Theory of Interpersonal Relations-peplau

04/11/23ma.estrella lena pusag,rn 1


Hildegard Peplau PhD, RN, FAAN(1909 - 1999)

September 1 1909, Reading, Pennsylvania 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. EdD in curriculum development in 1953.

Professor emeritus from Rutgers university

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.

1996: the American Academy of Nursing honored Peplau as a "Living Legend,

1997: Christiane Reimann Prize, at the ICN Quadrennial Congress "

1998: the ANA inducted her into its Hall of Fame.

Died in March 17,1999. 04/11/23ma.estrella lena pusag,rn 4

Person :A developing organism that tries to reduce anxiety caused by needs

Environment : Existing forces outside the organism and in the context of culture

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.

Nursing: A significant therapeutic interpersonal process. It functions cooperatively with other human process that make health possible for individuals in communities


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 reference to a need or interest


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


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


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


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


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


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


BASIC ELEMENTS: the patient the nurse the interaction between them


CLIENT/PATIENT – person, couple, group, community, deserving of humane care with dignity, privacy, ethics

ENVIRONMENT - Physiological, psychological and social fluidity that may be illness-maintaining or health-promoting

HEALTH – Forward movement of personality and other ongoing human processes in the direction of creative, constructive, personal, and community living


INTERPERSONAL – Phenomena that occur between persons

NURSE – The medium of the art of nursing; a maturing force. “The unique blend of ideals, values, integrity, and commitment to the well-being of others…”


Two original guiding assumptions of the theory: 1) The kind of nurse each person becomes

makes a substantial difference in what each client will learn as she or he is nursed throughout his or her experience with illness

2) Fostering personality development in the direction of maturity is a function of nursing and nursing education; it requires the use of principles and methods that permit and guide the process of grappling with everyday interpersonal problems or difficulties


FOUR PHASES OF RELATIONSHIP

ORIENTATION PHASE IDENTIFICATION PHASE EXPLOITATION PHASE RESOLUTION PHASE


Problem defining phase Starts when client meets nurse as stranger Parameters are established and met Early levels of trust are developed Roles begin to be understood 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




Selection of appropriate professional assistance

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 and promote responsibility for self



Use of professional assistance for problem solving alternatives

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 Client’s trust of nurse reached full

potential Identifying and orienting self to

[discharge] goals


Final phase of nurse-patient relationship Sense of security is found as patient has

less reliance and identification upon nurse helper

Client has increased self-reliance to deal with his/her problem

Termination of professional relationship The patients needs have already been

met by the collaborative effect of patient and nurse



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

Nursing diagnosis Planning Mutually set

goals

Orientation Non continuous

data collection Felt need Define needs

Identification Interdependent

goal setting


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


Interpersonal Relations theory assists the nurse to

Observe more intelligently

Intervene more sensitively


Peplau warns: danger of ‘social talk’ with patients – Nurses shouldn’t speak the same way to patient as to family or friends. It should lead to therapeutic effects – promoting long-term well-being

Nurse’s own emotional needs should not get in the way of tending to the needs of the patient


Without Theory With Theory

New ostomy patient Nurse senses tentions

and tries to help by lightening the mood through distraction toward other events – pt smiles

Nurse continues to help the patient by caring for the appliance for the patient

Inadequate coping is reinforced

Another day went by with nurse promoting increased patient dependency by staff “helping”

New ostomy patient Nurse recognizes her

own anxieties of ostomy, as well as patient’s anxiety (avoidance of care and involvement)

Nurse assists patient to explore feelings through therapeutics

Nurse openly prompts patient to talk about concerns during care of the appliance

Encourages patient to look at, touch, & care for appliance progressively throughout care



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