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Born in Chicago, raised with a sister and a brother with whom she shared a close loving
relationship
Also very fond of her father who was often ill and frequently hospitalized with GI
problem. This was the reason of choosing nursing as a career
Died in 1996
Educational Achievement
BSN:-University of Chicago,1949
Achievements
Conservational model
Model guides the nurse to focus on the influences and responses at the organismic level
Nurse accomplishes the goal of model through the conservation of energy, structure and
personal and social integrity
Adaptation
The responses will vary by heredity, age, gender or challenges of illness experiences
Example: The response to weakness of cardiac muscle is an increased heart rate, dilation
of ventricle and thickening of myocardial muscle
While the responses are same, the timing and manifestation of organismic responses will
be unique for each individual pulse rate)
An ongoing process of change in which patient maintains his integrity within the realities
of environment
Achieved through the "frugal, economic, contained and controlled use of environmental
resources by individual in his or her best interest"
Wholeness
Exist when the interaction or constant adaptations to the environment permits the
assurance of integrity
Conservation
"Keeping together "of the life systems or the wholeness of the individual
Achieving a balance of energy supply and demand that is with in the unique biological
realities of the individual
Nursings paradigm
Person
A unique individual in unity and integrity, feeling, believing, thinking and whole system
of system
Environment
Internal
Homeostasis
Homeorrhesis
External
Preconceptual
Operational
Conceptual
Internal Environment
Homeostasis: A state of energy sparing that also provide the necessary baselines for a
multitude of synchronized physiological and psychological factors
A state of conservation
Describe the pattern of adaptation, which permit the individuals body to sustain its well
being with the vast changes which encroach upon it from the environment
External Environment
Operational: Elements that may physically affects individuals but not perceived by hem:
radiation, micro-organism and pollution
Adaptation
Organismic response
Conservation
Adaptation
Characteristics
Historicity: Adaptations are grounded in history and await the challenges to which they
respond
Specificity: Individual responses and their adaptive pattern varies on the base of specific
genetic structure
Redundancy: Safe and fail options available to the individual to ensure continued
adaptation
Organismic response
They co-exist
2. Inflammatory: response intended to provide for structural integrity and the promotion
of healing
3. Stress: Response developed over time and influenced by each stressful experience
encountered by person
Vitals signs
Administration of medicine
Assumption
Human being are capable of prolonging reflection through such strategists raising
questions
Theories can interrelate concepts in such a way as to create a different way of looking at a
particular phenomenon
The concept of illness adaptation, using interventions, and the evaluation of nursing
interventions are interrelated .they are combined to look at nursing care in a different way
(more comprehensive view incorporating total patient care) form previous time.
Levines idea about nursing care are organized in such a way as to b sequential and
logical. they can be used to explain the consequences of nursing action
Its major elements are easily comprehensible and the relation ship have the potential for
being complex but are easily manageable
Certain isolated aspect of the theory are the generalizable i.e. those related to the
conservational principles
Theories contribute to and assist in increasing the general body of knowledge within the
discipline through the research implemented to validate them.
Since Levines idea have not yet been widely researched ,it is hard o determine the
contribution to the general body of knowledge with in the discipline
Theories can be utilized by the practitioner to guide and improve their practice.
These ideas lend themselves to use in practice particularly in acute care setting
Theories must be consistent with other validated theories, laws and principles but will
leave open unanswered questions that need to be investigated .
Levines ideas seem to be consistent with other theories, laws and principles particularly
those from the humanities and sciences
Conservational Principle
Conservation of energy
1. Conservation of energy
Example:
availability of adequate rest
Maintenance of adequate nutrition
2. Conservation of structural integrity
Example:
Assist patient in ROM exercise
Maintenance of patients personal hygiene
3. Conservation of personal integrity
Recognizes the individual as one who strives for recognition, respect, self awareness,
selfhood and self determination
Example:
Recognize and protect patients space needs
4. Conservation of social integrity
Example:
Health
It is not merely healing of an afflicted part ,it is return to daily activities, selfhood and the
ability of the individual to pursue once more his or her own interest without constraints
Disease: It is unregulated and undisciplined change and must be stopped or death will
ensue
Nursing
Goal of Nursing
o To promote wholeness, realizing that every individual requires a unique and
separate cluster of activities
o The individual integrity is his abiding concern and it is the nurses responsibility
to assist him to defend and to seek its realization
o Human being make decision through prioritizing course of action
o Human being must be aware and able to contemplate objects, condition and
situation
o Human being are agents who act deliberately to attain goal
o Adaptive changes involve the whole individual
o A human being has unity in his response to the environment
o Every person possesses a unique adaptive ability based on ones life experience
which creates a unique message
o There is an order and continuity to life change is not random
o A human being respond organismically in an ever changing manner
o A theory of nursing must recognized the importance of detail of care for a single
patient with in an empiric framework that successfully describe the requirement
of the all patient
o A human being is a social animal
o A human being is an constant interaction with an ever changing society
o Change is inevitable in life
o Nursing needs existing and emerging demands of self care and dependant care
o Nursing is associated with condition of regulation of exercise or development of
capabilities of providing care
Nursing Process
o Assessment
o Trophicognosis
o Hypothesis
o Interventions
o Evaluation
Nursing Process
Assessment
Theory of redundancy
Theory of redundancy
o Untested ,speculative theory that redefined aging and everything else that has to
do with human life
o Aging is diminished availability of redundant system necessary for effective
maintenance of physical and social well being
Theory of therapeutic intention
o Goal: To seek a way of organizing nursing interventions out of the biological
realities which the nurse has to confront
o Therapeutic regimens should support the following goals:
o Facilitate healing through natural response to disease
o Provide support for a failing auto regulatory portion of the integrated system
o Restore individual integrity and well being
Theory of therapeutic intention
o Provide supportive measure to ensures comfort
o Balance a toxic risk against the threat of disease
o Manipulate diet and activity to correct metabolic imbalance and stimulate
physiological process
o Reinforce usual response to create a therapeutic changes
Uses
o Critical, acute or long term care unit
o Neonates, infant and young children, pregnant young adult and elderly care unit
o Primary health care
o OT
o Community setting
Utility of Theory
o Nursing research
o Nursing education
o Nursing administration
o Nursing practice
Nursing research
o Principles of conservation have been used for data collection in various researches
o Conservational model was used by Hanson et al.in their study of incidence and
prevalence of pressure ulcers in hospice patient
o Newport used principle of conservation of energy and social integrity for
comparing the body temperature of infants who had been placed on mothers
chest immediately after birth with those who were placed in warmer
Nursing education
o Conservational model was used as guidelines for curriculum development
o It was used to develop nursing undergraduate program at Allentown college of
St.Francis de sales, Pennsylvania
o Used in nursing education program sponsored by Kapat Holim in Israel
Nursing administration
o Taylor described an assessment guide for data collection of neurological patients
which forms basis for development of comprehensive nursing care plan and thus
evaluate nursing care
o McCall developed an assessment tool for data collection on the basis of four
conservational principles to identify nursing care needs of epileptic patients
o Family assessment tool was designed by Lynn-Mchale and Smith for families of
patient in critical care setting
Nursing practice
o Conservational model has been used for nursing practice in different settings
o Bayley discussed the care of a severely burned teenagers on the basis of four
conservational principles and discussed patients perceptual, operational and
conceptual environment
o Pond used conservation model for guiding the nursing care of homeless at a
clinic, shelters or streets
Nursing process according to Levines model
Mrs. Mona, a wife of an abusive husband, underwent a radical hysterectomy. Post
operatively has pain ,weight loss, nausea and inability to empty bladder .Patient has
history of smoking and stays in house which is less than sanitary
Assessment
o Challenges to the internal env:-weight loss, nausea, loss of reproductive ability
o Challenges to the external env:-abusive husband, insanitary condition in home
o Energy conservation:-weight loss, nausea ,pain
o Structural integrity:-threatened by surgical procedure, inability to pass urine
o Personal integrity:-not able to give birth to more children
o Social integrity:-Strained relationship with husband
Trophicognosis
o Inadequate nutritional status
o Pain
o Potential for wound and bladder infection
o Need to learn self catheterization
o Decreased self worth
o Potential for abuse
Hypothesis
o Nutritional consultation
o Teaching and return demonstration of urinary self catheterization
o Care of surgical wound
o Exploring concern regarding hysterectomy
Interventions
Energy conservation
o Provide medication for pain and nausea
o Allowing rest period
Structural integrity
o Administrating antibiotic for wound,
o Teaching self catheterization
Personal integrity
o Exploring her feeling about uterus removal while respecting her privacy
Social integrity
o Assess potential abuse form husband
o Support to the family
Organismic response
o Controlled pain
o Abdominal wound healing
o Improved appetite ,weight gain
o Clean urinary self catheterization
o Assistance from husband
Critiquing the theory
o Conservation principles
o Nursing process
Assessment
Trophicogosis
Hypothesis
Interventions
Evaluation
o Theory of redundancy
o Theory of therapeutic intention
o Utility of theory
Nursing research
Nursing education
Nursing administration
Nursing practices
References
o Timber BK. Fundamental skills and concepts in Patient Care, 7th edition, LWW.
o George B. Julia , Nursing Theories- The base for professional Nursing Practice ,
3rd ed. Norwalk, Appleton & Lange.
o Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing
Philadelphia. Lippincott Williams& wilkins.
o Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd
ed. Philadelphia, Lippincott.
o Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed.
Philadelphia, Lippincott.