Peplau’s Interpersonal Relations Theory

Candace CreeseWilmington University

Hildegard E. Peplau’s Interpersonal Relations in Nursing

Theory was published in 1953Framework for psychodynamic nursingTheory was influenced by Harry Stack Sullivan’s theory of interpersonal relations.Middle range, descriptive, classification theory

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

• Six primary roles of the nurse• Six secondary roles of the nurse

4 Phases of nurse-patient relationship

Orientation-client seeking assistance, meeting of nurse-patient, identifying the problem and services needed ( interview process), and guidance.

Identification- identifying who is best to support needs, patient addresses personal feelings about the experience and is encouraged to participate in care to promote personal acceptance and satisfaction.

Phases cont.

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

Resolution- termination of the therapeutic relationship to encourage emotional balance for nurse and patient ( difficult for both patient and nurse as psychological dependence persists)

Roles of Nurses

PrimaryStrangerTeacherResource personCounselorSurrogateLeader

SecondaryTechnical expertMediatorSafety agentResearcherTutorManager of

environment

Application of Interpersonal Theory in Nursing Practice

• An article in Current Nursing evaluated using the theory in nursing practice – Assessment= Orientation phase– Nursing diagnosis– Planning=Identification phase– Implementing=Exploitation phase– Evaluation=Resolution phase(the theory allowed client’s needs to be assessed.

Application of the theory helped provide comprehensive care to the client)

Research completed

• Urology Nursing used the theory to educate newly diagnosed bladder cancer patients with the need for a urinary diversion, and ensure understanding.Outcome shows that the scope of a patient’s needs

requires a competent nurse to assume the changing roles in the four phases of the theory, expressing the importance of involving the patient in establishing goals and reviewing the goals frequently.

Research completed

• British Journal of Nursing had an article researching the credibility of Peplau’s theory, in mental health care, due to the expansion of nursing knowledge and the dynamics of a multidisciplinary team currently used in today’s practice.

• Public Health Nursing did a study, in homecare visits, (testing the use of Peplau’s theory) to work with multi-problem families, to identify interventions, individualized for the members, to see if relationship progression was increased within the family system resulting in optimized care of the patient.

Application of theory in “MY” nursing practice

• This theory would be useful with our newly diagnosed cancer patients and their family. Resistance is met when trying to educate them about the treatment, encouraging enrolment in studies, and education about how to care for the patient in their home setting. – Orientation-patient gets admitted to the unit, nurse helps the patient to

recognize and understand that they have cancer and the importance of treatment.

– Identification-Patient takes the time to internalize the diagnosis, the nurse participates in helping the patient to do so.

-- Exploitation-the nurse works to have the patient explore what help is needed to meet goals, incorporating other disciplines to problem solve (oncologists, therapists, alternative medicine, etc.).Patient test the limits of the nurses availability, and the nurse encourages patient to evaluate ways to meet their final goals.

-- Resolution-when in-patient treatment is complete, the nurse has to evaluate feelings and remove themselves from the bond that is made, allowing the patient and family to move on and regain balance in their own lives.