Conceptual Models 3

Nursing
Conceptual Models
Nursing Conceptual Models
 Nursing conceptual models are concepts and their relationships that
specify a perspective and produce evidence among phenomena specific to
the discipline.
 Conceptual models address broad metaparadigm concepts (human beings,
health, nursing, and environment) that are central to their meaning in the
context of the particular framework and the discipline of nursing.
 Nursing conceptual models provide perspectives with different foci for
critical thinking about persons, families, and communities, and for making
knowledgeable nursing decisions.
Martha Rogers “Science of Unitary Human Beings”
“Theoretical Basis of Nursing” (1970)

“Nursing Science and an Art” (1988)
“Nursing Science of Unitary Human Beings” (1990)
Roger’s conceptual model maintains that:

• Nursing is considered as an art and science
• The science of nursing is “a body of abstract knowledge emerging from a scientific
research and logical analysis”
• The emergent knowledge is translated into nursing practice
• Nursing is a science because the term nursing signifies a body of knowledge
Concepts in Rogers’ nursing theory:

Energy Field
• Fundamental unit of both living (people) and nonliving (environment)
• Provides a way to view people and the environment as irreducible wholes
• “ potential for process, movement and change”
Openness
• No boundaries or barriers to inhibit energy flow between fields
• “Human beings openly participate in energy transformation with the environment
creating mutual exchange”

Pattern
• Pattern manifestations include person’s experiences, expressions, perceptions and
physical, mental, social, and spiritual data”
• Pan-dimensionality
• The parameters the humans use in language to describe events are arbitrary and the
present is relative; there is no temporal ordering of lives

• Homeodynamic principles postulate a way of viewing unitary human beings.
Three principles are resonancy, helicy, and integrity. These principles describe the
nature of the person/environment process involving change and growth
• 1. Resonancy – the intensity of change, embraces the continuos variability of the
human energy field as it evolves.
• 2. Helicy – The life process evolves in sequential stages along a curve that has the
same general shape
• 3. Integrality- covers the mutual, continuous relationship of the human and
environmental fields by resonance waves
Nursing Process (3 steps in Theory of Unitary Human Beings)

1. Assessment – assessment of human and environmental fields
2. Voluntary manual patterning
3. Evaluation
Focus of nursing curriculum:
Transmission of the body of knowledge
Teaching
Practicing Therapeutic Touch
Conducting regular in-service education
Developing Self-awareness - emphasis
Major Assumptions
Person (Unitary Human Being)
- A person is an open system in continuous process with the open system that is the
environment (integrality)
- The person has the capacity to participate knowingly in the process of change
Environment
- Each environment field is specific to its given human field. Both change
continuously and creatively
Health
“characteristics and behavior emerging out of the mutual, simultaneous interactyion of
the human and environmental fields”
Dorothea E. Orem - Self-Care Deficit Theory of Nursing
Nursing Practice Sciences (Nursing Systems)

Wholly Compensatory Nursing – patient is dependent
Partly Compensatory Nursing – pt can meet some needs
Supportive-Developmental Nursing- can meet some self-care requisites but needs
assistance with decision making and skills to learn self-care
Foundational Nursing Sciences
The Science of Self-Care
The Science of the Development and Exercise of Self-Care Agency in the Absence or
Presence of Limitations for Deliberate Action
The Science of Human Assistance for Persons with Health-Associated Self-Care
Deficits
Applied Nursing Sciences

Basic Non-Nursing Sciences
Biological
Medical
Human
Environmental
Self-Care Deficit nursing theory is a general theory composed of the following four
related theories:
1. The theory of self-care, which describes why and how people care for themselves.
2. The theory of dependent-care, which explains how family members and/or friends
provide dependent-care for a person who is socially dependent.
3. The theory of self-care deficit, which describes and explains why people can be
helped through nursing
4. The theory of nursing systems, which describes and explains relationships that must
be brought about and maintained for nursing to be produced
SCDNT involves 4 structured cognitive operations:

1. Diagnostic – establish therapeutic communication, diagnose self-care deficits
2. Prescriptive – calculate ideal therapeutic self-care demand, design therapeutic
self-care demands, prioritize therapeutic self-care demands, prescribe client role
and nurse role
3. Regulatory – design, plan and production
4. Control – observe and appraise regulatory operations
Basic Conditioning Factors

Basic conditioning factors condition or affect the value of the therapeutic self-care demand
and/or the self-care agency of an individual at particular times and under specific
circumstances. The following ten factors have been identified:
Age
Gender
Developmental state
Health state
Pattern of living
Health care system factors
Family system factors
Socio-cultural factors
Availability of resources
External environmental factors
a. Universal Self-Care Requisites

The following eight self-care requisites common to men, women, and children are
suggested:
1. Maintenance of a sufficient intake of air
2. Maintenance of a sufficient intake of food
3. Maintenance of a sufficient intake of water
4. Provision of care associated with elimination processes and excrements
5. Maintenance of balance between activity and rest
Universal Self-Care Requisites

6. Maintenance of balance between solitude and social interaction
7. Prevention of hazards to human life, human functioning, and human well-being
8. Promotion of human functioning and development within social groups in
accordance with human potential, known human limitations, and the human desire to
be normal.
b. Developmental Self-Care Requisites (DSCRs)

1. Provisions of conditions that promote development
2. Engagement in self-development
3. Prevention of or overcoming effects of human conditions and life situations that
can adversely affect human development Ex. New job, pregnancy, adolescent
years, old age
c. Health Deviation Self-care Requisites

Required in conditions of illness, injury or disease
1. Seeking and securing appropriate medical assistance
2. Being aware of and attending to the effects and results of pathologic conditions
3. Effectively carrying our medically prescribed measures
4. Modifying self-concepts in accepting oneself as being in particular state of health
and in specific forms of health care
5. Learning to live with effects of pathologic conditions
Theory of self-care deficit

- Specific when nursing is needed because the person cannot carry out self-care
- Nursing is required when an adult (or in the case of a dependent, the parent) is
encapable or limited in the provision of continuous effective self-care
- 5 methods of helping:
1. Acting for and doing for others
2. Guiding others
3. Supporting another
4. Providing an environment to promote patient’s ability
5. Teaching another
Assumptions:
Person
• A unity that can function biologically, symbolically and socially
• A human being who has health-related/health-related derived limitations that render
him encapable of continuous self-care or dependent care or limitations that result in
ineffective/incomplete care
Environment
• Environmental factors, environmental elements, conditions and developmental
environment
Assumptions:
Health
• When human beings are structurally and functionally whole or sound
Nursing
• Is an art, a helping service, and a technology
• Actions deliberately selected and performed by nurses to help individuals or groups
under their care to maintain or change conditions in themselves or their
environment
Imogene M. King - Conceptual System and Middle-
Range Theory of Goal Attainment
Self
- “The self is a composite of thoughts and feelings
which constitute a person’s awareness of his [/her]
individual existence, his [/her] conception of who
and what he [/she] is.
- The self is the individual as known to the individual. It is
that to which we refer when we say, ‘I’”
Health
“dynamic life experiences of a human being, which implies continuous adjustment to
stressors in the internal and external environment through optimum use of one’s
resources to achieve maximum potential for daily living”
Nursing
“ process of action, reaction and interaction whereby nurse and client share
information about their perceptions in the nursing situation”
King (1995b) stated the following:

“Mutual goal setting [between a nurse and a client] is based on (a) nurses’ assessment
of a client’s concerns, problems, and disturbances in health; (b) nurses’ and clients’
perceptions of the interference; and (c) their sharing of information whereby each
functions to help the client attain the goals identified. In addition, nurses interact with
family members when clients cannot verbally participate in the goal setting”
3 Interacting Systems
a. Personal Systems
1. Perception
2. Self
3. Growth and Development
4. Body image
5. Learning
6. Time
7. Personal space
8. Coping
p. 215
b. Interpersonal Systems
1. Communication
2. Interaction
3. Role
4. Stress
5. Stressors
6. Transaction
p. 216
c. Social system
1. Organization
2. Authority
3. Power
4. Status
5. Decision making
Application of Nursing Process
Assessment
- Occur during interaction
- Nurse collects data regarding client
- Perception is the base for collection and interpretation of data
- Communication is required to verify accuracy of perception, for interaction and
transaction
Nursing Diagnosis
- The nurse identifies the problems, concerns and disturbances about which person
seeks help.
Application of Nursing Process
Planning
- Planning for interventions for problems
- Setting goals and making decisions to achieve goals
Implementation
- Actual activities to achieve goals
- Continuation of transaction
Evaluation
- Goals are achieved or not?
- - attainment of goal and effectiveness of care
Imogene M. King - Conceptual System and
Middle-Range Theory of Goal Attainment
Major Assumptions
Nursing
- Nursing is an interpersonal process of action, reaction, interaction, and
transaction.
- Perceptions of a nurse and a patient influence
the interpersonal process.
Major Assumptions
Person
- Individuals are spiritual beings
- Individuals have the ability through their language
and other symbols to record their history and preserve their culture
- Individuals are unique and holistic, of intrinsic
worth, and capable of rational thinking and decision
making in most situations
- Individuals differ in their needs, wants, and goals
Major Assumptions
Health
Health is a dynamic state in the life cycle, while illness interferes with that
process.
Health “implies continuous adjustment to stress in the internal and external
environment through the optimum use of one’s resources to achieve the
maximum potential for daily living”
Major Assumptions
Environment
- King (1981) believed that “an understanding of the
ways that human beings interact with their environment to maintain health
was essential for nurses”
- Open systems imply that interactions occur constantly between the system
and the system’s environment.
Betty Neuman’s Systems Model
The Neuman Systems Model is a unique, opensystems-
based perspective that provides a unifying focus for approaching a wide range
of concerns.
A system acts as a boundary for a single client, a group, or even a number of
groups; it can also be defined as a social issue. A client system in interaction
with the environment delineates the domain of nursing concerns
Wholistic Approach
Clients are viewed as wholes whose parts are in
dynamic interaction.
The model considers all variables simultaneously affecting the client system:
physiological, psychological, sociocultural, developmental, and spiritual
Open System
A system is open when there is a continuous flow of input and processes,
output, and feedback. Stress and reaction to stress are basic components of an
open system
Environment
As defined by Neuman, “ . . . internal and external forces surrounding the
client, influencing and being influenced by the client, at any point in time”
Client System
The client system is a composite of five variables (physiological,
psychological, sociocultural, developmental, and spiritual) in interaction with
the environment
Health
Health is a continuum of wellness to illness that is dynamic in nature. Optimal
wellness exists when the total system needs are being completely met
Stressors
Stressors are tension-producing stimuli that have
the potential to disrupt system stability, leading to an outcome that may be positive
or negative. They may arise from the following:
Intrapersonal forces occurring within the individual,
such as conditioned responses (seeing a dog/doctor)
Interpersonal forces occurring between one or
more individuals, such as role expectations (new mother)
Extrapersonal forces occurring outside the individual,
such as financial circumstances
Prevention As Intervention
Primary Prevention
Primary prevention is used when a stressor is suspected or identified. A
reaction has not yet occurred, but the degree of risk is known.
The purpose is to reduce the possibility of encounter with the stressor or to
decrease the possibility of a reaction
Secondary Prevention
- Secondary prevention involves interventions or treatment initiated after
symptoms from stress have occurred.
- The client’s internal and external resources are used to strengthen internal
lines of resistance, reduce the reaction, and increase resistance factors
Prevention As Intervention
Tertiary Prevention occurs after the active treatment
or secondary prevention stage.
It focuses on readjustment toward optimal client system stability.
The goal is to maintain optimal wellness by
preventing recurrence of reaction or regression.
Tertiary prevention leads back in a circular fashion
toward primary prevention
Reconstruction/Reconstitution
Reconstitution occurs after treatment for stressor
reactions.
It represents return of the system to stability, which may be at a higher or
lower level of wellness than before stressor invasion
Person Variables
1. Physiological variable
Individual system: Circulation-v/s, pulses, heart sounds, skin color, skin
temp.
Community system: vital statistics, morbidity, mortality
2. Psychological variable:
- Mental processes and emotions
Ex. Self-esteem and its effects on relationships for the individual
3. Developmental variable
“Empty Nest Syndrome” – a feeling of grief and loneliness parents may feel
when their children leave home for the first time, such as to live on their own
or to attend a college or university.
“Sandwich generation” – refers to middle-age adults (often in their 40s and
50s) who are caring for both elderly parents and their own children
4. Socio-cultural variable
- Relationships, social and cultural expectations and activities
Ex. Ethnic cultural practices and health belief practices on:
a. Birthing
b. Foo preferences in different regions of the country
c. Care of the dying and dead
5. Spiritual variable: Influence of spiritual beliefs
Ex.
a. Anointing the sick with oil among Roman Catholics
b. Avoiding scavenger fishes (shrimps, squids, crabs, fishes with no scales)
among Seventh Day Adventists
c. Prohibiting blood transfusions among Jehovah’s Witnesses
Major Assumptions
Nursing
Neuman (1982) believes that nursing is concerned with the whole person.
She views nursing as a “unique profession in that it is concerned with all of
the variables affecting an individual’s response to stress
Person
Neuman presents the concept of person as an open
client system in reciprocal interaction with the environment.
The client may be an individual, family, group, community, or social issue
Major Assumptions
Health
Neuman considers her work a wellness model.
She views health as a continuum of wellness to illness
that is dynamic in nature and is constantly changing
environment
Neuman defines environment as all the internal and
external factors that surround and influence the client
system.
Stressors (intrapersonal, interpersonal, and
extrapersonal) are significant to the concept of environment and are described as
environmental forces that interact with and potentially alter system stability
System S isterC a lista R o y ’sA D A P T A T IO N M O D E L
-“a set of parts connected to function as a

whole for some purpose and that does so by virtue of
the interdependence of its parts”
In addition to having wholeness and related parts, “systems also have inputs,
outputs, and control and feedback processes
Adaptation Level
- represents the condition of the life processes described on three levels as
integrated, compensatory, and compromised”
Adaptation Problems are “broad areas of concern related to adaptation.
S isterC a lista R o y ’sA D A P T A T IO N M O D E L
These describe the difficulties related to the indicators of positive adaptation”

Focal Stimulus
“the internal or external stimulus most immediately confronting the human
system”
Contextual Stimuli
-“are all other stimuli present in the situation that contribute to the effect of
the focal stimulus”
- “all the environmental factors that present to the person from within or
without but which are not the center of the person’s attention and/or energy”
Residual Stimuli S isterC a lista R o y ’sA D A P T A T IO N M O D E L
“are environmental factors within or without the human system with effects in
the current situation that are unclear”
Coping Processes
“are innate or acquired ways of interacting with the changing environment
Innate Coping Mechanisms
“are genetically determined or common to the species and are generally
viewed as automatic processes; humans do not have to think about them”
Acquired Coping Mechanisms
“are developed through strategies such as learning.
- The experiences encountered throughout life contribute to customary
responses to particular stimuli”
Regulator Subsystem S isterC a lista R o y ’sA D A P T A T IO N M O D E L
Regulator is “a major coping process involving the

Neural, chemical, and endocrine systems”
Cognator Subsystem
Cognator is “a major coping process involving four cognitive-emotive
channels: perceptual and information processing, learning, judgment, and
emotion”
Adaptive Responses
Adaptive responses are those “that promote integrity in terms of the goals of
human systems”
Ineffective Responses
- are responses “that do not contribute
to integrity in terms of the goals of the human system”
Integrated Life Process S isterC a lista R o y ’sA D A P T A T IO N M O D E L
refers to the “adaptation level at which the structures and functions of a life
process are working as a whole to meet human needs”
Physiological-Physical Mode
The physiological mode “is associated with the physical
and chemical processes involved in the function and activities of living
organisms”
Five needs are identified in the physiological-
physical mode relative to the basic need of
physiological integrity as follows: (1) oxygenation,
(2) nutrition, (3) elimination, (4) activity and rest,
and (5) protection
Complex processes that include the senses; fluid, electrolyte, and acid-base
balance; neurological function; and endocrine function contribute to

physiological adaptation
The basic need of the physiological mode is physiological integrity
The basic need of the physical mode is operating integrity
Self-Concept-Group Identity Mode
The self-concept-group identity mode is one of the
three psychosocial modes; “it focuses specifically on
the psychological and spiritual aspects of the human
system
Role Function Mode S isterC a lista R o y ’sA D A P T A T IO N M O D E L
- “is one of two social modes and focuses on the roles the person occupies in
society.
A set of expectations about how a person occupying one position behaves
toward a person occupying another position
Primary role determines the majority of behavior engaged in by the person
during a particular period of life. It is determined by age, sex, and
developmental stage
Secondary role are those that a person assumes to complete the task
associated with a developmental stage and primary role
Tertiary role are related primarily to secondary roles and represent ways in
which individuals meet their role associated obligations
- are normally temporary in nature, freely chosen by the individual, and may
include activities such as clubs or hobbies”
The major roles that one plays can be analyzed by
imagining a tree formation. The trunk of the tree is

one’s primary role, or developmental level, such as a
generative adult female.
Secondary roles branch off from this—for example, wife, mother, and
teacher.
Tertiary roles branch off from secondary roles—for example, the mother role
might involve the role of parent-teacher association president for a given
period.
Interdependence Mode S isterC a lista R o y ’sA D A P T A T IO N M O D E L
The basic need of this mode is termed relational integrity
Two specific relationships are the focus of the interdependence mode as it applies to
individuals:
First is with significant others, persons who are the most important to the individual.
Second is with support systems, others contributing to meeting interdependence need
Two major areas of interdependence behaviors have

been identified: receptive behavior and contributive
behavior. These behaviors apply respectively to the
“receiving and giving of love, respect and value in
interdependent relationships
Perception S isterC a lista R o y ’sA D A P T A T IO N M O D E L
- is the interpretation of a stimulus and the

conscious appreciation of it”
Perception links the regulator with the cognator and
connects the adaptive modes
Major Assumptions
Adaptation
- refers to “the process and outcome whereby thinking and feeling persons, as
individuals or in groups, use conscious awareness and choice to create human
and environmental integration”
Environmental Stimuli
Focal stimulus – internal or external stimulus most immediately challenging the
person’s adaptation
Contextual stimuli – all other stimuli existing in a situation that strengthen the
effect of the focal stimulus
Residual stimuli – any other phenomena arising from a person’s internal or
external environment that may affect the focal stimulus but whose effects are
unclear
Coping mechanisms
Regular subsystem – occur through neural, chemical and endocrine processes;
automatic responses to stimuli
Cognator subsystem – occur through cognitive-emotive processes – perceptual
and information processing, learning, judgment and emotion
Control processes that coincide with the regulator and cognator system when
a person responds to a stimulus S isterC a lista R o y ’sA D A P T A T IO N M O D E L
Stabilizer subsystem – “established structures, values and daily activities

whereby participants accomplish the primary purpose of the group
Innovator subsystem – cognitive and emotional strategies that allow a person to
change to higher levels of potential
Four adaptive modes:
1. Physiological
2. Self-concept
3. Role function
4. Interdependence
Major Assumptions S isterC a lista R o y ’sA D A P T A T IO N M O D E L
Nursing
as a “health care profession that focuses on human life processes and patterns
and emphasizes promotion of health for individuals, families, groups, and
society as a whole
Nursing science is “a developing system of
knowledge about persons that observes, classifies, and
relates the processes by which persons positively affect
their health status
Nursing as a practice discipline is “nursing’s scientific body
of knowledge used for the purpose of providing an essential service to people,
that is, promoting ability to affect health positively”
Person
- humans are holistic, adaptive systems.
“As an adaptive system, the human system is described as a whole
- Despite their great diversity, all persons are united in a common destiny.
Persons and the earth have common patterns and mutuality of relations and
meaning
- the person as the main focus of nursing, the recipient of nursing care, a
living, complex, adaptive system with internal processes (cognator and
regulator) acting to maintain adaptation in the four adaptive modes
(physiological, self-concept, role function, and interdependence).
Health
“Health is a state and a process of being and becoming integrated and a whole
person. It is a reflection of adaptation, that is, the interaction of the person
and the environment”
Environment
“It is the changing environment that stimulates the person to make adaptive
responses”
- Factors in the environment that affect the person are categorized as focal,
contextual, and residual stimuli.
Dorothy E. Johnson - Behavioral System Mode
Behavior
the output of intraorganismic structures and processes as they are coordinated
and articulated by and responsive to changes in sensory stimulation
behavior affected by the actual or implied presence of other social beings that
has been shown to have major adaptive significance
System
“A system is a whole that functions as a whole by virtue of the
interdependence of its parts”
- a person strives to maintain a balance in these parts through adjustments and
adaptations to the impinging forces.
Behavioral System
- A person as a behavioral system tries to achieve stability and balance by
adjustments and adaptations that are successful to some degree for efficient
and effective functioning.
- The system is usually flexible enough to accommodate
the influences affecting it
Subsystems
“a mini-system with its own particular goal and function that can be
maintained as long as its relationship to the other subsystems or the
environment is not disturbed”
The seven identified subsystems are attachment-affiliative, dependency,
ingestive, eliminative, sexual, achievement, and aggressive-protective -
Motivational drives direct the activities of these subsystems, which are
continually changing through maturation, experience, and learning
SUB-SYSTEMS:
Attachment-Affiliative Subsystem
- most critical because it forms the basis for all social organization
it provides survival and security
Its consequences are social inclusion, intimacy, and formation and
maintenance of a strong social bond
Dependency Subsystem
Promotes helping behavior that calls for a nurturing response
Its consequences are approval, attention or recognition, and physical
assistance
Developmentally, dependency behavior evolves from almost total dependence
on others to a greater degree of dependence on self
Ingestive Subsystem
- The ingestive subsystem “has to do with when, how, what, how much, and
under what conditions we eat”
“It serves the broad function of appetitive satisfaction”
This behavior is associated with social, psychological, and biological
considerations
Eliminative Subsystem
addresses “when, how, and under what conditions we eliminate
The social and psychological factors are viewed as influencing
the biological aspects of this subsystem and may be, at times, in conflict with
the eliminative subsystem
Sexual Subsystem
- has the dual functions of procreation and gratification.
- Including, but notlimited to, courting and mating, this response system
begins with the development of gender role identity and includes the broad
range of sex-role
Achievement Subsystem
Its function is control or mastery of an aspect of self or environment to some
standard of excellence.
Areas of achievement behavior include intellectual, physical, creative,
mechanical, and social skills
Aggressive-Protective Subsystem
The aggressive-protective subsystem’s function is protection and preservation.
Society demands that limits be placed on modes of self-protection and that
people and their property be respected and protected
Each subsystem has 3 functional requirements:
1. Must be protected from noxious influences with which system cannot
cope
2. Must be nurtured through the input of appropriate supplies from the
environment
3. Must be stimulated for use to enhance growth and prevent stagnation.
Equilibrium
-It is defined as “a stabilized but more or less transitory, resting state in which
the individual is in harmony with himself and with his environment”
- “It implies that biological and psychological forces are in balance with each
other and with impinging social forces”
It is “not synonymous with a state of health, since it may be found either in
health or illness”
Stressor
Internal or external stimuli that produce tension and result in a degree of
instability are called stressors
“Stimuli may be positive in that they are present; or negative in that something
desired or required is absent may be either endogenous or exogenous in origin
and may play upon one or more of our linked open systems
The open-linked systems include the physiological, personality, and
meaningful small group (the family) systems and the larger social system
Major Assumptions
Nursing
- Nursing’s goal is to maintain and restore the person’s behavioral system
balance and stability or to help the person achieve a more optimum level of
balance and functioning
- An art and a science, nursing supplies external assistance
both before and during system balance disturbance and therefore requires
knowledge of order, disorder, and control
Person
Johnson (1980) viewed the person as a behavioral system with patterned,
repetitive, and purposeful ways of behaving that link the person with the
environment.
- The conception of the person is basically a motivational one
Major Assumptions
Health
Johnson perceived health as an elusive, dynamic state
influenced by biological, psychological, and social factors.
Health is reflected by the organization, interaction,
interdependence, and integration of the subsystems of the behavioral system
Environment
- In Johnson’s theory, the environment consists of all
the factors that are not part of the individual’s behavioral
system, but that influence the system
- The nurse may manipulate some aspects of the environment so
the goal of health or behavioral system balance can be achieved for the patient
Major Assumptions:
Assessment
Johnson’s 7 subsystems:
• Affiliation
• Dependency
• Sexuality
• Aggression
• Elimination
• Ingestion
• Achievement
• Restorative
Major Assumptions:
Diagnosis:
4 categories of nursing diagnoses:
1. Insufficiency
2. Discrepancy
3. Incompatibility
4. Dominance
Outcomes, Planning and Implementation
• Focus on nurses; actions to modify client’s behavior
• The plan may include protection, nurturance, or stimulation of the identified
subsystem
Major Assumptions:
Evaluation
• A nurse-centered activity, with the nurse determining the client’s needs and
state behavior appropriate for the need.
• The nurse should be able to observe the return to the previous behavior
patterns
Myra Estrine Levine – Conservation Model
1. Conservation – is the keeping together of the life system
“Keep together” means to maintain a proper balance between active nursing

interventions coupled with patient participation and on the other hand, the safe
limits of the patient’s ability to participate
- Achieving a balance of energy supply and demand that is unique biological

realities of the individual
- - goal is health and the strength to confront disability

2. Adaptation – achieved through the frugal, economic, contained, and
controlled use of environmental resources by the individual in his/her best
interest
- Process by which individual “fit” to the environments in which they live
3. Wholeness – exists when the interactions or constant adaptations to the

environment permit the assurance of integrity
Conservation principles:
a. Conservation of Energy – balancing energy input and output.
- Rest, nutrition and exercise
a. Conservation of Structural integrity – maintaining or restoring the
structure of the body preventing physical breakdown and promoting
healing
e.g. providing ROM exercise to a bedridden patient to prevent deformities,

change of diaper and good perianal care for an infant to prevent perianal
rashes, turn the patient at regular intervals to prevent pressure sores
c. Conservation of personal integrity
- Recognizes the individual as one who strives for recognition, respect, self-
awareness, selfhood, and self-determination
e.g Recognize and protect patient’s privacy and space needs, assisting
patient to maintain good body image after breast surgery, providing adequate
information about procedures to be done
d. Conservation of social integrity – an individual is recognized as one who
has family and friends, community, workplace and school, religion, personal
choices, political system, cultural and ethnic heritage and a nation
e.g. allowing visits from family members in times of hospitalization,
supporting spiritual needs and religious practices of patients
Major Assumptions:
Nursing
• Nursing as both a profession and scientific discipline
• Nursing is a human interaction
• Nursing is a profession as well as an academic discipline
Person
• A holistic being; wholeness is integrity
• Integrity means the person has freedom of choice and movement
• The person has a sense of identity and self-worth
• Patient (to suffer); Client (to follow)
Major Assumptions:
Health
• The ability to function in a reasonably normal manner
• The return to self
Environment
• The individual actively participates in his environment
• The process of interaction is adaptation

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Conceptual Models 3

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Nursing

“Theoretical Basis of Nursing” (1970)

Roger’s conceptual model maintains that:

Concepts in Rogers’ nursing theory:

Concepts in Rogers’ nursing theory:

Concepts in Rogers’ nursing theory:

Nursing Process (3 steps in Theory of Unitary Human Beings)

Nursing Practice Sciences (Nursing Systems)

Applied Nursing Sciences

SCDNT involves 4 structured cognitive operations:

Basic Conditioning Factors

a. Universal Self-Care Requisites

Universal Self-Care Requisites

b. Developmental Self-Care Requisites (DSCRs)

c. Health Deviation Self-care Requisites

Theory of self-care deficit

King (1995b) stated the following:

-“a set of parts connected to function as a

These describe the difficulties related to the indicators of positive adaptation”

Regulator is “a major coping process involving the

balance; neurological function; and endocrine function contribute to

imagining a tree formation. The trunk of the tree is

The basic need of this mode is termed relational integrity

Two major areas of interdependence behaviors have

- is the interpretation of a stimulus and the

Stabilizer subsystem – “established structures, values and daily activities

“Keep together” means to maintain a proper balance between active nursing

- Achieving a balance of energy supply and demand that is unique biological

- - goal is health and the strength to confront disability

3. Wholeness – exists when the interactions or constant adaptations to the

e.g. providing ROM exercise to a bedridden patient to prevent deformities,

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