HILDEGUARD PEPLAU - INTERPERSONAL RELATIONS THEORY The need for a partnership between nurse and client is very substantial in nursing practice. This definitely helps nurses and healthcare providers develop more therapeutic interventions in the clinical setting. Through these, Hildegard E. Peplau developed her “Interpersonal Relations Theory” in 1952, mainly influence by Henry Stack Sullivan, Percival Symonds, Abraham Maslow, and Neal Elgar Miller.
Description
Peplau’s theory defined Nursing as “An interpersonal process of therapeutic interactions between an individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help.” It is a “maturing force and an educative instrument” involving an interaction between two or more individuals with a common goal.
In nursing, this common goal provides the incentive for the therapeutic process in which the nurse and patient respect each other as individuals, both of them learning and growing as a result of the interaction. An individual learns when she or he selects stimuli in the environment and then reacts to these stimuli.
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Assumptions
The assumptions of Peplau’s Interpersonal Relations Theory are: (1) Nurse and patient can interact. (2) Peplau emphasized that both the patient and nurse mature as the result of the therapeutic interaction. (3) Communication and interviewing skills remain fundamental nursing tools. And lastly, (4) Peplau believed that nurses must clearly understand themselves to promote their client’s growth and to avoid limiting client’s choices to those that nurses value.
Major Concepts
The theory explains the purpose of nursing is to help others identify their felt difficulties and that nurses should apply principles of human relations to the problems that arise at all levels of experience.
Man
Peplau defines man as an organism that “strives in its own way to reduce tension generated by needs.” The client is an individual with a felt need.
Health
Health is defined as “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.”
Society or Environment
Although Peplau does not directly address society/environment, she does encourage the nurse to consider the patient’s culture and mores when the patient adjusts to hospital routine.
Nursing
Hildegard Peplau considers nursing to be a “significant, therapeutic, interpersonal process.” She defines it as a “human relationship between an individual who is sick, or in need of health services, and a nurse specially educated to recognize and to respond to the need for help.”
Therapeutic nurse-client relationship
A professional and planned relationship between client and nurse that focuses on the client’s needs, feelings, problems, and ideas. It involves interaction between two or more individuals with a common goal. The attainment of this goal, or any goal, is achieved through a series of steps following a sequential pattern.
Four Phases of the therapeutic nurse-patient relationship:
Orientation Phase
*The orientation phase is directed by the nurse and involves engaging the client in treatment, providing explanations and information, and answering questions.
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
Identification Phase
*The identification phase begins when the client works interdependently with the nurse, expresses feelings, and begins to feel stronger.
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
In the exploitation phase, the client makes full use of the services offered.
In the exploitation phase, the client makes full use of the services offered.
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
In the resolution phase, the client no longer needs professional services and gives up dependent behavior. The relationship ends.
In the resolution phase, the client no longer needs professional services and gives up dependent behavior. The relationship ends.
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 between them.
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
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