Wound Management: Using Levine’s Conservation Model to Guide Practice

Author(s): 
Matthew J. Leach, BN(Hons), ND, PhD

Levine’s conservation model,1 initially constructed as a teaching framework for medical-surgical nursing,2 is based on the belief that nursing interventions should be aimed at conserving function.3,4 Roberts and Taylor5 and Fawcett4 state that nurses currently use Levine’s model in practice by acting to preserve client energy and integrity — encouraging bed rest, maintaining pressure area care, and preserving privacy. To clarify the relationship between Levine’s conservation model and wound management, each of the four principles of Levine’s model will be examined. To enhance understanding of the context in which Levine’s conservation principles are presented, the underlying assumptions, definitions, and limitations of the model are discussed.

Definitions

Levine’s conservation model1 consists of four major principles. The principles are defined as follows:

  • conservation of energy — balancing energy output and input to avoid excessive fatigue4

  • conservation of structural integrity — maintaining or restoring the body structure by preventing physical breakdown and promoting healing5

  • conservation of personal integrity — maintaining or restoring the patient’s sense of identity and self-worth5 and…acknowledging uniqueness4

  • conservation of social integrity — fostering awareness that the patient…is a social being who interacts with others5 in their social environment.

Each of these principles — the reduction in energy expenditure, the improvement in structural, personal and social integrity, and the reclaiming of individual wholeness and health — is compatible with wound management.1 Levine’s principles are also specific and testable; hence, they already have been utilized as a framework for many studies.6-11 Many nursing researchers and practitioners adopt Levine’s model because the conservation principles provide a scientific and research-oriented approach to the majority of nursing interventions.3 Furthermore, as a theoretical framework, the rules of conservation and integrity are applicable to all aspects of nursing, from clinical practice to administration.12 As such, the conservation principles help anticipate and predict all fields of nursing practice by placing independent information into an organized framework.12

References: 

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