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HILDEGARD E.

PEPLAU

• Born in Reading, Pennsylvania in September 1, 1909
• First published nursing theorist in a century, since Nightingale
• Created the nursing middle-range theory of Interpersonal Relations

NURSING EDUCATION OF PEPLAU’S TIME

• The autonomous, nursing controlled Nightingale Era schools came to an end;
schools controlled by hospitals now and formal book learning is discouraged
• Hospitals and physicians saw women in nursing as a source of free or inexpensive
labor
• exploitation was not uncommon of nurse’s employers, physicians and educational
providers
• nursing practice was controlled by medicine

NURSING EDUCATION & MILITARY SERVICE

• Graduated from a nursing diploma program in Pottstown, Pennsylvania in 1931.
• After graduating from the Pottstown, Pennsylvania Hospital School of Nursing in
1931 she worked as an operating room supervisor at Pottstown Hospital.
• Done Bachelor of Arts in interpersonal psychology from Bennington College in
1943.
• World War II: Army Nurse Corps – worked in a neuropsychiatric hospital in
London, England
• Master of Arts in psychiatric nursing in 1947 and Ed.D in curriculum
development in 1953from Colombia University New York
• Published Interpersonal Relations in Nursing in 1952
• 1968 :interpersonal techniques-the crux of psychiatric nursing

FOUNDATIONS OF PEPLAU’S FRAMEWORK

• Hildegard witnessed injustices in life
• First exposure to Interpersonal Theory at Bennington
o Attended lectures by Harold Sullivan on Interpersonal Relations

• She had visions to bring the Sullivan theory to interations with her patients – they
needed:
o Humane treatment
o Dignity and respect
o Healing discussion

was completed in 1948.A word symbol that implies forward movement of personality and other ongoing human processes in the direction of creative. It functions cooperatively with other human process that make health possible for individuals in communities • Interpersonal – phenomena that occur between persons FOUR PHASES IN THE INTERPERSONAL RELATIONS Orientation phase • Starts when client meets nurse as stranger • Problem defining phase • Defining problem and deciding type of service needed . constructive.Existing forces outside the organism and in the context of culture • Health . • Her book.A significant therapeutic interpersonal process. entitled Interpersonal Relations in Nursing GOALS OF THE THEORY • Publishing her book took four additional years because it was groundbreaking for a nurse to contribute this scholarly work without a coauthoring physician • Peplau’s original intent was not to theory development per se • She wanted “only to convey to the nursing profession ideas she thought were important to improve practice” • Peplau’s focus was the quality of nurse-patient interactions and nursing education INTERPERSONAL RELATIONS THEORY Basic Elements • The patient • The nurse • The interaction between them Definitions • Patient/Client .A developing organism that tries to reduce anxiety caused by needs • Environment . productive. • Nursing . or conceptual famework. personal and community living.

• Sometimes may be difficult for both as psychological dependence persists .asks questions. understand and adequately deal with the underlying problem • Patient may fluctuates on independence • Nurse aids the patient in exploiting all avenues of help and progress is made towards the final step Resolution phase • 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. • Client seeks assistance . helps to identify problems and to use available resources and services Factors influencing orientation phase Identification phase • 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 • Goal of the Nurse: help the patient to recognize his own interdependent/ participation role and promote self responsibility Exploitation phase • Use of professional assistance for problem solving alternatives • 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. shares preconceptions and expectations of past experiences • Nurse responds.conveys needs . explains roles to client.

• Patient drifts away and breaks bond with nurse and healthier emotional balance is demonstrated and both becomes mature individuals • Clients has increased self-reliance in dealing with his problems ROLES OF NURSE • Stranger: receives the client in the same way one meets a stranger in other life situations provides an accepting climate that builds trust. • Leader : helps client assume maximum responsibility for meeting treatment goals in a mutually satisfying way INTERPERSONAL THEORY AND NURSING PROCESS • Both are sequential and focus on therapeutic relationship • Both use problem solving techniques for the nurse and patient to collaborate on. • Teacher: who imparts knowledge in reference to a need or interest • Resource Person : one who provides a specific needed information that aids in the understanding of a problem or new situation • Counselors : helps to understand and integrate the meaning of current life circumstances .provides guidance and encouragement to make changes • Surrogate: helps to clarify domains of dependence interdependence and independence and acts on clients behalf as an advocate. with the end purpose of meeting the patients needs • Both use observation communication and recording as basic tools utilized by nursing Assessment Orientation • Data collection and analysis • Non continuous data collection [continuous] • Felt need • May not be a felt need • Define needs Nursing diagnosis Identification Planning • Interdependent goal setting • Mutually set goals Implementation Exploitation • Plans initiated towards achievement • Patient actively seeking and drawing of mutually set goals help .

JL is on pelvic traction and she is restricted to bed. Displacement of part of the gelatinous interior of an intervertebral disc so that it protrudes through the fibrous outer coat. the nurse and patient work together. clarifies and gathers important information. I. outcome and goal set. carried out and evaluation done based on mutually established expected behaviors. JL • 27 years • Diagnosis: Inter vertebral disc prolapse. meeting initiated by patient who expresses a felt need. JL based on Peplau’s theory is as follows: • Mrs. Planning (Identification phase) . once the patient has recovered. • May be accomplished by patient . the orientation phase parallels with assessment phase where both the patient and nurse are strangers. • The need for bed rest and restriction was discussed. exercises are often used to strengthen the abdominal and back muscles in order to reduce the risk of a recurrence of the prolapse. The interventions are planned. Based on this assessment the nursing diagnoses are formulated. • Patient initiated nurse or family Evaluation Resolution • Based on mutually expected • Occurs after other phases are behaviors completed successfully • May led to termination and initiation • Leads to termination of new plans APPLICATION OF INTERPERSONAL THEORY IN NURSING PRACTICE In Nursing Process. So-called slipped discs preclude physical activity but. Conjointly. The exuded disc material may press against adjacent nerves and cause severe pain. Peplau’s theory application in nursing process: The nursing process for Mrs. Assessment (Orientation phase) • Mrs. Nursing diagnosis • Impaired physical mobility related to the presence of pelvic traction.

JL was free to express problems regarding difficulty in mobilizing. JL is enquiring about the disease condition. • Provide active and passive exercises to all the extremities to improve the muscle tone and strength. Make the patient to perform the breathing exercises which will strengthen the respiratory muscle. Implementation (Exploitation phase) • Carried out plans mutually agreed upon. Assessment (Orientation phase) • Mrs. Provide positive reinforcement for even a small improvement to increase the frequency of the desired activity. its outcome and need for surgery • Discussed with the client regarding the disease process and the findings in the client Nursing diagnosis • Anxiety related to hospital admission as evidenced by verbalization and client & family appearing withdrawn Planning (Identification phase) • Goal setting was done along with patient • Client will have reduced feeling of anxiety as evidenced by asking fewer questions . Massage the upper and lower extremities which help to improve the circulation. • Goal setting was done along with patient • Patient will have improved physical mobility as evidenced by participating in self care within the limits. Provide articles near to the patient and encourage doing activities within limits. • Provided active and passive exercises to all the extremities • Made the patient to perform breathing exercises • Massaged the upper and lower extremities Provided article within the reach of the patient • Provided positive reinforcement to the patient Evaluation (Resolution phase) • Mrs. • She expressed satisfaction when able to move without difficulty II.

a mutual exchange of privileges. You can rely on yourself.is any person who receives medical attention. and you can do so well. • Taught the family regarding the disease process in simple Kannada • Allowed the client and family members to ask questions She and her husband expressed their anxiety • Allowed the family members to frequently visit the client Evaluation (Resolution phase) • Mrs. Cooperation . giving and taking. • She asked her doubts regarding the illness and the diagnostic procedures • She verbalized that her anxiety has reduced to some extent. Reciprocity .. THEORY OF RECIPROCITY Nurse . • Teach the family and client regarding the disease process. influence. Stress that frequent assessment are routine and do not necessarily imply a deteriorating condition. The person is most often ill or injured and in need of treatment by a physician or other health care professional. guidance. or funds. You can fend for yourself. .Not relying on others for support.a state or relationship in which there is mutual action. Allow the family members to visit the client frequently Implementation (Exploitation phase) • Carried out plans mutually agreed upon. correspondence. care. Allow and encourage the client and family to ask questions. etc. JL was free to express problems of self care.A person educated and trained to care for the sick or disabled.The act of taking part or sharing in something Independent . Others includes influence. care. etc. Patient . self-supporting An Independent Person is someone who doesn't always need others. control. instead of constantly looking to others for affirmation. Explain in simple understandable language of the client. or to help you. Allow the client and family to verbalize anxiety. between two parties. or treatment.

however. The social norm of reciprocity often takes different forms in different areas of social life.Patient Interaction . Theory of Reciprocity Orientation Identification Exploitation Resolution The paradigm depicts the level of cooperation of the nurse and patient during the Nurse . or mutual goodwill.The norm of reciprocity is the social expectation that people will respond to each other in kind—returning benefits for benefits. are distinct from related ideas such as gratitude. or in different societies. All of them. the Golden Rule. and responding with either indifference or hostility to harms.

PEPLAU (INTERPERSONAL RELATIONS THEORY) Submitted By: Arianne C. Holy Angel University Angeles City Graduate School Master of Science in Nursing HILDEGARD E. Gantan .