Theoretical Framework According to the nurse theorist, Sr.

Callista Roy in her Adaptation Theory, the theory provided a conceptual framework on how an individual assimilate and adjust to different environment and stimuli. The main purpose of this theory is to explain the patient needs to assess by the nurse and how the patient adapt on what the nurses was given. Therefore, the nurse must consider the needs of the patient that affects the psychological, physiological and sociological and aide them to align with this demand. As Roy stated on her Theory, self-perception was influenced by the perception of other responses. She also identifies nurses intervention and assessment that has an impact on patient adaptation. Nursing judgment is evaluated on how the nurse plans and implement on their intervention which will provide to their patient, with this patient adaptation and perceiving to the intervention of the nurse has the impact on the patient health status. Adaptation Theory also stated that the human thinking was inspire by how a person aware on a specific thing, feeling capacities and consciousness, by which they adjust and cope on the changes in the environment. The theory also defines adaption as the compensatory response and acceptance on a changes made up by external and internal environment. The theory depict human adaptation occurring at 3 levels : The (1.) Internal (self) , (2). Social (others) and (3). Physical (biochemical reactions). According to the theory, stimuli occur in external or internal environment, the adaptation level are consist of (1) Focal Stimuli, (2) Contextual Stimuli, and (3) Residual Stimuli. Focal Stimuli. The internal or external stimulus most immediately confronting the human system. this focal stimuli needs a response to or action from the person so that he/ she can deal or cope with it. For example, when a patient goes for abdominal surgery, the operation (focal stimuli) spends his/her attention in thinking of possible outcomes, until some action is taken to ease the stimuli such as nursing education and support. Contextual Stimuli. All other stimuli present in the situation that contribute to the effect of the focal stimulus in contrast to the focal stimuli, contextual stimuli is present in the environment but outside the person. The recovery room and ICU environment, which sometimes the patient will be taken to postoperatively, could be consider as the contextual stimuli. In pre-operative health education the nurse explain to patient the post operatively environment in order the patient was able to adapt on it. Residual Stimuli. are environmental factors that within or without the human system with effects in the current situation that are unclear This last Stimuli of environment, it is about the potential factors that may inspire the focal stimuli, such as lack of present of the family member in involving in

pre-operative health education which helps them to recognize and be aware on the health status and adhering regiment for the treatment in the discomfort and needs of their family who will undergo surgery. The presence of the significant others, visitors and family member help the patient of feeling being loved and supported, with this it give the patient be cooperative in perceiving the health education that the patient acquired from the nurse. The nursing interventions in this theory include the pain management to the surgical patient, which take in the possible outcomes after post-operative. Nurse must inform and provide education on skills, management and coping on the needs and discomfort that the patient will be able to experience after surgery such as pain.( (Tomey et. Al,2002)

Figure 1 ADAPTATION MODEL