Theory of

interpersonal
relations
Hildegard.E.Pepl
au ( life & works)

Presented by : shagun
 Who was Hildegard Peplau?

– Biography:
– Name: Hildegard Elizabeth Peplau
– Birthday: September 1,1909
– Died: march 17, 1999 in Sherman oaks, California
– Birthplace: reading, Pennsylvania
– Parents: immigrants of German descent
– Father: Gustav Peplau ( illiterate but hard working)
– MOTHER : Otyllie Peplau (oppressive & perfection)
– Birth order: she was the second daughter born of six children
 Characteristics

– Strong willed
– Strong motivation
– Has a vision to grow beyond traditional women`s roles.
– Wanted more out of life
 Why nursing?

– Nursing was one of few career choices for women in her day. As a child, she witnessed the devastating
flu epidemic of 1918, a personal experience that greatly influenced her understanding of the impact of
illness & death on families.
 Career timeline

– 1931- graduated from a diploma program in Pottstown, Pennsylvania.

– 1943- BA in interpersonal psychology- Bennington college
– 1947- MA in psychiatric nursing from Colombia university, New York
– 1952- published interpersonal relations in nursing
– 1953- Ed in curricular development
professor emeritus from Rutgers university
started first post baccalaureate program in psychiatric nursing
1968- interpersonal techniques – the crux of psychiatric nursing
 Affiliations & achievements

– Worked a s executive director of ANA.

– President of ANA from 1970-1972.
– Vice President of ANA from 1972-1974.
– Worked with W.H.O., NIHM & nurse corps.
– She was the first published nursing theorist since Florence Nightingale.
– Created the middle- range nursing theory of interpersonal relations, which helped to revolutionize the
scholarly work of nurses.
– Staff nurse in Pennsylvania & New York .
 Cntd..

– Certified in psychoanalysis at the William Alanson white institute of New York City.
– Faculty of the college of nursing at Rutgers University.
– Therapeutic care vs custodial care in mental hospitals.
– Strong advocate for graduate education & research in nursing.
– She is the primary contributor to mental health law reform, leading the way towards human treatment
of patients with behaviour & personality disorders.
Interpersonal theory

– Interpersonal relations model

– Psychodynamic nursing/major concepts
Interpersonal relations model

– This model explains an individual `s outlook towards relationship & how one`s perception changes in
due course.
– The interpersonal model emphasizes the need for a partnership between nurse & client.
– shared experience: nurses could facilities this through observation, description, formulation,
interpretation, validation, & intervention.
– Acc. to the model: 2 directional components are necessary in creating an individual`s perception about
relationship.
1. Other to self: represents an individuals awareness of other`s attitude thoughts , beliefs toward beliefs
toward himself.
2. Self to others: represents an individual`s awareness of his own behaviour attitude, towards others.
Psychodynamic nursing/ major concepts

– Using an understanding of one`s own behaviour.

– To help others identity their difficulties.
– Applies principles of human relations to the problems.
– In her book, discussed phases of interpersonal process, roles in nursing situation & method for studying
nursing as an interpersonal process.
– Acc. to Peplau , nursing is a healing art, assisting an individual who is sick or in need of health care.
– Nursing is an interpersonal process because it involves interaction between two or more individual with
a common goal.
– The attainment of goal is achieved through the use of a series of steps following a series of pattern.
Peplau`s seven role of a nurse

– Stranger: receives the client in the same way one meets a stranger in other life situations provides an
accepting climate that builds trust.
– Teacher: who imparts knowledge in references to a need or interest .
– Resource person: one who provide a specific needed information that aids in the understanding of a
problem or new situation.
– Counselor: helps to understand & integrate the meaning of current life circumstances, provides guidance
& encouragement to make changes.
– Surrogate: helps to clarify domains of dependence interdependence & independence & acts on clients
behalf as an advocate.
Cntd..

– Leader: helps client assume maximum responsibility for meeting treatment goals in a mutually
satisfying way.
– Technical expert: provides physical care by displaying clinical skills & operates equipment.
Theory of interpersonal relations

– Theory of interpersonal relations is a middle range descriptive classification theory.

– The theory was influenced by Harry Stack Sullivan`s theory of interpersonal relations (1953)
– The theorist was also influenced by Percival Symonds a Abraham Maslow`s & Neal Elger Miller .
– Peplau`s theory is also referred as psychodynamic nursing, which is the understanding of ones own
behaviour.
– Identified four sequential phases in interpersonal relationships.
Four sequential phases in the interpersonal
relationship

1. Orientation phase
2. Identification phase
3. Exploitation phase
4. Resolution phase
1. Orientation phase

– Problem defining phase.

– Starts when client meets nurse as stranger.
– Defining problem & deciding type of service needed.
– Client seeks assistance, conveys needs , asks questions, shares preconception & expectations of past
experiences.
– Nurse responds , explains roles to client, helps to identify problems & to use available resources &
services.
Cntd..

– Get acquainted phase of the nurse-patient relationship.

– Preconceptions are worked through.
– Parameters are established & met.
– Early levels of trust are developed.
– Roles begin to be understood.
Factors affecting the orientation phase

– Nurse patient
Nurse
Relationship Patient
values
Values
Culture race
cultural race
Beliefs
Beliefs
Past
Past
Experiences
Experiences
Expectation
Expectations
preconceived
Ideas
Elements involved in nurse- patent relationship

– Contract:
– The time , place & purpose of meetings as well as conditions for termination are established between
the nurse & the client.
– Boundaries:
– Roles of participants are clearly defined, the nurse is defined as a professional helper, the client`s needs
& problems focus of the interaction.
Confidentiality
the nurse should share information only with professional staff who need to know. Then nurse should
obtain client`s written permission to share information with others outside the treatment team.

– Therapeutic nurse behaviour :

1. Self awareness
2. Genuineness
3. Warmth & respectfulness
4. Empathy
5. Cultural sensitivity
6. Responsibility
7. Ethical practice
2. Identification phase

– Selection of appropriate professional assistance.

– Patient begins to have a feeling of belonging & a capability of dealing with the problem which decreases
the feeling of helplessness & hopelessness.
– The client begins to identify problems to be worked on within relationship.
– The goal of the nurse : help the patient to recognize his/ her own interdependent/participation role &
promote responsibility for self.
3. Exploitation phase

– Use of professional assistance for problem solving alternatives.

– Advantages of services are used is based on the needs & interests of the patients.
– Individual feels as an integral part of the helping environment.
– They may make minor requests or attention getting techniques.
– The principles of interview techniques must be used in order to explore, understand & adequately
deal with the underlying problem.
– Patient may fluctuates on independence.
– Nurse must be aware about the various phases of communication.
Cntd..

– Nurse aids the patient in exploiting all avenues of help & progress is made towards the final step.
– Client`s trust of nurse reached full potential.
– Client making full use of nursing services.
– Solving immediate problems.
– Identifying & orienting self to ( discharge ) goals
4. Resolution phase

– Termination of professional relationship.

– The patients needs have already been met by the collaborative effect of patient & nurse.
– Now they need to terminate their therapeutic relationship & dissolve the links between them.
– Sometimes may be difficult for both as psychological dependence persists.
– Patient drifts away & break bond with nurse & healthier emotional balance is demonstrated & both
becomes mature individuals.
Cntd..

– Client met needs.

– Mutual termination of relationship.
– Sense of security is formed.
– Patient is less reliant on nurse
– Increased self reliance to deal with own problems.
– The patient gradually puts aside old goals & adopt new goals. This is a process in which the patient
frees himself from identification with the nurse.
Metaparadigms

– Person:
– It is defined as a individual : does not include families, groups or communities.
– A developing organism that tries to reduce anxiety caused by needs.
– Lives in an stable equilibrium

– Environment:
– Existing forces outside the organism & in the context of culture.
Health

– Described as a concept that implies forward movement of personality & other ongoing human
processes in the direction of creative, constructive ,productive, personal & community living.
– Health is promoted through interpersonal process.
Nursing

– A significant therapeutic interpersonal process that makes health possible. It is a human relationship
between an individual who is sick or who has a felt need & a nurse who is skilled to recognize &
respond to the need for the help.
– involves the use of problem –solving techniques.
– Proceeds from general to specific in collecting data & clarifying problems by use of observation,
communication & recording as basic tool.
characteristics

– Four phases interrelate the different components of each phase . The interaction between nurse-
patient can apply to the concept of human being, health, environment & nursing.
– This theory provides a logical, systematic way of viewing nursing situations.
– This theory provides simplicity in regard to the natural progression of the nursing patients relationship.
Leads to adaptability in any nurse-patient relationship.
– Has generated testable hypothesis.
Interpersonal theory and nursing process

– Both are sequential and focus on therapeutic relationship.

– Both use problem solving techniques for the nurse and patient to collaborate on, with the end purpose
of meeting the patients needs.
– Both use observation communication and recording as basic tools utilized by nursing.
Application of theory to areas in nursing

Nursing education:
– Has an impact on the psychiatric nursing especially in the baccalaureate program in nursing teaching
CARE OF CLIENTS WITH MALADAPTIVE PATTERNS OF BEHAVIOUR .

Practice:
– Focuses on the interpersonal processes & therapeutic relationship that develops between the nurse &
client.
– It requires that the nurse attends to the interpersonal processes that occur between the nurse &
client.
Cntd..

– Interpersonal process is maturing force for personality. It includes the nurse-client relationship,
communication, pattern integration & role of the nurse.
– Psychodynamic nursing is understanding one`s own behaviour to help others identity felt & perceived
difficulties & to apply principles of human relations to the problems that arise at all levels of
experience.
Research based on Peplau`s theory

– Hays, D.(1961). Phases & 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 & test a nursing intervention framework for working with anxious patients. Students
developed competency in beginning interpersonal relationship.
Evaluation of the application of the theory of
interpersonal relationship by Peplau

– With the help of the theory of interpersonal relations, the client`s needs could be assessed.
– It helped her to achieve them with her limits. This theory application helped in providing
comprehensive care to the client.