levine's theory ppt levine's theory pptlevine's theory ppt

levine's theory ppt

1. M.Sc DEGREE COURSE IN NURSING
ADVANCED NURSING PRACTICE
UNIT – VI
Philosophy and Theories of Nursing
Myra Levines Conservation
Theory
DR. T.JAYADEEPA
VICE PRINCIPAL

2. MYRA LEVINES

3. INTRODUCTION
•Myra Estrin Levine (1920-1996) was born in Chicago, Illinois.
•She was the oldest of three children. She had one sister and
one brother.
•Levine developed an interest in nursing because her father
(who had gastrointestinal problems) was frequently ill and
required nursing care on many occasions.
•Levine graduated from the Cook County School of Nursing in
1944 and obtained her BS in nursing from the University of
Chicago in 1949.
•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

4. •After earning an MS in nursing at Wayne State University in 1962,
she taught nursing at many different institutions (George, 2002)
such as the University of Illinois at Chicago and Tel Aviv University
in Israel.
•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.

5. 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 (Levine, 1967). The conservation
is fundamental to the outcomes expected when the model is used,
Levine also discussed two other important concepts critical to the
use of her model – adaptation and wholeness.

6. ADAPTATION WHOLENESS CONSERVATION

7. 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 (Levine, 1966, 1989a). Adaptation is
achieved through the “frugal, economic, contained, and
controlled use of environmental resources by the individual
in his or her best interest”

8. Wholeness
•Wholeness - Levine (1973, p. 11) 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.”

9. Conservation
•Conservation, on the other hand, is the product of
adaptation. Conservation is from the Latin word
conservation, 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”.

10. Conservation
•The primary focus of conservation is keeping together of
the wholeness of the individual.
•Although nursing interventions may deal with one particular
conservation principle, nurses must also recognize the
influence of other conservation principles (Levine, 1990).

11. MAJOR CONCEPTS

12. 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” (Levine,
1973, p. 17). The person is also described as a unique
individual in unity and integrity, feeling, believing, thinking
and whole system of system.

13. ENVIRONMENT
•The environment completes the wholeness of the
individual. The individual has both an internal
and external environment.

14. INTERNAL
ENVIRONMENT
HOMEOSTASI
S
HOMEORRHESIS

15. EXTERNAL
ENVIRONMENT
PERCEPTUAL
OPERATIONA
L
CONCEPTUAL

16. HEALTH
•Health and disease are patterns of adaptive change. Health is implied to mean
unity and integrity and “is a wholeness and successful adaptation”. The health is:
“… 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.” On the other
hand, disease is “unregulated and undisciplined change and must be stopped or
death will ensue”. disease is “unregulated and undisciplined change and must be
stopped or death will ensue”.

17. NURSING
•Nursing involves engaging in “human interactions” (Levine,
1973, p.1). “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).

18. 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.

19. RESPONSES BASED ON THREE
FACTORS

20. Historicity
Historicity refers to the notion that adaptive responses are
partially based on personal and genetic past history. Each
individual is made up of a combination of personal and
genetic history, and adaptive responses are the result of
both

21. Specificity
•Specificity refers 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. Responses that are stimulated in multiple
pathways tend to be synchronized and occur in a cascade
of complimentary (or detrimental in some cases) reactions

22. Redundancy
•Redundancy describes the notion that if one system or
pathway, is unable to ensure adaptation, then another
pathway may be able to take over and complete the job.
This may be helpful when the response is corrective (e.g.,
the use of allergy shots over a lengthy period of time to
diminish the effects of severe allergies by gradually
desensitizing the immune system).

23. CONSERVATION MODEL

24. Conservation of energy
•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

25. Conservation of structural integrity
•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

26. 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

27. ASSUMPTIONS
1.1. Human being are agents who act deliberately to attain goal
2. Adaptive changes involve the whole individual
3. A human being has unity in his response to the environment
4. Every person possesses a unique adaptive ability based on
one’s life experience which creates a unique message
k.5. There is an order and continuity to life change is not random

28. ASSUMPTIONS contd……...
6. A human being respond organismically in an ever changing
manner
7. A human being is an constant interaction with an ever
changing society
8. A human being is a social animal

29. Nursing Process
•Assessment
•Trophicognosis (nursing diagnosis)
•Hypothesis
•Interventions
•Evaluation

30. Nursing Process
•Assessment:
•Internal environment: weight loss, nausea, loss of
reproductive ability .
•Externalenvironment : abusive husband, unhygienic
condition at home.
•Structuralintegrity : Threatened by surgical procedure,
inability to pass urine.
•Personal Integrity : not able to give birth to more children.
•Social integrity:strained relationship with husband.

31. Nursing Process
•Trophicognosis:
•Inadequate nutritional status.
•Pain
•Potential for wound and bladder infection.
•Need to learn self cateterization.
•Decreased self worth.
•Potential for abuse.

32. Nursing Process
•Hypothesis:
• Nutritional consultation.
•Teaching and return demonstration of urinary self
catheterization.
•Care of surgical wound.
•Exploring concern regarding hysterectemy.

33. Nursing Process
Interventions:
•Energy conservation: provide medication for pain and nausea.
•Allowing rest period.
•Structural integrity:
•Administrating antibiotic for wound.
•Teaching self catherization
•Personal integrity:
•Exploring her feeling about uterus removal while respecting her privacy.
•Social integrity:
•Assess potential abuse from husband.
•Support to family.

34. Nursing Process
•OrganismicResponse:
•Controlled pain
•Abdominal wound healing.
•Improved appetite & weight gain.
•Clean urinary self catheterization.
•Assistance from husband.

35. •How to apply this theory in to practice?

36. Levine's Theory
USES:
- Critical, acute, or long term care unit.
-Neonates, infant and young children, pregnant, youngadult,
& elderly care unit
-Primary health care.
-Operation Theatre.
-Community setting.

37. Limitation of Levine's Theory
•Limited attention can be focused on health promotion and
illness prevention.
•The major limitation is focused on individual in an illness state
& on the dependency of patient.
•If the patient,s ability to participate in the care & perception of
nurse about the ability of patient participation is mismatched
then area of conflict arises.

38. CONCLUSION
•Levine’s theory is Logical in nature.
•Relatively simple yet generalized.
•Easy to use.
•Levine’s idea can be tested.
•Conservational principle is specific enough to be tested.
•Guide & improve the practice

39. REFERENCE
1.Alligood, A., & Marriner-Tomey, A., (2002). Nursing Theorists
and Their Work. (5
th Ed.). St. Louis: Mosby.
2. Basavanthappa, BT. (2007). Nursing Theories. New
Delhi: Jaypee Brothers Publishers.
3. McEwen, M. & Wills, E. (2014). Theoretical basis for
nursing. (4
th ed.). Philadelphia: Wolters Kluwer. Lippincott
Williams & Wilkins
4.Paraska, K., & Clark, C. (2012). Health promotion in
nursing practice. Burlington, MA: Jones & Bartlett
Publisher.