HILDEGARD .E. PEPLAU (1909 – 1999)THEORY OF INTERPERSONAL

RELATIONS

BY: NAZEERSAB G B1st year M.sc

NURSING

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.

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.

DEFINITIONS1.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 expert2.   Consultant3.   Health teacher4.   Tutor5.   Socializing agent6.   Safety agent7. Manager of environment8.   Mediator9.   Administrator10.  Recorder observer11.  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

PEPLAU’S INTERPERSONAL PROCESS MODEL OF

NURSING

C A

D INTERPERSONAL PROCESS

BENERGY

ENERGY TRANSFORMATION

NURSES ROLESTRANGERRESOURCE

PERSONTEACHING

LEADERSHIPSURROGATECOUNSELING

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

AssessmentData collection and

analysis [continuous]May not be a felt need

OrientationNon continuous data

collectionFelt needDefine needs

Nursing diagnosis

PlanningMutually set goals

IdentificationInterdependent goal

setting

INTERPERSONAL THEORY AND NURSING PROCESS

ImplementationPlans initiated towards

achievement of mutually set goals

May be accomplished by patient , nurse or family

ExploitationPatient actively seeking and

drawing helpPatient initiated

EvaluationBased on mutually

expected behaviorsMay led to termination

and initiation of new plans

ResolutionOccurs after other phases are

completed successfullyLeads 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 activities—the 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 DIAGNOSISPLANNING/

IMPLIMENTATION

EVALUATION

FAMILY HISTORY OF SCHIZOPHRENIA AND MENTAL ILLNESS

POOR PERSONAL HYGIENE

POOR HYGIENE AND GROOMINGINCREASED MOTOR ACTIVITYINABILITY TO SIT IN ONE PLACEDIFFICULTY IN SLEEPINGSUICIDAL AND HOMICIDAL EFFECTAUDITORY AND VISUAL HALLUCINATIONS

DEVELOPED TRUSTING RELATIONSHIP WITH RESPECT FOR ONE ANOTHERINTERACTIONS WITH THE NURSE TO DISCUSS HIS THOUGHT & FEELINGSEXPLAIN IMPORTANCE OF PERSONAL HYGIENE

MR RAVI BECOME MORE VISIBLY COMFORTABLENO LONGER EXPERIENCING AUDITORY HALLUCINATIONLESS DEPRESSIONSLEEPING PATTERN INCREASESSUICIDAL 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.