Levine's point (Major & Key Concepts)

LEVINE’S CONSERVATION THEORY

 and ITS CONCEPTS

Levine’s Conservation Theory was developed because she believed that nursing revolves around controlling and preserving the energy resources of the patient. A big factor in the development of this theory was her strong physical science background. With this background she influenced the practice of nursing through the attainment of the nursing goal, promoting “wholeness”.

                               

   MAJOR CONCEPTS

PERSON

•  A holistic being—not only in the physical needs, but also the psychosocial, cultural and spiritual aspects—who constantly strives to preserve wholeness and integrity
•   One who is sentient, thinking, future-oriented, and past-aware
•  A unique individual in unity and integrity, feeling, believing, thinking and whole system of system.
• A holistic being who has open and fluid boundaries that coexist with the environment. He is a whole being who is conserved and integral. An example is a patient’s anxiety is still present despite the alleviation of pain.

ENVIRONMENT

•  Plays an important role in completing the individual’s wholeness.
• Where the individual lives her life.
• The individual has both an internal and external environment:

a.    internal environment combines the physiological and pathophysiological aspects of the individual and is constantly challenged by the external environment.

b.    external environment is divided into the perceptual, operational, and conceptual environments: 

•   perceptual environment - 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.
• operational environment - 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.
•  conceptual environment - 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.

Individuals respond to the environmental challenges by means of four integrated processes:

1. Fight-or-flight mechanism - most primitive response. Hospitalization, illness and new experiences triggers a response . An individual may turn away "flight" or face his condition "fight" to assure his safety and well-being.
2. Inflammatory-immune response - a way of healing, a defense mechanism to protect self from insult in a hostile environment. Uses available energy to remove or keep out unwanted irritants or pathogens. Environmental control is important.
3. Stress response- according to Selye, stress response syndrome is a predictable non-specifically induced organismic changes. Characterized by irreversibility and influences the way patients respond to nursing care.
4. Perceptual awareness—information seeking response used by the individual to seek and maintain safety for himself. Includes the basic orienting, synaptic, auditory, visual, and taste-smell systems.

NURSING

•  Involves engaging in “human interactions” - rooted on the organic dependency of an individual as well as communications with other human beings.
• The goal of nursing is to promote wholeness. 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).
•   “Wholeness” can be achieved through the use of supportive and therapeutic aspect of caring.
• A profession as well as an academic discipline that always should be studied and practiced along with other health sciences. Human interaction is the focus of nursing.A nurse should have the following goals: 
• 1. Realize that every individual requires a unique and separate cluster of activities
• 2. Assist the person (his sole concern) to defend and to seek its realization
• 3. Make decision through prioritizing course of action
• 4. Be aware and able to contemplate objects, condition and situation
• 5. Involve the whole individual
•   Nurses should also use the nursing process in giving care to their patients.

HEALTH

•  A state of wholeness and not just an absence of disease and successful adaptation and not merely healing of an affected part.
•  Ability to function normally and able to return to daily activities, self-hood, and ability to pursue one's interest without constraints.

KEY CONCEPTS

The Four Conservation Principles

The nurse has to promote conservation of energy, structural integrity, personal integrity and social integrity of the client.

       I. Conservation of Energy

• It refers to balance between energy expenditure and conservation.  Patient activity is dependent on energy balance.
•  Illness increases energy demand, and that increased energy demand can be measured by the level of fatigue.
• Energy is measured in everyday nursing practice via body temperature, blood gases, pulse, and blood pressure; fluctuations determine either energy expenditure or conservation.
• The balance is brought by proper rest, adequate hydration, inhaling of clean air, proper nutrition and exercising.

      II. Conservation of Structural Integrity

•  Focused on preserving the anatomical structure of the body and preserving healing
• Refers to maintaining or restoring the structure of body preventing physical breakdown and promoting healing
•   Changes in structure ultimately affect function, that structural integrity may be compromised by pathophysiological processes, and that healing restores.structural integrity.  Therefore, to regain structure and function, the body needs to restore structural integrity through repair and healing
•  Nursing Intervention aims in helping the individual to prevent skin breakdown and limiting the amount of tissue involvement in infectious disease. Examples include:

a.    Maintenance of clean, dry, wrinkle free linen.

b.    Regular turning of patient side to side every 2 hours to patients who are bedridden.

c.    Perform ROM  exercise

d.    Maintenance of patient’s personal hygiene

  

III. Conservation of Personal Integrity 

• A client is a person with dignity, sense of identity and self-worth.
•  Individual strives for recognition, respect, self awareness, self-hood and self-determination.
•  Individuals require privacy and are responsible for their own decisions.
• Illness and hospitalization compromise personal integrity, self-identity, and self-respect
• Person’s integrity is compromised when the individual becomes dependent.
• Nursing interventions include protecting and respecting patient privacy, possessions, and defense mechanisms and supporting personal choice. 
• Examples include:

a.    Expression of patient’s feelings

b.    Involvement of patient in plan of care,

c.    Focus on self aspect by not comparing to others

d.    Reinforce positive traits

e.  Promote socialization in such a way he can developed positive self-esteem.

f.     Recognize and protect patient’s space needs

IV. Conservation of Social Integrity

•   An individual is recognized as someone who resides and interacts with in a family, a community, academe, a religious group, an ethnic group, a political system and a nation
•   Individuals recognize social responsibilities, traditional customs and spiritual group.
•   Individual behavior is influenced by the ability to relate to various social groups, families often are affected by an individual’s illness, and hospitalization results in social isolation.
•   Nursing Intervention: Helping the individual to preserve his or her place in the family, community and society. Examples include:

a.  In the case of a pregnant women scheduled for caesarean operation,her support system is very important both before and after the operation.

b.    Position patient in bed to foster social interaction with other patients

c.    Avoid sensory deprivation

d.    Promote patient’s use of news paper, magazines, radio. TV

e.    Provide support and assistance to family

“The Goal of the individual is conservation or preserving an integrated and balance whole”(Levine, 1973)