research efforts should focus on the search for nursing interventions to help develop the skills to feed by suction. In this case the science of nursing with the Roy Adaptation Model guided the study the process of attainment of oral feeding in preterm infants. This model considers that the knowledge base of nursing is based on the understanding of adaptation of the person in their life situation. And from the perspective of adaptation, infant feeding, is both biological and social process, which considers the various subsystems, both the newborn and the environment and caregiver, which interact with the effect of development the oral feeding skills. This development can be seen through the transition between the initiation of oral suction and the achievement of total oral, hemodynamic stabilization during feeding (as measured by episodes of bradycardia and desaturation), the amount and during feeding time spent and number of sucks in each shot, another aspect related to the attainment of oral feeding is the weight gain during this transition. Contextual stimulus that can help the infant premature to the achievement of food in a successful and can be applied by the nurse is applied through the intervention- "multi-sensory stimulation auditory, tactile, vestibular and visual (ATVV) which applied prior to feeding. Objective: To determine the efficacy of high dose application of contextual stimulus: ATVV multisensory stimulation, physiologic adaptive mode related to preterm infant feeding, in terms of the transition from the beginning of the mouth to the total oral. Methods: Controlled Clinical Trial in infants between 29 and 32 weeks gestational age, hemodynamically stable. Randomized to a dose of multisensory stimulation ATVV intervention. They were followed daily from the start of the suction mouth up to the total oral suction. Different doses of the intervention were applied to 58 preterm infants. Results: The characteristics of infants in both groups were similar. The findings indicate that the application of contextual stimulus through multisensory stimulation ATVV has a statistically significant effect on the attainment of oral feeding and weight gain. There was a difference of two days between the two groups in the number of days to arrive at the total mouth suction (p=.005) and an average difference in weight gain of 7g.(p=.04). The results suggest no difference in the presentation of episodes of bradycardia (p=.0608) and episodes of desaturation (p=.896), ie the implementation of the intervention three times a day does not influence the changes in these parameters. In feeding skills, the results show a greater number of sucks (p =. 0100), increased the amount taken (p =. 0207) and a short duration of feeding (p =. 0104) in newborns to who to the intervention applied three times daily. The average difference between the two groups in hospital stay was 3 days but was not statistically significant (p =. 229). Conclusion: The application of contextual stimulus through multi-sensory stimulation intervention ATVV applied three times daily reduced the number of days to reach the total oral intake and increased weight gain. And although less seriously diminished the bradycardia and desaturation events during feeding, helped to improve the skills of feeding in terms of number of suctions, quantity and time spent in taking food and decreased hospital stay. No side effects were observed in the administration of one of the two doses. It is pertinent to continue assessing the skills of power by a longer follow-up to determine the specific changes in the same turn and look at other outcomes related to the establishment of parent-child bonding.

Aplicación del Modelo de Adaptación en un Servicio de Rehabilitación Ambulatoria

En el presente artículo se realiza un análisis del Modelo de Adaptación de Callista Roy y se plantean algunas aproximaciones que se han empleado para su aplicación en el servicio de rehabilitación de la Clínica Puente del Común. El artículo describe cómo se desarrollan cada una de las etapas del proceso de enfermería en la consulta que realizan los profesionales de enfermería a los pacientes vinculados al programa integral de rehabilitación.

An analysis of Callista Roy Adaptation Model is done in this article. Some approaches used for its application are stated in the service of rehabilitation of Puente del Común Clinic. The article describes how each stage of the nursing process is applied by the nursing professionals to patients assisting to the integral rehabilitation program.