Theoretical Foundation In Nursing

Worksheet

Name: Kristine Mae M. Merhan Score: ________ _

Course/section: BSN-1B Date: October 4, 2021

THEORIST AND ITS THEORY

HILDEGARD PEPLAU
Theory of Interpersonal Relations

Hildegard Elizabeth Peplau (September 1, 1909 – March 17, 1999) was an American nurse who played a
significant role in the professionalization of nursing. She is the only one to serve the American Nurses Association (ANA)
as Executive Director and later as President. After Florence Nightingale, she was the first published nursing theorist.

Peplau was well-known for her Theory of Interpersonal Relations, which contributed to change scholarly work in
nursing. Her accomplishments are recognized by nurses all over the world, and she was called the "Mother of Psychiatric
Nursing" and the "Nurse of the Century" by many.

Hildegard Peplau was born on September 1, 1909. Gustav and Otyllie Peplau, her German-descent parents, raised
her in Reading, Pennsylvania. She was the second of five children, with two sisters and three brothers. Her father, while
being illiterate, persevered, however her mother was a perfectionist and repressive. Peplau's ambition to go beyond typical
female roles was commendable given her early age. Nursing, she believes, was one of the few career options available to
women at the time. In 1918, she observed the catastrophic flu epidemic, which strongly impacted her awareness of the
impact of illness and death on families.

Hildegard Peplau’s Interpersonal Relations Theory, a middle range descriptive classification theory, that
described the importance of the nurse-client relationship as the foundation of nursing practice emphasized the give-and-
take of nurse-client relationships that was seen by many as revolutionary. Peplau went on to make an interpersonal model
emphasizing the necessity for a partnership between nurse and client as against the client passively receiving
treatment and also the nurse passively acting out doctor’s orders. "Peplau's theory is based on the premise that the
relationship between the patient and the nurse is the focus of attention, rather than the patient only as the unit of attention.
(Forchuk, 1993). Peplau’s work is specific to the nurse-patient-relationship and is a theory for the practice of nursing.

She discussed four psychobiological experiences that compel destructive or constructive patient responses—
needs, frustrations, conflicts, and anxieties. The nursing model identifies four sequential phases within the interpersonal
relationship: orientation, identification, exploitation, and resolution. It also includes six nursing roles: stranger, resource
person, teacher, leader, surrogate, and counselor. Peplau also believed that the nurse could take on many other roles, but
these were not defined in detail. However, they were ―left to the intelligence and imagination of the readers.‖ (Peplau,
1952) Additional roles include: Technical expert, Consultant, Health teacher, Tutor, Socializing agent, Safety agent,
Manager of environment, Mediator, Administrator, Recorder observer, and Researcher

References: Martha Raile Aligood, Nusing Theorists and Their Works, 9th Ed.,2018
Octaviano and Balita, C & E,(2008), Theoretical foundation in Nursing The Phillipine Perspective

Prepared by: Melvin D. Cadao, RN, MAN Date Submitted: October 4, 2021
 Theoretical Foundation In Nursing
Worksheet

The theory was influenced by Freud’s, Maslow’s, and Sullivan’s theory of interpersonal relationship theories and
by the contemporaneous psychoanalytical model. She borrowed the psychological model to synthesize her Theory of
Interpersonal Relations. Peplau’s theory is also referred as psychodynamic nursing, which is the understanding of one’s
own behavior. The theory is based on how the nurse and the patient can work together. Peplau is emphasizing the
importance of a healthy relationship with the patient, establishing trust, maintaining that trust and helping the patient reach
full self reliance.

Hildegard Peplau’s Interpersonal Relations Theory’s assumptions are: (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. And lastly, (4) Peplau believed that nurses must clearly
understand themselves to promote their client’s growth and avoid limiting their choices to those that nurses value.

NURSE-PATIENT RELATIONSHIP (Interpersonal Relations Theory)

She described four phases of this relationship:

1. Orientation - in which the person and the nurse mutually identify the person's problem
2. Identification - in which the person identifies with the nurse, thereby accepting help
3. Exploitation - in which the person makes use of the nurse's help
4. Resolution - in which the person accepts new goals and frees herself or himself from the relationship.

NURSING ROLES

1. Stranger Role: Receives the client the same way one meets a stranger in other life situations; provides an accepting
climate that builds trust. Accepting the patient objectively.

2. Resource Person Role: Answers questions, interprets clinical treatment data, gives information. Interpreting the
medical plan to the patient.

3. Teaching Role: Gives instructions and provides training; involves analysis and synthesis of the learner's experience.
Offering information and helping the patient to learn.

Peplau separates teaching into two categories : Instructional—which consists largely of giving information and is the form
explained in educational literature. Experiential— which is using the experience of the learner as a basis from which
learning products are developed.

References: Martha Raile Aligood, Nusing Theorists and Their Works, 9th Ed.,2018
Octaviano and Balita, C & E,(2008), Theoretical foundation in Nursing The Phillipine Perspective

Prepared by: Melvin D. Cadao, RN, MAN Date Submitted: October 4, 2021
 Theoretical Foundation In Nursing
Worksheet

4. Counseling Role: Helps client understand and integrate the meaning of current life circumstances; provides guidance
and encouragement to make changes. Working with the patient on current problems.

5. Surrogate Role: Helps client clarify domains of dependence, interdependence, and independence and acts on client’s
behalf as advocate. Figuratively standing in for a person in the patient's life.

6. Active Leadership Role: Helps client assume maximum responsibility for meeting treatment goals in a mutually
satisfying way. Working with the patient democratically.

THEORETHICAL FRAMEWORK

With Peplau's eagerness and drive to learn about life, and the many processes it presents, she created a theoretical
framework in the psychiatric nursing field that can be applied to nursing as a whole. Peplau is known for her many
contributions to nursing, but one that sticks out above the rest is her theory of Interpersonal Relations in Nursing. She
believed that "nursing is based on the interpersonal process and the nurse-patient relationship" (Chitty & Black, 2007, p.
340). According to Chitty & Black (2007, p. 340), nursing care revolves around not just the patient, but around the nurse,
the patient, and the therapeutic relationship they create together. This relationship should produce certain goals that are
"twofold: first is the survival of the patient; second is the patient's understanding of his or her health problems and
learning from these problems as he or she develops new behavior pattern" (Chitty & Black, 2007, p. 340). This means that
not only does the patient learn how to better themselves, but the nurse learns about their patient through personal
interactions and through thorough assessments of their health and health history. This theory has and will continue to
greatly affect how nurses work in today's health-care system and also student nurses learning how to complete thorough
care plans and how to establish a therapeutic relationship.

References: Martha Raile Aligood, Nusing Theorists and Their Works, 9th Ed.,2018
Octaviano and Balita, C & E,(2008), Theoretical foundation in Nursing The Phillipine Perspective

Prepared by: Melvin D. Cadao, RN, MAN Date Submitted: October 4, 2021
 Theoretical Foundation In Nursing
Worksheet

METAPARADIGM IN NURSING

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.‖ It functions cooperatively with other human process that make health possible for
individuals in communities.

PERSON

Peplau defines man as an organism that ―strives in its own way to reduce tension generated by needs.‖ The person is a
developing organism that tries to reduce anxiety caused by needs. And a person lives in a stable equilibrium.

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.‖

ENVIRONMENT

It is defined as the ―existing forces outside the organism and in the context of culture.‖ Although Peplau does not directly
address environment, she does encourage the nurse to consider the patient’s culture when the patient adjusts to the
hospital routine.

These four metaparadigm concepts work together in order to help form nursing philosophies and provide an
organizational structure to make clearer connections between the concepts. The person has human needs that are affected
by their environment. Once the environment affects the person’s health in a negative way, nurses make an encounter with
the patient and make their contribution. Peplau has a holistic view of nursing, because she focuses on the interpersonal
relationship of the whole person.

References: Martha Raile Aligood, Nusing Theorists and Their Works, 9th Ed.,2018
Octaviano and Balita, C & E,(2008), Theoretical foundation in Nursing The Phillipine Perspective

Prepared by: Melvin D. Cadao, RN, MAN Date Submitted: October 4, 2021
 Theoretical Foundation In Nursing
Worksheet

ACCEPTANCE BY THE NURSING COMMUNITY

PRACTICE

Peplau's theory applies to all aspects of nursing practice. You begin to develop a therapeutic relationship the moment your
patient is admitted and you begin the interpersonal process. The nurse can more easily obtain important information from
the patient when there is a good patient-nurse relationship.

EDUCATION

This theory applies to both the educator and the student. In a classroom setting, developing a student teacher relationship
will help the student become more eager to learn, resulting in a better understanding and better grades. In the health care
setting, the nurse educates the patient. This makes the patient feel more comfortable when being educated on their
medications and treatments.

RESEARCH

This theory applies to research in a research team situation. You develop a therapeutic relationship with your group
members throughout your studies.

Nursing Research Based on Peplau’s Theory

 Hays, D. (1961). Phases and steps of experimental teaching to patients of a concept of anxiety: Findings revealed
that when taught by the experimental method, the patients were able to apply the concept of anxiety after the
group was terminated.
 Burd, S.F. Develop and test a nursing intervention framework for working with anxious patients: Students
developed competency in beginning interpersonal relationship.

References: Martha Raile Aligood, Nusing Theorists and Their Works, 9th Ed.,2018
Octaviano and Balita, C & E,(2008), Theoretical foundation in Nursing The Phillipine Perspective

Prepared by: Melvin D. Cadao, RN, MAN Date Submitted: October 4, 2021
 Theoretical Foundation In Nursing
Worksheet

ANALYSIS OF THEORY

CLARITY

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 individuals incapable of conversing, specifically those who are unconscious.

SIMPLICITY

The theory is easily understood, it was demonstrated clearly and the four sequential phases of nurse-patient relationship
was identified properly. Concepts were clearly given, explained, broken down and outlined and it is also consistent and
semantic. The theory was applied effectively in the nursing profession.

GENERALITY

It is applicable to all nurses in any setting but it is used only in situations where communication can occur because it is
impossible to work with patients in one sided relationship (senile, comatose or new-born patients).

EMPIRICAL PRECISION

Theoretical area and empirical data are validated and verified. The theory was based from the reality and it could be tested
and observed by pure observation.

DERIVABLE CONSEQUENCES

This theory touched the lives of many, it widens the perception of nursing profession and broaden the scope of nursing
practice.

References: Martha Raile Aligood, Nusing Theorists and Their Works, 9th Ed.,2018
Octaviano and Balita, C & E,(2008), Theoretical foundation in Nursing The Phillipine Perspective

Prepared by: Melvin D. Cadao, RN, MAN Date Submitted: October 4, 2021