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Reporter: Nina Hamili G.


(Myra E. Levine)


Chicago, Illinois

developed an interest in nursing because her father (who had gastrointestinal

problems) was frequently ill and required nursing care on many occasions
graduated from the Cook County School of Nursing in 1944
obtained her BS in nursing from the University of Chicago in 1949
worked as a private duty nurse and a civilian nurse for the US Army, as a surgical
nursing supervisor
authored 77 published articles which included An Introduction to Clinical Nursing with
multiple publication years on 1969, 1973 & 1989
received an honorary doctorate from Loyola University in 1992


holistic being who constantly strives to preserve wholeness and integrity and 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.

completes the wholeness of the individual

Internal Environment

combines the physiological and pathophysiological aspects of the individual and is

constantly challenged by the external environment
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. )
External Environment

divided into the perceptual, operational, and conceptual environments

Perceptual Environment

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
Operational Environment

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
Conceptual Environment
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

is implied to mean unity and integrity and is a wholeness and successful adaptation.
not only the insult or the injury that is repaired but the person himself or herself, 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

involves engaging in human interactions

goal is to promote wholeness, realizing that every individual requires a unique and
separate cluster of activities. The individuals integrity is his/her abiding concern and it
is the nurses responsibility to assist the patient to defend and to seek its realization
Levines Conservation Model
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, and personal and social integrity.



process of change, and conservation is the outcome of adaptation, whereby the patient
maintains integrity within the realities of the environment
achieved through the frugal, economic, contained, and controlled use of
environmental resources by the individual in his or her best interest

wholeness emphasizes a sound, organic, progressive mutuality between diversified

functions and parts within an entirety, the boundaries of which are open and fluid
the unceasing interaction of the individual organism with its environment represents an
open and fluid system, and a condition of health, wholeness, exists when the
interaction or constant adaptations to the environment, permit easethe assurance of
integrity in all the dimensions of life

the product of adaptation.

conservation is from the Latin word conservatio, meaning to keep together describes
the way complex systems are able to continue to function even when severely
challenged through conservation, individuals are able to confront obstacles, adapt
accordingly, and maintain their uniqueness
the goal of conservation is health and the strength to confront disability
primary focus is keeping together of the wholeness of the individual, although nursing
interventions may deal with one particualr conservation principle, nurses must also
recognize the influence of other conservation principles.
The core, or central concept, of Levines theory is conservation. 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.

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.
I. 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
II. 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 patients personal hygiene
III. Conservation of Personal Integrity
-recognizes the individual as one who strives for recognition, respect, self awareness, selfhood
and self determination
Example: Recognize and protect patients space needs
IV. 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: Help the individual to preserve his or her place in a family, community, and society.

The nurse creates an environment in which healing could occur

A human being is more than the sum of the part
Human being respond in a predictable way
Human being are unique in their responses
Human being know and appraise objects ,condition and situation
Human being sense ,reflects, reason and understand
Human being action are self determined even when emotional
Human being are capable of prolonging reflection through such strategists raising
Human being make decision through prioritizing course of
Human being must be aware and able to contemplate objects, condition and situation
Human being are agents who act deliberately to attain goal
Adaptive changes involve the whole individual
A human being has unity in his response to the environment
Every person possesses a unique adaptive ability based on ones life experience which
creates a unique message
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
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 needs existing and emerging demands of self care and dependant care
Nursing is associated with condition of regulation of exercise or development of
capabilities of providing care
There are a number of limitations when it comes to the four principles. On conservation of
energy, Levines goal is to avoid fatigue or excessive use of energy. This is manageable in the
bedside care of ill clients. In cases where energy needs to be utilized rather than conserved
like in manic patients, ADHD in children or those with limited movements such as paralyzed
clients, Levines theory does not apply. On conservation of structural integrity, the focus is to
preserve the anatomical structure of the body as well as to prevent damage to the anatomical
structure. This, again, has limitations. In cases where the anatomical structure is not so
perfect but without identified disfigurement or problems as in plastic surgeries, procedures
like breast enhancements and liposuctions; the person's structural integrity is compromised
but it is the patient's choice seeking physical beauty and psychological satisfaction that is
taken into consideration.
Talking to a 70 yrs old patient with a chief complaint of difficulty of breathing and chest pain
diagnosed with congestive heart failure. As part of his care plan, As his nurse I need to make
sure that he can recover not only with the aid of pharmacological treatment such as diuretics
and anti anginal drugs and dependent nursing actions coming from doctors but also to initiate
action in such a way to alleviate his condition. Conserving his energy to promote better
respiration, lessen cardiac workload is a big help for the patient having congestion. On the
other hand, assisting patient what to do in a nice way or with respect will maintain their
personal integrity. by these simple nursing intervention, faster recovery of patient is at hand,
Levine's conservation principles were indeed valuable in hospital settings.
Levine expressed the view that within the nurse-patient relationship a patients 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.