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8/8/2019 Theories Leininger
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Leiningers Theory ofLeiningers Theory ofCulture Care DiversityCulture Care Diversity
& Universality& Universality
VsVsLevines ConservationLevines ConservationModelModel
Leanne McFarland, LaraLeanne McFarland, LaraKim, & Astrid AndersonKim, & Astrid Anderson
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Madeleine LeiningerMadeleine Leininger
Theory of Culture CareDiversity & Universality
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Leiningers TheoryLeiningers Theory
Caring is the essence of nursing and is unique tonursing
Does not rely upon the four nursing paradigms ofperson, environment, health, and nursing
Too restrictive for open discovery aboutculture and care
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Leiningers TheoryLeiningers Theory Care & culture are inextricably linked
Leininger recognized the importance of anunderstanding of culture - both the nursesand the clients - to effective nursing practice.
All cultures have practices related to caring. Practices common across cultures are culture
care universalities Practices specific to a given culture are culture
care diversities Research findings indicate there is more
diversity than universality.
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Leiningers TheoryLeiningers Theory To practice from a cultural perspective:
Respect the culture
Recognize the importance of the culture to
nursing care
If not practiced:
Patient can show signs of cultural conflict,noncompliance, stress, and ethical or moral
concern
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Leiningers Sunrise EnablerLeiningers Sunrise EnablerA conceptual model to guide nursing judgments andA conceptual model to guide nursing judgments and
activities to provide culturally congruent careactivities to provide culturally congruent care
(See Chitty & Black, 2007, pg. 343)(See Chitty & Black, 2007, pg. 343)
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How does Leiningers theoryHow does Leiningers theory
inform our practice?inform our practice? Remember.culturally congruent care is carethat is beneficial and meaningful to the peoplebeing served (Andrews & Boyle, 2003, p. 6)
Culture should determine the way thatindividuals receive care, based on the differentways their cultures meet their basic needs.
By 2050, white native-born Americans areestimated to represent less than 50% of thepopulation. To care for this increasinglydiversified nation, nurses must embrace theconcept of culturally congruent care!
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Leininger in Practice ContLeininger in Practice Cont Leiningers theory does not focus on medical
symptoms, disease, or treatment, it focuses onthe nurses approach to care (this is truly aholistic nursing idea!)
Tailor your nursing care to your patients withthe goal of improving their comfort andresponse to care
Utilize this theory for holistic assessments ofthe patient
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Leininger In Practice ContLeininger In Practice Cont
Leiningers Theory is flexible and widely useful
it can be utilized with individuals, families,
groups, communities and institution in diversehealth systems (Andrews & Boyle, 2003, p. 6).
No matter what type or setting of nursing you
pursue, there is always a model to guide yourcare with concern to culture!
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Key Points to Remember..Key Points to Remember..
CULTURE
E
IN
GUIDES
N
G
E
CARE
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Levines Conservation ModelLevines Conservation Model
Four Guiding Principles
of the
Art of Nursing(1973)
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Primary Focus = ConservationPrimary Focus = Conservationof the Individualof the Individual
Adaptation to changes in health and disease soas to preserve individual integrity
Individuals require nursing care when they areunable to adapt and retain wholenessthemselves.
Conservation aims to maintain an equilibriumconducive to health; accordingly, many nursinginterventions use conservation principles tomaintain patient wholeness (Leach, 2006).
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A Conceptual Model toA Conceptual Model toGuide Nursing InterventionsGuide Nursing Interventions
Conservation of:
Energy
Structural Integrity Personal Integrity
Social Integrity
o Nursing Interventions focus on promotion andsupport of adaptation to preserve the fourprinciples
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Conservation of EnergyConservation of Energy
Promote the bodys energy balance when facedwith changes in psychological or physiologicalprocesses so as to sustain life
Energy conservation is based on the followingideas:
Patient activity is dependent on energy balance
Illness increases energy demand
Increased energy demand can be measured bythe level of fatigue (Leach, 2006)
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Conservation of StructuralConservation of StructuralIntegrityIntegrity
Age and illness can produce structural changeswhich require adaptation
Through conservation of structural integrity,patients will feel intact and whole andsubsequently manifest improvements in self-
identity (Leach, 2006)
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Conservation of PersonalConservation of PersonalIntegrityIntegrity
The conservation of personal integrity aims toprotect personal identity, an intrinsic factor towholeness of the individual
Conserving personal integrity is based on thefollowing ideas:
Individuals require privacy and are responsiblefor their own decisions
Illness and hospitalization compromise
personal integrity, self-identity, and self-respect (Leach, 2006).
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Conservation of SocialConservation of SocialIntegrityIntegrity
Social interaction and relationship of self to others iskey to unity of the individual
Conserving social integrity is based on the followingprinciples:
Individual life has meaning only in the context ofsocial life
Individual behavior is influenced by the ability torelate to various social groups
Families often are affected by an individuals illness
Hospitalization results in social isolation (Leach,2006)
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Example of Levines Conservation ModelExample of Levines Conservation Modelwww.idswww.ids--healthcare.comhealthcare.com
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How does Levines ModelHow does Levines Model
inform our practice?inform our practice? RememberLevines Conservation Model is used to guide
nursing interventions with the goal of conserving integrityof the individual through adaptation to physical andpsychological changes.
Nursing actions and interventions should
aim to conserve 4 areas of integrity:
Energy
Physical Integrity
Personal Integrity Social Integrity
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Nursing Interventions forNursing Interventions forConservation of EnergyConservation of Energy
The nurse will foster balance between energy output andinput to avoid excessive fatigue
Support adjustment to changes in livingsituations (i.e. SNF)
Improve nutritional status
Control pain and anxiety
Reduce patient activity when appropriate
Promote exercise andrehabilitation within the
patients abilities, limitations
and comfort
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Nursing Interventions forNursing Interventions forConservation of StructuralConservation of Structural
IntegrityIntegrity The nurse will help maintain or restore the patients body
structure by preventing physical breakdown and promotinghealing
Precautions in infection and injury prevention Promote mobility
Early ambulation to prevent complications of bed rest
Assist in adaptation to decreased mobility Maintain musculoskeletal integrity through ROM exercises
Maintain venous integrity through use of compression therapyand/or TED hose Maintain skin integrity (early detection and
management of disease processes conservestructural integrity)
Positioning
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Nursing Interventions forNursing Interventions forConservation of PersonalConservation of Personal
IntegrityIntegrity The nurse will help maintain or restore the patients sense
of identity and self-worth, acknowledging uniqueness of thepatient
Respect ones privacy and property Support personal choice Enhance self-esteem through good hygiene and dress Foster independence
Loss of independence negatively affects pride and self-
identity Provide knowledge and support, but encourage patient tomaintain independence
Promote appropriate coping mechanisms Exercise
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Nursing Interventions forNursing Interventions forConservation of SocialConservation of Social
IntegrityIntegrity
The nurse will foster awareness that the patient is a social
being who interacts with others in their social environment.
Promote meaningful social activities and outings
Encourage family support & education
Promote family participation in care
Foster patient interaction with others Promote healing to restore the
patients mobility
Promote exercise to increase
the patients ability to socialize
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Key Points to Remember.Key Points to Remember.
Levines Model focuses on conserving thepatients wholeness by regaining or maintainingtheir:
Energy Structural Integrity Personal Integrity Social Integrity
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ReferencesReferences Andrews, M.M. & Boyle, J.S. (2003). Transcultural concepts in nursing care (4th ed.).
Lippincott: Philadelphia.
Chitty, K.K. & Black, B.P. (2007) Professional nursing concepts and challenges (5th
ed.). Suanders Elsevier: St. Louis.
Cox, R.A. (2003). Using NANDA, NIC, and NOC With Levine's Conservation Principles
in a NursingH
ome. International Journal of Nursing Terminologies andClassifications, Oct-Dec.
Leach, M.J. (2006, August 1). Wound management: using Levines conservationmodel to guide practice. Ostomy Wound Management, 52 (8). Retrieved October 17,2008, from http://www.o-wm.com/article/6024
Mock V., St. Ours C., Hall S., Bositis A. , Tillery M. , Belcher A., Krumm S. &McCorkle R. (2007) Using a conceptual model in nursing research - mitigating fatigue
in cancer patients.Journal of Advanced Nursing 58(5), 503512.
Schaefer, K., Potylycki, M.J. (1993). Fatigue associated with congestive heart failure:use of Levine's Conservation Model.Journal of Advanced Nursing, 18, 260-268.
www.madeleine-leininger.com