a conceptual model of nursing, formulated by Myra E. levine, concerned with the maintenance of the person's wholeness. The person is a holistic being, an organism that is a system of systems, and changes through adaptation. Adaptation is facilitated by the fight-or-flight mechanism, inflammatory processes, nonspecific bodily responses to stress, and perceptual awareness as experienced through the basic orienting, visual, auditory, taste-smell, and haptic systems. The environment includes internal and external components: the internal environment manifests homeorhesis, a stabilized flow, in the face of continuous change; the external environment is further divided into perceptual, operational, and conceptual components. The perceptual environment encompasses stimuli that can be perceived by the sense organs. The operational environment encompasses environmental factors that cannot be perceived by the sense organs. The conceptual environment encompasses exchange of language, ability to think, and ability to experience emotions, as well as value systems, religious beliefs, and ethnic and cultural traditions. Health is characterized as patterns of adaptive change. Adaptation is viewed as a matter of degree; some adaptations are successful, and some are not. Wellness in this model apparently refers to successful adaptation and wholeness. Illness is adaptation to noxious environmental forces, and disease is viewed as undisciplined and unregulated change. Nursing is a human interaction whose goal is to promote wholeness. The recipient of nursing care is a patient, or a person who is temporarily dependent on the nurse. The patient is viewed as a partner or participant in nursing care. Nursing process is conservation, or keeping together, and is based on both the scientific method and messages given by the patient. Thus the nursing care plan is viewed as a testable hypothesis based on facts that provoke the nurse's attention. Although a specific nursing process is not explicit in Levine's writings, some components can be extracted from her publications. Assessment focuses on the patient's nursing requirements. The primary question is: To what extent is the person adapting successfully or effectively? trophicognosis, an alternative to nursing diagnosis, is a nursing care judgment. One element of trophicognosis is the establishment of an objective and scientific rationale for nursing care; this includes identifying a basis for implementation of the prescribed medical or paramedical regimens, determining nursing processes demanded by medical treatment, and identifying the basis for implementation of the unique nursing needs of the patient. The second element is the implementation of nursing care. Nursing intervention is structured according to four conservation principles, including conservation of the patient's energy, conservation of the patient's structural integrity, conservation of the patient's personal integrity, and conservation of the patient's social integrity. Nursing interventions based on the conservation principles may be therapeutic, as when nursing intervention has a favorable influence on adaptation, or supportive, as when intervention can only maintain the status quo or fails to halt a downward course.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.
A conceptual model of nursing developed by Myra Levine. The person is viewed as a holistic being who adapts to environmental challenges. In this model the goal of nursing is to promote wholeness through conservation of energy, structural integrity, personal integrity, and social integrity.
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