Congress Abstracts 2005

24

USING THE LEVINE CONSERVATION MODEL TO GUIDE AN INTERVENTION TRIAL OF EXERCISE TO MITIGATE CANCER TREATMENT-RELATED FATIGUE. Christine St. Ours, MS, RN, Amy Bositis, BS, RN, Sue Hall, MS, CRNP, and Victoria Mock, DNSc, RN, AOCN^®, FAAN, Johns Hopkins University School of Nursing, Baltimore, MD.

Using an appropriate theoretical framework can be a useful guide to the development, implementation, and evaluation of nursing intervention research.

Rigorous research design and methods are essential to the conduct of high quality intervention-testing research to manage cancer treatment-related fatigue. The purpose of this presentation is to illustrate the use of a theoretical framework to clarify the research question as well as to guide the intervention and selection of instruments in the design and conduct of a nursing intervention study.

The Levine Conservation Model defines four conservation principles: conservation of energy, structural integrity, personal integrity, and social integrity. Cancer diagnosis and treatment causes alterations and thus the need for adaptation in all four areas identified by Levine.

As this randomized clinical trial was designed, the Levine model was used to make sure all the principles were being considered. The intervention is a home-based moderate-intensity walking program that supports the conservation of energy and structural integrity by increasing functional capacity. It is also hypothesized that personal and social integrity will be enhanced when energy is conserved and individuals are able to maintain their social interactions. The intervention is being tested in 160 patients beginning chemotherapy or radiation therapy for a variety of cancer diagnoses. Evaluation of intervention effectiveness includes measurement of the four components of the Levine Model. Conservation of energy is measured by the Piper Fatigue Scale; structural integrity by measures of physical functioning using VO2 MAX on treadmill tests, physical functioning scale of the Medical Outcomes Study (MOS), pedometer, and accelerometer. Conservation of personal integrity is evaluated by the Profile of Mood States and the Symptom Distress Scale. Conservation of social integrity is measured with the social functioning scale of the MOS.

The Levine Model will be tested as the intervention is evaluated by comparing the exercise and usual care groups using Repeated Measures Analysis of Variance.

Using a theoretical model to guide nursing research informs development of the intervention and ensures that appropriate outcomes are included in the evaluation. In addition, study findings can be placed in the appropriate context of knowledge to guide nursing practice.