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Theory of Interpersonal Relations
Nursing (RLE70)
Capitol University
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HILDEGARD E. PEPLAU:
CREDENTIALS AND BACKGROUND OF
THE THEORIST
Hildegard E. Peplau, RN, EdD, FAAN, was born on September 1, 1909. She was raised in Reading, Pennsylvania, by her parents of German descent, Gustav and Otyllie Peplau. She was the second daughter, having two sisters and three brothers. Though illiterate, her father persevered while her mother was a perfectionist and oppressive. With her young age, Peplau’s eagerness to grow beyond traditional women’s roles was precise. She considers nursing as one of the few career choices for women during her time. In 1918, she witnessed the devastating flu pandemic that greatly influenced her understanding of the impact of illness and death on families. In 1931, she graduated from the Pottstown, Pennsylvania School of Nursing. Peplau earned a Bachelor’s degree in interpersonal psychology in 1943 at Bennington College in Vermont. She studied psychological issues with Erich Fromm, Frieda Fromm-Reichmann, and Harry Stack Sullivan at Chestnut Lodge, a private psychiatric hospital in Maryland. Peplau held master’s and doctoral degrees from Teachers College, Columbia University, in 1947.
Peplau was devoted to nursing education for the entire length of her career. After she retired from Rutgers, she served as a visiting professor at the University of Leuven in Belgium in 1975 and 1976. There she helped establish the first graduate nursing program in Europe. She was the only nurse who served the ANA as executive director and later as president. She served two terms on the Board of the International Council of Nurses (ICN). And as a member of the New Jersey State Nurses Association, she actively contributed to the ANA by serving on various committees and task forces. Her fifty-year career in nursing left an unforgettable mark on the field and the mentally challenged lives in the United States. During the peak of her career, she became the founder of modern psychiatric nursing, an innovative educator, an advocate for the mentally ill, proponent of advanced education for nurses, an Executive Director and then President of the ANA, and a prolific author.
Like any other famous personality, her life was often marked with controversy, which she faced with boldness, prowess, and
conviction. On March 17, 1999, Peplau died peacefully at her home in Sherman Oaks, California.
Hildegard Peplau’s Interpersonal
Relations Theory
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. In her theory, she defined Nursing as “An interpersonal process of therapeutic interactions between an individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help.” It is a “maturing force and an educative instrument” involving an interaction between two or more individuals with a common goal.
In nursing, this common goal provides the incentive for the therapeutic process in which the nurse and patient respect each other as individuals, both of them learning and growing due to the interaction. An individual learns when she or he selects stimuli in the environment and then reacts to these stimuli.
MAJOR CONCEPTS AND
DEFINITION
Therapeutic nurse-client
relationship
A professional and planned relationship between client and nurse focuses on the client’s needs, feelings, problems, and ideas. It involves interaction between two or more individuals with a common goal. The attainment of this goal, or any goal, is achieved through a series of steps following a sequential pattern. Four Phases of the therapeutic nurse- patient relationship:
- 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.
Factors influencing orientation phase.
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.
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.
- Resolution Phase In the resolution phase, the client no longer needs professional services and gives up dependent behavior. The relationship ends. 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.
Subconcepts of the Interpersonal
Relations Theory
Peplau’s model has proved greatly used by later nurse theorists and clinicians in developing more sophisticated and therapeutic nursing interventions. The following are the roles of the Nurse in the Therapeutic relationship identified by Peplau:
Stranger: offering the client the same acceptance and courtesy that the nurse would respond to any stranger
Resource person: providing specific answers to questions within a larger context
Teacher: helping the client to learn formally or informally
Leader: offering direction to the client or group
Surrogate: serving as a substitute for another such as a parent or a sibling
Counselor: promoting experiences leading to health for the client such as expression of feelings
Technical Expert: providing physical care for the patient and operates equipment
- Communication and interviewing skills remain fundamental nursing tools. And lastly,
- Peplau believed that nurses must clearly understand themselves to promote their client’s growth and avoid limiting their choices to those that nurses value.
METAPARADIGM
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 at 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.”
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.”
Theory of Interpersonal Relations
Course: Nursing (RLE70)
University: Capitol University
