HILDEGARD PEPLAU

Theory of Interpersonal Relations

“Nursing is an interpersonal process because it involves

interaction between two or more individuals with a common goal.
Nursing is therapeutic in that it is a healing art assisting an individual
who is sick or in need of health care “.. Peplau 1952

 Pepalaus’s theory --- focuses on the interpersonal processes and

therapeutic relationship that develops between the nurse and the
client.
 The client is an individual with a felt need.
 The nurse strives to develop a nurse-patient relationship in which
the nurse serves as a resource person, counselor and surrogate.
 The attainment of goal is achieved through the use of a series of
steps following a series of pattern in the interpersonal
relationship namely;
a. orientation phase
b. working phase
a. identification
b. exploitation

c. termination phase (resolution phase)

History:

 Hildegard Peplau was born in Pennsylvania in 1909.

 Finished Master of Arts in Psychiatric Nursing from Columbia
University, New York in 1947.
 In 1968, introduced interpersonal techniques ---- the crux of
psychiatric nursing. (crux)
  Three phases in the interpersonal nurse-patient relationship as
follows;

1. Orientation Phase

 Problem defining phase

 Starts when client meets nurse as stranger.
 Defining problem and deciding type of service needed.
 Client seeks assistance, conveys needs, ask questions, shares
preconceptions and expectations of past experiences.
 Nurse responds, explains roles to client, helps to identify
problems and to use available resources and services.
 During the orientation phase the;
a. the individual has a felt need and seeks professional assistance.
b. the nurse helps the individual to recognize and understand
his/her problem and determine the need for help.

Factors influencing orientation phase:

Nurse Patient

Values nurse /patient values

Culture race relationship culture race

Beliefs beliefs

Past experiences past experiences

Expectations expectations

Preconceived ideas preconceived ideas

2. Working Phase:

A. Identification Phase:

o Selection of appropriate professional assistance

o Patient begins to have a feeling of belonging and a capability of
dealing with the problem which decreases the feeling of
helplessness and hopelessness.
o The patient identifies with those who can help him/her. The
nurse permits exploration of feelings to and the patient I
undergoing illness as that reorients feelings and strengthens
positive forces in the personality and provides needed
satisfaction.

B. exploitation phase

 Use of professional assistance for problem solving alternatives.

 During this phase, the patient attempts to derive full value from
what he/she is offered through the relationship. The nurse can
project new goals to be achieved through personal effort and
power shifts from the nurse to the patient delays gratification to
achieve the newly formed goals.

3. Resolution phase

 Termination of professional relationship

 The patient’s needs have already been met by the collaborative
effort of patient and the nurse.
 Now they need to terminate the therapeutic relationship between
the nurse and the patient.
  Patient drifts away and breaks bond with the nurse and healthier
emotional behavior is demonstrated and both become mature
individuals.
 The patient gradually puts aside old goals and adopts new goals.
This is the process in which the patient frees himself from
identification with the nurse.

Peplau’s advocates that the roles of the nurses in the nurse-patient

interpersonal relationship are as follows;

 Stranger ----- receives the client in the same way one meets a
stranger in other life situations. Provides and 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.
 Counselor ---- helps to understand and integrate the meaning of a
current life circumstances provides guidance and encouragement
to make changes.
 Surrogate ---- helps to clarify domains of dependence,
interdependence and independence and acts on client’s behalf as
an advocate.
 Leader ---- helps client assume maximum responsibility for
meeting treatment goals in a mutually satisfying ways.

Additional roles;

1. technical expert
2. consultant

3. health teacher

4. tutor

5. socializing agent

6. safety agent

7. manager of environment

8. mediator

9. administrator

10. record observer

11. researcher

ACTIVITY : Hildegard Peplau’s Theory:

Based on this Case History, formulate your care based on Theory of

Peplau’s theory of Interpersonal Relations on the basis of the
following;

1. Assessment ( Orientation Phase)

2. Planning (Identification phase)

3. Implementation (exploitation phase)

4. Evaluation ( Resolution phase)

Case History:

Mrs. Celina Crisanto, a 35 –year old female came to the Hospital

with complaints of severe low back pain that radiates to her llower
extremities. She verbalized that she had been moving several pieces
of furniture in their living room when she heard a “click” from her
back, followed by very severe pain in the lower back. She claims that
the pain is worse while standing and relieved by rest and lying down.

She is seeking medical help to relieve her pain, improve her ability to

move, and be able to perform her activities of daily living including

her job as an elementary grade teacher. She wants to know if she
injured her back and what will be the consequences of her condition.
She expressed her willingness to cooperate with any prescribed
diagnostic procedures, treatment and therapy.

After undergoing physical examination, myelography, and MRI, the

patient was diagnosed to heave Herniated nucleus Pulposus (slipped
disk) lumbar 4 and 5.

Nurse Johnn Duanne was assigned to care for Ms. Crisanto… How he
applied Peplau’s Therapy of Interpersonal Relations: