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206 UNIT III Nursing Conceptual Models

MAJOR CONCEPTS & DEFINITIONS
The three major concepts of the Conservation of failed redundancy of physiological and psycho-
Model are (1) wholeness, (2) adaptation, and (3) logical processes” (p. 6).
conservation.
Environment
Wholeness (Holism) Levine (1973) also views individuals as having their
“Whole, health, hale are all derivations of the Anglo- own environment, both internally and externally.
Saxon word hal” (Levine, 1973, p. 11). Levine based Nurses can relate to the internal environment as
her use of wholeness on Erikson’s (1964, 1968) the physiological and pathophysiological aspects
description of wholeness as an open system. Levine of the patient. Levine uses Bates’ (1967) definition of
(as cited in 1969a) quotes Erikson, who states, the external environment and suggests the following
“Wholeness emphasizes a sound, organic, progres- three levels:
sive mutuality between diversified functions and 1. Perceptual
parts within an entirety, the boundaries of which are 2. Operational
open and fluent” (p. 94). Levine (1996) believed that 3. Conceptual
Erikson’s definition set up the option of exploring These levels give dimension to the interactions
the parts of the whole to understand the whole. between individuals and their environments. The
Integrity means the oneness of the individuals, perceptual level includes aspects of the world that
emphasizing that they respond in an integrated, individuals are able to intercept and interpret with
singular fashion to environmental challenges. their sense organs. The operational level contains
things that affect individuals physically, although
Adaptation they cannot directly perceive them, things such as
“Adaptation is a process of change whereby the indi- microorganisms. At the conceptual level, the envi-
vidual retains his integrity within the realities of his ronment is constructed from cultural patterns,
internal and external environment” (Levine, 1973, characterized by a spiritual existence and mediated
p. 11). Conservation is the outcome. Some adapta- by the symbols of language, thought, and history
tions are successful and some are not. Adaptation is (Levine, 1973).
a matter of degree, not an all-or-nothing process.
There is no such thing as maladaptation. Organismic Response
Levine (1991) speaks of the following three char- The capacity of individuals to adapt to their envi-
acteristics of adaptation: ronmental conditions is called the organismic re-
1. Historicity sponse. It is divided into the following four levels
2. Specificity of integration:
3. Redundancy 1. Fight or flight
She states, “. . . every species has fixed patterns 2. Inflammatory response
of responses uniquely designed to ensure success 3. Response to stress
in essential life activities, demonstrating that 4. Perceptual awareness
adaptation is both historical and specific” (p. 5). Treatment focuses on the management of these
In addition, adaptive patterns may be hidden in responses to illness and disease (Levine, 1969a).
individuals’ genetic codes. Redundancy represents
the fail-safe options available to individuals to Fight or Flight
ensure adaptation. Loss of redundant choices The most primitive response is the fight or flight
through trauma, age, disease, or environmental syndrome. Individuals perceive that they are
conditions makes it difficult for individuals to threatened, whether or not a threat actually exists.
maintain life. Levine (1991) suggests that “the Hospitalization, illness, and new experiences elicit
possibility exists that aging itself is a consequence a response. Individuals respond by being on the