Hildegard Peplau: Theory of Interpersonal Relations

Hildegard Peplau was born in Reading, Pennsylvania [1909]. She graduated from a diploma program in Pottstown, Pennsylvania in 1931 and done BA in interpersonal psychology from Bennington College in 1943. She received her MA in psychiatric nursing from Colombia University New York in 1947 and EdD in curriculum development in 1953. Peplau became a professor emeritus from Rutgers university.

She started the first post baccalaureate program in nursing and published Interpersonal Relations in Nursing in 1952. She worked as executive director and president of ANA and with W.H.O, NIMH and nurse corps.
Hildegard Peplau Died in 1999.

Psychodynamic nursing

  • Understanding of ones own behavior
  • To help others identify felt difficulties
  • To apply principles of human relations to the problems that arise at all levels of experience
  • In her book she discussed the phases of interpersonal process, roles in nursing situations and methods for studying nursing as an interpersonal process.
  • According to Peplau, nursing is therapeutic in that it is a healing art, assisting an individual who is sick or in need of health care.
  • Nursing is an interpersonal process because it involves interaction between two or more individuals with a common goal.
  • The attainment of goal is achieved through the use of a series of steps following a series of pattern.
  • The nurse and patient work together so both become mature and knowledgeable in the process.

Metaparadigms

Person : A developing organism that tries to reduce anxiety caused by needs
Environment : Existing forces outside the organism and in the context of
culture
Health : 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.
Nursing : A significant therapeutic interpersonal process. It functions
cooperatively with other human process that make health possible for individuals in communities

Roles of a Nurse

Stranger: receives the client in the same way one meets a stranger in other
life situations provides an accepting climate that builds trust.
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.
Leader : helps client assume maximum responsibility for meeting treatment goals in a mutually satisfying way
Additional Roles include:
1. Technical expert
2. Consultant
3. Health teacher
4. Tutor
5. Socializing agent
6. Safety agent
7. Manager of environment
8. Mediator
9. Administrator
10. Recorder observer
11. Researcher

Theory of Interpersonal Relations

• Middle range descriptive classification theory
• Influenced by Harry Stack Sullivan’s theory of inter personal relations (1953)
• Also influenced by Percival Symonds , Abraham Maslow’s and Neal Elger Miller

Identified four sequential phases in the interpersonal relationship:
1. Orientation
2. Identification
3. Exploitation
4. Resolution


Orientation phase

• Problem defining phase
• Starts when client meets nurse as stranger
• Defining problem and deciding type of service needed
• Client seeks assistance ,conveys needs ,asks questions, shares preconceptions and expectations of past experiences
• Nurse responds, explains roles to client, helps to identify problems and to
use available resources and services

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
Exploitation phase
• Use of professional assistance for problem solving alternatives
• Advantages of services are used is based on the needs and interests of the
patients
• 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, understand and adequately deal with the underlying problem
• Patient may fluctuates on independence
• Nurse must be aware about the various phases of communication
• 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.
• Sometimes may be difficult for both as psychological dependence persists
• Patient drifts away and breaks bond with nurse and healthier emotional balance is demonstrated and both becomes mature individuals

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