Interpersonal Relations

Hildegard E. Peplau

Background

Regarded as Founder of psychiatric nursing

Born in 1909 , Pennsylvania

Diploma from Pottstown Hospital School of Nursing,

BA in interpersonal psychology from Bennington College Pennsylvania in

1931.

MA in psychiatric nursing from Colombia University, New York in 1947

Her Theory was published in 1953

Died in 1999

Interpersonal Relations in Nursing Theory

Stresses the importance of nurses ability to understand their own behaviors to

help others identify perceived difficulties.
Emphasizes the focus on the interpersonal processes and therapeutic
relationship that develops between the nurse and client.
Four phases of the nurse-patient relationship are identified

Nursing roles

Peplau describe different nursing roles that emerge in the various phases of the
nurse-patient relationship.

Nursing Roles

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

Resource person

provides specific, needed information that helps the client understand his
or her problem and the new situation.

Counselor

listens as the client reviews feelings related to difficulties he or she is

experiencing in any aspect of life

Teacher
identifies learning needs

provides information to the client or family that may aid in improvement of

the life situation.

Surrogate

serves as a substitute figure for another

acts on clients behalf as advocate

Leader

directs the nurseclient interaction

ensures that appropriate actions are undertaken to facilitate achievement of

the designated goals

Technical expert

understands various professional devices

possesses the clinical skills necessary to perform the interventions that are in
the best interest of the client.

Phases
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 ,asks

preconceptions , expectations and past experiences

questions,

shares

Nurse responds, explains roles to client, helps to identify problems

Factors influencing orientation phase

Identification

identifying who is best to support needs

Selection of appropriate professional assistance

patient addresses personal feelings about the experience

is encouraged to participate in care to promote personal acceptance and

satisfaction.

the client begins to identify problems to be worked on within relationship

Patient begins to have a feeling of belonging and a capability of dealing with

the problem which decreases the feeling of helplessness and hopelessness

the goal of the nurse: help the patient to recognize his/her own
interdependent/participation role and promote responsibility for self

Exploitation phase

patient attempts to explore, understand and deal with the problem, and gains
independence on achieving the goal

Clients trust of nurse reached full potential

Client making full use of nursing services

Solving immediate problems

Resolution phase

termination of the therapeutic relationship to encourage emotional balance

for nurse and patient ( difficult for both patient and nurse as psychological
dependence persists)

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.

Concepts and Definitions

Person

A developing organism that tries to reduce anxiety caused by needs

An individual is made of physiological, psychological and social

spheres striving towards equilibrium in life

Environment

Being and occurring in the context of the nurse client relationship

Existing forces outside of the individual

Health

Peplau didn't include an exact definition of health within her model.

Peplau viewed health as "a word symbol that implied forward movement of
personality and other ongoing human processes in the direction of creative,
constructive, productive, personal, and community living"(Peplau,1992, p.12).

Nursing

An educative and therapeutic relationship in which the nurse makes the

client a partner in their health care and promotion

A significant therapeutic interpersonal process

Application of Theory

Peplaus theory can be used to guide the nurse in the various aspects of
nursing practice.

It will be reflected in the focus of the assessment, the planned strategies and
the criteria used to evaluate the nursing care.

Nurse would use self-reflection and self awareness as well as observing and
understanding phenomena related to the client

In nursing practice

Assessment= Orientation phase

Nursing diagnosis and Planning=Identification phase

Implementing=Exploitation phase

Evaluation=Resolution phase

(the theory allowed clients needs to be assessed. Application of the theory

helped provide comprehensive care to the client)

Nurse also needed to be aware of preconceptions, cultural background, age,

gender, diagnoses, previous hospitalization and similarities to previous clients

Used widely around the world nursing education

Nurse educator will be aware of keeping relationship with her students.

Peplaus theory is most commonly used in psychiatric mental health nursing.