NURSING THEORIES GUIDE HILDEGARD PEPLAU HILDEGARD PEPLAU Theory of Interpersonal Relations Prepared by Rey D. Pinalba, RN, MNHildegard Peplau “ Nursing is as interpersonal process because it involves interaction between two or more individuals with a common goal. Nursing is therapeutic in that it is a healing art assisting an individual who is sick or in need of health care”Hildegard Peplau Pepiau's theory focuses on the interpersonal process and thefapeutc relationship that develops between the nutse and client. The client is an individual with felt need. Nursing’s goal iso educate the client and family and fo, help clients reach mature personality development (Chinn and Kramer, 2004) The nurse strives to develop a nurse-client relationship in which the nutse serves as a resource person, counselor, and surrogate. Psychodynamic nursing involves: Understanding of one’s behavior Helping other identify felt difficulties Applying principles of human relations fo the problems that atise at all levels of experience. The attainment of goal is achieved through the use of a series of sleps following a series of pattern in the inferpersonal relationship namely: 1. Orientation Phase 2. Working Phase A. Identification 8. Exploitation 3. Termination Phase (Resolution Phase)History and Background + Hildegard Peplou was bom in Reacing, Pennsylvania in 1908. + Graduated from a diploma program in Pottstown, Pennsyivaniain 1931 + + Eomed Bachelor of Asin interpersonal Psychology from Benninglon College in 1943. + Finished Master of Ars in Psychiatic Nusing from Colombia Univesity, New Yorkin 1947 + Achieved EdD in curiculum developmentin 1953, + Hos been Professor emetits from Ruige's Universy. Started fist post baccalaureate program in nutsing + Published Interpersonal Relations in Nursing in 1962. In 1968, infroduced interpersonal techniques ~ the crux of psychiatric nusing, + Worked as executive director and president of ANA. (American Nurse's Association) + Worked with WHO, NIHM (National institute of Mental Health) and nurse corps. + She diediin March 17, 1999 at the age of 90 yearsTheory of Interpersonal Relations * Hildegard E. Peplau has been described as the mother of psychiatric nursing because her theoretical and clinical work led to the development of the distinct specialty field of psychiatric nursing. * she stressed the importance of nurses’ ability to understand their own behavior to help others identify perceived difficulties. * Has 3 sequential phases in the Interpersonal nurse-patient relationship:phases of the nurse-patient relationship * Orientation + Identification * Exploitation * Resolution+ Ofientation 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. During the orientation phase. the ingividual has a fell need and seeks professional assistance. The ‘nurse helps the individual to recognize and understand his/her problem and determine the need forhelp.+ Working Phase A. 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. + The patient identifies with those who can help him/her. The nurse permits exploration ,-Of feelings to and the patient in undergoing illness as an experience that reorients feeling and strengthens positive forces in the personality and provides needed satisfaction.8. Exploitation Phase + Use of professional assistance for problem solving alternatives, + Advantages of services are used and based on the needs and interests of the patients. + Individual feels as an integral part of the helping environment. + The individual 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 fluctuate on independence. + During this phase, the patient attempts to derive full value from what he/she is offered through the relationship. The nurse can project new goals fo be achieved through personal effort and power shifts from the nurse to the patient as the patient delays gratification fo achieve the newly formed goals. + Nurses must be aware about the various phases of communication, + Nurses aid the patient in exploiting all avenues of help and progress is made towards the final step. 9 a+ Resolution Phase + Termination of professional relationship. + The patient's needs have already been met by the collaborative effort 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 diffs away and breaks bond with nurse and healthier emotional behavior is demonstrated and both become mature individuals. + The patient gradually puts aside old goals and adopts new goals. This is a process in which the patient frees himself from identification with the nurse.In capsule: + Orientation: Nurse and patient come together as strangers; meeting initiated by patient who expresses a “felt need”, work together to recognize, clarify, and define facts related to the need. + Identification: Patient participates in goal setting; has feeling of belongingness and selectively responds to those who can meet his/her needs. + Exploitation: Patient actively seeks and draws knowledge and expertise of those who can help. + Termination (Resolution): Occurs after other phases are completed successfully. This leads to termination of the relationship.six nursing roles: Stranger resource person Teacher + Leader Surrogate counselorPeplau advocates that the roles of the nurse in the nurse-patient interpersonal relationship are as follows: * SHTANGET receives the cient in the same way one meets a stranger in other He Stuation® Provides an accepting clmate that Bulls trust. * Teacher who imparts knowledge in eference fo anced orntres + Resource Person: one who provides a specific needed information that {Gdn the understand ing of a problem or new situation. * COUNSEIOI: helps to understand and integrate the meaning of curent lfe circumstances; provides guidance and encouragement to make changes, * Surrogate: helps to clarify domains of dependence, interdependence and indepensience and acis on cients behal as an advocate, * LEAEF: helps cient assume maxi mum responsibilty for meeting treatment ‘9paK in @ mutually satsying 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 with the end purpose of meeting the patients needs. Both use observation, communication, and recording as basic tools utilized by nursing, reer) Cr Pome er oe co) Lien reer eerie) ee) Peers Nuting Diagnosis Identiication Planning Interdependent goal seting ‘Mutual set goals Implementation Explotation Plans inated loved achievement of mutvaly set goats Patient actively seeking and drawing help May be eccomplshed by patient, nase of family Patient iniiatod! Evaluation Resolution Based on mutually expected behaviors ‘Occurs after ciner phases ore completed successuly May lead fo termination and ination of now Leads fo termination plans+ Concepts Person. A developi ng orgarism that tries to reduce anviely caused by needs, Environment, Existing forces outside the organism and in the context of culture. Health. A word symbol that implies foward 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 processes that make health possible for individuals in communities. According fo Peplay (1952/1988), nursing is therapeutic because its a healing art, assisting an individual who is sick or in need of health care.*END