288424199-Myra-Levine-s-Conservation-Theory.pptx

theory of theories

1. Myra Levine’s Conservation Theory

2. Myra Estrin Levine 1920 1996 (Group A, 2011 ) Introduction to Theorist

3. Education (Group A, 2011 )

4. ( Meleis , 2012 and Group A, 2011 ) Experience

5. Beliefs Theory should influence practice Acceptable use of adjunct science Conservation came from physics Patients give up independence when they enter health-care environment and should regain it when they leave (Levine, 1989, Levine, 1990, and Levine, 1996 )

6. Theory Beginnings Began as nursing curriculum Gives rationale behind nursing actions Goals: Teach problem solving skills Teach individualized patient care Avoid procedure-oriented methods (Group A, 2011 )

7. Internal environment adapts to external environmental cues through conservation so that person maintains integrity Conservation Theory (Levine, 1969, Levine, 1989, Levine, 1990, Levine 1996 Levine, 1996 )

8. Internal Environment (Levine, 1996 )

9. External Environment (Levine, 1989 )

10. Adaptation Process of interacting with environment Process of change or of life Can be equated with Homeostasis Stability Equilibrium Balance (Levine, 1989 and Levine, 1990)

11. Three Parts of Adaptation (Levine, 1989 and Levine, 1996 )

12. Types of responses (Levine, 1989 )

13. Conservation Product of adaptation Is how a system sustains itself even when challenged Can be equated with a thermostat Negative feedback systems Efficient use of energy Goal of conservation is health (Levine, 1989, Levine, 1990, and Levine, 1996)

14. (Levine, 1990 and Levine, 1996) Principles of Conservation

15. Integrity Same root as health and whole Independence Control over own life (Levine, 1990 and Levine, 1996 )

16. (Levine, 1969, Levine, 1989, Levine, 1990, Levine 1996 Levine, 1996 )

17. Nurse’s Role in Supporting Adaptation (Levine, 1969 ) Therapeutically Encourages favorable adaptation Supportively Maintains status quo cannot prevent decline

18. Interventions based on principles of conservation (Levine,, 1989 and Levine 1990 )

19. Example Bed bath conserves energy and promotes structural integrity The nurse also must look at personal integrity (privacy) and social integrity (visitors present) Can intervention be timed differently or done in a way to encourage conservation principles in ALL areas? (Levine, 1990 )

20. Internal environment adapts to external environmental cues through conservation so that person maintains integrity (Levine, 1969, Levine, 1989, Levine, 1990, Levine 1996 Levine, 1996 )

21. Critique of Theory ( Meleis , 2012 )

22. Purpose Describes rationale for nursing actions Written for hospital-based nursing, but can apply to all patient-care situations (Group A, 2011 and Levine, 1990 )

23. Concepts Person Viewed holistically As having integrity Environment Internal and external Internal environment adapts External environment is manipulated Health Fitting into external environment through adaptation Integrity Wholeness Nursing Duty is to promote wholeness and adaptation Uses conservation principles to plan interventions Must use thorough observation and scientific method to arrive at nursing actions.

24. Definitions Specific definitions already covered in detail Internal environment External environment Adaptation Conservation Integrity Multiple definitions derived from Latin/Greek roots Author was very careful in word selection Patient vs. client Integrity (Levine, 1991 and Levine, 1996 )

25. Relationships Concepts are well related Patient’s internal environment adapts to external environmental cues through conservation so that person maintains integrity (Levine, 1969, Levine, 1989, Levine, 1990, Levine 1996 Levine, 1996 )

26. Structure Concepts are divided into subcomponents All concepts move toward end goal—integrity Does not lie in a linear fashion, rather ongoing process of events No internal diagram Has been depicted as mandala art

27. Assumptions Assumptions are implicit Values a patient-centered approach Patient is to be viewed as a whole Patient interacts with environment Nurse is provider of care Nurse is an active participant in patient’s environment Disease is a disruption which must be adapted to (Glass, 1989)

28. Clarity and Simplicity Well organized, easy to read, flows logically All concepts are divided and clearly defined Language is consistent throughout Succeeds in giving nurse rationale for interventions

29. Generalizability Broad purpose Theory applies to all people. Used with multiple patient populations Used in multiple settings

30. Importance Supported with empirical data Results can be generalized to other populations Forward-looking theory for time written Many writings address current issues noncompliant patients (Levine, 1970) healthcare costs (Levine, 1969) May be able to look at issues in a renewed light (Levine, 1969, and Levine, 1970)

31. Contributions to Nursing/Healthcare Provided nursing with a systematic way to view patient holistically and intervene accordingly Advocated for use of scientific process in nursing Now called…Evidence Based Practice

32. Application to Care for Fatigue According to Levine, fatigue is a manifestation of the body trying to heal itself. Effects of exercise on fatigue during cancer treatment Conservation principles addressed and measured during treatment Theory of Conservation determined to be effective model for study design Description of fatigue in congestive heart failure patients Fatigue described by patients Nursing interventions developed based on Conservation principles to foster adaptation and maintain wholeness of patient (Mock et. al., 2007 and Schaefer & Shober , 1993 )

33. Nurse Consistency Effect of nurse consistency during NICU stay on patient outcomes ( Mefford & Alligood , 2011) Consistent nurse more familiar with patient’s unique patterns of adaptation and tailor interventions accordingly Consistency has positive impact on length of stay and patient outcomes Translates to other areas of care ( Mefford & Alligood , 2011 )

34. Personal Evaluation Overall like theory and viewing patient holistically Being familiar with theory has allowed insight into patient behavioral reactions—and allowed improved interventions Reminds nurse to care for the person