Myra Estrin Levine

II. PHILOSOPHICAL UNDERPINNINGS OF THEORY

1. Who directed Levine’s attention to numerous authors that became influential in her
thinking?
 Beland directed Levine’s attention to numerous authors who became influential in
her thinking
2. Who were the inspirations or motivation of Levine to develop her theory?
 The inspiration of Levine to develop her theory were: Goldstein (1963), Hall (1966),
Sherrington (1906), and Dubos (1961, 1965), 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
3. Who was her first editor?
 Levine was proud that Rogers (1970) was her first editor.
4. Who contributed to her thinking about the “guardian activity” of observation used by
nurses to “save lives and increase health and comfort”
 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”

III. MAJOR ASSUMPTIONS, CONCEPTS, AND RELATIONSHIPS

 Environment
1. Perceptual
2. Operational
3. Conceptual
 Organic Response
1. Fight of flight
2. Inflammatory response
3. Response to Stress
4. Perceptual Awareness

Matching type
1. C
2. A
3. D
4. B

IV. MODEL/DIAGRAM/PARADIGM
1. Conservation of Structural Integrity
2. Conservation of Personal Integrity
3. Conservation of Social Integrity
4. Historicity
5. Redundancy
6. Health and Disease
7. Responsibility of nursing during vulnerable time of dependency
 8. Optimal health is goal of adaptation

V. USEFULNESS, TESTABILITY, PARSIMONY & VALUE IN

EXTENDING NURSING SCIENCE
1. The strength of Levine’s Conservative model is that she had
interconnected the ideas of adaptation, conservation, and integrity in a way
that gives a nursing perspective distinct from that of the auxiliary disciplines
that share these principles with nursing. One thinking or idea follows on
from the preceding one, which follows a logical pattern. Her model
also outlined a method that shed light on a balanced approach to assisting
the development of healing in medical–surgical patients. Her Conservation
Model highlights the connection of wholistic nursing care and patients'
natural potential to attain higher levels of health.
However, despite of the strengths that the Conservative Model has,
there are also limitations. One of those is that limited attention only focused
on health promotion and disease prevention. The nurse is responsible for
evaluating the patient's capacity to engage in care, and if the nurse and
patient's perceptions of the patient's ability to participate in care differ, this
mismatch will be an area of conflict. And the major limitation is the
emphasis on the individual in a state of sickness and on the patient's
reliance wherein he/she will rely heavily on the nurse to achieve his/her
aim. There are also instances that her theory doesn’t apply. For example,
in conservation of energy Levine's objective is to avoid fatigue and
unnecessary energy use. This is doable while providing bedside care to
sick patients. Her theory does not apply when energy must be used rather
than saved, such as in manic patients, children with ADHD, or those with
limited movement, such as paralyzed clients.
2. A post-op patient who had hip replacement surgery done 30 minutes ago
is admitted in my unit. Levine’s Conservation Principle can be incorporated
for the recovery of the patient while in my nursing care.
Conservation of Energy focuses on the balance of energy input and
output to prevent excessive fatigue. The post-op patient may surely
experience mild to severe pain while admitted, and it might take several
days before the pain can be gone. I need to do certain tasks to maintain
responsibility for the patient care, these include taking of vital signs,
monitoring if the patient is having enough rest, ensuring that the patient is
eating adequate food, and checking if he/she is drinking the medicine.
Conservation of Structural Integrity involves maintaining the structure
of the body to promote healing. After several hours of surgery, the patient
will regain feeling in his or her legs. Assistance is vital in aiding the patient
during the stay in the unit, and there are many ways that I can help in
assisting the patient. These include assisting the patient in bending the
ankles and flexing other gluteal muscles when asked by doctor; assisting
the patient in doing gentle exercises for few minutes; giving him
precautions to avoid dislocating the new hip; as well as toileting,
ambulation, and grooming/personal hygiene of the patient.
Conservation of Personal Integrity involves the maintenance of one’s
sense of personal worth and self-esteem. There are many ways I can help
in maintaining the self-worth of the patient such as: introducing myself the
first time we met since I am the one who will monitor him for the rest of his
stay in the hospital; showing respect to the patient while interacting with
him; respecting and maintaining his privacy; respecting his wishes; and
calling him by his preferred name.
Conservation of Social Integrity fulfills professional roles, provide for
family members, assist with religious needs, and use interpersonal
relationships to conserve social integrity. Nursing interventions are needed
to maintain the social integrity of the patient. There are many ways that can
help the patient feel better despite of the pain he is experiencing. The
presence of family member or a friend at bedside gives a positive effect on
the patient’s well-being. Promoting interaction with the patient is also an
important factor such as talking with him, encouraging to read the bible,
and discussing the medication therapy to help her achieve restful sleep.