levine's conservational model presenting

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NURSING THEORY

Levines Conservation Model


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Myra Estrin Levine(1920-1996) was born inChicago, Illinois.

Levine graduated from the Cook CountySchool of Nursing in 1944 and obtained herBS in nursing from the University of Chicagoin 1949.

Following graduation, Levine worked as a

private duty nurse, as a civilian nurse for theUS Army, as a surgical nursing supervisor,and in nursing administration.

After earning an MS in nursing at WayneState University in 1962, she taught nursingat many different institutions (George, 2002)such as the University of Illinois at Chicagoand Tel Aviv University in Israel.

She authored 77 published articles whichincluded An Introduction to Clinical Nursingwith multiple publication years on 1969, 1973& 1989.

She also received an honorary doctorate fromLoyola University in 1992. She died on 1996.


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CONSERVATION

Berasal dari bahasa latin conservatioyang berarti to Keep Together

Suatu sistem yang kompleks dan mampu

meneruskan fungsi walaupun dalamkondisi dengan tantangan yang berat

Individu berusaha melawan gangguan,beradaptasi,dan mempertahankan

keunikannya.(Tomey, 2006. ed.8)


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FOKUS CONSERVATION MODEL

Goal:To promote adaptation andmaintain wholeness using the principlesof conservation

Model guides the nurse to focus on theinfluences and responses at theorganismic level

Nurse accomplishes the goal of model

through the conservation of energy,structure and personal and social integrity


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COMPOSITION OF

CONSERVATION MODEL

Adaptation Levine,1989 defines adaptation is the process of change,

and conservation is the outcome of adaptation. Adaptationis the process whereby the patient maintains integritywithin the realities of the environment (MasterStudent,2009)

Every individual has a unique range of adaptive responses The responses will vary by heredity, age, gender or

challenges of illness experiences Example: The response to weakness of cardiac muscle is an

increased heart rate, dilation of ventricle and thickening ofmyocardial muscle

While the responses are same, the timing and manifestationof organismic responses will be unique for each individualpulse rate)

An ongoing process of change in which patient maintains hisintegrity within the realities of environment

Achieved through the "frugal, economic, contained andcontrolled use of environmental resources by individual in hisor her best interest"


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Cont...

Conservation (Levine, 1973)

is the product of adaptation.

The goal of conservation is health and the

strength to confront disability as ... the rulesof conservation and integrity hold in allsituation in which nursing is requires(Tomey,2006)

Achieving a balance of energy supply and demandthat is with in the unique biological realities of theindividual (Current Nursing,2010)


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MAJOR CONCEPTS

CONSERVATION MODEL

four central or major concepts:

(Nursings Paradigm)

1.

person,2. environment,

3. nursing

4. health.

(Master Student,2009 & Current

Nursing 2010)


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1. PERSON

A holistic being who constantly strives to preserve wholeness andintegrity

A unique individual in unity and integrity, feeling, believing,thinking and whole system of system

thinking, future-oriented, and past-aware.

The wholeness (integrity) of the individual demands that theindividual life has meaning only in the context of social life

(Current Nursing,2009)


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2. ENVIRONMENT

Lingkungan internal Kombinasi aspek fisiologi dan patofisiologi individu dan

dipengaruhi oleh lingkungan eksternal, dan merupakaninteraksi fungsi tubuh antara homeorrhesis danomeostasis yang bertujuan membentuk energi

Lingkungan Eksternal Perceptual : respon individu terhadap sensori (cahaya, suara,

sentuhan, suhu, bahan kimia dan keseimbangan Operational; elemen yang mempengaruhi fisik individu

(interaksi dengan jaringan) seperti radiasi,mikroorganismedan pollutants.

conceptual environments; terdiri dari bahasa, ide, simbol-simbol, kemampuan berfikir dan pengalaman emosi, sistemnilai, kepercayaan agama, suku, tradisi budaya, keadaanpsikologi individu yang dibentuk dari pengalaman hidup.


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3. KESEHATAN (HEALTH)

unity and integrity wholeness and successful adaptation. The goal of nursing is to promote health

Levine (1991,)health as: the avenue of return to the daily

activities compromised by ill health. It is not only the insult orthe injury that is repaired but the person himself or herself It isnot merely the healing of an afflicted part. It is rather a return toself hood, where the encroachment of the disability can be setaside entirely, and the individual is free to pursue once more hisor her own interests without constraint.

disease is unregulated and undisciplined change and must bestopped or death will ensue.


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4. NURSING (LEVIN,1973)

human interactions The nurse enters into a partnership of human experience

where sharing moments in timesome trivial, somedramaticleaves its mark forever on each patient

The goal of nursing

is to promote adaptation and maintain wholeness (health). 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 andto seek its realization.

The goal of nursing is accomplished through the use of the

conservation principles: energy, structure, personal, andsocial integrity.


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Conservational Principle

Conservation of energy

Conservation of structural integrity

Conservation of personal integrity Conservation of social integrity


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Conservation of Energy

Refers to balancingenergy input andoutput to avoidexcessive fatigue

includes adequaterest, nutrition andexercise

Example:

Availability of

adequate restMaintenance ofadequate nutrition


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Conservation of structural integrity

Refers to maintainingor restoring thestructure of bodypreventing physical

breakdown Andpromoting healing

Example:

Assist patient in ROM

exerciseMaintenance ofpatients personalhygiene


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Conservation of Social integrity

An individual is recognized assome one who resides: with in afamily, a community, a religiousgroup, an ethnic group, a politicalsystem and a nation.

Example:

Position patient in bed to fostersocial interaction with otherpatients

Avoid sensory deprivation Promote patients use of news

paper, magazines, radio. TV Provide support and assistance to

family

Help the individual to preservehis or her place in a family,community, and society.(Current Nursing,2010)


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Primary Focus =

Conservation of the Individual

Adaptation to changes in health and disease so as topreserve individual integrity

Individuals require nursing care when they are unable toadapt and retain wholeness themselves.

Leach (2006)Conservation aims to maintain anequilibrium conducive to health; accordingly, manynursing interventions use conservation principles tomaintain patient wholeness (McFarland,2010).


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A Conceptual Model to

Guide Nursing Interventions

Conservation of:

Energy

Structural Integrity

Personal Integrity Social Integrity

o

Nursing Interventions focus onpromotion and support ofadaptation to preserve the four principles(McFarland,2010)


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Conservation of Energy

Promote the bodys energy balance when faced withchanges in psychological or physiological processes so asto sustain life

Leach (2006)Energy conservation is based on thefollowing ideas:

Patient activity is dependent on energy balance

Illness increases energy demand

Increased energy demand can be measured by the

level of fatigue (McFarland,2010)


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Conservation of Structural Integrity

Age and illness can produce structural changes whichrequire adaptation

Through conservation of structural integrity, patients willfeel intact and whole and subsequently manifestimprovements in self-identity (Leach, 2006)


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Conservation of Personal Integrity The conservation of personal integrity aims to protectpersonal identity, an intrinsic factor to wholeness of the

individual

Leach, (2006)Conserving personal integrity is based on thefollowing ideas:

Individuals require privacy and are responsible fortheirown decisions

Illness and hospitalization compromise personalintegrity, self-identity, and self-respect(McFarland,2010).


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Conservation of Social Integrity

Social interaction and relationship of self to others is keyto unity of the individual

Leach (2006)Conserving social integrity is based on the

following principles: Individual life has meaning only in the context of

social life

Individual behavior is influenced by the ability torelate to various social groups

Families often are affected by an individuals illness Hospitalization results in social isolation

(McFarland,2010).


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Example of Levines Conservation Modelwww.ids-healthcare.com


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How does Levines Model inform our

practice?

RememberLevines Conservation Model is used to guidenursing interventions with the goal of conserving integrity ofthe individual through adaptation to physical and psychologicalchanges.

Nursing actions and interventions should

aim to conserve 4 areas of integrity:

Energy

Physical Integrity

Personal Integrity

Social Integrity


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Nine Models To Guide Assessment

(Levine,1973)

Vital Sign Body Movement and Positioning Ministration of personal hygiene needs Pressure gradient system in nursing intervention

(Fluids) Nursing determinants in provision for nutritional

needs Pressure gradient system in nursing (gases) Local application of heat and cold

Administration of medication Establishing an aseptic environment(Meleis,1985 & Current Nursing,2010)


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Nursing Interventions for Conservation

of Energy

The nurse will foster balance between energy output and inputto avoid excessive fatigue

Support adjustment to changes in living

situations (i.e. SNF)

Improve nutritional status

Control pain and anxiety

Reduce patient activity when appropriate

Promote exercise and

rehabilitation within the

patients abilities, limitations

and comfort


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Nursing Interventions for Conservation of

Structural Integrity

The nurse will help maintain or restore the patients bodystructure by preventing physical breakdown and promotinghealing

Precautions in infection and injury prevention Promote mobility

Early ambulation to prevent complications of bed rest

Assist in adaptation to decreased mobility Maintain musculoskeletal integrity through ROM exercises Maintain venous integrity through use of compression therapy

and/or TED hose Maintain skin integrity (early detection and

management of disease processes conservestructural integrity)

Positioning


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Nursing Interventions

for Conservation of Social Integrity

The nurse will foster awareness that the patient is a social

being who interacts with others in their social environment.

Promote meaningful social activities and outings

Encourage family support & education

Promote family participation in care

Foster patient interaction with others

Promote healing to restore the

patients mobility

Promote exercise to increase

the patients ability to socialize


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Key Points to Remember.

Levines Model focuses on conserving thepatients wholenessby regaining or maintainingtheir:

EnergyStructural IntegrityPersonal IntegritySocial Integrity


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Area Aplikasi


Burns

Cancer

Chronic Pain

CHF Critical Care

LOng-Term Care

Perioperatif

Preoperative adults Pressure Ulcer

(Tomey,2006. Ed.3)

Cardiomyopathy

Wound Healing

Emergency

Holistic care Nursing adults

Nursing Children

Nursing infant

Rehabilitation


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Referensi

Meleis, 1985. Theoritical Nursing : Development & Progress. J.B Lippincott Company.

Tomey,2006. Nursing Theorists and Their Work. Sixth Edition.Mosby

Tomey,2006. Nursing Theory: Utilization & Application. Third Edition. Mosby

University of Philippines,2009. Nursing Theory : Myra Levine's Conservation Theory.Diakses tanggal 30 November 2010 darihttp://nursingtheories.blogspot.com/2009/07/myra-levines-conservation-theory.html

Current Nursing, 2010. Levin's Four Conservation Principles. diakses tanggal 30 November2010 daricurrentnursing.com/Levin_four_conservation_principles.html

McFarland et all,2010. Leiningers Theory of Culture Care Diversity& UniversalityVsLevines Conservation Model diakses tanggal 1 Desember 2010 dariwww.findtoyou.com/powerpoint/download-chf-506817.html
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