THEORETICAL FOUNDATIONS OF NURSING
LECTURE-DISCUSSION
THEORIST: Hildegard E. Peplau’s Theory of Interpersonal Relations
OUTLINE
1. Credentials and Background of Hildegard E.
Peplau
2. Assumptions
3. Therapeutic Nurse-Patient Relationship
4. Four Phases of Nurse-Patient Relationship
5. Sub-concepts of Interpersonal Relations Theory
a. Roles of Nurses
b. Four levels of Anxiety
6. Theoretical Assertions
CREDENTIALS AND BACKGROUND OF THE
THEORIST
WHO IS HILDEGARD E. PEPLAU
● Hildegard Peplau was born on September
1, 1909 and died on March 17, 1999
● In 1918, she witnessed the devastating flu
epidemic that greatly influenced her
understanding of the impact of illness and
death on families.
● Earned a Bachelor’s degree in
interpersonal psychology
● Only one to serve the American Nurses
Association (ANA) as Executive Director
and later as President.
● She became the first published nursing
theorist since Florence Nightingale.
● “Mother of Psychiatric Nursing” and the
“Nurse of the Century.”
ASSUMPTIONS
1. Nurse and the patient can interact.
2. Peplau emphasized that both the patient
and nurse mature as the result of the
therapeutic interaction.
3. Communication and interviewing skills
remain fundamental nursing tools.
4. Peplau believed that nurses must clearly
understand themselves to promote their
client’s growth and to avoid limiting the
client’s choices to those that nurses value.
THERAPEUTIC NURSE-CLIENT RELATIONSHIP
● A professional and planned relationship
between client and nurse that focuses on
the client’s needs, feelings, problems, and
ideas.
4 PHASES
ORIENTATION PHASE
● Defines the problem
● Identifies the type of service needed by
the patient
● Patient seeks assistance, tells the nurse
what he or she needs, asks questions, and
shares preconceptions and expectations
based on past experiences
● The nurse’s assessment of the patient’s
health and situation.
IDENTIFICATION PHASE
● Selection of the appropriate assistance by
a professional.
● The patient begins to feel as if he or she
belongs, and feels capable of dealing with
the problem which decreases the feeling
of helplessness and hopelessness.
● Development of a nursing care plan
based on the patient’s situation and
goals.
EXPLOITATION PHASE
● Uses professional assistance for
problem-solving alternatives.
● The client makes full use of the services
offered.
● Advantages of services are used based on
the needs and interest of the patients
● Individual feel as an integral part of the
helping environment
● They may make minor request
● Principles of interview techniques
THEORETICAL FOUNDATIONS OF NURSING
LECTURE-DISCUSSION
THEORIST: Hildegard E. Peplau’s Theory of Interpersonal Relations
● Various phases of communication
● Exploiting all avenue of help and progress
is made towards the final step
● Implementation of the nursing plan,
taking actions toward meeting the
goals set in the identification phase.
RESOLUTION PHASE
● Termination of the professional
relationship since the patient’s needs have
been met through the collaboration of
patient and nurse.
● The patient drifts away from the nurse and
breaks the bond between them.
● The nurse and patient evaluate the
situation based on the goals set and
whether or not they were met.
The goal of psychodynamic nursing is to help
understand one’s own behavior, help others
identify felt difficulties, and apply principles of
human relations to the problems that come up at all
experience levels.
SUBCONCEPTS
● Stranger - the nurse receives the patient
in the same way the patient meets a
stranger in other life situations. The nurse
should create an environment that builds
trust.
● Teacher – the nurse imparts knowledge in
reference to the needs or interests of the
patient.
● Resource person – the nurse provides
specific information needed by the patient
that helps the patient understand a
problem or situation.
● Counselor – the nurse helps the patient
understand and integrate the meaning of
current life situations, as well as provides
guidance and encouragement in order to
make changes.
● Surrogate – the nurse helps the patient
clarify the domains of dependence,
interdependence, and independence, and
acts as an advocate for the patient.
● Leader - the nurse helps the patient take
on maximum responsibility for meeting his
or her treatment goals.
4 LEVELS OF ANXIETY
● Anxiety - initial response to a psychic
threat.
● Mild Anxiety - is a positive state of
heightened awareness and sharpened
senses, allowing the person to learn new
behaviors and solve problems.
● Moderate Anxiety - involves decrease of
perceptual field.
● Severe Anxiety - involves of dread and
terror. Person can’t be redirected to a task.
● Panic Anxiety - involves loss of rational
thoughts, delusional, hallucinations, and
complete physical immobility and
muteness.
METAPARADIGM
MAN
● Organism that “strives in its own way to
reduce tension generated by needs.”
● The client is an individual with a felt need.
person, which is a developing organism
that tries to reduce anxiety caused by
needs.
HEALTH
● “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.”
SOCIETY/ENVIRONMENT
● Environment which consists of existing
forces outside of the person and put in the
context of culture.
● Encourage the nurse to consider the
patient’s culture and mores when the
patient adjusts to the hospital routine.
NURSING
● “Significant, therapeutic, interpersonal
process.”
● “Human relationship between an individual
who is sick, or in need of health services,
and a nurse specially educated to
recognize and to respond to the need for
help.”