Hildegard E. Peplau Theory of Interpersonal Relations

By Anna Cunningham, Jessica Morgan, Brea Yang, & Stephanie Wietecha

Ferris State UniversityFall 2010

Hildegard E. Peplau

1909-1999

Hildegard E. Peplau Born in Reading, PA in 1909 BA in interpersonal psychology from

Bennington College in 1943 MA in psychiatric nursing from

Columbia University in New York in 1947

EdD in curriculum development in 1953 Published Interpersonal Relations in

1952 Executive director and president of

ANA

Historical Evolution of the Theory of Interpersonal Relations Model

Mother of psychiatric nursing for her theoretical and clinical work

Influence includes contributions as a psychiatric nursing expert, educator, author, and nursing leader and theorist.

Much on her life’s work focus on the extension of Harry Stack Sullivan’s theories whom she worked along side of while obtaining her psychology degree.

Historical Evolution of the Theory of Interpersonal Relations Model

She was the only nurse to serve the ANA as executive director and later president.

1997 she received the world of nursing’s highest honor, the Christiane Reimann Prize. (The award is given every 4 years for outstanding national and international contribution to nursing and health care).

1996 the American Academy of Nursing honored her as a living legend.

Her career in nursing began in 1931. 1943 – 1945 She served in the Army Nurse Corps

where she met leading figures of British and American psychiatry.

Historical Evolution of the Theory of Interpersonal Relations Model

After the war, she worked to reshape the mental health system in the U.S. through the passage of the National Mental Health Act of 1946.

1950 she developed and taught the first classes for graduate psychiatric nursing students at Teachers College.

1950s to 1960s She taught summer workshops for nurses where she taught interpersonal concepts and interviewing techniques.

Historical Evolution of the Theory of Interpersonal Relations Model

She helped established the first graduate nursing program in Europe.

Her theoretical and clinical work led to the development of distinct specialty field of psychiatric nursing.

It has been argued that her life and work produced the greatest changes in nursing practice since Florence Nightingale.

Metaparadigm: Person A developing organism that tires to

reduce anxiety caused by needs.

Metapardigm: Environment Existing forces outside the organism

and in the context of culture.

Metaparadigm: 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.

Metaparadigm: Nursing A significant therapeutic interpersonal

process. It functions cooperatively with other human process that make health possible for individuals in communities.

A human relation between an individual who is sick, or in need of health services, and a nurse especially educated to recognize and to respond to the need for help.

Unique Concept of the Theory of Interpersonal Relations

Roles of the nurse› Stranger› Teacher› Resource person› Counselors› Surrogate› Leader

Roles of Nurse Stranger

› A stranger is an individual with whom another individual is not acquainted.

› Accepting the patient as he is to build trust.

› Treating the patient as an emotionally able stranger and relating to him on this basis until evidence shows him to be otherwise.

Roles of Nurse Teacher

› Impacts knowledge in reference to a need or interest.

› Identifies learning needs and provides information to the patient or family that may aid in improvement of the life situation.

Roles of Nurse Resource person

› A resource person provides specific, needed information that helps the patient understand his or her problem and the new situation.

› Example: a patient might state he does not know how to change his dressing and the nurse explains it to the patient and demonstrates the procedure then observes the patient doing the demonstration.

Roles of Nurse Counselor

› Helps to understand and integrate the meaning of current life circumstances, provides guidance and encouragement to make changes.

› Listens as the patient reviews feelings in any aspect of life.

Roles of Nurse Surrogate

› Helps to clarify domains of dependence, interdependence and independence and acts on the patient’s behalf as an advocate.

Roles of Nurse Leader

› Help patient assume maximum responsibility for meeting treatment goals in a mutually satisfying way.

Additional Roles Technical expert Consultant Health teacher Tutor Socializing agent Mediator Administrator Recorder observer Researcher

Theory of Interpersonal relations

Influenced by Harry Stack Sullivan’s theory of Interpersonal relations of 1953.

Idenitified four sequential phases in the interpersonal relationship› Orientation› Identification› Exploitation› Resolution

Theory of Interpersonal Relations

Orientation› Problem defining phase› Patient meets nurse as stranger› Patient and nurse collaborates to define

problem and decide type of services needed. › Patient seeks assistance from nurse, conveys

needs, and asks questions.› Patient shares preconceptions and

expectations of past experiences.› Nurse identifies problems to use available

resources to assist patients.

Theory of Interpersonal Relations

Identification› Nurse selects appropriate professional assistance.› Patient begins to feel comfortable with nurse.› Patient begins to feel belonging and capability of

dealing with problem.

Theory of Interpersonal Relations

Exploitation› The phase during which the patient makes full

use of available professional services.› Patient may fluctuate on independence.› Patient may make minor requests or attention

getting techniques.› Nurse must be aware about the various

phases of communication.› Nurse uses appropriate interview techniques

in order to explore, understand, and adequately deal with patient problem.

Theory of Interpersonal Relations

Resolution› The phase in which the work accomplished

is summarized and closure occurs. › Termination of professional relationship.› Patient’s needs have already been met by

the collaboration of nurse and patient relationship.

› This is a difficult process for patients if psychological dependence persists.

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, with the end purpose of meeting the patients needs

Both use observation communication and recording as basic tools utilized by nursing

Interpersonal Theory and Nursing Process

Assessment

Data collection and analysis [continuous]

May not be a felt need

Orientation

Non continuous data collection

Felt need

Define needs

Nursing diagnosis Planning

Mutually set goals 

Identification

Interdependent goal setting

Implementation

Plans initiated towards achievement of mutually set goals

May be accomplished by patient , nurse or family

Exploitation

Patient actively seeking and drawing help

Patient initiated

Evaluation

Based on mutually expected behaviors

May led to termination and initiation of new plans  

Resolution

Occurs after other phases are completed successfully

Leads to termination a

Education from Peplau’s View

Teaching role: Gives instructions and provides training; involves analysis and synthesis of the learner's experience.

Current Research Hays .D. (1961).Phases and steps of

experimental teaching to patients of a concept of anxiety: Findings revealed that when taught by the experimental method, the patients were able to apply the concept of anxiety after the group was terminated.

Burd .S.F. Develop and test a nursing intervention framework for working with anxious patients: Students developed competency in beginning interpersonal relationship

Without Theory•New ostomy patient•Nurse senses tension and tries to enlighten the mood through distraction towards other events, Patient smiles•Nurse continues to help the patient by carried for the appliance for the patient•Inadequate coping is reinforced•Another day went by with the nurse promoting increased patient dependence by “staff helping”

With Theory•New ostomy patient•Nurse recognizes her own anxieties of ostomies, as well as the patients anxiety (avoidance of care and involvement)•Nurse assists patient to explore feelings through therapeutics•Nurse openly prompts patient to talk about concerns during care of the appliance•Encourages the patient to look at, touch, and care for appliance progressively throughout care

Strength of the Theory of Interpersonal Relations

This theory provides nurses with a framework to interact with patients whom have regressed to an earlier level of development. Nurses will help the client progress to the appropriate developmental level which helps the individual have the courage to confront the problems he or she has in life. Nurses serve to facilitate learning which individuals are not taught earlier in life.

Theories can interrelate concepts in such a way as to create a different way of looking at a particular phenomenon.

This theory provides logical systematic way of viewing nursing situations.

This theory help patient ‘s address their anxiety, tensions and frustrations.

Limitations of the Theory of Interpersonal Relations

Intra family dynamics and personal space consideration are not a priority.

Community social service resources are often less considered .

This theory will not work for a patient without a felt need such as withdrawn or unconscious patients.

References Theory of interpersonal relations,

Hildegard peplau. (July 23, 2010). Retreived from http://en.wikipedia.org/wiki/Hildegard_Peplau

Wikipedia, the free encyclopedia. (October 9, 2010). Hildegard Peplau. Retreived from http://en.wikipedia.org/wiki/Hildegard_Peplau

Analyzes the model overall, demonstrating new insights about the model

10 8 10 6 0 10 9 8 7 8 10 10 9 5 10 9 10 9 8 10

PRESENTATION CRITERIA

    POINTS

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POINTS AWARDED

  POINTS

AWARDED

POINTS AWARDE

D

POINTS

AWARDE

D

POINTS

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POINTS

AWARDE

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DOrganizes the presentation in a logical manner

5 5 5 5 5 5 5 4 5 5 5 5 5 5 5 5 5 5 5 5

Communicates ideas clearly 5 4 5 5 2 5 5 4 4 5 5 5 5 5 5 5 5 5 5 5

Demonstrates collaboration among presenters

5 5 5 5 5 5 5 5 4 5 5 5 5 5 5 5 5 4 5 5

Demonstrates professionalism, originality & creativity in presentation of content.

5 1 5 5 5 5 4 4 4 3 5 5 5 5 5 5 5 5 5 5

Makes provisions for class discussion 5 4 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5

Responds to questions in a knowledgeable manner

5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5

Uses a variety of presentation methods, including audiovisual and media technology

5 0 5 5 5 5 5 9 7 4 5 5 4 5 5 5 5 5 5 5

Demonstrates critical thinking during presentation and questioning.

5 5 5 94 5 5 5 93 91 5 5 5 5 5 5 5 5 5 5 5

TOTAL POINTS 100 84 100 94 84 100 97 93 91 94 100 100 98 95 100 97 98 88 96 100

Grade:  89.92Average grade by peers > 75% = full credit, 74-65% = 90% of grade above, 64-55% = 75% of grade above, below 55% = 50% of grade above Peer Grading

Average grade from peers

% of grade earned

Your grade

Anna Cunningham 100 95 95 96.67

100% 90

Jessica Morgan 100 95 95 96.67

100% 90

Brea Yang 95 98 95 96.00

100% 90

Stephanie Wietecha 97 95 94 95.33

100% 90