Myra Levine “Conservation Model”
Conservation of structural integrity
- 1944 – Diploma from Cook Country School of Nursing
- 1962 – MSN from Wayne State University
- 1994 – PDN
- 1945 – Civilian nurse in the US Army
- 1947-1950 – Preclinical nurse instructor at Cook Country
- 1950-1951 – Director of Nursing at Drexel Home in Chicago
- Died at age of 75 on 20 March 1996
I. Major Concepts and Definition
1. Wholeness (Holism)
- Based her use of wholeness on Erickson’s description of
wholeness: an open system
- Emphasizes a sound, organic, progressive mutuality between
diversified functions and parts within an entirety, the
boundaries of which are open and fluent
- Integrity – means the oneness of the individuals,
emphasizing that they respond in an integrated, singular
fashion to environmental challenges
2. Adaptation
- Process of change whereby the individual retains his
integrity within the realities of his internal and external
environment
- Conservation is the outcome.
- it is a matter of degree, not an all or nothing process
- no such thing as maladaptation.
(3 Characteristics of Adaptation)
a. Historicity – adaptation is a historical process, responses are
based on past experiences, both personal and generic
b. Specificity – each system has specific responses & responses
are tasked specific & synchronized but not linear (they
cascade)
c. Redundancy – the systems are both protective and adaptive.
If one system does not adapt, another can take over. It may
function in a time frame, some are corrective, others permit a
previously failed response to be re-established.
3. Conservation
- The product of adaptation
- The way the complex systems are able to continue to
function even when severely challenged.
- The individuals are able to confront obstacles, adapt
accordingly and maintain their uniqueness
- The goal is health and the strength to confront disability
- Primary focus is keeping together the wholeness of the
individual
(Principles of Conservation)
a. Conservation energy
- individual requires a balance of energy and a constant
renewal of energy to maintain life activities. Nursing
has been using this in everything that she does to the
patient.
b.
- healing is a process of restoring structural and
functional integrity in a defence of wholeness
c. Conservation of personal integrity
- Self-worth and sense of identity are important
- Nurse’s goal is to impact knowledge and strength so
that the individual can resume a private life.
- Ex. Calling them by name, respecting their wishes,
valuing personal possessions, providing privacy,
teaching them.
d. Conservation of social integrity
- Nurses fulfill professional roles, provide for family
members, assist with religious needs, use interpersonal
relationship to conserve social integrity
4. Environment
- “where we are and constantly involved”
- Each individual has his/her own internal and external
environment
- Levels of environment according to Bate:
a. Perceptual – aspects of the world that individuals
are able to intercept and interpret with their sense
organs
b. Operational – contains things that affect
individuals physically although they cannot directly
perceive them, such as patterns, characterized by a
spiritual existence and medicated by the symbols
of language, thought and history
- it is a universal concept, a natural law
- ex. Thermostat – it is set at a selected temperature. As the
temperature in the room is the same as the set temperature,
nothing occurs. When the room temperature falls below the
selected temperature, the thermostat activates the heating
system – but only until the room temperature again reaches
the thermostat setting. When the setting is reached, the
thermostat turns the heating system off.
II. Four Levels of Behavior according to Levine
1. “fight or flight” response by Cannon (1939)
- the adrenocortical-sympathetic reactions that provide both
physiological and behavioral readiness in the face of sudden
and unexpected challenges in the environment
2. Inflammatory-immune response
- Which the person rely on for restoration of physical
wholeness and healing.
3. Stress response by Selye (1955)
- Integrated defense that occurs overtime and is influenced by
the accumulated experience of the individual
4. Perceptual system by Gibson (1966)
- The sense not only provide access to environmental energy
sources but also to convert these sources into meaningful
experiences: people not only see, they look; they not only
hear, they listen.
 III. Levine’s Theory and Nursing’s Metaparadigm
1. Human being
- Focus should be a wholeness
- Person cannot be understood outside the context of the
place and time in which he or she is functioning
- Have need for nursing when they are suffering and can set
aside independence and accept the services of another
2. Health and disease are patterns of adaptive change
- The most successful adaptation are the ones that achieve
the best fit in the most conserving manner
- Is the goal of conservation
3. Environment
- Social context – is important to the wholeness of the
individual
- Includes the ethnic and cultural heritage, economic niche,
the opportunities ignored or seized
- Established the values that direct it and sets the rules by
which its members are judged
- The social integrity of the individual mirrors the community
to which he or she belongs.
4. Nursing
- Purpose is to take care of others when they need to be taken
care of
- Nurse-patient relationship is based on the willful
participation of both parties
Evelyn Tomlin, Mary Ann Swain, and Helen Erickson
“The Modeling and Role-Modeling Theory”
Evelyn Tomlin
- BSN – University of Southern California
- Masters Degree in Psychiatric Nursing – University of
Michigan (1976)
- Clinical Instructor – LA Country Gen. Hospital School of
Nursing. She was a school nurse and practiced family
nursing, a relief nurse. After her retirement from nursing
with pay, she lived in Illinois
Mary Ann Swain
- Educational background is Psychology with Bachelor of __ De
PaUW University in Greencastle, Indiana
Helen Erickson
- Diploma in Nursing, BSN; Masteral (Psychiatry), Doctor of
Educational Psychology (1984) – all in University of Michigan
- Head nurse (Midland Community Hospital in Texas)
- Teaching assistant at University of Michigan – Dean of the
Undergraduate program.
A. The Theory of Modeling and Role Modeling
It is an interpersonal and interactive theory of nursing that
requires the nurse to assess (model) and plan (role-model) and
intervene (5 aims of intervention) on the basis of the client’s
perspective of the world. The nurse always acknowledges the
uniqueness and individuality of the client and appreciate that
individuals at some level, know what makes them ill and what makes
them well (Self-care knowledge)
The nurse assists the individual to recognize and obtain resources
that are important for their health and healing (Self-care resources)
and facilitate the use of these resources (Self-care action).
B. *Modeling
- Process used by the nurse as she develops an image and
understanding of the client’s world – an image and
understanding developed within the client’s framework and
from the client’s perspective
- Modeling is both an art and a science
- The art of modeling is the development of a mirror image of
the situation from the client’s perspective
- The science of modeling is the scientific aggregation and
analysis of data collected about the client’s model.
C. *Role Modeling
- Is the facilitation of health
- Both an art and science
- The art of role-modeling involves the individualization of
care based on the client’s model of the world. Occurs when
the nurse plans and implements interventions that area
unique for the client.
- The science of role-modeling occurs as the nurse plans
interventions with respect to her theoretical base for the
practice of nursing.
D. *Five Aims of Intervention
1. Build Trust
- Involves honesty, acceptance, respect, empathy, belief in the
client’s model of the world
- Therapeutic communication is essential
2. Promote positive orientation
- Nurse should promote self-worth as well as the client’s hope
for the future
3. Promote perceived control
- Nurse must promote the client’s perception of control
- An individual has some control over their lives
4. Promote strengths
- Means of assisting clients to mobilize resources
5. Set mutual goals that are health directed
- Nurse and the client have the same goal: to meet the
client’s basic needs
- If the goal is different – the nurse has most likely not fully
modelled the client’s world. Incomplete modeling can be the
result of inadequate data gathering and empathy, as lack of
knowledge for analysis and interpretation of the data
collected
E. Self-Care
(3 Aspects of Self-care)
1. *Self-care knowledge
- Knowledge one has about ‘what made him/her sick,
lessened his/her effectiveness, or interfered with his/her
own growth. The person also knows what will make him/her
well, promote his/her growth’
2. Self-care resources
- All individuals have internal and external resources that will
help gain, maintain and promote OLOF (optimum level of
functioning)
- Internal self-care resources – characteristic that result from
appropriate need satisfaction, positive resolution of
developmental tasks
- External self-care resources – perception, type of resources
used when ill or well, transitional objects (including technical
devices)
3. *Self-care action
- the development of self-care knowledge and self-care
resources – focus is on the individual’s personal knowledge
about what makes him or her well or ill.
F. Affiliated Individuation
- individuals are having simultaneous needs to be attached to
other individuals and to be separate from them.
- Ex. No decrease in affiliated individuation for caregiver of
persons with Alzheimer’s disease when the caregivers
participate in theory-based support group intervention
- Different from interdependence – it can occur without being
reciprocated.
 G. Theory and the Nursing Metaparadigm
1. Human being
- Holistic person
- Holism – the whole is greater than the sum of the parts
- Wholism – a person is an aggregate of parts and the whole is
equal to the sum of the parts.

2. Environment
- Internal and external that includes both stressors and
resources for adapting to stressors

3. Health
- same as the definition of WHO : a state of complete physical,
mental and social well-being and not merely the absence of
disease or infirmity
- connotes a state of dynamic equilibrium

4. Nursing
- Nurse and the client requires an interpersonal and
interactive nurse
- Client relationship
a. Facilitation – the nurse aids the individual to identify,
mobilize and develop his/her strengths
b. Nurturance – fusing and integrating of cognitive,
psychological, affective processes with the aim of assisting a
client toward holistic health
c. Unconditional acceptance – each individual is unique,
worthwhile and important with no strings attached
 Is the holistic helping of persons with their self-care
activities in relation to their health
 The goal is to achieve a state of perceived OLOF and
contentment