HILDEGARD .E.

PEPLAU (1909 1999)

THEORY OF INTERPERSONAL
RELATIONS
BY: NAZEERSAB G B
1
st
year M.sc
NURSING
CREDENTIAL OF THE AUTHOR

INTRODUCTION
Born in Reading, Pennsylvania [1909]
Graduated from a diploma program in Pottstown,
Pennsylvania in 1931.
Done BA in interpersonal psychology from
Bennington College in 1943.
MA in psychiatric nursing from Colombia University
New York in 1947.
PhD.Ed in curriculum development in 1953.
Published Interpersonal Relations in Nursing in
1952
1968 :interpersonal techniques-the crux of
psychiatric nursing
Worked as executive director and president of ANA.
Worked with W.H.O, NIMH and nurse corps.
Died in 1999.

MAJOR CONCEPTS AND DEFINITIONS
PSYCHODYNAMIC NURSING
Understanding of ones own behavior.

To help others identify felt difficulties.

To apply principles of human relations to the
problems that arise at all levels of experience.

In her book she discussed the phases of
interpersonal process, roles in nursing
situations and methods for studying nursing
as an interpersonal process.


DEFINITIONS
1.Person :A developing organism that tries to
reduce anxiety caused by needs.
2.Environment : Existing forces outside the
organism and in the context of culture.
3.Health : 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.
4.Nursing: A significant therapeutic
interpersonal process. It functions cooperatively
with other human process that make health
possible for individuals in communities.

ROLES OF NURSE:

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

2.Teacher: who imparts knowledge in reference
to a need or interest.

3.Resource Person : one who provides a specific
needed information that aids in the
understanding of a problem or new situation


4.Counselors : helps to understand and
integrate the meaning of current life
circumstances ,provides guidance and
encouragement to make changes.

5.Surrogate: helps to clarify domains of
dependence interdependence and independence
and acts on clients behalf as an advocate.

6.Leader : helps client assume maximum
responsibility for meeting treatment goals in a
mutually satisfying way.

Additional Roles include:
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. Recorder observer
11. Researcher

THEORY OF INTERPERSONAL RELATIONS:
Middle range descriptive classification theory.

Influenced by Harry Stack Sullivan's theory of
inter personal relations (1953).

Also influenced by Percival Symonds , Abraham
Maslow's and Neal Elger Miller.

Identified four sequential phases in the
interpersonal relationship:
1. Orientation
2. Identification
3. Exploitation
4. Resolution
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
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

Factors influencing orientation phase:



IDENTIFICATION PHASE


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
Use of professional assistance for problem
solving alternatives.

Advantages of services are used is based on the
needs and 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 and
adequately deal with the underlying problem.

Patient may fluctuates on independence.

Nurse must be aware about 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
Termination of professional relationship.

The patients 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 betweenthem.

Sometimes may be difficult for both as
psychological dependence persists.

Patient drifts away and breaks bond with nurse
and healthier emotional balance is demonstrated
and both becomes mature individuals

PEPLAUS INTERPERSONAL
PROCESS MODEL OF
NURSING








C A D

INTERPERSONAL
PROCESS



B
ENERGY
ENERGY TRANSFORMATION
NURSES ROLE
STRANGER
RESOURCE
PERSON
TEACHING
LEADERSHIP
SURROGATE
COUNSELING
PRODUCTIVE
PERSON IN
HEALTH ANXIETY
BOUND PERSON
IN ILLNESS
ANXIETY
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

Assessment
Data collection and
analysis [continuous]
May not be a felt need
Orientation
Non continuous data
collection
Felt need
Define needs
Nursing diagnosis
Planning
Mutually set goals
Identification
Interdependent goal
setting
INTERPERSONAL THEORY AND NURSING
PROCESS

Implementation
Plans initiated towards
achievement of
mutually set goals
May be accomplished by
patient , nurse or
family

Exploitation
Patient actively seeking and
drawing help
Patient initiated
Evaluation
Based on mutually
expected behaviors
May led to termination
and initiation of new
plans
Resolution
Occurs after other phases are
completed successfully
Leads to termination
Nursing education
Peplau contributed significantly to moving the
nursing profession to graduate education. Her model
has been used extensively in educating both
undergraduates as well as graduate nursing students
about a major component of nursing activitiesthe
interpersonal relationship.
She has provided theoretically based knowledge for
nursing specialization in psychiatric settings where in
one-to-one relationship is the primary methodology in
nursing.

APPLICATION OF THE MODEL
APPLICATION OF INTERPERSONAL
THEORY IN NURSING PRACTICE

Mr. . Ravi 37 years old male unmarried,
admitted in the psychiatric hospital with a long
documented history of schizophrenia.
Chief complaints are
- poor hygiene and grooming
- Increased motor activities
- Inability to sit in one place
- difficulty in sleeping
- suicidal and homicidal tendency
- auditory and visual hallucinations

ASSESSMENT DIAGNOSIS
PLANNING/
IMPLIMENTATIO
N
EVALUATION
FAMILY
HISTORY OF
SCHIZOPHRENI
A AND MENTAL
ILLNESS


POOR
PERSONAL
HYGIENE
POOR
HYGIENE AND
GROOMING
INCREASED
MOTOR
ACTIVITY
INABILITY TO
SIT IN ONE
PLACE
DIFFICULTY IN
SLEEPING
SUICIDAL AND
HOMICIDAL
EFFECT
AUDITORY
AND VISUAL
HALLUCINATION
S
DEVELOPED
TRUSTING
RELATIONSHIP
WITH RESPECT
FOR ONE
ANOTHER
INTERACTION
S WITH THE
NURSE TO
DISCUSS HIS
THOUGHT &
FEELINGS
EXPLAIN
IMPORTANCE
OF PERSONAL
HYGIENE
MR RAVI
BECOME MORE
VISIBLY
COMFORTABLE
NO LONGER
EXPERIENCING
AUDITORY
HALLUCINATIO
N
LESS
DEPRESSION
SLEEPING
PATTERN
INCREASES
SUICIDAL
AND
HOMICIDAL
TENDANCY
DECREASES


Peplau postulated several topics of research
today. Her model provides a theoretical frame
work for research about anxiety and mental
health as a whole. The theory can be used for
qualitative and quantitative research designs.
Her interpersonal models operational
concepts can be used in explaining the
effectiveness of the nursing process in
productive patient behavior.
APPLICATION OF INTERPERSONAL
THEORY IN NURSING REASERCH
EVALUATION OF THE THEORY OF
INTERPERSONAL RELATIONS BY PEPLAU



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