untitled

psychology, sociology, theology, etc.). The Theory
of Therapeutic Intention is directly related to the
biological realities. Therefore, the guiding assump-
tions for this theory are:

1. Conservation is the outcome of adaptation.


2. Change associated with therapeutic intervention
   results in adaptation.


3. The proper application of conservation (conser-
   vation principles) results in the restoration of
   health.


4. Activities directed toward the preservation of
   health include health promotion, surveillance,
   illness prevention, and follow-up activities.
   According to Fawcett (2000), Levine identified
   the following goals of the theory of therapeutic in-
   tention:


5. Support the integrated healing and optimal
   restoration of structure and function [by sup-
   porting and enhancing] the natural response to
   disease. This goal can be reached if the nurse
   caring for a patient with burns changes dressing
   as ordered, provides medication to reduce the
   pain associated with treatment, offers comple-
   mentary pain-reducing techniques, listens care-
   fully to the concerns the patient may have
   regarding self related to scarring from the burns,
   refers to appropriate counseling, and works
   closely with the family or support persons to
   maintain connections for the patient.


6. Provide support for a failing autoregulatory
   portion of the integrated system (e.g., medical/
   surgical treatments).


7. Restore individual integrity and well-being (e.g.,
   work with children with ADHD—attention
   deficit hyperactivity disorder).


8. Provide supportive measures to assure comfort
   and promote human concern when therapeutic
   measures are not possible (e.g., care of the dying).


9. Balance a toxic risk against the threat of disease
   (e.g., nurses who facilitate immunization).


10. Manipulate diet and activity to correct meta-
    bolic imbalances and to stimulate physiological
    processes (e.g., care of the anorexic young
    woman).


11. Reinforce or antagonize usual response to create
    a therapeutic change (e.g., enhance pain relief
    with music therapy).
    The expected outcome of therapeutic intentions
    would be a therapeutic response measured by the

organismic change (e.g., adaptation resulting in

conservation).

The theory of redundancy is grounded in the

concept of adaptation. Change is the process of

adaptation and conservation is the outcome of

adaptation. The theory of redundancy assumes that

there are fail-safe options available in the physio-

logical, anatomical, and psychological responses

of individuals who are employed in the develop-

ment of patient care. The body has more than

one way for its function to be accomplished. It in-

volves a series of adaptive responses (cascade of

integrated responses—simultaneous, not separate)

available when the stability of the organism is chal-

lenged (Schaefer, 1991b). The selection of an op-

tion rests with the knowledge of the health-care

provider in consultation with the patient. When re-

dundant choices are lost, survival becomes difficult

and ultimately fails for lack of fail-safe options—

either those that the patient possesses (e.g., two

lungs) or those that can be employed on his or her

behalf (e.g., medications or a pacemaker) (Levine,

1991).

Levine’s notion of the environment as com-

plex provides an excellent basis for continu-

ing to develop an improved understanding of

the environment. Studying the interactions

between the external and the internal envi-

ronment will provide for a better under-

standing of adaptation. This focus will

provide for additional information about the

challenges in the external environment

and how they change over time. It is impor-

tant that we understand the changes that

occur and how the person who adapted

before now changes the adaptive response in

order to maintain balance or integrity. This

adaptive response will inform the organismic

response. With an improved repertoire of or-

ganismic responses, we can test how to pre-

dict these responses, hence assure that the

responses that are adaptive will occur. This is

said with the understanding that nurses rec-

ognize when the goal is to maintain comfort

only (e.g., supportive interventions).

Moving to a more global perspective, the

environment as defined according to Levine

CHAPTER 9 Myra Levine’s Conservation Model and Its Applications 107