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?Running Head: A COMPARISON OF OREM AND PEPLAU'S NURSING THEORIES 1 A Comparison of Orem and Peplau's Nursing TheoriesMaryBeth FrickerCollege of New Caledonia, Quesnel, British ColumbiaJudy Crain RN, Bsn2013/10/23A COMPARISON OF OREM AND PEPLAU'S NURSING THEORIES 2The Interpersonal Relations in Nursing Theory by Hildegard E. Peplau and the Self-Care Deficit Theory by Dorothea Orem are both very useful theories within the nursing practice. There are many similarities and differences between the Self-Care Deficit Theory and the Interpersonal Relations Theory, and both of these theories have practical applications to the nursing practice. This paper will go over the concepts of both of these theories, and then compare and contrast the two, and discuss which theory helps to best support the communication in nursing today.Hildegard Peplau Dr. Peplau was born in 1909 and started her career in nursing in 1931. In 1943, she completed a degree in Interpersonal Psychology, in 1947 she completed an M.A. in Psychiatric Nursing, and in 1953, she completed an Education Degree in Curriculum Development. Peplau was a pioneer in nursing (Belcher , Brittain Fish). Peplau taught many nursing classes and had the title Professor Emeritus. Peplau's theories and ideas greatly impact the way that nursing courses have developed today and "Peplau influenced the development of many nursing programs, including the creation of the first postbaccalaureate nursing program in Belgium" (Potter and Perry, p.61). Peplau also wrote many articles about issues within the nursing practice and "published numerous articles in professional journals on topics ranging from interpersonal concepts to current issues in nursing." (Potter and Perry, p.61).Peplau's theory is very much based on working with the patient therapeutically as well as interactively in order to develop a solid relationship between the nurse and the patient. Potter and states, "Peplau, a psychiatric specialist, defined the core of nursing care as the interpersonal relationship between the nurse and the patient" (Potter and Perry p.61). Peplau wanted to be able to help patients during their stay in the unit by developing a relationship with them to allow them to feel cared for and understood. Potter and Perry also state that, "Peplau depicted the practice of nursing as an interactive and therapeutic relationship. Peplau felt that such relationships allowedA COMPARISON OF OREM AND PEPLAU'S NURSING THEORIES 3 nurses to challenge the practice of long-term stays in large inpatient psychiatric hospitals and to envision supporting patients to achieve independent living" (Potter and Perry, p.61). Peplau's theory says that a nurse should always try to be supportive and show as much acceptance as possible, as stated here, "The nurse should provide an atmosphere of acceptance and support, one in which the person can become more self-aware and begin to use his or her strengths to minimize weaknesses. It is the nurse's responsibility to create a climate for the patient that is conducive to responsible self-growth" (George, 2001, p.68). Peplau's theory shows that a nurse needs to develop a trusting relationship with the patient in order to effectively treat that patient and allow them to heal and grow from their experience.Dorothea OremDorothea E. Orem was born in 1914 and she dedicated her life to improving the nursing practice. Orem graduated in 1934 and then received a Bachelor of Science in Nursing Education in 1939 and an Masters of Science in Nursing Education in 1946. Orem was a very caring and gentle as well as an avid reader and an extraordinary thinker. Orem's theory is mainly focused on helping the patient until the patient is able to help themselves, and giving them the skills and knowledge they need to be able to care for themselves. As stated by Ann Sparks, "Orem (2001) defined self-care as the practice of activities that individuals initiate and perform in their own behalf in maintaining life, health, and well-being" (Sparks, p.128). Sparks summarized the theory in her journal comparing the theories of Orem and Peplau. Sparks stated that, "The self-care deficit subtheory proposes that individuals may experience self-care limitations related to their health state and may benefit from nursing provision of this care or augmentation of their ownA COMPARISON OF OREM AND PEPLAU'S NURSING THEORIES 4self-care efforts. The self-care subtheory describes self-care and care of dependents of learned behavior which acts to regulate 'human-structural integrity, functioning and development'. The nursing system is formed when a nurse intervenes with a client to prescribe, design, or providecare to meet the self-care deficit or regulate the client's own self-care capabilities (Orem 1985)" (Sparks, as quoted in Comely, 1994, p. 755-760) . Potter and Perry stated that, "Orem's theory focused on the individual's role in maintaining health" (Potter and Perry, p. 60), and also that "Orem acknowledged the effects of various lifestyle factors such as smoking, diet, and exercise, reminding nurses that patients can look after their own health and that they must learn to for themselves within their families and communities. Thus, the role of the nurse, according to Orem, was to act temporarily for the patient until the patient could resume a more independent role in self-care" (Potter and Perry, p. 61). Orem's theory was based around caring for the patient until the patient was able to care for themselves.Similarities and DifferencesThere are many similarities and differences between the Self-Care Deficit theory and the Interpersonal Relationships theory. Peplau's theory of Interpersonal Relations is all about building a strong, therapeutic relationship between the client and the nurse so that the client is able to get well in body and mind, while Orem's theory of the Self-Care Deficit is all about giving clients the skills that need to care for themselves once they are well enough to, and also understanding that it is ultimately up to the client whether or not they will continue to practice the skills they learned while healing in the hospital and apply them to their daily lives in order to continue to heal and live a healthy life. While both theories focus on the client learning how to grow and take care of themselves and both theories focus on the client being able to help themselves, the theories have some interesting differencesA COMPARISON OF OREM AND PEPLAU'S NURSING THEORIES 5 between each other for example, each nurse had a different outlook on different aspects of nursing. Sparks does a great job of showing this. The journal compares the way that Peplau and Orem would define the word "person", and Orem's definition was "An integrated unity functioning biologically, symbolically, and socially" (Orem, 1985), while Peplau's definition was , "Man is an organism that lives in an unstable environment", (Peplau, 1952). Another example is how each nurse defined "nursing".Orem's definition of nursing was, "Identifying a person's requirements and ability for self-care and assisting the person in sustaining that self-care at a therapeutic level is the unique domain for nursing", (Orem, 1985), while Peplau's definition was, "A significant, therapeutic, interpersonal process. It functions cooperatively with other human processes that make health possible for individuals in communities", (Peplau, 1952) and "Nursing is an educative instrument, a maturing force that aims to promote forward movement of personality in the direction of creative, constructive, productive, personal, and community living", (Peplau, 1952). Clearly, just from reading Peplau and Orem's definitions of the words, "person" and "nursing" you can easily see that Peplau was very much interested in the relationships between patient and nurse, and that Peplau strongly believed that the key to helping to heal someone was to develop a therapeutic bond with them, while Orem believed that one should be a teacher to the patient, and provide them with the help they need and the knowledge they need to be able to help themselves. Peplau goes in depth when talking about the different aspects that nursing requires, while Orem is more straight forward when describing nursing. Peplau talks about growth between both the patient and the nurse who learn from each other. Orem speaks more of just caring for the patient and teaching them what to do and then allowing them and their families to be independent. Sparks' states that, "Peplau emphasizes the interaction of the nurse and client for their mutual growth and benefit. Orem's model does not require the client to be interactive for nursing to take place", (Sparks and quoted in Comely, 1994, p.759).A COMPARISON OF OREM AND PEPLAU'S NURSING THEORIES 6ConclusionBoth theories, Peplau's Interpersonal Relations in Nursing theory, and Orem's Self-Care Deficit theory greatly contributed to the growth of nursing practice as it evolved and continues to contribute today, but one might feel as though Peplau's theory is more useful as it allows the nurse to gain a relationship with the client and learn from them while they care for them, while Orem's theory doesn't really need any form of relationship, but to just simply care and teach and then send the patient on their way without any sort of relationship. One might feel as though Peplau's theory is more personal because there is a trusting bond formed between client and nurse and both parties are able to grow and learn from the healing experience, while Orem's theory is more of just teaching the patient. Both theories contribute a lot of positive input into the nursing practice we use today, but Peplau's will contribute more in a positive way. The Interpersonal Relations in Nursing Theory by Hildegard E. Peplau and the Self-Care Deficit Theory by Dorothea Orem are both very useful theories within the nursing practice. Both of the theories have a lot in common, and both theories have many practical applications to the nursing practice, but they also have many important differences between them. After comparing and contrasting these two theories Peplau's theory contributes more towards the nursing practice than Orem's theory simply because it allows a strong bond to be formed between the nurse and the client, and learning is able to take place amongst everyone involved in the nurse-client relationship. The knowledge gained from the relationship can better one's personal nursing practice, and the nurse is able to take the knowledge that was gained from the relationship and apply it to the next situation encountered. Both nursing theories are very useful and have both contributed to years of nursing development. A COMPARISON OF OREM AND PEPLAU'S NURSING THEORIES 7ReferencesComley, A. (1994). A comparative analysis of Orem's self-care model and Peplau's interpersonal theory. Journal of Advanced Nursing, 20(4), 755-760. doi:10.1046/j.1365-2648.1994.20040755.xHartweg, D.L. (1990). Health promotion self-care within Orem's general theory of nursing Journal of Advanced Nursing, 15(1), 35-41.Hartweg D.L. (1991), Dorothea Orem: Self-Care Deficit Nursing Theory. Newbury Park. CA: Sage.Hartweg D.L. (1993). Self-care actions of healthy, middle-aged women to promote well-being. Nursing Research, 42(4), 221-227.Hartweg D.L. (2001). Use of Orem's conceptualizations in a baccalaureate nursing program (1980-2000). International Orem society news letter, 8(1), 5-7.Orem D.E. (1987). Orem's general theory of nursing. In: R. Parse Ed, Nursing science: Major paradigms, theories and critiques (pp.67-89). Philadelphia: W.B. Sanders.Orem D.E. (2001). Nursing: Concept of Practice (6th Ed.). Saint Louis: Mosby.Orem D.E. (2003). Development of the Self-Care Deficit Theory of nursing: Event and Circumstances.In: K.Mc.Renpenning & S.G.Taylor (Eds.) Self Care Theory in Nursing. Selected Papers of Dorothea Orem,(pp.254-266), New York: Springer.Orem D.E. (2006) Dorothea E. Orem's Self-Care Nursing Theory. In: M.E. Parker (Ed.) Nursing theories and nursing practice (2nd ed.,pp.141-149). Philadelphia: F.A. Davis.Peplau, H.E. (n.d.) Basic Principles of Patient CounsellingPeplau H.E. (1988). Interpersonal Relations in nursing. NY: Springer. (Original work published 1952, New York: G.P. Putnam's Sons.)Peplau H.E. (1992). Interpersonal Relations: A theoretical framework for application in nursing practice. Nursing Science Quarterly, 5, 13-18.Peplau H.E. (1994a). Psychiatric mental health nursing: Challenge and changr. Journal of Psychiatric and Mental Health Nursing, 1, 3-7.Peplau H.E. (1994b). Quality of Life: An Interpersonal perspective, Nursing Science Quarterly, 7, 10-15.Peplau H.E. (1994c). The "Bridges of Madison County" has been in the best-seller for more than 1 year. From psycho-social perspective, what is the appeal of this popular book? Journal of Psychosocial Nursing, 32, 57-58.Peplau H.E. (1995). Some unresolved issues in the era of biopsychosocial nusing. Journal of the American Psychiatric Nurses Association, 1, 92-96. ................
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