THEORETICAL FOUNDATION OF

NURSING

NELLAS, SOFIE MAY C.

PROFESSOR FAYE FELICILDA RN, MAN

HILDEGARD PEPLAU

HILDEGARD PEPLAU’S THEORY OF INTERPERSONAL RELATIONS :

“Nursing is the interpersonal therapeutic process of functioning cooperatively with other human processes that make health possible for individuals in communities through education that aims to promote forward movement of personality.”

Hildegard Peplau

considered the mother of psychiatric mental health nursing.

credited for the following in the nursing profession:

Promotion of professional standards and regulation through credentialing

Introduced the concept of advanced nursing practices

Stressed the importance of psychodynamics in nursing practice

Proponent of the nurse’s unique ability to understand his or her own behavior in order to help others identify their perceived difficulties

Four phases of the nurse-patient relationship :

Orientation- on admission -the nurse-patient

interaction where the client seeks help and the nurse assists the client to understand the problem and the extent of the need for help

Identification -during intensive treatment

period-characterized by the client

who assumes a posture of dependence, interdependence, or independence in relation to the nurse. The nurse’s focus is to assure the person that the nurse understands the interpersonal meaning of the client’s situation

Exploitation

-convalescence and rehabilitation

-client derives full value from what the nurse offers through the relationship. The client uses available services based on self-interest and needs. Power shifts from the nurse to the client.

Resolution

-discharge-old needs are resolved,

newer and more mature one become evident.

Six nursing roles:

Stranger role-role of nurses is

exemplified by the nurse receiving the client in the same way one meets a stranger in other life situations. The nurse provides an accepting climate that builds trust.

Resource role-the nurse answers

questions, interprets clinical treatment data, and gives information.

Teaching role-the nurse gives instructions

and provides training. She also involves analysis and synthesis of the learner’s experience.

Counseling role-the nurse helps the client

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

Surrogate role-the nurse helps client clarify

domains of dependence, interdependence, and independence and acts on clients’ behalf as advocate.

Active leadership-the nurse helps the client

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

Four psychological experiences that compel destructive or constructive responses:

NeedsFrustrationsConflictsAnxieties

Peplau’s contribution to the nursing profession is greatly influenced by the works of Sigmund Freud (Psychoanalytical Theory), Abraham Maslow (Hierarchy of Needs Model), and Harry Sullivan (Interpersonal Relationship Theory).The usefulness of her theory is based on contemporary psychoanalytical models. Peplau’s works reflect mastery of the theories of different disciplines. Her synthesis of theories from different fields into a theory that is significant to the nursing profession is one of the hallmarks of her career as a nurse theorist. She used the psychological model to develop her Interpersonal Relations Theory in the practice of the nursing profession.

Theory Assertions:

Person- viewed as an organism that

strives to reduce and minimize the tension generated by needs.

Environment-described as the psychodynamic

milieu that receives attention emphasizing on the patient’s culture and tradition.

Health-defined as an ongoing human

processes in the direction of creative, constructive, productive, personal, and community living.

Nursing-viewed as the interpersonal

therapeutic process that functions cooperatively with other human processes that make health possible for individuals in the communities. It is an educative instrument, a maturing force that aims to promote forward movement of personality.

Applications of the Theory:Peplau’s theory is significant in terms of the different phases of the nurse-patient interaction and the different roles the nurse can play in giving nursing care to patients. It thus, becomes important for nurses to understand the principles behind each of these concepts so that clinical nursing will be more meaningful for the nurse. Eventually, this will translate to better patient outcomes like improved health, prevention of disease, and or enhancement of care faculties