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Levine’s Conservation Model Paper

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This was the reason of choosing | |nursing as a career | |Also called as renaissance women-highly principled, remarkable| |and committed to patient’s quality of care | |Died in 1996 | | | |EDUCATIONAL BACKGROUND | |Diploma in nursing:-Cook county SON, Chicago, 1944 | |BSN:-University of Chicago,1949 | |MSN:-Wayne state University, Detroit, 1962 | |Publication:-An Introduction to Clinical Nursing, 1969,1973 & | |1989 | |Received honorary doctorate from Loyola University in 1992 | | | |CONSERVATION THEORY | | | |Central Theme: Empahasis is on the ill person in the | |healthcare setting; describes detailed nursing skills and | |actions | | | |Composition of Conservation Model | | | | | |1. Conservational model | |Goal: To promote adaptation and maintain wholeness using the | |principles of conservation | |2. Adaptation | |An ongoing process of change in which patient maintains his | |integrity within the realities of environment | |3. Wholeness | |Emphasizes a sound, organic, progressive, mutuality between | |diversified functions and parts within the entirety, the | |boundaries of which are open and fluid. |Exist when the interaction or constant adaptations to the | |environment permits the assurance of integrity | |Promoted by use of conservation principle | |4. Conservation | |The product of adaptation | |”Keeping together “of the life systems or the wholeness of the| |individual | |Achieving a balance of energy supply and demand that is within| |the unique biological realities of the individual | |Nursing’s paradigm/ Major Concepts | |1. Person | |A unique individual in unity and integrity, feeling, | |believing, thinking and whole system of system | |2.Environment | |Competes the wholeness of person | |Internal Environment | |Homeostasis: A state of energy sparing that also provide the | |necessary baselines for a multitude of synchronized | |physiological and psychological factors | |A state of conservation | |Homeorrhesis: A stabilized flow rather than a static state | |Emphasis the fluidity of change within a space-time continuum | |External Environment | |Preconceptual: Aspect of the world that individual are able to| |intercept | |Operational: Elements that may physically affects individuals | |but not perceived (e. g. adiation, micro-organism and | |pollution) | |Conceptual: Part of person’s environment including cultural | |patterns characterized by spiritual existence, ideas, values, | |beliefs and tradition | |3. Person and environment | |Adaptation | |Characteristics: | |Historicity: Adaptations are grounded in history and await the| |challenges to which they respond | |Specificity: Individual responses and their adaptive pattern | |varies on the base of specific genetic structure | |Redundancy: Safe and fail options vailable to the individual | |to ensure continued adaptation | |Organismic response | |A change in behavior of an individual during an attempt to | |adapt to the environment | | | |There are four types: | |1. Flight or fight: An instantaneous response to real or | |imagined threat, most primitive response | |2. Inflammatory: response intended to provide for structural | |integrity and the promotion of healing | |3.Stress: Response developed over time and influenced by | |each stressful experience encountered by person | |4. Perceptual: Involves gathering information from the | |environment and converting it in to a meaning experience | |4. Health and Disease | |Health is a wholeness and successful adaptation | |It is not merely healing of an afflicted part ,it is return to| |daily activities, selfhood and the ability of the individual | |to pursue once more his or her own interest without | |constraints | |Disease: It is unregulated and undisciplined change and must | |be stopped or death will ensue | |5.Nursing | |The human interaction relying on communication ,rooted in the | |organic dependency of the individual human being in his | |relationships with other human beings | |Nursing involves engaging in “human interactions” | |Goal of Nursing | |To promote wholeness, realizing that every individual requires| |a unique and separate cluster of activities | |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 | |Conservational models | |Conservational model provides the basis for development of two| |theories | |Theory of redundancy | |Theory of therapeutic intention | |1) Theory of redundancy | |Untested ,speculative theory that redefined ging and | |everything else that has to do with human life | |Aging is diminished availability of redundant system necessary| |for effective maintenance of physical and social well being | |2) Theory of therapeutic intention | |Goal: To seek a way of organizing nursing interventions out of| |the biological realities which the nurse has to confront | |Therapeutic regimens should support the following goals: | |Facilitate healing through natural response to disease | |Provide support for a failing auto regulatory portion of the | |integrated system | |Restore individual integrity and well being | |Provide supportive measure to ensures comfort | |Balance a toxic risk against the threat of disease | |Manipulate diet and activity to correct metabolic imbalance | |and stimulate physiological process | |Reinforce usual response to create a therapeutic changes | |Conservational Principle | |1.Conservation of energy | |Refers to balancing energy input and output to avoid excessive| |fatigue | |includes adequate rest, nutrition and exercise | |Example: Availability of adequate rest | |Maintenance of adequate nutrition | |2. Conservation of structural integrity | |Refers to maintaining or restoring the structure of body | |preventing physical breakdown And promoting healing | |Example: Assist patient in ROM exercise | |Maintenance of patient’s personal hygiene | |3.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 | |4. 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: | |Position patient in bed to foster social interaction with | |other patients | |Avoid sensory deprivation | |Promote patient’s use of news paper, magazines, radio.TV | |Provide support and assistance to family | |Nine models of guided assessment | |Vital’s signs | |Body movement and positioning | |Ministration of personal hygiene needs | |Pressure gradient system in nursing interventions | |Nursing determination in provision of nutritional needs | |Pressure gradient system in nursing | |Local application of heat and cold | |Administration of medicine | |Establishing an aseptic environment | |Assumption | |The nurse creates an environment in which healing could occur | |A human being is more than the sum of the part | |Human beings respond in a predictable way | |Human beings are unique in their responses | |Human beings know and appraise objects ,condition and | |situation | |Human beings sense ,reflects, reason and understand | |human beings action are self determined even when emotional | |Human beings are capable of prolonging reflection through such| |strategists raising questions | |A human being has unity in his response to the environment | |There is an order and continuity to life change is not random | |A human being respond organismically in an ever changing | |manner | |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 | |A human being is a social animal | |A human being is an constant interaction with an ever changing| |society | |Change is inevitable in life | |Nursing Process | |Assessment | |Collection of provocative facts through observation and | |interview of challenges to the internal and external | |environment using four conservation principles | |Trophicognosis | Nursing diagnosis- gives provocative facts meaning | |Judgment is made about patient’s needs for assistance | |Hypothesis | |Planning | |Nurse proposes hypothesis about the problems and the solutions| |which becomes the plan of care | |Interventions | |Testing the hypothesis | |Interventions are designed based on the conservation | |principles | |Evaluation | |Observation of organismic response to interventions | |It is assesses whether hypothesis is supported or not | |supported | |If not supported, plan is revised, new hypothesis is proposed | |Uses | |Critical, acute or long term care unit | |Neonates, infant and young children, pregnant young adult and | |elderly care unit | |Primary health care | |Community setting | |Implication | |a) Nursing | |The patient is the center of nursing activities, with nursing | |care provided based on four conservation principles to help | |patients adapt to their environment | |Nursing needs existing and emerging demands of self care and | |dependent care | |Nursing is associated with condition of regulation of exercise| |or development of capabilities of providing care | |b) Person | |Person is referred to as a holistic being who constantly | |strives to preserve wholeness and integrity.A person should | |strive to achieve or maintain his integrity within the | |realities of environment | |The individual integrity is his abiding concern and it is the | |nurse’s responsibility to assist him to defend and to seek its| |realization | |Every person possesses a unique adaptive ability based on | |one’s life experience which creates a unique message | |c) Society | |Society relates to environment, which has been defined as the | |one who competes the wholeness of person. Person should | |attempt to adapt to his/ her changing environment to achieve | |homeostasis using the four conservation principles. | |Strengths | |More comprehensive view incorporating total patient care | |Organized in such a way as to be sequential and logical. They | |can be used to explain the consequences of nursing action | |Simple yet generalizable. | |Easy to use . |It’s major elements are easily comprehensible and the | |relationship have the potential for being complex but are | |easily manageable | |Levine’s idea can be tested | |The principle of conservation are specific enough to be | |testable | |Levine’s ideas seem to be consistent with other theories, laws| |and principles particularly those from the humanities and | |sciences | |Limitations | |Not yet been widely researched | |Hard to determine the contribution to the general body of | |knowledge within the discipline | |Limited attention can be focused on health promotion and | |illness prevention. | |Nurse has the responsibility for determining the patient | |ability to participate in the care ,and if the perception of | |nurse and patient about the patient ability to participate in | |care don’t match, this mismatch will be an area of conflict. | |The major limitation is the focus on individual in an illness | |state and on the dependency of patient. | Summary Levine expressed the view that within the nurse-patient relationship a patient’s state of health is dependent on the nurse-supported process of adaptation
• This guides nurses to focus on the influences and responses of a client to promote wholeness through the Conservation Principles
• The goal of this model is to accomplish this through the conservation of energy, structural, personal and social integrity
• The goal of nursing is to recognize, assist, promote, and support adaptive processes that benefit the patient. SAMPLE CASE: Mrs. MN, a wife of an abusive husband, underwent a radical hysterectomy. Post operatively has pain ,weight loss, nausea and inability to empty bladder . Patient has history of smoking and stays in house which is less than sanitaryAssessment
• Challenges to the internal env:-weight loss, nausea, loss of reproductive ability
• Challenges to the external env:-abusive husband, insanitary condition in home
• Energy conservation:-weight loss, nausea ,pain
• Structural integrity:-threatened by surgical procedure, inability to pass urine
• Personal integrity:-not able to give birth to more children
• Social integrity:-Strained relationship with husband Trophicognosis
• Inadequate nutritional status
• Pain
• Potential for wound and bladder infection
• Need to learn self catheterization
• Decreased self worth
• Potential for abuse Hypothesis
• Nutritional consultation Teaching and return demonstration of urinary self catheterization
• Care of surgical wound
• Exploring concern regarding hysterectomy Interventions Energy conservation
• Provide medication for pain and nausea
• Allowing rest period Structural integrity
• Administrating antibiotic for wound,
• Teaching self catheterization Personal integrity
• Exploring her feeling about uterus removal while respecting her privacy Social integrity
• Assess potential abuse form husband
• Support to the family Organismic response
• Controlled pain
• Abdominal wound healing
• Improved appetite ,weight gain
• Clean urinary self catheterization
• Assistance from husband

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