Dixon E L
Mount Saint Mary's College, Nursing Department, Los Angeles, CA 90049, USA.
Public Health Nurs. 1999 Aug;16(4):290-300. doi: 10.1046/j.1525-1446.1999.00290.x.
In the current health care environment in the United States, the work performed by community health nurses is increasingly being recognized and valued by society at large. An increased societal emphasis on health promotion and disease prevention has generated many opportunities for community health nurses (CHNs) to stretch their practices from individually-oriented type practice models to more encompassing population-focused type practices. Addressing this trend, the Roy Adaptation Model of nursing has been reconceptualized and expanded to offer a framework for the systematic delivery of nursing care to aggregates in community settings. The purpose of this paper is to describe the current health promotion movement in the United States and discuss the impact of this movement on the practice of community health nursing. In recognition of the importance of theory-based nursing practice and the opportunities that CHNs will have in the health promotion movement, the use of the a specific conceptual model, the reconceptualized Roy Adaptation Model, will be presented as a theoretical framework for community health nursing practice. The nursing process according to Roy is applied to community health nursing and specific attention is paid to the performance of community assessments within the newly defined adaptive modes that relate to collectives: the physical, group identity, role function, and interdependence modes. To date, few references appear in the literature which link the Roy Adaptation Model to community health nursing.
在美国当前的医疗环境中，社区健康护士所开展的工作日益得到广大社会的认可和重视。社会对健康促进和疾病预防的重视程度不断提高，为社区健康护士（CHNs）创造了诸多机会，使他们能够将业务范围从以个体为导向的实践模式拓展至更具包容性的以人群为重点的实践。为顺应这一趋势，护理的罗伊适应模式已被重新概念化并加以扩展，从而为在社区环境中向人群系统提供护理服务提供了一个框架。本文旨在描述美国当前的健康促进运动，并探讨该运动对社区健康护理实践的影响。鉴于基于理论的护理实践的重要性以及社区健康护士在健康促进运动中所面临的机遇，将介绍一种特定概念模型——重新概念化的罗伊适应模式的应用，作为社区健康护理实践的理论框架。按照罗伊的理论，护理程序应用于社区健康护理，并特别关注在与群体相关的新定义适应模式（生理、群体认同、角色功能和相互依赖模式）内进行社区评估的情况。迄今为止，文献中很少有将罗伊适应模式与社区健康护理联系起来的参考文献。
