Peplau's Nursing Theory

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Hildegard E. Peplau : 

Hildegard E. Peplau Theory of Interpersonal Relations By Christina Biggs and Casey Springer

Hildegard E. Peplau : 

Hildegard E. Peplau Regarded as “mother of psychiatric nursing” Born in 1909, Reading, Pennsylvania Graduated from a diploma program in Pottstown, Pennsylvania in 1931 BA in interpersonal psychology from Bennington College in 1943 MA in psychiatric nursing from Colombia University, New York in 1947

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EdD in curriculum development in 1953 Professor emeritus from Rutgers University Started first post baccalaureate program in psychiatric nursing Certified in psychoanalysis by William Alanson White Institute of New York City Worked as executive director and president of ANA Worked with WHO, NIMH and nurse corps Died in 1999

Publications : 

Publications In 1952 published Interpersonal Relations in Nursing Originally delayed because of no physician co-author Credited with transformation of nursing from a group of skilled workers to a profession Published another book, papers, speeches and journal articles First nurse to synthesize nursing theory from other scientific fields

Historical Evolution of the Theory : 

Historical Evolution of the Theory 1943-45 served in the Army Nurse Corps 312th Field Station Hospital in England American School of Military Psychiatry Worked with leading figures in British and American psychiatry After war worked to reshape mental health system in U.S. Passage of National Mental Health Act of 1946

Influences : 

Influences First nursing theory to borrow concepts from other disciplines Freud, Maslow, Sullivan’s interpersonal relationship theories and the psychoanalytical model

Purpose : 

Purpose The purpose of this theory is to facilitate the development of problem solving skills, within the context of the interpersonal relationship between nurse and client, using education and therapeutic interactions

Purpose : 

Purpose Peplau felt that nursing was a healing art and an interpersonal process between two or more people with a common goal Psychodynamic nursing facilitates Understanding of one’s own behavior Helping others identify felt difficulties Nurse-patient relationship as partners Application of human relations to problems at all levels of experience

Uniqueness : 

Uniqueness Theory was considered revolutionary at the time of development Nursing as a profession, not just a skill Made the way for psychiatric nursing specialty

Concepts and Definitions : 

Concepts and Definitions Commonplaces Person Environment Health Nursing

Person : 

Person 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 : 

Environment Being and occurring in the context of the nurse client relationship Existing forces outside of the individual

Health : 

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 : 

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

Concepts and Definitions : 

Concepts and Definitions Roles of the Nurse Stranger Teacher Resource Person Counselor Leader Advocate Additional roles

Structure : 

Structure Four phases of the interpersonal relationship Orientation Identification Exploitation Resolution

Orientation : 

Orientation Nurse-Client, strangers Felt need/Define problem Trust and empowerment Encourage active participation Nurse determines what help client needs

Factors influencing orientation phase : 

Factors influencing orientation phase

Identification : 

Identification Identify problems to be worked on during the relationship Clarify perceptions and expectations Level of dependence/independence Selection of professional assistance Capability to deal with identified problem/s Decreases helplessness and hopelessness

Exploitation : 

Exploitation Client utilizes all available services Plan is implemented and evaluated Continued assessment and assisting new needs of client Fluid with implementation phase: together called working phase.

Resolution : 

Resolution Clients needs met Mutual termination of relationship Goal, support systems, problem prevention Independence

Assumptions : 

Assumptions Both nurse and patient want an interpersonal relationship The patient is able to participate in an interpersonal relationship The interpersonal relationship will enhance self maturity and/or self fulfillment The patient has a felt need

Internal Criticism : 

Internal Criticism Clarity Concepts defined Concepts consistent Simplicity Simple in nature, yet generalizable Definitions not clearly defined logical systematic way of viewing nursing situations Specificity or Generality of the Theory Multi-use Can apply to any nurse-patient relationship

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Accessibility Easily accessible to practitioners to guide and improve their practice Scope of the Theory Middle range descriptive classification theory Level of Theory Development Factor-relating Situation-producing

Importance of the Theory to Nursing : 

Importance of the Theory to Nursing Understanding of ones own behavior Integrates into any area of nursing Adaptability in any nurse patient relationship with the end purpose of meeting the patients needs

How Contagious? : 

How Contagious? In nursing Every area with nurse patient relationships Clinical environment Nursing education Nursing research

Do we like this theory? : 

Do we like this theory? YES Simple, easy to use and relevant to all areas of nursing

Case Study : 

Case Study Example of Peplau’s theory at work: Scenario common to ED’s: 54 yr old male to ED with CC of abd pain for 3 days with N/V. Pt with hx of pancreatitis and ETOH abuse. Lets look at the 4 phases with this pt

Case Study : 

Case Study Orientation: Problem defining phase Introductions : Nurse as stranger Asking questions Client conveys needs, expectations Nurse helps client identify problem: abd pain, N/V and alcohol abuse

Case Study : 

Case Study Identification: Nurse as counselor and advocate Identify problems to be addressed N/V and abd pain: conveyed by pt Education and resources for alcohol abuse Exploitation: Nurse as teacher, resource person, advocate and mediator Utilize available services and implement plan Lab, crisis, CT, X-ray, MD Continue to assess and re-evaluate

Case Study : 

Case Study Resolution: Termination of relationship Pt has all needs met: pt with abd pain and N/V resolved Pt with a plan for health maintenance: ie teaching and resources for alcohol abuse

Web CT Discussion : 

Web CT Discussion How do you create an effective nurse client relationship in your current practice and how does it relate to this theory? Are there pt care areas that this theory would be inapplicable?

References : 

References Tomey, A.M. & Alligood, M.R. (2006). Nursing theorists and their work (6th ed.). St. Louis, MO: Mosby. Nursing Theories. (2008). Theory of interpersonal relations. Retrieved on November 15, 2008, from http://currentnursing.com/nursing_theory/interpersonal_theory.htm Johnson, B.M. & Webber, P.B. (2004). An introduction to theory and reasoning in nursing (2nd ed.). New York, NY: Lippincott Williams & Wilkins. A Comparison of the Peplau Interpersonal Relations Model and the Neuman Health Care Systems Models Applied to a Clinical Situation. (n.d.). Retrieved on November 15, 2008, from http://members.tripod.com/~psychnursing/peplauneuman.html Peplau, H.E. (1992). Interpersonal Relations in Nursing. New York: Springer.