TFN 5

• Myra E. Levine's Conservation Model


  Nursing is a human interaction that promotes adaptation and maintains wholeness either by acting in the therapeutic sense or by providing supportive care in order to influence adaptation favorably, or toward renewed social wellbeing
• Myra E. Levine's Conservation Model

  • Focused on the preservation of the individual's wholeness or totality
  • Nursing activities were conservation activities, a keeping together function that promotes wholeness in the patient
• Myra E. Levine's Four Principles

  • Conservation of Energy
  • Conservation of Structural Integrity
  • Conservation of Personal Integrity
  • Conservation of Social Integrity
• Conservation


  • Describes the way complex systems are able to continue to function even when severely challenged
  • It is through conservation that man is able to confront obstacles, adapt accordingly, and maintain their uniqueness and individuality
• Wholeness


  • Emphasizes a sound, organic, progressive, mutuality between diversified functions and parts within an entirety, the boundaries of which are open and fluent
  • It connotes integrity - the oneness of persons, highlighting their capacity to respond in an integrated and singular fashion to environmental challenges
• Adaptation


  • The process of change wherein the person is able to keep his integrity within situations and circumstances of his environment, both internal and external
  • It is the bridge; the process by which individuals fit the environments in which they live
  • Health and disease are patterns of adaptive change
  • The goal of adaptive change is the conservation of wholeness (health) and integrity
• Environment

  • Internal environment - composed of the physiologic and pathophysiologic domains of the person
  • External environment has three levels: Perceptual level, Operational level, Conceptual level
• Organismic response


  Refers to the person's ability to adapt to his or her environment and is made up of four levels of integration: Fight or flight, Inflammatory response, Response to stress, Perceptual awareness / Sensory response
• Trophicognosis


  A scientific method of reaching a nursing care judgment; an alternative recommendation of Levine to Nursing Diagnosis
• Person


  This refers to holistic being; wholeness is integrity. Integrity means a person has a freedom of choice and movement
• Health


  This is the ability to function in a reasonable manner
• Environment


  This is not a passive backdrop, the individual actively participates in his environment. The process of interaction is adaptation
• Martha E. Roger's Science of Unitary Human Being Conceptual Model


  Nursing is an art and science that seeks to promote symphonic interaction between the environment and man, to strengthen the coherence and integrity of the human beings, and to direct and redirect patterns of interaction between man and his environment for the realization of maximum health potential
• Wholeness


  Refers to the state in which the human being is regarded as a unified whole which is more than and different from the sum of the parts
• Openness


  Where the individual and the environment are continuously exchanging matter and energy with each other
• Open systems (openness)


  Describe the open nature of the fields, the preferred terminology being that there is a "continuous process" without the mention of energy or matter
•  Conservation of Energy  – all physiologic and psychological 

  processes that 

  sustain life depend on the body’s energy balance 

  ✔ adjusting to life in the nursing home 

  ✔ improving nutritional status, balancing resident activity 

  ✔ controlling resident anxiety and pain.
•  Conservation of Structural Integrity – all body systems 

  decline with aging; chronic illness also produces bodily 

  structural changes 

  ✔ maintaining or promoting mobility 

  ✔ preventing injury 

  ✔ preventing infection 

  ✔ maintaining skin integrity
•  Conservation of Personal Integrity – self-identity is intrinsically 

  bound to wholeness and all individuals cherish the 

  sense of self; it includes recognition of the holiness of each person 

  ✔ respecting one’s privacy and property 

  ✔ enhancing self-esteem through good personal hygiene, grooming 

  and dressing 

  ✔ fostering independence through choice and rehabilitation 

  ✔ promoting self-identity for those who are cognitively impaired 

  ✔ obtaining advance directives for treatment 
•  Conservation of Social Integrity – individual life has meaning only 

  in the context of social life 

  ✔ providing meaningful social activities for residents and staff, 

  considering the family and resident as a unit describes the way complex systems are able to continue to function even when severely challenged 

  → it is through conservation that man is able to confront obstacles, adapt accordingly, and maintain their uniqueness and individuality, from Latin word conservation which means “to keep together” 
• the result of adaptation is conservation which has 3 characteristics: 

  ✔ Historicity – patterned responses passed on through genetics 

  ✔ Specificity – unique adaptive responses to specific environmental challenges 

  ✔ Redundancy – availability of multiple adaptive responses
• Levine suggests “the possibility exists that aging itself is a consequence of failed redundancy of physiological and psychological processes”
• Perceptual level – includes all aspects of the world wherein the person is able to intercept and interpret with his sense organs. 
• 2. Operational level – refers to things that physically affect the individual but may not be perceived by the individual himself. An example of these are microorganisms. We can get an infection because of a microorganism but we cannot really perceive what a microorganism really is.
• 3. Conceptual level – the environment is the product of cultural patterns, characterized by spirituality, and moderated by language, history, and thought.
• Fight or flight


  The most primitive response; the person either "fights" or "flies away" from a perceived stressor in order to ensure his own safety and well-being
• Inflammatory response


  Body defense mechanism that protects the body tissue from insults in an unfriendly environment
• Response to stress


  Refers to the wear and tear of body tissues that reflect the body's continued response and adaptation to stressful situations; it is characterized by irreversibility and influences the way the patients respond to nursing care
• Perceptual awareness / Sensory response


  It occurs as the person experiences life and the world around him; individuals are constantly immersed in an environmental background of sensory input that never cases, even during sleep, prompts to maintain safety and seek wholeness
• Nursing (Myra E. Levine's): 'Nursing intervention must be founded not only on scientific knowledge, but specifically on recognition of the individual's behavioral responses which indicate the nature of the adaptation taking place.'
• Person (Myra E. Levine's)


  This refers to holistic being; wholeness is integrity. Integrity means a person has a freedom of choice and movement. The word patient comes from the Latin "to suffer" while the word client comes from Latin means "to follow".
• Health (Myra E. Levine's)


  This is the ability to function in a reasonable manner
• Environment (Myra E. Levine's)


  This is not a passive backdrop, the individual actively participates in his environment. The process of interaction is adaptation.
• KATIE ERIKSSON'S (CARITATIVE CARING THEORY ): 'Nursing is an art and science that seeks to promote symphonic interaction between the environment and man, to strengthen the coherence and integrity of the human beings, and to direct and redirect patterns of interaction between man and his environment for the realization of maximum health potential.'
• Four "critical elements" that are basic in the theory: CARITATIVE CARING THEORY

  • Energy fields
  • Open system
  • Pattern
  • Pan-dimensionality – was previously known as multidimensionality, and prior to that, four dimensionality
• Wholeness


  Refers to the state in which the human being is regarded as a unified whole which is more than and different from the sum of the parts
• Openness


  Where the individual and the environment are continuously exchanging matter and energy with each other
• Open systems (openness)


  Describe the open nature of the fields, the preferred terminology being that there is a "continuous process" without the mention of energy or matter
• Unidirectionality


  Refers to where the life process exists along an irreversible space time continuum
• Pattern and organization


  Identify individuals and reflect their innovative wholeness