Abstract
The theory of interpersonal relationships was forwarded by Hildegard. E. Peplau and is known as Peplau’s theory. The theory of interpersonal communications was influenced by Harry Stack Sullivan's theory. Researchers have also named Peplau’s theory as psychodynamic nursing. The term psychodynamic nursing is associated with the understanding of one’s behavior. Peplau’s theory describes the different roles a nurse would play in a healthcare setting. Leader, counsellor, teacher, resource person, stranger, and surrogate are the different roles of a nurse described by Peplau’s theory. Orientation, identification, exploitation and resolution are the 4 phases of interpersonal relationship. The paper highlights the importance of Peplau’s theory in different healthcare settings. The paper emphasizes on two problems observed in a healthcare setting and the use of Peplau’s theory in each of the problems.
The importance of Peplau’s theory is observed in many healthcare settings. The theory can be applied for various patient populations. Lastly, Peplau’s theory is considered to be one of the best middle-range nursing theories.
Introduction
Hildegard. E. Peplau, born in Reading, Pennsylvania [1909], USA is known for her theory of interpersonal relationships. Her theory of interpersonal communications is considered to be a middle range descriptive classification theory. Peplau has worked with the World health organization (WHO) and the National Institutes of mental health. The theory of interpersonal communications was influenced by Harry Stack Sullivan's theory. Peplau’s theory is also known as psychodynamic nursing that is the understanding of one’s own behavior. It is important to understand the major concepts of Peplau’s theory. The theory is based on a nurse’s role to identify and help others difficulties. The theory is associated with the nurse’s role in the application of human principles at all levels of experience. The roles in nursing situations, the different phases of interpersonal process, and the methods for studying nursing as an interpersonal process are explained by Peplau’s theory. Nursing is considered to be an interpersonal process because it involves interaction between two or more individuals. Peplau’s theory is based on a series of steps and patterns. The attainment of goal is achieved when the steps and patterns of Peplau’s theory are thoroughly followed. (Senn, JF. 2013)
Peplau’s theory describes the different roles a nurse would play in a healthcare setting. Leader, counsellor, teacher, resource person, stranger, and surrogate are the different roles of a nurse described by Peplau’s theory. There are different phases of interpersonal relationship as per Peplau’s theory. Orientation, identification, exploitation and resolution are the 4 phases of interpersonal relationship. Peplau’s theory is considered to be important since it is associated with the relationship of the nurse and the patient. The applications of Peplau’s theory have been studied in different healthcare scenarios. The paper highlights the importance of Peplau’s theory in two different problems identified in a healthcare setting. The paper also describes the strategies employed to resolve the problem/issue. Lastly, the paper provides an ethical aspect of the theory and states the importance of Peplau’s theory.
The Healthcare Encounters of Survivors of Sexual Violence
Sexual violence is considered to be one of the most serious problems in the society. Women and children are common victims of sexual violence. The number of sexual violence cases has increased since 2000. In the United States, 1 child per 1.000 children experience sexual abuse in the society. Survivors of sexual violence may suffer from serious physical and mental health problems. Many victims suffer from psychological trauma. The effects of sexual abuse are seen in childhood or adulthood depending on the length of abuse. The most common mental health problems associated with sexual abuse/violence are anxiety disorders, depression, substance abuse, and post-traumatic stress disorder. Victims of sexual abuse may suffer from physical injuries like gastrointestinal pain, abdominal pain, pelvic pain, and headaches. (Courey, JT, et al; 2011)
Victims of sexual violence seek help from healthcare professionals, nurses, and psychologists. Victims prefer to visit healthcare professionals on a daily basis and benefit from their encounters with healthcare professionals. However, many victims of sexual abuse often feel distressed, reluctant, and distrustful. Researchers suggest that discomfort among victims of sexual abuse after medical intervention is observed due to secondary victimization. Victims of rape are considered to have the least benefit from nurses or healthcare professionals. Studies claim that lack of interpersonal communication or relationships of nurses is the major cause of secondary victimization or distress among sexual abuse cases. Researchers have reported that 25% of victims who received mental health services, 29% of victims who received medical services and 12% victims who received emergency services report the services to be stressful. Many victims of sexual abuse report negative experiences after visiting the trauma care center. It is claimed that lack of interpersonal development of nurses has led to the poor management of sexual abuse victims. Peplau’s theory is based on the enhancement of interpersonal communication of nurses to help sexual victim patients.
The major problem in research studies is the lack of well-trained nurses. Peplau’s theory describes nurses as communicators and leaders in the healthcare industry. However, many research studies have untrained nurses who lack interpersonal skills. Participants in research studies report discomfort and discontinue the study due to the lack of communication from nurses. In some research studies, participants complained that nurses were not helpful during the study program. In rare cases, conflicts between nurses and patients were reported due to the lack of interpersonal skills of nurses. Subject retention and participation is the most important phase of a research study. However, this remains a major problem in most research studies. Peplau’s theory is associated with the enhancement of nurse’s interpersonal skills. Thus, the application of Peplau’s theory in research studies could be beneficial.
Improving Subject Recruitment, Retention, and Participation in Research through Peplau’s Theory of Interpersonal Relations
Peplau’s theory is associated with the different roles of a nurse in a healthcare setting. In research studies, a nurse is said to motivate, encourage, and interact efficiently with the participants. According to Peplau’s theory, nurses should enhance their interpersonal skills to improve the retention and participation of the study. A nurse should understand the patient’s behavior and cultural background. Based on the patient’s behavior and cultural background, the nurse should educate, consult, and motivate the patient. The success of patient retention and participation is associated with patient-nurse relationship. It is important that nurses understand the needs of each patient. Nurses are required to treat patients with respect to acceptance, empathy, and respect. (Penckofer, S., et al; 2011)
Pelpau’s theory is based on three four phases that form the basis of a strong patient-nurse relationship. In the case of subject recruitment and participation, nurses should understand the problem faced by the patient. Nurses would then identify the source of the problem (why do patients leave the research study). In the third phase, nurses would seek professional help to assist and motivate patients (subjects) to continue with the study. The strategy developed and implemented for each patient is different. Nurses would need to individualize the strategy for each patient. Effective communication with respect to the patient’s cultural background, beliefs, past, experiences, expectations, ideas, and concerns is highly recommended. Peplau’s theory is also associated with the time of the patine-nurse interaction. Nurses should understand the time constrains in a healthcare setting. Nurses should note the progress of each patient for better understanding. Lastly, Peplau’s theory of interpersonal relationships or communication could help and improve the current scenario of patient (subject) retention and participation to a significant extent. (Penckofer, S., et al; 2011)
Hildegard Peplau’s Theory and the Healthcare Encounters of Survivors of Sexual Violence: As mentioned earlier, victims of sexual abuse/violence lack trust and confidence in seeking help from nurses and healthcare professionals. Many victims complained of secondary victimization or distress after seeking help from nurses. One of the major reasons of discomfort and lack of confidence from patients is the lack of interpersonal skills of nurses. It is important that nurses understand the background and circumstances of the situation. Each case of sexual abuse/assault should be handled appropriately. For example, nurses should cater to rape victims in a humble and supportive manner. Nurses should avoid asking questions about the incidence since this could affect the patient’s mental and emotional health. According to Peplau’s theory, nurses should understand and identify the problem of the victim. Efficient communication is required for sexual assault cases. The time taken for sexual assault victims to recover could be longer compared to a conventional disease. One of Peplau’s principles are associated with the role of a nurse as a consultant and safety agent. (Courey, JT, et al; 2011)
One of the most important concept of Peplau’s theory is nurse’s role in gaining the victims trust. More than 90% of rape or sexual abuse victims do not trust their counsellors or immediate helpers. It is important that nurses should interact with such victims to gain their trust and confidence. According to Peplau’s theory nurses play an important role as a safety and socializing agent to sexual assault victims. Nurses would also encourage victims of sexual assault to interact with family members and close friend. Peplau’s theory would also encourage nurses to create a safe and friendly environment to sexual assault victims. Counselling is a key aspect of Peplau’s theory that can be applied by nurses in such cases. It takes time and effort to help a sexual assault victim. Lastly, nurses should evaluate the victim’s mental and psychological health on a daily basis. To conclude, Peplau’s theory is considered to be helpful for nurses in helping and catering sexual abuse/assault victims.
Conclusions
Peplau’s theory of interpersonal communication has helped many nurses to work and perform efficiently in different healthcare settings. The paper highlighted the importance of Peplau’s theory in different healthcare settings. As mentioned earlier, Peplau’s theory is a middle-range theory and is considered to be the best middle-range theory till date. The paper emphasized on the applications of Peplau’s theory in different healthcare settings. The first case was the role of nurses with sexual assault victims. The second case was the role of nurses in the retention and participation of subjects in research studies. The problems of each case was described along with a strategy to solve the problem.
However, after a couple of reviews on Pelau’s theory and its applications in different healthcare settings, it has helped understand the importance of Peplau’s theory in different healthcare settings. Apart from sexual assault cases and subject retention, Peplau’s theory can be applied in rural and emergency nursing. Moreover, Peplau’s theory can be applied to different age groups like pediatric or geriatric populations. The theory of interpersonal communication can be applied for critically ill patients. It is important to understand the key concepts of Peplau’s theory. It can be applied in different healthcare settings since it is associated with the nurse’s interpersonal skills. To conclude, Peplau’s theory can be considered to be one of the best middle-range theory for nurses.
References
Senn, JF. (2013). Peplau's theory of interpersonal relations: application in emergency and rural nursing. Nurs Sci Q. 2013 Jan; 26(1):31-5. Retrieved: http://www.ncbi.nlm.nih.gov/pubmed/23247346
Courey, JT., Martsolf, SD., Draucker, BC., & Strickland, B., K. (2011). Hildegard Peplau’s Theory and the Healthcare Encounters of Survivors of Sexual Violence. J Am Psychiatr Nurses Assoc. May 2008; 14(2): 136–143. Retrieved: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163527/#__ffn_sectitle
Penckofer, S., Byrn, M., Mumby, P., & Ferrans, C. (2011). Improving subject recruitment, retention, and participation in research through Peplau's Theory of Interpersonal Relations. Nurs Sci Q. 2011; 24: 146–151. Retrieved: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687539/#__ffn_sectitle
