Peplau's Theory of Interpersonal Relationships



Peplau’s Theory of Interpersonal Relationships

Clarke Krugman

Student UIN #00962091

Verde Campus, Clarkdale AZ

Submitted in partial fulfillment of the requirements in the course

Course #610: Theoretical Foundation Nursing Practice

Old Dominion University

NORFOLK, VIRGINIA

Peplau’s Theory of Interpersonal Relationships

This paper will assess the components of Hildegard Peplau’s Theory of Interpersonal Relationships. By researching the content of established published works on Peplau’s theory, this writer will determine its validity as a theory and define its purpose and its core concepts. Also, the writer will determine the theory’s practicability and appropriateness of use in his own nursing practice.

  Peplau’s theory is by definition a theory, not a conceptual model. ‘Strictly speaking they differ in their levels of abstraction; conceptual framework is more abstract than theory’ (Blais & Hayes, 2011, p. 99). Further, Fawcett states, ‘… middle-range theories such as Peplau's Theory of Interpersonal Relations contain testable propositions (as cited in Armstrong & Kelly, 1995, p. 40). Peplau's theory is a middle-range theory because the propositions of the theory are specific, testable, and limited (Armstrong & Kelly, 1995, p. 41). Peplau’s theory has been deemed testable, and has functioned as a framework for nursing practice according to scholarly inquiry and study. Jacqueline Fawcett, an acknowledged expert on nursing theory and developer of criteria for evaluation of theory, in reference to Peplau writes, ‘Peplau’s work is a middle-range descriptive classification theory that focuses on the phases of the interpersonal process that occur when an ill person and a nurse come together to resolve a health-related difficulty’ (Fawcett, 2005, p. 528).

The purpose of Peplau’s theory from this writer’s perspective is to guide the nurse in the development of his or her skills, emphasizing communication skills, and - using these communication skills in interaction with the patient - create an improved healing environment as they engage therapeutically through the nursing process.

Peplau’s theory works within the parameters of four key concepts. The four major concepts are: nursing, person, environment, and health. Definitions of these concepts follow for better understanding:

1. As defined by Peplau, ‘Nursing is an educative instrument, a maturing force that aims to promote forward movement of the personality in the direction of creative, constructive productive personal and community living’ (Peplau, 1952).

2. ‘Person’ has been defined in context to Peplau as an organism that “strives in its own way to reduce tension generated by needs.” The client is an individual with a felt need (as cited in Gonzalo, 2011).

3. Environment:  Existing forces outside the organism and in the context of culture ("Nursing Theories," 2012)

4. Health is described 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’ (Peplau, 1952, p. 12).

It is within the domain created by these four concepts that the operational elements of Peplau’s theory work.    

Peplau’s original work listed three specific phases to the interpersonal relationship process:

1. Orientation, wherein nurse and patient meet and begin to interact, the nurse does a self-evaluation, information is gathered – a plan of action and interaction forms (Butts & Rich,).  

2. Working phase: Goals are set, patient and nurse take on dynamic and changing roles. Nurse: that of teacher, advocate and counselor. Patient: takes an active role in their healing process. In some literature, this working phase has been modified to two sub-phases, identification and exploitation. For brevity and purposes of this paper, this description suffices) (Butts & Rich, 2011).

3. Resolution: The relationship heads toward termination. There is mutuality regarding what has been accomplished; a plan is made post-discharge (Butts & Rich, 2011).

This writer has observed in his assessment of Peplau’s theory that it can be readily used in his own practice, just as it is being used in facilities and practices around the world. This will be achieved by pro-actively auto diagnosing as he addresses the unique situations confronting each patient, mindful of the spoken and unspoken communications as they take place, and building trust with improved therapeutic communication.

The theory readily explains the communication processes which facilitate positive outcomes, and what becomes apparent in the study of the theory is how it nicely overlays the universally accepted nursing process (assessment, diagnosis, planning, implementation, evaluation). Good communication in the orientation phase enhances the processes of assessment and diagnosis. The working phase coincides with planning and implementation, and so on.

In summary, what has been learned is that the Interpersonal Relationship Theory developed by Hildegard Peplau is a practicable theory that can work in everyday nursing interactions with patients to yield better outcomes as it concurrently serves to fulfill its purpose, which is to develop the nurse’s own skill set and thus improve the healing environment.

References

Armstrong, M. A., & Kelly, A. E. (1995, February, 1995). More than the sum of their parts: Martha Roberts and Hildegard Peplau. Archives of Psychiatric Nursing, 9(1), 40-44. Retrieved from

Blais, K. K., & Hayes, J. S. (2011). Professional nursing practice Concepts and perspectives (6 ed.). Upper Saddle River, NJ: Pearson.

Butts, J. B., & Rich, K. L. (2011). Philosophies and theories for advanced nursing practice. Sudbury, MA: Jones & Bartlett Learning.

Fawcett, J. (2005). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories (2 ed.). Philadelphia, PA: F.A. Davis.

Gonzalo, A. (2011). Hildegard E. Peplau. Retrieved 9/15 2013, from

Nursing Theories: Hildegard Peplau. (2012). Retrieved 9/15 2013, from

Peplau, H. E. (1952). Interpersonal relations in nursing. New York, NY: Springer Publishing Company, Inc.

“I pledge to support the Honor System of Old Dominion University. I will refrain from any form of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a member of the academic community it is responsibility to turn in all suspected violators of the Honor Code. I will report to a hearing if summoned.”

Clarke Krugman, 9/22/2013

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