Sunday, July 26, 2009

Comparing And Analyzing A Core Concept From Two Different Nursing Theories

In this write -up, I would be comparing and analyzing a core concept from two different nursing theories. I would be writing on the ‘person’ as my core concept, and I would be writing from Sister Calista Roy’s adaptation model and Myra Levine Conservation theory.

Sister Calista Roy views the individual or person as an adaptive system and sees the nurse as the person to guide through the adaptation. Below are some extracts from the theory:
- Nursing is the science and practice that expands adaptive abilities and enhances person and environment transformation
- Nursing goals are to promote adaptation for individuals and groups in the four adaptive modes, thus contributing to health, quality of life, and dying with dignity
- This is done by assessing behavior and factors that influence adaptive abilities and

by intervening to expand those abilities and to enhance environmental interactions’. (Adapted from

Roy classifies stressors into internal and external stimuli, and sees the individual adapting to the internal and external stimuli. The nurse promotes adaptation in four adaptive modes which are: physiologic-physical, self-concept group identity, role function, and interdependence. Below are extracts about the concept of the ‘person’ from Roy’s theory:
- An adaptive system with coping processes
- Described as a whole comprised of parts
- Functions as a unity for some purpose
- Includes people as individuals or in groups (families, organizations, communities, nations, and society, as a whole)
An adaptive system with cognator and regulator subsystems acting to maintain adaptation in four adaptive modes: physiologic-physical, self concept, group identity, role function and interdependence’ (

On the other hand, ‘Myra Levine's Conservation Model focuses on conserving an individual's wholeness. Her framework includes four "Conservation Principles:" Energy, structural integrity, personal integrity, and social integrity. She describes three environments that present challenges to the individual: Perceptual, operational, and conceptual. She coined a word, "trophicognosis" to describe the nurse's judgments about the patient's condition’. (Summary by Becky Sisk, PhD, RN Adapted from
The four conservation principles are:
‘* Conservation of Energy: All physiologic and psychological processes that sustain life depend on the body's energy balance (adjusting to life in the nursing home; improving nutritional status, balancing resident activity, controlling resident anxiety and pain).
* Conservation of Structural Integrity: All body systems decline with aging. Chronic illness also produces bodily structural changes (maintaining or promoting mobility, preventing injury, preventing infection, maintaining skin integrity).
* Conservation of Personal Integrity: Self-identity is intrinsically bound to wholeness and all individuals cherish the sense of self (respecting one's privacy and property; enhancing self-esteem through good personal hygiene, grooming, and dress; fostering independence through choice and rehabilitation; promoting self-identity for those who are cognitively impaired; obtaining advance directives for treatment).
* Conservation of Social Integrity: Individual life has meaning only in the context of social life (providing meaningful social activities for residents and staff, considering the family and resident as a unit).’ (Cox, 2003)

The two theorists view the person as a ‘whole entity’. While Roy views the person as an adaptive system which is a whole entity comprising of different parts and functioning as a unit, for some reason, Levine views the person as a whole entity of which the different integrity have to be conserved, otherwise the person’s wholeness is affected.

A major difference is that Roy elaborates on her ‘person’ concept to involve groups, like families, and not just an individual whereas Levine sees the ‘person’ as one individual.

In conclusion, both theorists project the nurse as a powerful tool in the maintenance of the wholeness of this person, and as such, using both the art and science of nursing, the wholeness of the person (adaptive system in Roy’s and individual integrity in Levine’s) must be maintained.


International Journal of Nursing Terminologies and Classifications, Oct-Dec 2003 by Cox, Ruth Alyce