Interactive Theories PepLau

Interactive Theories
Hildegard E. Peplau
Theory of Interpersonal Relations
 Regarded as “mother of psychiatric nursing”
 Born in September 1,1909 at Reading, Pennsylvania
 Graduated from a diploma program in Pottstown, Pennsylvania in 1931
- (OR nurse supervisor)
 BA in interpersonal psychology from Bennington College in 1943
 MA in psychiatric nursing from Colombia University, New York in 1947
 EdD in curriculum development in 1953
 Professor emeritus from Rutgers University
 Started first post baccalaureate program in psychiatric nursing
 Certified in psychoanalysis by William Alanson White Institute of New York City
 Worked as executive director and president of ANA
 Worked with WHO, and nurse corps
 Died – March 7, 1999
Publications
 In 1952 published Interpersonal Relations in Nursing
 One of her first books that stated the need to emphasize importance of N-P
relationship in providing hlt care
 Credited with transformation of nursing from a group of skilled workers to a

profession
Historical Evolution of the Theory
 1943-45 served in the Army Nurse Corps
 312th Field Station Hospital in England
 American School of Military Psychiatry
 Worked with leading figures in British and American psychiatry
 After war worked to reshape mental health system in U.S.

 Passage of National Mental Health Act of 1946
Purpose
 The purpose of this theory is to facilitate the development of problem solving skills, within
the context of the interpersonal relationship between nurse and client, using education
and therapeutic interactions
 Peplau felt that nursing was a healing art and an interpersonal process between two or
more people with a common goal
 Psychodynamic nursing facilitates
 Understanding of one’s own behavior
 Helping others identify felt difficulties
 Nurse-patient relationship as partners
 Application of human relations to problems at all levels of experience
Uniqueness
 Theory was considered revolutionary at the time of development
 Nursing as a profession, not just a skill
 Made the way for psychiatric nursing specialty
Concepts and Definitions
 Person
 Environment
 Health
 Nursing
 Person
 A developing organism that tries to reduce anxiety caused by needs
 An individual is made of physiological, psychological and social spheres striving

towards equilibrium in life
 Environment
 Existing forces outside of the individual
 Being and occurring in the context of the nurse client relationship ( norms, customs
and beliefs)
 Health
 Peplau didn't include an exact definition of health within her model.
 Peplau viewed health as "a word symbol that implied forward movement of
personality and other ongoing human processes in the direction of creative,
constructive, productive, personal, and community living".
 Needs are physiological demands and interpersonal conditions.
 Nursing
 An educative and therapeutic relationship in which the nurse makes the

client a partner in their health care and promotion
 A significant therapeutic interpersonal process
Concepts and Definitions
 Roles of the Nurse
 Stranger
 Teacher
 Resource Person
 Counselor
 Leader
 Surrogate
Structure
 Four phases of the interpersonal relationship
 Orientation
 Identification
 Exploitation
 Resolution
 Orientation
 Nurse-Client, strangers
 Felt need/Define problem
 Trust and empowerment
 Encourage active participation
 Nurse determines what help client needs

 Factors influencing orientation phase
 Identification
Identify problems to be worked on during the relationship
Clarify perceptions and expectations
Level of dependence/independence
Selection of professional assistance
Capability to deal with identified problem/s
Decreases helplessness and hopelessness
 Exploitation
 Client utilizes all available services
 Plan is implemented and evaluated
 Continued assessment and assisting new needs of client
 Fluid with implementation phase: together called working phase.
 Resolution
 Clients needs met
 Mutual termination of relationship
 Goal, support systems, problem prevention

 Independence
Assumptions
 Both nurse and patient want an interpersonal relationship
 The patient is able to participate in an interpersonal relationship
 The interpersonal relationship will enhance self maturity and/or self fulfillment
 The patient has a felt need
Internal Criticism
 Clarity
 Concepts defined
 Concepts consistent
 Simplicity
 Simple in nature, yet generalize
 Definitions not clearly defined
 logical systematic way of viewing nursing situations (based on 4 phases of NPR
 Generality
 Multi-use
 Can apply to any nurse-patient relationship ( except comatose)
 Accessibility
 Easily accessible to practitioners to guide and improve their practice
 Empirical Precision
 Provides a theory based on reality. Tested and observed using pure observation
 Derivable Consequences
 Her thought, works and ideas have greatly touched the lives of many patients and
nurses, from students to practitioners.
Importance of the Theory to Nursing
 Understanding of one’s own behavior

 Integrates into any area of nursing
 Adaptability in any nurse patient relationship with the end purpose of meeting the patients
needs
Case Study
 Example of Peplau’s theory at work:
 Scenario common to ED’s: 54 yr old male to ED with CC of abd pain for 3 days with N/V. Pt
with hx of pancreatitis and ETOH abuse.
 Let’s look at the 4 phases with this pt
 Orientation: Problem defining phase
 Introductions : Nurse as stranger
 Asking questions
 Client conveys needs, expectations
 Nurse helps client identify problem: abd pain, N/V and alcohol abuse
 Identification: Nurse as counselor and advocate
 Identify problems to be addressed
 N/V and abd pain: conveyed by pt
 Education and resources for alcohol abuse
 Exploitation: Nurse as teacher, resource person, advocate and mediator
 Utilize available services and implement plan
 Lab, CT, X-ray, MD
 Continue to assess and re-evaluate
 Resolution:
 Termination of relationship
 Pt has all needs met: pt with abd pain and N/V resolved
 Pt with a plan for health maintenance: ie teaching and resources for alcohol abuse

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Interactive Theories

 Regarded as “mother of psychiatric nursing”

 Born in September 1,1909 at Reading, Pennsylvania

 Graduated from a diploma program in Pottstown, Pennsylvania in 1931

- (OR nurse supervisor)

 BA in interpersonal psychology from Bennington College in 1943

 MA in psychiatric nursing from Colombia University, New York in 1947

 EdD in curriculum development in 1953

 Professor emeritus from Rutgers University

 Started first post baccalaureate program in psychiatric nursing

 Certified in psychoanalysis by William Alanson White Institute of New York City

 Worked as executive director and president of ANA

 Worked with WHO, and nurse corps

 Died – March 7, 1999

 In 1952 published Interpersonal Relations in Nursing

 Credited with transformation of nursing from a group of skilled workers to a

Historical Evolution of the Theory

 1943-45 served in the Army Nurse Corps

 312th Field Station Hospital in England

 American School of Military Psychiatry

 Worked with leading figures in British and American psychiatry

 After war worked to reshape mental health system in U.S.

 Psychodynamic nursing facilitates

 Understanding of one’s own behavior

 Helping others identify felt difficulties

 Nurse-patient relationship as partners

 Application of human relations to problems at all levels of experience

 Theory was considered revolutionary at the time of development

 Nursing as a profession, not just a skill

 Made the way for psychiatric nursing specialty

Concepts and Definitions

 A developing organism that tries to reduce anxiety caused by needs

 An individual is made of physiological, psychological and social spheres striving

 Existing forces outside of the individual

 Needs are physiological demands and interpersonal conditions.

 An educative and therapeutic relationship in which the nurse makes the

 A significant therapeutic interpersonal process

Concepts and Definitions

 Roles of the Nurse

 Four phases of the interpersonal relationship

 Felt need/Define problem

 Trust and empowerment

 Encourage active participation

 Nurse determines what help client needs

Identify problems to be worked on during the relationship

Clarify perceptions and expectations

Selection of professional assistance

Capability to deal with identified problem/s

Decreases helplessness and hopelessness

 Client utilizes all available services

 Plan is implemented and evaluated

 Continued assessment and assisting new needs of client

 Fluid with implementation phase: together called working phase.

 Clients needs met

 Mutual termination of relationship

 Goal, support systems, problem prevention

 Both nurse and patient want an interpersonal relationship

 The patient is able to participate in an interpersonal relationship

 The patient has a felt need

 Simple in nature, yet generalize

 Definitions not clearly defined

 logical systematic way of viewing nursing situations (based on 4 phases of NPR

 Can apply to any nurse-patient relationship ( except comatose)

 Easily accessible to practitioners to guide and improve their practice