peplau’s interpersonal relations theory

Peplau’s Interpersonal Relations Theory

By,Jannet maria elias

1st year msc nursing Mosc college of nursing

kolenchery

Hildegard E. Peplau’s Interpersonal Relations in Nursing

peplau's inter personal theory 205/02/23

• As Peplau entered nursing school. she made the conscious decision that if she was going to be a nurse. then she should be a good one.

• Peplau served as college head nurse and later as executive of health service at Bennington College, Vermont.

• Prior to it, psychiatric nurses were viewed only as companion to patients but her goal was to prepare nurse psychotherapists.

• Peplau require of her students examining their own verbal and nonverbal communications.


• Born in Reading. Pennsylvania (1909), USA. Diploma program in Pottstown, Pennsylvania in 1931.

• She is the only person who has been the executive director and president of ANA.

• Peplau was adviser to WHO, member of their first advisory committee.

• BA in interpersonal psychology from Bennington College in I943.


• MA in psychiatric nursing from Columbia University New York in 1947.

• Started first post baccalaureate program in nursing. • Published Interpersonal Relations in Nursing in 1952. • 1968 : Interpersonal techniques-the crux of psychiatric

nursing.• In 1974, Peplau retired from Rutgers, this allowed her

more time to devote to larger profession of nursing.• Worked as executive director and president of ANA. • Worked with WHO, NIMH and Nurse Corps.• Died in 1999.


Interpersonal Relations in Nursing Theory

• Stresses the importance of nurses’ ability to understand their own behaviors to help others identify perceived difficulties.

• Emphasizes the focus on the interpersonal processes and therapeutic relationship that develops between the nurse and client.

• Four phases of the nurse-patient relationship are identified

• Six primary roles of the nurse• Six secondary roles of the nurse


PEPLAU’S THEORY AND NURSING’S METAPARADIGM Person • According to Peplau, it is defined as an organism that “strives in its own way to reduce tension generated by needs“.Health•It is defined as 'a word symbol that implies forward movement of personality and other ongoing human processes in the “ direction of creative,constructive, productive, personal, and community living.”Environment•Peplau defined“ it in terms 0f existing forces outside the organism and in the context of culture from where customs and beliefs are acquired”.peplau's inter personal theory 705/02/23

Nursing •“It is a significant, therapeutic, interpersonal process”. •She defines it as a “human relationship between an individual who is sick or in need of health services, and a nurse especially educated to recognize and to respond to the need for help.”


MAJOR CONCEPTS OF PEPLAU’S THEORY•Nurses should apply principles of human relations to the problems that arise at all levels of experience.•Peplau’s theory explains the phases of interpersonal process, roles in nursing situations and methods for studying nursing as an interpersonal process.•Nursing is therapeutic in that it is a healing art, assisting an individual who is sick or in need of healthcare.


• Nursing is an interpersonal process because it involves interaction between two or more individuals with a common goal.

• The attainment of goal is achieved through the use of a series of steps following a series of pattern.

• The nurse and patient work together so that both become mature and knowledgeable in the process.


Roles of Nurses

PrimaryStrangerTeacherResource personCounselorSurrogateLeader

SecondaryTechnical expertMediatorSafety agentResearcherTutorManager of

environment


Different nursing roles assumed during the various phases of nurse -patient relationship

•Stranger: Receives the client in the same way one meets a stranger in other life situations. provides an accepting climate that builds trust.

•Teacher: Who imparts knowledge in reference to a need or interest.

•Resource person: One who provides a specific needed information that aids in the understanding of a problem or new situation.


• Counselors: Help to understand and integrate the meaning of current life circumstances. provide guidance and encouragement to make changes.

• Surrogate: Helps to clarify domains of dependence, interdependence and independence and acts on clients behalf as an advocate.

• Leader: Helps client assume maximum responsibility for meeting treatment goals in a mutually satisfying way.


ELEMENTS INVOLVED IN NURSE-PATIENT RELATIONSHIPContract•The time, place and purpose of meetings as well as conditions for termination are established between the nurse and the client. Boundaries•Roles of participants are clearly defined, the nurse is defined as a professional helper, the client’s needs and problems focus of the interaction.


Confidentiality•The nurse should share information only with professional staff who need to know. The nurse should obtain client’s written permission to share information with others outside the treatment team.Therapeutic Nurse Behaviors•Self-awareness •Genuineness . •Warmth and respectfulness . •Empathy•Cultural sensitivity •Responsibility . •Ethical practice.


4 Phases of nurse-patient relationship Orientation-client seeking

assistance, meeting of nurse-patient, identifying the problem and services needed ( interview process), and guidance.

Identification- identifying who is best to support needs, patient addresses personal feelings about the experience and is encouraged to participate in care to promote personal acceptance and satisfaction.


Phases cont.

Exploitation- patient attempts to explore, understand and deal with the problem, and gains independence on achieving the goal

Resolution- termination of the therapeutic relationship to encourage emotional balance for nurse and patient ( difficult for both patient and nurse as psychological dependence persists)


PEPLAU‘S WORK AND CHARACTERISTICS OF A THEORY

Interrelation of concepts .•Four phases inter-relate the different components of each phase Applicability•The nurse-patient interaction can apply to the concepts of human being, health, environment and nursing


Theories must be logic in nature

•This theory provides a logical systematic way of viewing nursing situations .•Key concepts such as anxiety, tension, goals and frustration are indicated with explicit relationships among them and progressive phases.

Generalizability

• This theory provides simplicity in regard to the natural progression of the NP relationship


Theories can be the bases for hypothesis that can be tested•Peplau’s theory has generated testable hypotheses.

Theories can be utilized by practitioners to guide and improve their practice • Peplau's anxiety continuum is still used in anxiety patients.

Theories must be consistent with other validated theories , laws and principles but will leave open unanswered questions that need to be investigated•Peplau s theory 15 consistent with various theories.


LIMITATIONS

•personal space considerations and community social service resources are considered less•health promotion and maintenance were less emphasized•Cannot be used in a patient who does not have a felt need eg.withdrawn patients, unconscious patients•some areas are not specific enough to generate hypothesis.


Application of Interpersonal Theory in Nursing Practice

• An article in Current Nursing evaluated using the theory in nursing practice – Assessment= Orientation phase– Nursing diagnosis– Planning=Identification phase– Implementing=Exploitation phase– Evaluation=Resolution phase(the theory allowed client’s needs to be assessed.

Application of the theory helped provide comprehensive care to the client)


Assessment Orientation Data collection and

analysis(continuous) May not be a felt need

Nursing diagnosisPlanning Mutually set goals

Implementation Plans initiated toward

achievement of mutually set goals May be accomplished by patient ,

nurse or family.Evaluation Based on mutually expected

behaviours. May lead to termination and

initiation of new plans

Non- continuous data collection Felt need Define needs

Identification Interdependent goal setting

Exploitation Patient actively seeking and

drawing help Patient initiated Resolution Occurs after other phases are

completed successfully Leads to termination.

INTERPERSONAL THEORY AND NURSING PROCESS


Education

•The theory urged the nurses to use nursing situations as a source of observations from which unique concepts could be derived.•By applying this theory in clinical areas, nurse acts as a participant observer and thus upgrades her previously acquired theoretical knowledge.•Interpersonal Relations in Nursing-used as a manual of instructions to nursing students.•Foundation of psychiatric nursing education.


Research

• Urology Nursing used the theory to educate newly diagnosed bladder cancer patients with the need for a urinary diversion, and ensure understanding.Outcome shows that the scope of a patient’s needs

requires a competent nurse to assume the changing roles in the four phases of the theory, expressing the importance of involving the patient in establishing goals and reviewing the goals frequently.


Research • British Journal of Nursing had an article researching

the credibility of Peplau’s theory, in mental health care, due to the expansion of nursing knowledge and the dynamics of a multidisciplinary team currently used in today’s practice.

• Public Health Nursing did a study, in homecare visits, (testing the use of Peplau’s theory) to work with multi-problem families, to identify interventions, individualized for the members, to see if relationship progression was increased within the family system resulting in optimized care of the patient.


peplau’s interpersonal relations theory

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