Adaptación del paciente politraumatizado en urgencias: abordaje desde el Modelo de Adaptación de Callista Roy

Johanna Elizabeth Caicedo Mina; Juan Camilo Revelo Zuñiga; Alex José Malquín Quiroz

doi:10.70577/asce.v4i4.553

Autores/as

Johanna Elizabeth Caicedo Mina Universidad Politécnica Estatal del Carchi https://orcid.org/0000-0002-2255-1458
Juan Camilo Revelo Zuñiga Universidad Politécnica Estatal del Carchi https://orcid.org/0009-0000-2011-4038
Alex José Malquín Quiroz Universidad Politécnica Estatal del Carchi https://orcid.org/0009-0002-0089-5900

DOI:

https://doi.org/10.70577/asce.v4i4.553

Palabras clave:

Politrauma, Adaptación, Modelo De Adaptación De Roy, Enfermería De Urgencias, Resiliencia.

Resumen

Introducción: El politrauma genera secuelas físicas, psicológicas y sociales; se requiere un abordaje de la adaptación desde modelos enfermeros como el Modelo de Adaptación de Callista Roy. Metodología: Se realizó una revisión sistemática (2020–2025) en bases de datos, sin restricción de idioma, siguiendo PRISMA y seleccionando 35 estudios sobre adaptación en personas politraumatizadas o con trauma en urgencias y hospitalización aguda. Resultados: Predominaron estudios observacionales que describen deterioro de calidad de vida, carga de síntomas emocionales y dificultades para el retorno al trabajo; los trabajos que aplican el Modelo de Roy mostraron mejoría en síntomas físicos, afrontamiento y apoyo percibido. Discusión: La adaptación del politraumatizado se configura como un proceso dinámico que afecta los cuatro modos del modelo de Roy y depende de factores personales, relacionales y organizativos, y exige intervenciones interdisciplinarias y continuidad asistencial. Conclusiones: Integrar el Modelo de Adaptación de Callista Roy en urgencias puede orientar valoraciones y cuidados centrados en la persona, aunque se requieren más estudios de intervención y en contextos latinoamericanos.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

Akarsu, K. (2024). Nursing care after hand replantation based on Roy's adaptation model: A case report. International Journal of Orthopaedic and Trauma Nursing, 52, 101039. https://doi.org/10.1016/j.ijotn.2023.101039 DOI: https://doi.org/10.1016/j.ijotn.2023.101039

Alvarado García, A. M., Venegas Bustos, B. C., & Salazar Maya, Á. M. (2023). Aplicación del Modelo de Adaptación de Roy en el contexto comunitario. Revista Cuidarte, 14(3), e3016. https://doi.org/10.15649/cuidarte.3016 DOI: https://doi.org/10.15649/cuidarte.3016

Carlson, E. B., Palmieri, P. A., Barlow, M. R., Macia, K. S., Bruns, B. R., Shieh, L., & Spain, D. A. (2024). Development and initial performance of the Hospital Mental Health Risk Screen. Journal of the American College of Surgeons, 238(2), 147–156. https://doi.org/10.1097/XCS.0000000000000904 DOI: https://doi.org/10.1097/XCS.0000000000000904

Clay, F. J., Newstead, S. V., Watson, W. L., Ozanne-Smith, J., McClure, R. J., & Stevenson, M. (2010). Determinants of return to work following non life threatening acute orthopaedic trauma: A prospective cohort study. Journal of Rehabilitation Medicine, 42(2), 162–169. DOI: https://doi.org/10.2340/16501977-0495

Davidson, T. M., Palmieri, P. A., Bruns, B. R., Spain, D. A., & Carlson, E. B. (2023). Implementation of a stepped care program to address emotional recovery among traumatic injury patients. Journal of the American College of Surgeons, 237(6), 1265–1275. https://doi.org/10.1097/XCS.0000000000000862 DOI: https://doi.org/10.1097/XCS.0000000000000862

Espeleta, H. C., Davidson, T. M., Palmieri, P. A., Bruns, B. R., Spain, D. A., & Carlson, E. B. (2023). Implementation of a stepped care program to address acute stress, posttraumatic stress disorder, and depression after traumatic injury. Injury. Advance online publication. DOI: https://doi.org/10.1016/j.injury.2023.110922

Hernández, L. J. R., Rivera, L., Torres, J., Jiménez, M., & Román, P. (2024). Proceso de Atención de Enfermería basado en el Modelo de Adaptación de Callista Roy a una persona con respuesta conductual principal de traumatismo craneoencefálico. Ciencia Latina Revista Científica Multidisciplinar, 8(5), 8682–8701. https://doi.org/10.37811/cl_rcm.v8i5.14269 DOI: https://doi.org/10.37811/cl_rcm.v8i5.14269

Hudson, C., Wray, J., Davies, S., Brown, J., & Christie, N. (2022). A qualitative study to understand the impact of caring for traumatic injury survivors. BMJ Open, 12(12), e063769. https://doi.org/10.1136/bmjopen-2022-063769

Jennings, K. M. (2017). The Roy Adaptation Model: A theoretical framework for nurses in practice. International Journal of Nursing Sciences, 4(4), 445–451. https://doi.org/10.1016/j.ijnss.2017.08.004 DOI: https://doi.org/10.1097/ANS.0000000000000175

Kang, J., et al. (2024). A qualitative study of survivors’ experiences after severe musculoskeletal trauma. Yonsei Medical Journal, 65(1), 1–10. DOI: https://doi.org/10.3349/ymj.2023.0459

Kendrick, D., Dhiman, P., Kellezi, B., Coupland, C., Whitehead, J., Beckett, K., Christie, N., Sleney, J., Barnes, J., Joseph, S., & Morriss, R. (2017). Psychological morbidity and return to work after injury: Multicentre cohort study. British Journal of General Practice, 67(661), e555–e564. https://doi.org/10.3399/bjgp17X691673 DOI: https://doi.org/10.3399/bjgp17X691673

Kiwanuka, O., Lassarén, P., Thelin, E. P., Hånell, A., Sandblom, G., Fagerdahl, A., & Boström, L. (2023). Long term health related quality of life after trauma with and without traumatic brain injury: A prospective cohort study. Scientific Reports, 13, 2986. https://doi.org/10.1038/s41598-023-30082-4 DOI: https://doi.org/10.1038/s41598-023-30082-4

Kim, J. M. (2024). Predictors of the course of post traumatic stress disorder after physical injury over two years. BJPsych Open, 10(S1), S53. https://doi.org/10.1192/bjo.2024.186 DOI: https://doi.org/10.1192/bjo.2024.186

Kratz, A. L., Sander, A. M., Brickell, T. A., Lange, R. T., Carlozzi, N. E., & Hahn, E. A. (2015). Traumatic brain injury caregivers: A qualitative analysis of quality of life. Brain Injury, 29(6), 702–711.

Lotfalla, A., Halm, J., Schepers, T., & Giannakópoulos, G. (2023a). Health related quality of life after severe trauma and available PROMS: An updated review (part I). European Journal of Trauma and Emergency Surgery, 49(2), 747–761. https://doi.org/10.1007/s00068-022-02178-5 DOI: https://doi.org/10.1007/s00068-022-02178-5

Lotfalla, A., Halm, J., Schepers, T., & Giannakópoulos, G. (2023b). Parameters influencing health related quality of life after severe trauma: A systematic review (part II). European Journal of Trauma and Emergency Surgery. Advance online publication. https://doi.org/10.1007/s00068-023-02276-y DOI: https://doi.org/10.1007/s00068-023-02276-y

Maclennan, B., Wyeth, E., & Derrett, S. (2024). Health related quality of life following trauma: Prevalence of problems and factors associated with six month outcomes in a New Zealand cohort. Injury, 55(4), 111468. https://doi.org/10.1016/j.injury.2024.111468 DOI: https://doi.org/10.1016/j.injury.2024.111468

Middlebrook, N., Brigg, N., Tronstad, Ø., & Flaws, D. (2025). Experiences, views and perceptions of recovery following musculoskeletal trauma: A qualitative study. PLOS ONE, 20(x), e0323575. https://doi.org/10.1371/journal.pone.0323575 DOI: https://doi.org/10.1371/journal.pone.0323575

Neubert, A., Hempe, S., Jaekel, C., Gaeth, C., Spering, C., Fetz, K., Windolf, J., Kollig, E., Bieler, D., & LeAf Trauma Group. (2025a). Lived experiences of working age polytrauma patients in Germany: A qualitative analysis. Injury, 56(1), 111938. https://doi.org/10.1016/j.injury.2024.111938 DOI: https://doi.org/10.1016/j.injury.2024.111938

Neubert, A., Hempe, S., Jaekel, C., Gaeth, C., Spering, C., Fetz, K., Windolf, J., Kollig, E., Bieler, D., & LeAf Trauma Group. (2025b). Return to work after major trauma: A systematic review. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 33(1), 44. DOI: https://doi.org/10.1186/s13049-025-01351-0

Patterson, S., Brigg, N., Handy, M., Tronstad, Ø., & Flaws, D. (2025). A reason to recover: A qualitative study of recovery after traumatic chest wall injury requiring intensive care admission. SSRN. http://dx.doi.org/10.2139/ssrn.5167210 DOI: https://doi.org/10.2139/ssrn.5167210

Pérez Estrada, L., Coot Tzuc, O. E., & Chi May, C. I. (2025). Abordaje de enfermería en el perioperatorio de un paciente con craneofaringioma: Un estudio de caso. Revista Chilena de Enfermería, 7, 79286. https://doi.org/10.5354/2452-5839.2025.79286 DOI: https://doi.org/10.5354/2452-5839.2025.79286

Perfetti, A. R., Lichtman, J. H., Szyld, D., Finlay, G. D., & Mikkelsen, M. E. (2022). Improving post injury care: Key family caregiver experiences throughout intensive care unit care and recovery. Critical Care Explorations, 4(5), e0703. DOI: https://doi.org/10.1097/CCE.0000000000000685

Rauen, K., Reichelt, L., Probst, P., Schäpers, B., Müller, F., Jahn, K., & Plesnila, N. (2020). Quality of life up to 10 years after traumatic brain injury: A cross sectional analysis. Health and Quality of Life Outcomes, 18(1), 166. DOI: https://doi.org/10.1186/s12955-020-01391-3

Roy, C. (2011a). Extending the Roy Adaptation Model to meet changing global needs. Nursing Science Quarterly, 24(4), 345–351. https://doi.org/10.1177/0894318411419210 DOI: https://doi.org/10.1177/0894318411419210

Roy, C. (2011b). Research based on the Roy Adaptation Model: Last 25 years. Nursing Science Quarterly, 24(4), 312–320. https://doi.org/10.1177/0894318411419218 DOI: https://doi.org/10.1177/0894318411419218

Sandström, L., Engström, Å., Nilsson, C., Juuso, P., & Forsberg, A. (2021). Trauma patients’ health related quality of life and perceptions of care: A longitudinal study based on data from the Swedish Trauma Registry. International Emergency Nursing, 55, 100850. https://doi.org/10.1016/j.ienj.2020.100850 DOI: https://doi.org/10.1016/j.ienj.2020.100850

Savell, T. C., Carlson, E. B., Palmieri, P. A., Macia, K. S., Bruns, B. R., & Spain, D. A. (2025). Mental health screening in a rural trauma center: Implementation of the Injured Trauma Survivor Screen. Journal of Trauma Nursing, 32(2), 85–92. DOI: https://doi.org/10.1097/JTN.0000000000000864

Selj, J. N., Taalas, W., et al. (2025). Health related quality of life and unmet healthcare needs among adult survivors after severe trauma. Journal of Clinical Medicine, 14(12), 4213. https://doi.org/10.3390/jcm14124213 DOI: https://doi.org/10.3390/jcm14124213

van Erp, S., Van Beeck, E. F., Metsemakers, J. F. M., & others. (2014). Determinants of limitations in unpaid work after major trauma. Injury, 45(12), 1983–1989. DOI: https://doi.org/10.1016/j.injury.2013.10.019

Vardon Bounes, F., Gracia, R., Abaziou, T., Crognier, L., Seguin, T., Labaste, F., Geeraerts, T., Georges, B., Conil, J. M., & Minville, V. (2021). A study of patients’ quality of life more than 5 years after trauma: A prospective follow up. Health and Quality of Life Outcomes, 19(1), 18. https://doi.org/10.1186/s12955-020-01652-1 DOI: https://doi.org/10.1186/s12955-020-01652-1

Vu, H. M., Nguyen, L. H., Nguyen, A. T., Tran, B. X., Latkin, C. A., Ho, C. S. H., & Ho, R. C. M. (2024). Health related quality of life among inpatients suffering from trauma in Vietnam. PLOS ONE, 19(3), e0308372. https://doi.org/10.1371/journal.pone.0308372 DOI: https://doi.org/10.1371/journal.pone.0308372

Wasilewski, M., Jones, S., et al. (2025). Peer support experiences and needs across the continuum of care for adult traumatic injury survivors, family caregivers, and healthcare providers: A qualitative study. Injury. Advance online publication. DOI: https://doi.org/10.1016/j.injury.2025.112259

Zatzick, D., O’Connor, S. S., Russo, J., Wang, J., Bush, N., Love, J., Peterson, R., Roy Byrne, P., Katon, W., & Rivara, F. P. (2021). Stepped collaborative care targeting posttraumatic stress disorder and comorbidities after acute trauma care: A randomized clinical trial. JAMA Surgery, 156(5), 462–470. https://doi.org/10.1001/jamasurg.2020.6710

Zheng, L., Fang, J., Zhang, Y., Chen, H., Wang, Y., & Xu, L. (2022). Roy Adaptation Model based nursing diagnosis and implementation reduces the sense of shame and enhances nursing outcomes in female patients with breast cancer. American Journal of Translational Research, 14(8), 5719–5728.