“Application of Sister Callista Roy’s Adaptation Model in Managing Dysmenorrhea: A Conceptual Framework for Comprehensive Nursing Interventions”

“Application of Sister Callista Roy’s Adaptation Model in Managing Dysmenorrhea: A Conceptual Framework for Comprehensive Nursing Interventions”

Ms. Muneeswari J

Obstetric And Gynecological Nursing, The Tamilnadu Dr. M.G.R. Medical University, India

DOI: https://doi.org/10.51584/IJRIAS.2025.100800142

Received: 13 August 2025; Accepted: 19 August 2025; Published: 23 September 2025

ABSTRACT

Dysmenorrhea is a common condition that adversely affects the physical, psychological, and academic well-being of adolescent girls. Effective management requires holistic strategies that address both physiological discomfort and coping mechanisms. This study applied Sister Callista Roy’s Adaptation Model as the theoretical foundation for developing a comprehensive, non-pharmacological nursing intervention framework. A quasi-experimental time series design was conducted with 240 adolescent girls (120 experimental, 120 control) recruited from schools in Chennai, India. Interventions for the experimental group included hydrotherapy, rice heat application, turmeric therapy, acupressure, and educational support, while the control group received standard care. Outcomes were assessed using the Numerical Rating Pain Scale and a Modified Menstrual Symptom Questionnaire across six consecutive menstrual cycles. Results demonstrated a significant reduction in pain perception and dysmenorrhea symptoms among the experimental group compared to controls (p ≤ 0.001). The framework effectively promoted adaptive responses, improved physiological comfort, and enhanced psychological well-being. Findings emphasize the importance of evidence-based, holistic nursing strategies in improving the quality of life for adolescents with dysmenorrhea and provide a foundation for future empirical studies.

INTRODUCTION

Dysmenorrhea is one of the most prevalent and distressing gynecological problems among adolescent girls, often leading to school absenteeism, reduced academic performance, and compromised quality of life. Effective management requires a comprehensive approach that alleviates pain while strengthening adaptive coping mechanisms. Sister Callista Roy’s Adaptation Model offers a robust theoretical framework for guiding nursing practice by viewing individuals as adaptive systems responding to internal and external stimuli. This model emphasizes both physiological and psychosocial adaptation, making it particularly relevant for addressing dysmenorrhea in adolescents. The present study integrates evidence-based, non-pharmacological interventions—including hydrotherapy, rice heat application, turmeric therapy, acupressure, and structured educational support—within Roy’s Adaptation Model to evaluate their effectiveness in reducing menstrual pain and associated symptoms. By promoting adaptive responses, this framework aims to improve overall well-being and provide direction for future nursing research and practice.

RESEARCH METHODOLOGY

A quasi-experimental time-series design with a quantitative approach was adopted to evaluate the effectiveness of comprehensive nursing interventions on dysmenorrhea among adolescent girls. The study included 240 participants aged 13–17 years, recruited from two schools in Chennai, India, using a simple random sampling technique. Participants were divided into two groups: an experimental group (n = 120) and a control group (n = 120). The experimental group received a structured nursing intervention package consisting of hydrotherapy, rice heat pad application, turmeric therapy, acupressure, and a self-learning educational booklet. The control group received standard care. Data collection occurred over six menstrual cycles: a baseline pre-test during the first cycle, followed by five consecutive post-tests after intervention. Pain perception was measured using the Numerical Rating Pain Scale, and dysmenorrhea-related symptoms were assessed using a Modified Menstrual Symptom Questionnaire. The tools were validated by subject experts, and reliability was confirmed through a pilot study. Ethical approval was obtained from the Institutional Review Board, and informed consent/assent was secured from all participants and their guardians. Data analysis included descriptive statistics, independent t-tests, paired t-tests, and Chi-square tests to determine intervention effectiveness.

Conceptual Framework

The conceptual framework illustrated in the diagram is developed in alignment with Sister Callista Roy’s Adaptation Model, a prominent theoretical model in nursing that emphasizes individuals as adaptive systems responding to internal and external stimuli. This model has been effectively applied to examine the effectiveness of comprehensive nursing interventions on adolescent girls suffering from dysmenorrhea. The framework systematically outlines the input, throughput (process), and output stages, which are fundamental to understanding adaptive responses within a nursing care context.

1. Input Phase

The input phase includes the personal and contextual characteristics of the subjects—in this case, adolescent girls with dysmenorrhea. These individuals represent the focal stimuli, as their pain and associated symptoms are central to the intervention.

• Personal Component: This comprises the basic demographic such as Age in Years, Class in standard, Type of family, Family history of dysmenorrhea, Occupation of parents, Education of parents, Dietary Pattern, Involvement in Sports activities and physiological (menstrual) characteristics of the adolescent participants such as Age at menarche, Body Mass Index, Duration of menstrual cycle, Days of menstrual flow, Type of material used for menstruation, Number of pads used per day, Previous remedies for menarche, Support during menstrual pain.
• Assessment Parameters: The framework includes specific input variables such as:

• Demographic details and menstrual characteristics
• Level of pain perception (likely measured using a standardized Numerical Rating pain assessment scale)
• Dysmenorrhea-related symptoms (measured using a Modified Menstrual Symptoms Questionnaires).

These inputs establish the baseline data necessary for implementing targeted interventions and enable classification into two primary groups—Experimental Group and Control Group.

Fig 1: Modified Sister Callista Roy’s Adaptation Model

Throughput (Process) Phase

The throughput or processing phase refers to the transformation of inputs via purposeful interventions. It involves structured therapeutic engagement and nursing care processes:

• Experimental Group: Receives an comprehensive nursing intervention which includes:

• Hydrotherapy
• Rice heat pad application
• Turmeric therapy
• Acupressure
• Distribution of a self-learning booklet

These non-pharmacological interventions are chosen for their evidence-based effectiveness in reducing menstrual pain and improving psychological well-being.

• Control Group: Receives standard care without the specified experimental interventions. This group serves as a comparative benchmark to evaluate the relative effectiveness of the applied therapies.

During this phase, the participants undergo the intervention and generate a physical response, which is the immediate outcome observed.

Physical Response

This intermediary outcome measures the perceived change in pain perception and dysmenorrhea symptom relief:

• For the experimental group, there is a reduction in pain perception and alleviation of dysmenorrhea symptoms, indicating a positive physiological reaction to the applied interventions.
• Conversely, in the control group, pain persists, reflecting the limited effectiveness of standard care when compared to the holistic experimental approach.

This stage helps differentiate between effective and ineffective coping mechanisms in response to stimuli, as per Roy’s model.

Output Phase

In Roy’s Adaptation Model, the output, or adaptive responses, are the ways a person reacts to stimuli. These responses indicate whether a person has successfully adapted to a situation. These are categorized as:

• Adaptive Response: Occurs when the individual demonstrates improvement in both:

• Physiological well-being: evidenced by reduced pain perception and relief from dysmenorrhea symptoms.
• Psychological well-being: indicated by decreased anxiety and enhanced overall mental health and functionality.

• Ineffective Response: In this context, likely associated with the control group, where standard methods of care are insufficient, resulting in:

• Persistent or worsened pain
• Minimal psychological relief
• Poor coping outcomes

This differentiation highlights the efficacy of the comprehensive nursing interventions in promoting adaptive behaviour.

Feedback Loop

The final component of the framework is the feedback mechanism, which is vital for continuous evaluation and adaptation of care plans. Based on the observed outcomes (adaptive or ineffective responses), further refinement of the intervention strategies can be implemented. This ensures ongoing patient-centred care and continuous quality improvement in nursing practice.

RESULT

Data from 240 adolescent girls were analyzed to evaluate the effectiveness of the intervention package. At baseline, both groups reported comparable pain intensity and dysmenorrhea symptoms. Following the intervention, the experimental group demonstrated a highly significant reduction in pain scores (mean pre-test: 7.21 vs. mean post-test 5: 2.49; p ≤ 0.001). Similarly, dysmenorrhea symptoms decreased markedly (mean pre-test: 131.13 vs. mean post-test 5: 88.20; p ≤ 0.001). In contrast, the control group showed only minimal improvement over the same period. A moderate positive correlation was identified between reductions in pain and dysmenorrhea symptoms in the experimental group (r = 0.48, p = 0.001), confirming the interrelationship between pain relief and overall symptom improvement. Overall, the comprehensive nursing interventions proved significantly more effective than standard care, demonstrating both statistical and clinical importance in alleviating menstrual discomfort and improving adaptive responses.

CONCLUSION

This study demonstrated that comprehensive, non-pharmacological nursing interventions, grounded in Sister Callista Roy’s Adaptation Model, significantly reduced pain intensity and dysmenorrhea-related symptoms in adolescent girls. The interventions not only enhanced physiological comfort but also promoted psychological well-being and adaptive coping responses.

By applying Roy’s theoretical framework, the study highlights the importance of holistic, evidence-based nursing strategies in adolescent reproductive health. These findings provide strong implications for nursing education, clinical practice, and policy development, underscoring the need for patient-centered, non-pharmacological approaches in managing dysmenorrhea. Future research is recommended to replicate and expand this framework in diverse populations and clinical settings to strengthen its generalizability and contribute to global adolescent health promotion.

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