Research article

LEVINE’S THEORY

PRESENTED BY : PRAMOD KUMAR

INTRODUCTION • Myra Estrin Levine (1920-1996) was born in

Chicago, Illinois.

---Levine developed an interest in nursing

because her father (who had gastrointestinal

problems) was frequently ill and required

nursing care on many occasions.

INTRODUCTION contd......

---Levine graduated from the Cook County School of

Nursing in 1944 and obtained her BS in nursing

from the University of Chicagoin1949.

---Following graduation, Levine worked as a private

duty nurse, as a civilian nurse for the US Army, as

a surgical nursing supervisor, and in nursing

administration

INTRODUCTION contd......

---After earning an MS in nursing at

Wayne State University in 1962

---She authored 77 published articles

which included “An Introduction to Clinical

Nursing” with multiple publication years on

1969, 1973 & 1989.

---She also received an honorary

doctorate from Loyola University in 1992.

She died on 1996.

• Levine told others that she did not set out

to develop a “nursing theory” but had

wanted to find a way to teach the major

concepts in medical-surgical nursing and

attempt to teach associate degree

students a new approach for daily nursing

activities. Levine also wished to move

away from nursing education practices

that were strongly procedurally oriented

and refocus on active problem solving

and individualized patient care (George,

2002).

COMPOSITION OF CONSERVATION MODEL :

• Levine’s Conservation Model is focused in

promoting adaptation and maintaining wholeness

using the principles of conservation. The model

guides the nurse to focus on the influences and

responses at the organismic level. The nurse

accomplishes the goals of the model through the

conservation of energy, structure, and personal and

social integrity .

ADAPTATION WHOLENESS CONSERVATION

ADAPTATION • Adaptation is the process of change,

and conservation is the outcome of

adaptation. Adaptation is the process

whereby the patient maintains integrity

within the realities of the environment.

WHOLENESS

• Levine 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, exists when the interaction or

constant adaptations to the environment,

permit ease—the assurance of integrity…in

all the dimensions of life.”

CONSERVATION • the product of adaptation. Conservation is from the

Latin word conservatio, meaning “to keep together” .

“Conservation describes the way complex systems are

able to continue to function even when severely

challenged.”Through conservation, individuals are

able to confront obstacles, adapt accordingly, and

maintain their uniqueness. “The goal of conservation

is health and the strength to confront disability” as “...

the rules of conservation and integrity hold” in all

situation in which nursing is requires”.

The primary focus of conservation is keeping

together of the wholeness of the individual.

Although nursing interventions may deal with

one particualr conservation principle, nurses

must also recognize the influence of other

conservation principles (Levine, 1990).

META PARADIGM

PERSON The person is a holistic being who constantly strives

to preserve wholeness and integrity and one “who

is sentient, thinking, future-oriented, and past-

aware.” The wholeness (integrity) of the individual

demands that the “individual life has meaning only

in the context of social life” The person is also

described as a unique individual in unity and

integrity, feeling, believing, thinking and whole

system of system.

ENVIRONMENT • The environment completes the wholeness of the

individual. The individual has both an internal and

external environment.

INTERNAL ENVIRONMENT

HOMEOSTASIS HOMEORRHESIS

EXTERNAL ENVIRONMENT

PERCEPTUAL

OPERATIONAL

CONCEPTUAL

HEALTH

Levine (1991) clarified what she meant by health as: “…

the avenue of return to the daily activities

compromised by ill health. It is not only the insult or

the injury that is repaired but the person himself or

herself… It is not merely the healing of an afflicted

part. It is rather a return to self hood, where the

encroachment of the disability can be set aside

entirely, and the individual is free to pursue once more

his or her own interests without constraint.”

• disease is “unregulated and

undisciplined change and must be

stopped or death will ensue”.

NURSING Nursing involves engaging in

“human interactions” “The

nurse enters into a

partnership of human

experience where sharing

moments in time—some

trivial, some dramatic—leaves

its mark forever on each

patient”. The goal of nursing

is to promote adaptation and

maintain wholeness (health).

PERSON AND ENVIRONMENT:

• person and the environment become

congruent over time. It is the fit of the

person with his or her predicament of

time and space. The specific adaptive

responses make conservation possible

occur on many levels; molecular,

physiologic, emotional, psychologic, and

social.

RESPONSES BASED ON THREE FACTORS:

CONSERVATION MODEL

CONSERVATION OF ENERGY:

• Refers to balancing energy input and output to

avoid excessive fatigue. It includes adequate rest,

nutrition and exercise.

• Examples: Availability of adequate rest;

Maintenance of adequate nutrition

CONSERVATION OF STRUCTURAL INTEGRITY: • Refers to maintaining or restoring the structure of

body preventing physical breakdown and promoting

healing.

Examples: Assist patient in ROM exercise;

Maintenance of patient’s personal hygiene

CONSERVATION OF PERSONAL INTEGRITY

• Recognizes the individual as one

who strives for recognition,

respect, self awareness,

selfhood and self determination.

Example: Recognize and protect

patient’s space needs

ASSUMPTIONS a. The nurse creates an environment in which

healing could occur

b. A human being is more than the sum of the

part

c. Human being respond in a predictable way

d. Human being are unique in their responses

e. Human being know and appraise objects

,condition and situation

CONSERVATION OF SOCIAL INTEGRITY:

• An individual is recognized

as some one who resides

with in a family,: a

community, a religious group,

an ethnic group, a political

system and a nation.

Example: Help the individual

to preserve his or her place

in a family, community, and

society.

ASSUMPTIONS contd……...

f. Human being sense ,reflects, reason and understand

g. Human being action are self determined even when

emotional

h. Human being are capable of prolonging reflection

through such strategists raising question

i.Human being make decision through prioritizing

course of action

j. Human being must be aware and able to

contemplate objects, condition and situation

ASSUMPTIONS contd……...

k. Human being are agents who act deliberately to attain

goal

l. Adaptive changes involve the whole individual

m. A human being has unity in his response to the

environment

n. Every person possesses a unique adaptive ability

based on one’s life experience which creates a unique

message

o. There is an order and continuity to life change is not

random

ASSUMPTIONS contd……...

p. A human being respond organismically in an

ever changing manner

q. 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

r. A human being is a social animal

ASSUMPTIONS contd……...

s. A human being is an constant interaction

with an ever changing society

t. Change is inevitable in life. Nursing needs

existing and emerging demands of self care

and dependant carev. Nursing is associated

with condition of regulation of exercise or

development of capabilities of providing care.