NURSING THEORIES

HILDEGARD PEPLAU’S INTERPERSONAL RELATIONS THEORY

Biography of Hildegard E. Peplau Hildegard Elizabeth Peplau

(September 1, 1909 – March 17, 1999)

 was an American nurse who is the 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.
Peplau was well-known for her Theory of Interpersonal Relations, which helped
to revolutionize nurses’ scholarly work.
 Her achievements are valued by nurses worldwide and became known to many
as the “Mother of Psychiatric Nursing” and the “Nurse of the Century.

Hildegard Peplau's Interpersonal Relations Theory

 In 1952, Hildegard Peplau published her Theory of Interpersonal Relations

influenced by Henry Stack Sullivan, Percival Symonds, Abraham Maslow, and
Neal Elgar Miller.
 Hildegard Peplau's Interpersonal Relations Theory emphasized the nurse-client
relationship as the foundation of nursing practice. It emphasized the give-and-
take of nurse-client relationships that was seen by many as revolutionary.
 Peplau went on to form an interpersonal model emphasizing the need for a
partnership between nurse and client as opposed to the client passively receiving
treatment and the nurse passively acting out doctor's orders.
 The four components of the theory are person, which is a developing organism
that tries to reduce anxiety caused by needs; environment, which consists of
existing forces outside of the person and put in the context of culture; health,
which is a word symbol that implies a forward movement of personality and
nursing, which is a significant therapeutic interpersonal process that functions
cooperatively with another human process that makes health possible for
individuals in communities.

The nursing model identifies four sequential phases in the interpersonal relationship: orientation,
identification, exploitation, and resolution.

Four Phases of the therapeutic nurse-patient relationship:

1. Orientation Phase

The nurse's orientation phase involves engaging the client in treatment, providing
explanations and information, and answering questions.
  Problem defining phase
 It starts when the client meets the nurse as a stranger.
 Defining the problem and deciding the type of service needed
 Client seeks assistance, conveys needs, asks questions, shares
preconceptions and expectations of past experiences.
 Nurse responds, explains roles to the client, identifies problems, and uses
available resources and services.

2. Identification Phase

The identification phase begins when the client works interdependently with
the nurse, expresses feelings, and begins to feel stronger.

 Selection of appropriate professional assistance

 Patient begins to have a feeling of belonging and a capability of dealing with
the problem, which decreases the feeling of helplessness and hopelessness.

3. Exploitation Phase
In the exploitation phase, the client makes full use of the services offered.

 In the exploitation phase, the client makes full use of the services offered.
 Use of professional assistance for problem-solving alternatives
 Advantages of services are used based on the needs and interests of the
patients.
 The individual feels like an integral part of the helping environment.
 They may make minor requests or attention-getting techniques.
 The principles of interview techniques must be used to explore, understand
and adequately deal with the underlying problem.
 Patient may fluctuate on independence.
 Nurse must be aware of the various phases of communication.
 Nurse aids the patient in exploiting all avenues of help, and progress is made
towards the final step.

Major Concepts of t h e Interpersonal Relations Theory

The theory explains nursing's purpose is to help others identify their felt difficulties and
that nurses should apply principles of human relations to the problems that arise a t all
levels of experience.
 Man
Peplau defines man as an organism that "strives in its own way to reduce tension
generated by needs." The client is an individual with a felt need.

Health
Health 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."

4. Resolution Phase

In the resolution phase, the client no longer needs professional services and
gives up dependent behavior. The relationship ends.

Termination of professional relationship

 The patient’s needs have already been met by the collaborative effect of patient
and nurse.
 Now they need to terminate their therapeutic relationship and dissolve the links
between them.
 Sometimes may be difficult for both as psychological dependence persists.
 The patient drifts away and breaks the nurse’s bond, and a healthier emotional
balance is demonstrated, and both become mature individuals.

Society or Environment
Although Peplau does not directly address society/environment, she does encourage
the nurse to consider the patient’s culture and mores when the patient adjusts to the
hospital routine.

Nursing
Hildegard Peplau considers nursing to be 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 specially educated to recognize and to respond
to the need for help.”

Analysis

Peplau conceptualized clear sets of nurse’s roles that every nurse can use with their
practice. It implies that a nurse’s duty is not just to care, but the profession
encompasses every activity that may affect the patient’s care.
The idea of a nurse-client interaction is limited to those individual’s incapable of
conversing, specifically those who are unconscious.
The concepts are highly applicable to the care of psychiatric patients considering
Peplau’s background. But it is not limited to those sets of individuals. It can be applied
to any person capable and has the will to communicate.