Conservation Theory
Paradigm
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, personal and social integrity (Levine, 1967). Although 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.
• Adaptation
Adaptation is the process of change, and conservation is the outcome of adaptation. “Adaptation is a process of change whereby the individual retains his integrity within the realities of his internal and external environment” (Levine, 1973, p. 11). Conservation is the outcome. Some adaptation are successful and some are not. Adaptation is achieved through the “frugal, economic, contained, and controlled use of environmental resources by the individual in his or her best interest” (Levine, 1991, p. 5).
• Wholeness (Holism)
Wholeness is based on Erikson’s (1964, p. 63) description of wholeness as an open system: “Wholeness emphasizes a sound, organic, progressive mutuality between diversified functions and parts within an entirety, the boundaries of which are open and fluid.” 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.” This continuous dynamic, open interaction between the internal and external environment provides the basis for holistic thought, the view of the individual as whole.
• Conservation
Conservations is from the Latin word conservatio, meaning “to keep together” (Levine, 1973). “Conservation describes the way complex system are able to continue to function even when severely challenged” (Levine, 1990, p. 192). Through conservation, individuals are able to confront abstacles, adapt accordingly, and maintain their uniqueness. “The goal of conservation is health andthe strength to confront disability” as “...the rules of conservation and integrity hold” in all situations in which nursing is required (Levine, 1973, p. 193-195). The primary focus of conservation is keeping together of the wholeness of the individual. Although nursig interventions may deal with one particular conservation principle, nurses must also recognize the influence of the other conservation principles (Levine, 1990).
Levine’s (1973) model stresses nursing interactions and interventions that are intended to promote adaptation and maintain wholeness. Theseinteration based on the scientific background af te conservation principles. Conservation focuses on achieving a balance of energy supply anddemand within the biological realities unique to the individual. Nursing care is based on scientific knowledge and nursing skill. There are four conservation principles.
Description of The Theory
The core, or central concept, of Levine’s theory is conservation (Levine, 1989). When a person is in a state of conservation, it means that individual adaptive responses conform change productively, and with the least expenditure of effort, while preserving optimal function and identity. Conservation is achieved through successful activation of adaptive pathways and behaviors that are appropriate for the wide range of responses required by functioning human beings.
Myra Levine described the Four Conservation Principles. These principles focus on conserving an individual's wholeness. She advocated that nursing is a human interaction and proposed four conservation principles of nursing which are concerned with the unity and integrity of individuals. Her framework includes: energy, structural integrity, personal integrity, and social integrity.
• Conservation of Energy
The individual requires a balance of energy and a constant renewal of energy to maintain life activities. Processes such as healing and aging challenge that energy. This second law of thermodynamics applies to everything in the universe, including people.
Conservation of energy has long been used in nursing practice even with the most basic procedures. Nursing interventions “scaled to the individual’s ability are dependent upon providing care that makes the least additional demand possible” (Levine, 1990, pp. 197-198).
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 Interity
Healing is a process of restoring structural and functional integrity through conservation in defense of wholeness (Levine, 1991). The disabled are guided to a new level of adaptation (Levine, 1996). Nurses can limit the amount of tissue involved in disease by early recognition of functional changes and by nursing interventions.
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
Self-worth and a sense of identity are important. The most vulnerable become patients. This begins with the erosion of privacy and the creation of anxiety. Nurses can show patiens respect by calling them by name, respecting their wishes, valuing personal possessions, providing privacy during procedures, supporting their defenses, and teaching them. “The nurse’s goal ia always to impart knowledge and strenght so that the individual can resume a private life no longer a patient, no longer dependent” (Levine, 1990, p. 199). The sanctity of life is manifested in all people. “The conservational of personal integrity includes recognition of the holiness of each person” (Levine, 1996, p. 40).
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.
• Conservation of Social Integrity
Life gains meaning through social communities and health is socially determined. Nurses fulfill professional roles, provide for family members, assist with religious needs, and use interpersonal relationships to conserve social integrity (Levine, 1967b; 1969a).
Conservation of social integrityAn 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.
Metaparadigm
Over the years, nurses (like Myra Levine) have developed various theories that provide different explanations of the nursing discipline. Like her Conservation Model, all theories share four central or major concepts: person, environment, nursing and health. In addition to this, Levine’s Model also discussed that person and environment merge or become congruent over time, as it will be discussed below.
• Person
Person is described as a holistic being who constantly strives to preserve wholeness and integrity and one “who is sentiment, 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). Integrity means that the person has freedom of choice and movement. The person has a sense of identity and self-worth. The person is also described as a unique individual in unity and integrity, feeling, believing, thinking and whole system of system. Persons experience life as change through adaptaion with the goal of conservation. According to Levine (1989), “The life process is the process of change” (p. 326).
• Environmnet
Environment is conceptualized as the context in which individuals live their lives. The environment completes the wholeness of the individual. The individual has both an internal and external environment.
The internal environment combines the physiological and pathophysiological aspects of the individual and is constantly challenged by the external environment. The internal environment also is the integration of bodily functions that resembles homeorrhesis rather than homeostasis and is subject to challenges of the external environment, which always are a form of energy.
Homeostasis is a state of energy sparing that also provides the necessary baselines for a multitude of synchronized physiological and psychological factors, while homeorrhesis is a stabilized flow rather than a static state. The internal environment emphasizes the fluidity of change within a space-time continuum. It describe the pattern of adaptation, which permit the individual’s body to sustain its well being with the vast changes which encroach upon it from the environment.
The external environment is divided into the perceptual, operational, and conceptual environments. The perceptual environment is that portion of the external environment which individuals respond to with their sense organs and includes light, sound, touch, temperature, chemical change that is smelled or tasted, and position sense and balance. The operational environment is that portion of the external environment which interacts with living tissue even though the individual does not possess sensory organs that can record the presence of these factors and includes all forms of radiation, microorganisms, and pollutants. In other words, these elements may physically affect individuals but are not perceived by the latter. The conceptual environment is that portion of the external environment that consists of language, ideas, symbols, and concepts and inventions and encompasses the exchange of language, the ability to think and experience emotion, value systems, religious beliefs, ethnic and cultural traditions, and individual psychological patterns that come from life experiences.
• Health
Health is socially determined by the ability to function in a reasonably normal manner (Levine, 1969b). Social groups predetermine health. Health is not just an absence of pathological conditions. Health is the return to self; individuals are free and able to pursue their own interests within the context of their own resources. Levine stressed the following:
It is important to keep in mind the health is also culturally determined it is not an entity on its own, but rather a definition imparted by the ethos and beliefs of the group to which individuals belong. (M. Levine, personal communication, February 21, 1995)
Even for a single individual, the definition of health will change over time. Health is implied to mean unity and integrity and “is a wholeness and successful adaptation”. The goal of nursing is to promote health. Levine (1991, p. 4) 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.” On the other hand, disease is “unregulated and undisciplined change and must be stopped or death will ensue”.
• Nursing
Levine (1973) stated the following about nursing:
Nursing is human interaction. (p. 1)
Professional nursing should be reserved for those few who can complete a graduate program as demanding as the expected of professionals in any other discipline.... There will be very few professional nurse. (Levine, 1965, p. 214)
Nursing practice is based on nursings unique knowledge and the scientific knowledge of other disciplines adjuctive to nursing knowledge (Levine, 1988b), as follows:
It is the nurse’s task to bring a body of scientific principles, on which decision depend, into the precise situation which she shares with the patient. Sensitive observation and the selection ofthe relevan data from the basic f her assesment for his nursing requirements.
The nurse participates actively in every patient’s environment and much of what she does supports his adjustments as he struggles in the predicament of illnes. (Levine, 1966, p. 2452)
The essence of Levine’s theory is as follows:
... when nursing intervention influence adaptation favorably, or toward renewed social well being, then the nurse is acting in a therapeutic sence; when the response is unfavorable, the nurse provides support care (1966b, p. 2450). “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” (Levine, 1977, p. 845). The goal of nursing is to promote adaptation and maintain wholeness. (1971b, p. 258)
REFERENCES
Bautista J.N. (2008). Theoretical Foundation of Nursing (1st ed). A Beginner’s Journey Into Professional Nursing. Manila: Educational Publishing House.
Edward Christopher. (2007). Myra Levine. Retrieved July 7,2010 from http://www.enursescribe.com/levine.php#Websites
Gemilene F. et al., (2009). Myra Levine's Conservation Theory. Retrieved July 7,2010 from http://nursingtheories.blogspot.com/2009/7/myra-levines-conservation-theory.html
Mandala. (2010). Theories about Broad Nursing Practice Areas: Grand Theories Myra Estrine Levine’s Conservation Model. Jones and Bartlett Publisher. Retrive from http//:nursing.jbpub.com/sitzman/artGallery.cfm on July 17, 2010.
McEwen M. & Wills E. M. (2006). Theoretical BasicFor Nursing (2nd ed). Philadelphia: Lippincott Williams & Wilkins.
Taber’s cyclopedic Medical Dictionary 21st ed. (2009). Myra Levine's Conservation Model. Retrieved from http://www.tabers.com on July 7,2010
Tomey A. M. & Alligood M. R. (2008). Nursing Theorists and Their Work (6th ed). Elsevier Health Sciences.
