NUR 205 Q4 Pepalu’s Theory of Interpersonal Relations

theory of interpersonal relations
hildegard peplau

Middle ranged theory

Focuses on the relationship between the nurse and the patient

Important aspect of nursing…How persons relate to one another.

“Nurse-patient relationship is the center of nursing”, (Young, Taylor and McLaughlin-Renpenning, 2001)

Three Phases of Nurse-Patient Relationships

a health problem emerges that results in “felt need,” and professional assistance is sought

patient identifies those who can help and the nurse permits exploration of feelings and begins to focus the patient on achievement of new goals

time when patient gradually adopts new goals and frees himself or herself from identification with nurse
Resolution (termination)

Six Original Nursing Roles of Nurse-Patient Relationship
Teaching role
Resource role
Counselor role
Leadership role
Technical expert role
Surrogate role

nurse provides knowledge about a need or problem
Teaching role

nurse provides information to understand problem
Resource role

nurse helps recognize, face, accept, and resolve problems
Counselor role

nurse initiates and maintains group goals through interaction
Leadership role

nurse provides physical care using clinical skills
Technical expert role

nurse may take the place of another
Surrogate role

Psychobiological experiences of the Theory
Needs: what the patient wants or desires

Anxiety: energy that emerges in response to a perceived threat to security

Communication: closely linked with anxiety; involves verbal/nonverbal communication and symbolic meaning behind communication

Pattern integrations: enables transformation of energy into patterns of action that bring satisfaction in the face of a recurring problem

These experiences “all provide energy that is transformed into some form of action”

Four Types of Integrating Patterns (CMAA)
Complementary patterns
Mutual patterns
Alternating patterns
Antagonistic patterns

occur when the behavior of one person fits with and complements the behavior of the other
Complementary patterns

occur when the same or similar behaviors are used by both persons
Mutual patterns

occur when different behaviors used by two persons alternate between the two persons
Alternating patterns

may occur if the behaviors of two persons do not fit but the relationship continues
Antagonistic patterns

Major Concepts of Nursing According to Peplau
Person: encompasses the patient (one who has problems for which expert nursing services are needed or sought) and the nurse (a professional with particular expertise)

Environment: forces outside the organism within the context of culture

Health: implies forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal, and community living

Nursing: therapeutic, interpersonal process between the nurse and the patient

Assumptions of the Theory of Interpersonal Relations
The kind of person that the nurse becomes makes difference in what each patient will learn as he or she receives nursing care

Fostering personality development toward maturity is a function of nursing

Nursing uses principles and methods that guide the process toward resolution of interpersonal problems

Propositions of the Theory of Interpersonal Relations
The nurse-patient relationship is an interpersonal process made up of four components: client, nurse, professional expertise of nurse, and client’s problem for which expert nursing serves are sought

The nurse-patient relationship is an interpersonal process that comprises three sometime overlapping or interlocking phases

Brief Critique of Peplau’s Theory of Interpersonal Relations
Primarily inductive and based on observations in clinical work and environment

Theory a had foundations in established theory

Clear and easy to understand

Basic concepts are defined

Can be generalized, tested and has been utilized in practice, education, and research

Peplau’s Theory of Interpersonal Relations as a Framework for Practice
Assessment: nurse works in the orientation phase as counselor to establish a relationship with the patient and identify problems

Planning: nurse and patient are no longer strangers and are ready to move into the working phase of the relationship

Implementation: once working phase of the relationship is achieved, nurse-patient partnership is clarified to agree upon one level of dependence/ independence expected

Evaluation: based on patient’s achievement of goals set during earlier phase of nursing process; termination phase occurs when patient’s problem is resolved and patient is ready for independence from nurse

History of hildegarde peplau
Grew up in Pennsylvania- born in 1909
Graduated from Pottstown Hospital School of Nursing in Pennsylvania in 1931
In 1943, she received her bachelors of arts degree in interpersonal psychology from Bennington College in Bennington Vermont
Masters of Arts degree in psychiatric nursing from Columbia University in1947
In 1953, she received an EdD in curriculum development from Columbia University
Considered the mother of psychiatric nursing
Development of the theory of interpersonal relations
Introduced the concept of advanced nursing practice
Theory was build on personal and practice experiences
Built using aspects of psychiatry, medicine, education and sociology
Work influenced by Freud, Maslow and Sullivan’s interpersonal relationship theories

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