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CHAPTER 12 Myra Estrin Levine 209

backdrop. “The individual actively participates in his
his adjustments as he struggles in the predicament environment” (Levine, 1973, p. 443). Levine discussed
of illness (Levine, 1966b, p. 2452).
the importance of the internal and external environ-
The essence of Levine’s theory is as follows: ment to the determinant of nursing interventions to
promote adaptation. “All adaptations represent the
. . . when nursing intervention influences adap- accommodation that is possible between the internal
tation favorably, or toward renewed social well- and external environment” (p. 12).
being, then the nurse is acting in a therapeutic
sense; when the response is unfavorable, the
nurse provides supportive care (1966b, p. 2450). Theoretical Assertions
The goal of nursing is to promote adaptation
and maintain wholeness (1971b, p. 258). Although many theoretical assertions can be generated
from Levine’s work, the four major assertions follow:
1. “Nursing intervention is based on the conserva-
Person tion of the individual patient’s energy” (Levine,
Person is described as a holistic being; wholeness is 1967a, p. 49).
integrity (Levine, 1991). Integrity means that the per- 2. “Nursing intervention is based on the conserva-
son has freedom of choice and movement. The person tion of the individual patient’s structural integrity”
has a sense of identity and self-worth. Levine also (Levine, 1967a, p. 56).
described person as a “system of systems, and in its 3. “Nursing intervention is based on the conserva-
wholeness expresses the organization of all the con- tion of the individual patient’s personal integrity”
tributing parts” (pp. 8–9). Persons experience life as (Levine, 1967a, p. 56).
change through adaptation with the goal of conserva- 4. “Nursing intervention is based on the conservation
tion. According to Levine (1989), “The life process is of the individual patient’s social integrity” (Levine,
the process of change” (p. 326). 1967b, p. 179).
Levine (1991) provided some thoughts about two
Health theories in their early stages of development. The the-
Health is socially determined by the ability to func- ory of therapeutic intention is intended to provide the
tion in a reasonably normal manner (Levine, 1969b). basis of nursing interventions that focus on biological
Social groups predetermine health. Health is not just realities of the patient. Although not planned as such,
an absence of pathological conditions. Health is the the theory naturally flows from the conservation prin-
return to self; individuals are free and able to pursue ciples. The theory of redundancy expands the redun-
their own interests within the context of their own dancy domain of adaptation and offers explanations
resources. Levine stressed the following: for redundant options such as those found in aging
and the physiological adaptation of a failing heart.
It is important to keep in mind that health is also
culturally determined—it is not an entity on its
own, but rather a definition imparted by the Logical Form
ethos and beliefs of the groups to which individu- Levine primarily uses deductive logic. In developing
als belong her model, Levine integrates theories and concepts
(M. Levine, personal communication, from the humanities and the sciences of nursing,
February 21, 1995).
physiology, psychology, and sociology. She uses the
Even for a single individual, the definition of information to analyze nursing practice situations
health will change over time. and describe nursing skills and activities. With the
assistance of many of her students and colleagues,
Environment and through her own personal health encounters,
Environment is conceptualized as the context in Levine has experienced the Conservation Model and
which individuals live their lives. It is not a passive its principles operating in practice.