Dimalanta, Racine Andrea C.

July 6, 2019
Master’s in Nursing TFN

I. Title of the Theory: The Conservation Model

II. Brief Background of the Theorist

Myra E. Levine was born in 1920 in Chicago, the first child in a family of three siblings.
Her experience during her father’s frequent illness contributed to her interest in and dedication to
nursing. She received a diploma from Cook County School of Nursing in 1944, a BSN degree
from the University of Chicago in 1949, and a Master’s of Science in Nursing from Wayne State
University in 1962. Her career in nursing has been varied. Clinically, she held position as private
duty nurse, a civilian nurse for the U.S. Army, surgical supervisor, and director of nursing. She
held faculty positions at Cook County School of Nursing, Loyola University, Rush University,
University of Illinois, Chicago. Levine filled visiting professorship at Tel-aviv University and
Recanati School of Nursing, Ben Gurion University of the Negev, both in Israel. (Tomey &
Alligood, 2014)

Levine is a charter fellow in the American Academy of Nursing and has been honored by
the Illinois Nurses Association. She was the first recipient of Sigma Theta Tau’s Elizabeth Russell
Belford Award for teaching excellence. She was granted an honorary doctorate by Loyola
University, Chicago, in 1992. (Tomey & Alligood, 2014)

Levine died on March 20, 1996, at 75 years of age. She leaves a legacy as an administrator,
educator, friend, mother, nurse, scholar, student of humanities, and wife (Pond, 1996). Dr.
Baumhart, President of Loyola University, said the following of Levine (MidYear Convocation,
Loyola University, 1992): Mrs. Levine is a renaissance woman . . . who uses knowledge from
several disciplines to expand the vision of health needs of persons that can be met by modern
nursing. In the Talmudic tradition of her ancestors, [she] has been a forthright spokesperson for
social justice and the inherent dignity of [the] human person as a child of God (p. 6). (Tomey &
Alligood, 2014)

III. Theoretical Source of the Developed Theory

When Levine first began putting her ideas about nursing into writing, she was able to adopt
from Beland’s (1971) presentation of the theory of specific causation and multiple factors, Levine
learned historical viewpoints of diseases and learned that the way people think about disease
changes over time. Beland directed Levine’s attention to numerous authors who became influential
in her thinking, including Goldstein (1963), Hall (1966), Sherrington (1906), and Dubos (1961,
1965). Levine uses Gibson’s (1966) definition of perceptual systems, Erikson’s (1964)
differentiation between total and whole, Selye’s (1956) stress theory, and Bates’ (1967) models of
external environment. Levine was proud that Rogers (1970) was her first editor. She acknowledged
Nightingale’s contribution to her thinking about the “guardian activity” of observation used by
nurses to “save lives and increase health and comfort” (Levine, 1992, p. 42).

IV. Major Concepts and Definitions

The three major concepts of the Conservation Model are (1) wholeness, (2) adaptation, and (3)
conservation.

1. Wholeness - emphasizes a sound, organic, progressive, mutuality between diversified

functions and parts within an entirety, the boundaries of which are open and fluent. It exists
when the interaction or constant adaptations to the environment permit ease.
2. Adaptation - Levine defined adaptation as the process whereby the patient maintains
integrity within the realities of the environment; it is the result of interaction between the
person and his internal and external environment (Tomey & Alligood). The physiological
and behavioral responses of each individual are different under different conditions.
Therefore, it is possible to anticipate certain kinds of reactions, but the individuality or
uniqueness of responses vary. Adaptation includes the following characteristics:
a. historicity - adaptation is a historical process, responses are based on past experiences
and genetic pattern.
b. specificity - each system has very specific responses in relation to a particular challenge.
c. redundancy - represents the options available to the individual to ensure continued
adaptation; if one system does not adapt, another can take over.
3. Conservation -It is the product of adaptation. It describes the way complex systems are
able to continue to function even when severely challenged. It is through conservation that
persons are able to face challenges, adapt, and maintain their uniqueness. It focuses on
achieving a balance of energy supply and demand within the biological realities unique to
the individual (Tomey & Alligood).

The goals of conservation model are achieved through interventions geared toward the "Four
Conservation Principles":

a. Conservation of Energy -the individual requires a balance of energy and a constant

renewal of energy to maintain life activities
b. Conservation of Structural Integrity -it focuses on the healing process. It involves
maintaining or restoring the structure of the body by preventing physical breakdown
and promoting health. Nursing activities are geared towards limiting injury.
c. Conservation of Personal Integrity - includes recognition of the wholeness of each
person; seeing the individual as one who strives for recognition, respect, self-
awareness, and self-determination. It encompasses the ideas that self-worth and self-
identity are important and, therefore, nurses should show patients respect.
d. Conservation of Social Integrity - life gains meaning through social communities and
health is socially determined. Individuals use their relationships to define themselves,
 and one’s identity is connected to his social circles (ex: family, community, workplace,
school, religion). Nurses fulfill professional roles and use interpersonal relationships to
conserve social integrity.

V. Brief Discussion of the Theory

THE CONSERVATION PRINCIPLES: A MODEL FOR HEALTH

This is an artwork taken from Sitzman and Eichelberger's artistic impressions of Levine’s
Conservation Model. Based from the concept, Levine believed that the foundational belief of the
sanctity of life provided the structure for all moral systems and that all of the efforts of the healing
sciences were founded upon the holiness and wholeness of the human being. She used the term
conservation to label the framework because it was derived from the Latin word meaning “to keep
together”. Levine viewed adaptation as the process by which conservation is achieved. The goal
of the conservation model is to promote adaptation and maintain wholeness using the principles
of conservation (Tomey & Alligood).
VI. Major Assumptions to Nursing, Person, Health and Environment

The assumptions of Levine’s Conservation Model are:

a) Nursing is a human interaction designed to promote "wholeness" through adaptation. it

courses at the interface between the open and fluid boundaries of the person and his
environment. nursing care is seen as both supportive and therapeutic. the supportive aspect
is designed to maintain a state of wholeness in the face o a client's failing health.
b) Person is a holistic being; cannot be understood outside the context of the place and time
in which he is functioning, or separated from the influence of everything that is happening
around him.
c) Health is a state of being "whole" and just not the absence of a disease. health is socially
determined and modified by person's interaction or relationship with other people,
particularly family and peers.
d) The environment is where a person is constantly and actively involved. each individual has
his own environment, both internal and external. the internal environment involves the
physiologic element, while the external includes three levels: Perception, Operation, and
conceptual

VII. Application to the Nursing Profession as to Practice, Education, and Research

Nursing Practice

 Conservational model has been used for nursing practice in different settings
 Bayley discussed the care of a severely burned teenagers on the basis of four
conservational principles and discussed patient’s perceptual, operational and conceptual
environment
 Pond used conservation model for guiding the nursing care of homeless at a clinic,
shelters or streets

Nursing Education

 Conservational model was used as guidelines for curriculum development

 It was used to develop nursing undergraduate program at Allentown college of St.Francis
de sales, Pennsylvania
 Used in nursing education program sponsored by Kapat Holim in Israel

Nursing Research

 Principles of conservation have been used for data collection in various researches
 Conservational model was used by Hanson et al.in their study of incidence and
prevalence of pressure ulcers in hospice patient
  Newport used principle of conservation of energy and social integrity for comparing the
body temperature of infant’s who had been placed on mother’s chest immediately after
birth with those who were placed in warmer

VIII. A published journal which used the theory and discuss how the authors utilized it in
their research work.

A study conducted by Mock et al. entitled “Using a conceptual model in nursing research
- mitigating fatigue in cancer patients”, discusses the use of the Levine Conservation Model to
guide the investigation of an exercise intervention to mitigate cancer-related fatigue. A descriptive
approach was used to present the components of the conceptual model and details of the
articulation of the study intervention and outcomes with the model.

The study design employed is a randomized controlled clinical trial. The enrolment
eligibility criteria require that patients be 21 years of age or older with a newly diagnosed cancer,
histologically staged at 0, I, II or III. Patients must be scheduled to receive chemotherapy, radiation
therapy, or both as their initial treatment, must show no evidence of metastatic disease, and be free
of concurrent health problems/disabilities that would limit their ability to participate in an exercise
programme. They must not currently be exercising more than three times per week, for a total of
120 minutes. One-hundred and thirty-eight patients scheduled to receive chemotherapy or
radiation therapy at one of four academic cancer centre-affiliated treatment sites have been
enrolled. The study was approved by the University Institutional Review Board.

The Levine Conservation Model was adopted for the study discussed here because it
includes principles that help explain cancer-related fatigue and support exercise as a potential
intervention for the fatigue. The four conservation principles that underlie this model are
conservation of energy, conservation of structural integrity, conservation of personal integrity and
conservation of social integrity was used. When environmental challenges occur, as in the case of
cancer and its treatment, the individual begins a multidimensional process of adaptation to
maintain life and conserve individual integrity. Nursing interventions are aimed at promoting and
supporting this adaptation.
Sources:

Tomey, Ann Meriner & Alligood, Marthe Rovile. Nursing Theory. 8th Edition. Elsevier, Inc. 2014

Sitzman, Kathleen. Understanding The Work of Nurse Theorist: A Creative Beginning. 2 nd Edition. Jones
& Bartlett Publishers. 2011

Mock, V., St Ours, C., Hall, S., Bositis, A., Tillery, M., Belcher, A., … McCorkle, R. (2007). Using a
conceptual model in nursing research--mitigating fatigue in cancer patients. Journal of advanced
nursing, 58(5), 503–512. doi:10.1111/j.1365-2648.2007.04293.x

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