theories leininger

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

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