NINE INSTITUTE OF NURSING COLLEGE,

PGIMER

SEMINAR ON – LEVINE’S THEORY

Submitted by: Mrs. Monika Dutta submitted by: Neeraj

M.sc nursing 1st year
 LEVINE’S THEORY

MYRA LEVINE

MILESTONES
 Myra Estrin Levine (1920-1996) was born in Chicago, illionis.
 The eldest among the three children (has 1 sister and 1 brother)
 1969/1973/1989- publication on “an introduction to clinical nursing” made a
significant contribution to the “why’s of nursing actions.
 1992-awarded as honorary doctorate from Loyola university
 1996-she died at the age of 75
EDUCATIONAL ACHIEVEMENT
 She received her diploma from the cook country school of nursing in 1944.
She obtained her bachelor of science from the university of Chicago in 1949
and her master of science in nursing from wayne state university Michigan, in
1962. After earning an MS in nursing at wayne university in1962 she authored
77 published article.
  She also received an honorary doctorate from Loyola university in 1992
 Levine told others that she did not set out to develop a “nursing theory” but
had wanted to find a way to search the major concepts in medical surgical
daily nursing activities.
 Levine developed an interest in nursing because her father (who had
gastrointestinal problems) was frequently ill and required nursing care on
many occasion.

GOAL: To promote adaptation and maintain wholeness using the principal of

conservation.
LEVINE’S WORK AND CHARACTERSTIC OF THEORY
 logical in nature
 relatively simple or yet generalized
 easy to use
 levine’s idea can be tested
 conservation principal is specific enough to be tested
 guide and improve the practice.

LEVINE CONSERVATION MODEL

 The conservation model is an esoteric model of nursing created by Myra
Levine in 1989.
 It is based around the physical concept of conservation of energy combined
with psycho-social aspects of the individual’s needs.

COMPOSITION OF CONSERVATION MODEL

o This model is focused in promoting adaptation and maintaining
wholeness
o Using the principal of conservation.
 o The model guide the nurse to focus on the influence and responses at
the organismic level .The nurse accomplish the goal of model through
the conservation of energy, structure, personal and social integrity.

CONCEPTS

Adaptation Wholeness

conservation
n

 Adaptation: It is the process of change and conservation is the outcome of

adaptation. Adaptation is the process where by a patient maintain the integrity
within the realities of environment. It is achieved through the economical and
contained and controlled use of environmental resources by the individual in his
or her best interest.
 Wholeness: It is based on Erikson (1964) description of wholeness of as an
open system. Levine’s stated that, the unceasing interaction of the individual
organism with its environment does represent an open and fluid, system and a
condition of health, wholeness, exits when the interaction or constant adaptation
to the environment, permit ease the assurance of integrity in all dimension of
life. This continuous dynamic, open interaction between the internal or external
environment provide the basis for holistic thought, the view of the individual as
whole.
 Conservation: It is the product of the adaptation. It describe the way complex
system are able to continue to function even when severely challenged.
Through conservation, individuals are able to confront obstacles and adapt
accordingly and maintain their uniqueness.
The primary focus of conservation is keeping togetherness of the wholeness of
the individual. This is through the help of nursing care and nursing
 interventions, to conserve the patient’s personal integrity, structural integrity
and conservation of energy.

FOUR MAJOR PRINCIPLES OF LEVINE CONSERVATION

MODEL:
 It balancing energy output and input to avoid excessive fatigue.
 Conservation of structural integrity maintaining or restoring the body
structure by preventing physical breakdown and promoting healing.
 Conservation pf personal integrity maintaining or restoring the patient’s
sense of identity and self -worth and acknowledging uniqueness.
 Conservation of social integrity fostering awareness that the patient is a
social being who interacts with others.

MAJOR CONCEPTS

PERSON ENVIRONMENT

HEALTH NURSING
PERSON: The person is described as a unique individual in unity and integrity,
feeling, believing, thinking and whole system of system. The wholeness of the
individual demand that the individual life has meaning only in the context of social
life.
ENVIRONMENT: The environment completes the wholeness of the individual.
The individual has both an internal or external environment. Internal environment
combines the physiological and pathological aspects of the individual and is
constantly challenged by the external environment.
The external environment is divided into perceptual, operational and conceptual
environment.
THE PERCEPTUAL ENVIRONMENT is that portion of the external environment
which individual respond to with their sense organ and include light, sound, touch,
temperature, chemical change that is smelled or tested and position sense and
balance.
THE OPERATIONAL ENVIRONMENT is interact with living tissues even
through the individual does possess sense organ that can record the presence of
these factors and include all forms of radiation, microorganisms and pollutants.
THE CONCEPTUAL ENVIRONMENT consist of language, ideas, symbols, and
concepts and inventions, the ability to think and experience emotions, value
system, religious beliefs, ethnic and cultural traditions.
HEALTH: health and disease are patterns of adaptive change. The goal of nursing
is to promote health. According to Levine heath is the avenue of return to the daily
activities compromised by ill health. It is a return of selfhood, where the
encroachment of the disability can be set aside entirely and the individual is free to
pursue his own interests without constraints.
NURSING: It involve engaging in human interactions. The nurse enters into a
partnership of human experience where sharing moments in time leaves it mark
forever on each patient. The goal of nursing is to promote adaptation and maintain
wholeness, that every individual requires a unique and separate duster of activities.

CONSERVATION MODEL
Levin conservation model explained that the way in which the person and the
environment become congruent over time. It is fit of the person with his or her
predicament of time and space. The specific adaptive responses make conservation
possible at many levels.
 Molecular
 Physiologic
 Emotional
 Psychological
 Social

These responses are based on 3 factors :

1) Historicity: It refers to the motion that adaptive response are partially based
on personal and genetic past history. Individual is made up of combination
of personal and genetic history and adaptive response are result of both.
2) Specificity: It refers to the fact that each system that makes up a human
being has unique stimulus response pathways. Responses are stimulated by
specific stressors and are task oriented.
 3) Redundancy: It describes the notion that if one system or pathway is unable
to ensure adaptation then another pathway may be able to takecover and
complete the job. This may be helpful when the response is corrective.
A change in the behaviour of the individual during an attempt to adapt to the
environmentis called as organisimic response. It help idividual to protect and
maintain their integrity. There are 4 types:
1) Flight or fight
2) Inflammatory
3) Stress
4) Perceptual

ASSUMPTIONS:
 The nurse create and environment in which healing could occur.
 Human being is respond in a predictable way.
 Human being are unique in their response.
 Human being knows and appraise objects, condition and situation.
 Human being sense, rflects reason and understand.
 Adaptive change involve the whole individual.
 A human being has unity in his response to the environment.
 There is an order and continuity to life, change is not random.
 Human being is a social animal.
 A human being is constant interaction with an over changing society.
 Human being are agents who act deliberately to attain goal.
 Changes are inevitable in life.
 Nursing need existing and emerging demand of self care and dependent care.

APPLICATION:
 Application of conservation model

APPLICATION IN NURSING RESEARCH

 Studies conduct by wong and winslow(1989) support the importance of

energy conservation for patient with myocardial infarction.
 Principle of conservation have been used for data collection in various
researches.
 Used by many researcher as a concetual framework.
APPLICATION IN NURSING EDUCATION
 It was used as guidelines for curriculum development.
 It provide a student friendly nursing theory.
  It provide an organizational structure for teaching medical surgical nursing
and stimulus for theory development.
 It can be used to develop nursing undergraduate and postgraduate programs.
APPLICATION IN NURSING PRACTICE
 It can be used in variety of setting from critical care, acute care, long term
care, community care, homeless, geriatric nursing where majority of the
elderly patient have some problems.
 It can be used with the patient across the life span.
 It can be used a sa framework for many purpose such as development of
nursing diagnose, care of cancer patients.
NURSING PROCESS:
ASSESSMENT-collection of provocative facts through observation and interview
of challenges to the internal or external environment using 4conservation
principles.
Nurse observe patient for organismic responses to illness, reads medical reports,
talk to the patient and family.
DIAGNOSIS: (TROPHICOGNOSIS)
Nursing diagnosis gove provocative factors meaning.
Judgement is made about patient’s need for assistance.

GOAL: (HYPOTHESIS)
To maintain and promoting adaptation.
Planning.
Nurse propose hypothesis about the problem and the solution which become the
plan of care.
The nurse seek validation about the problem.

INTERVENTION:
Test the hypothesis
Intervention are designed based on theconservation principles
Goal is to maintain wholeness and promoting adaptation
These are measure in which nurses would providein order for the patient to
maintain or regain his integrity.
The intervention would also be based from the conservation model.

EVALUATION:
Evaluation is the response of the client with the intervention, if the goal were met
or not.
It assesses whether hypothesis is supported or not supported.
If not supported,the plan is revised or a new hypothesis is proposed.
This is the process of validating whether he goal were attained in the given period
of time.

LIMITATION OF THE THEORY:

 Limited attention can be focused on health promotion and illness
preventions
 The major limitation is focused on individual in an ineer state and on the
dependency of the patient
 If the patient ability to participate in the care and perception of nurse about
the ability of the patient participation is mismatched then area of conflict
arise.
 Venous leg
ulceration

Compression Primary dressing

bandaging

Internal environment External environment

modified modified

Ulcer healing

Conservation of structural
integrity

Decreased physical and Decreased depression Decreased isolation

healing energy anxiety and negative self- immobility and financial
expenditure image expenditure

Conservation of Conservation of personal Conservation of social

energy integrity integrity

Conceptual framework outlining the relationship between the wound management and positive patient
outcome through Levine conservation model

Levine theory include nine model of guided assessment:

 1. Vital signs
2. Body movement and positioning
3. Personal hygiene needs
4. Pressure gradient system in nursing intervention
5. Nursing determination in provision of nutritional needs
6. Local application oh heat and cold
7. Medicine administration
8. Establishing aseptic environment
9. Pressure gradient system in nursing

BIBLIOGRAPHY: