Overview/Description
The Peplau’s theory of interpersonal relations has contributed significantly to the nursing field because of the encouraging concepts and ideas developed by the theory. It provides a clear connection with research in the nursing phenomena. It seeks to emphasize on the need to develop strong relationships with patients and nurses. The paper focuses on describing, evaluating, and discussing the Peplau’s theory of interpersonal relations to the nursing profession around the world with the aim of changing the perceptions of many nurses about the profession.
The theorist who developed the Peplau's theory of interpersonal relations is Hildegard E. Peplau, who was born in 1909 in Reading, Pennsylvania, United States of America. She pursued a diploma program in Pottstown, Pennsylvania in 1931 then joined the Bennington College in 1943 to pursue Bachelor of Arts in Interpersonal Psychology (Peplau, 1952). In 1947, she furthered her studies at Colombia University in New York City, where she did Masters in Psychiatric Nursing. Upon completing her masters, she was involved in the curriculum development in 1953 before becoming a professor at Rutgers University.
Hildegard Peplau published a book on interpersonal relations in nursing in 1952. She worked as an executive director and president of All Nippon Airways in United States of America. She also worked in other reputable institutions in the line of her fields, such as the National Institute of Mental Health, World Health Organization, and Nurse Corps. The theorist is well known for developing the theory of interpersonal relations, which was influenced by the theory of interpersonal relations by Harry Stack Sullivan and other theorists, such as Abraham Maslow's, Neal Elger Miller and Percival Symonds (Peplau, 1952). Her theory of interpersonal relations is also termed as psychodynamic nursing because it gives a clear understanding of a person’s behavior.
Hildegard Peplau contributed significantly towards theory development having been one of the leading nurses and theorists in the world during her time. Her influence in the nursing practice contributed to theory development through scholarly activities, clinical activities, and policy development (Sheldon & Ellington, 2008). She shaped the profession and discipline of nursing over three decades through her theory that focused on psychological and psychiatric concepts of nursing practice. She is referred to as the mother of psychiatric nursing due to her theoretical and clinical work that contributed to the advancement of the field of psychiatric nursing.
The theory of interpersonal relations developed by Peplau has been used by other authors in research works within the field of nursing. The research paper published by Lisa Kennedy and Lee Ellington on the applications of a model of social information processing to nursing theory focuses on the manner in which the nurses respond to the patients in healthcare centers. These authors use the Peplau's theory of interpersonal relations to establish the most appropriate mode of communication between nurses and patients to ensure quality healthcare service is delivered, and the clients are well satisfied (McCrae, 2011). The theory of interpersonal relations provided a strong theoretical background for this paper as the authors tried to ling the interpersonal relationships between the nurses and patients.
The discussion paper by Niall McCrae on the value of nursing theory in the context of evidence-based practice and multidisciplinary health care also uses the Peplau’s theory of interpersonal relations as the background for the study of interpersonal relations in the nursing practice (McCrae, 2011). The paper focuses on the interactional process described by Peplau's theory, such as the orientation of the patients by the nurses to understand their problems, identification of patients with nurses who can help them out, exploitation of the available resources to get the best results and resolution of new goals after discarding the previous goals. The use of Peplau’s concepts in this discussion paper shows the level of impact created by Peplau’s theory of interpersonal relations in the entire nursing field.
The phenomenon of concern and the problems addressed by the theory of interpersonal relations is the phase of the therapeutic nurse-patient relationship. Her main concern was the manner in which the nurses relate to the patients because it determines the outcome of the healthcare services provided. She developed critical phases that should be followed to create a strong nurse-patient relationship. The orientation phase, the identification phase, exploitation phase, and resolution phase are discussed in this theory comprehensively since they form the background of the theory (Peplau, 1952). Peplau also focused on the four levels of anxiety, which include mild anxiety, moderate anxiety, severe anxiety, and panic anxiety, which are portrayed by the patients according to the nature of their relationship with the nurses.
Theory Description
Hildegard Peplau used inductive reasoning in developing the theory of interpersonal relations because the conclusion developed by the theory was based on the actual findings established in the course of her research. According to the analysis of the theory, the theorist conceptualized on the significant roles of the nurses towards providing quality healthcare to the patients. She emphasized that the role of nurses was not just to take care of the patient but also to offer all the professional services since they all affect the overall care of the patient. According to her arguments, she believed that the idea of nurse-patient interaction was only limited to the patients who are unconscious and not able to converse (Warren, 2016). Therefore, her sentiments on the nature of the interaction between patients and nurses developed the conclusion of the theory of interpersonal relations. The inductive reasoning was portrayed because the outcome of the theory is based on real facts about the required level of interaction between patients and nurses as well analyzed in the process of developing the theory.
The theorist identified the major concepts of the theory, which portrays that she used inductive reasoning to develop the theory. Peplau started by defining man as an organism that makes a lot of effort to reduce the tension caused by the needs. She also defined health as a state of the body that implies forward movement of personality and other human processes, such as creative, personal, and productive processes. Despite her less study on the social/environment of the people, she motivates the practicing nurses to consider the culture of the patients once they get adapted to the hospital routine (Sheldon & Ellington, 2008). Finally, she considered nursing as a significant therapeutic interpersonal process whereby the relationship between the patients and the nurses is created. The analysis of these major concepts in her theory signifies that the conclusion on the need to create a strong relation between patients and nurses is based on real facts.
The concepts are explicitly defined in the process of development of the theory of interpersonal relations because of the availability of genuine arguments presented, which provide an explicit content. The theory provides an explicit definition of the main concepts developed in the theory, such as the definition of a person, health, environment, and nursing concepts. The major concepts developed in the theory are closely related because they are integrated to produce an explicit conclusion of the theory (Sheldon & Ellington, 2008). It emphasizes that the main aim of nursing is to identify the difficulties felt by the patients, application of principles of human relations in dealing with the patients, providing a therapeutic healing of the heart, and developing an interpersonal process through interaction between the patients and nurses. The analysis of the main concepts of the theory shows there exists a close relationship between the concepts and ideas developed in the theory.
Evaluation
The theory development process is associated with numerous implicit and explicit assumptions about different concepts and ideas developed for the theory. Its main assumptions are that the nurse and the patient can actively interact. It also assumes that both the patients and nurses mature in the process of the therapeutic interaction between them. Thirdly, it assumes that communication and interviewing skills are very significant tools for quality execution of the nursing practice. Moreover, it is assumed that nurses should always understand their role in promoting the client’s healing process and avoiding limiting the client’s choices to the basic services required from a professional nurse (McCrae, 2011). All these assumptions of the Peplau’s interpersonal relations theory revolve around the concept of interaction between the patients and nurses in the health care facilities.
Out of the four assumptions of the Peplau’s theory of interpersonal relations, the theorist built her theory on the assumption that nurses and patients can actively interact. It is the main assumption portrayed in the theory development process because the theorist focusses on the four sequential phases in the interpersonal relationship, which are based on this assumption (Peplau, 1952). The orientation phase involves problem identification, and it begins when the nurse meets the clients.
The identification phase involves the selection of the most appropriate professional support to offer to the patient with the aim of creating a compassionate relationship between the two. The exploitation phase involves the use of professional assistance to solve the problems identified by the patient based on the interests and specific needs of the patient. The final phase is the resolution phase, which involves the ending of the professional relationship and the therapeutic relationship that develops because of close interaction (Sheldon & Ellington, 2008). The presentation of the four concepts of the nursing meta-paradigm shows that the theory is purely developed on the assumption that patients and nurses can interact.
The theory is presented in a very clear manner with lucidness and consistency of the highest level. The concepts and ideas presented are in a very clear and logical fashion considering that they have been developed by one of the best theorists in the nursing field. The definitions of the main concepts are very clear and understandable to everyone; irrespective of their field of specialization. It shows that the theory of interpersonal relations can be used in different fields of profession and still deliver the same message intended by the theorist. Although the concepts and ideas presented in the theory development have very high level of abstraction, they can be learned through practice to attain full knowledge of the concepts addressed by the theorist (Warren, 2016). The lucidness and consistency of the concepts of the theory are outstanding because the author expresses her thinking in a logical manner without any contradiction of concepts or ideas.
Application
The Peplau’s theory of interpersonal relations emphasizes on the interpersonal processes and therapeutic relationship that result from the interaction between the nurses and patients. The main concepts and ideas developed by this theory can affect the nursing field significantly through guiding the nursing actions. The nurses can use the four phase nurse-patient relationship development criteria to promote professionalism. The activities described in the orientation phase, the identification phase, exploitation phase, and the resolution phase provide comprehensive information upon which the nurses can use to develop their nursing skills. The theory also provides the basic roles for a nurse that build a therapeutic relationship between the patients and the nurses (McCrae, 2011). The concepts presented in this theory encourage the nurses to accord the same acceptance and courtesy to the strange patients just like the familiar patients.
The theory also teaches nurses to become resourceful people who can offer specific solutions to the problems conveyed to them by the patients. It builds confidence among the patients making them feel free to share their interest and needs with the nurses; thus, creating strong a therapeutic relationship. The concepts of the theory also guide the actions of the nurses through encouraging them to develop a teacher attitude; such that they can help the patients understand their conditions better in either formal or informal manner (Sheldon & Ellington, 2008). The theory trains nurses to have good leadership and counseling skills to enable them offer appropriate directions to the patients and develop feelings towards the patients' health problems. The concepts and ideas presented by Peplau in her theory of interpersonal relations can be used as a guide to the nursing actions because most of the concepts have been utilized to develop the nursing practice policies in different countries.
As a family nurse practitioner specialized in Botox and Juverderm, Plasm Rich Platelet Injections, I would specifically use the concepts and ideas presented in this theory to develop in my area of nursing. From the concept of treating strangers fairly, I would be able to execute my roles of providing injections to the patients without any discrimination to build their trust in my services and develop a strong relationship with my patients (McCrae, 2011). In addition, the concept of nurses offering more services than what is professionally required creates a difference. Therefore, I would be very keen to offer my best to the patients \ to ensure they get the best services from the healthcare facility am working.
References
McCrae, N. (2011). Whither nursing models? The value of nursing theory in the context of evidence-based practice and multidisciplinary health care. Journal of Advanced Nursing, 68(1), 222-229.
Peplau H. (1952). Interpersonal relations in nursing. New York: G.P. Putnam &Sons.
Sheldon, L., & Ellington, L. (2008). Application of a model of social information processing to nursing theory: how nurses respond to patients. Journal of Advanced Nursing, 64(4), 388-398.
Warren, H. (2016). Middle-range theories: Frameworks for examining a nonsurgical cosmetic problem. Plastic Surgical Nursing, 36(1), 9-11.
