Peplau’s Theory of Interpersonal Relations, Research Paper Example

Introduction

The following is a summary and critique of Hildegard Peplau’s (1992) “Theory of Interpersonal Relations”. The synthesized method of theory evaluation was used to perform this brief critique and analysis. According to McEwen and Wills (2007), this method was designed to evaluate middle range and practice theories. This method was chosen to evaluate a grand theory because it appears to be the most comprehensive and inclusive technique.

Theory Description

Scope of Theory

The Theory of Interpersonal Relations is consistent with grand theory.

Purpose of Theory

To assist with the development of problem solving skills between a nurse and patient using an interpersonal relationship that consists of both education and therapeutic resources.

Origin of Theory

The actual term ‘interpersonal relations’ was defined by Jacob Moreno in relation to psychodrama and psychoanalysis (Peplau, Interpersonal relations: A theoretical framework for application in nursing practice, 1992). Harry Sullivan began using the term during his work and intertwined it with his basic foundation of the Freudian theory. After Peplau began studying Sullivan’s work and started performing clinical analyses of her own using psychiatric patients, she based the concept of interpersonal relations more on the nursing practice in order to paint a clearer picture of the nurse-patient interaction process. She believed that a nurse’s job consisted of much more than the medical aspect of patient care. Nurses, in her opinion, served as role-players and were many things to a patient. Some of these roles were teacher, educator, surrogate, and counselor. It is through these roles that the vast amount of emotional relationships were formed between the patient and nurse rather than through the normal route of medical delivery. If the patient formed an interpersonal relationship with his or her nurse and developed a sense of trust, many times there could be the avoidance of negative situations by simply speaking with the nurse rather than have unnecessary procedures performed due to the procedures being wasteful, albeit routine in the medical schema.

While this theory is quite useful in all areas of nursing, it is especially unique to the area of psychiatric nursing because there is a greater need for communication and the increased ability to relate to others (Peplau, Peplau’s Theory of Interpersonal Relations, 1997). Peplau found that psychiatric patients did not necessarily have intensive medical conditions right away; rather, they had a greater need for communication and many times this was hard for them to do unless there was a basis of trust established between the patient and his or her nurse. Thus, with the theory of interpersonal relations, the nurse could develop one of the roles needed to gain the patient’s trust and this ensured a more positive experience for the patient as well as the nurse and physician. It also went a long way in creating a positive atmosphere for the duration of the patient’s stay, especially if the patient was in the psychiatric ward of an institution.

The main focus of nursing, as Peplau believes, is the nurse-patient relationship and all of the interactions between the nurse and patient should focus on benefitting the patient and thus determining the source of the patient’s problem. While the theory of interpersonal relations does not necessarily provide the medical information for the patient’s problem, it gives a grounded approach to the relationship between the nurse and patient in order for a relationship to be formed and emotional needs to be met. This often facilitates the physical needs the patient may have and helps with finding a diagnosis much quicker (Reynolds, 1997).

Major Concepts

The major concepts of the interpersonal theory are nursing, person, environment, health, interpersonal relationships, communication, pattern integration, roles, thinking, learning, competencies, and anxiety.

Major Theoretical Propositions

1. Nursing aims to promote health by using education. This education can be in the form of specific medical education or general health education.
2. Health is the overall goal of nursing and is within a person. The person is also a part of the environment, which can be a positive or negative aspect to the person’s health.
3. The environment has a direct link on interpersonal relationships and these relationships will have an influence on a person’s health. A person’s health, likewise, will be influenced by continuous interpersonal relationships that are ongoing and may have either positive or negative effects on the individual.
4. Communication occurs between persons, within the context of interpersonal relationships, and as part of the environment. This communication is essential as a part of our daily lives and can be verbal communication or nonverbal communication.
5. Pattern integrations occur between persons, are a part of nursing, and occur as a part of the environment. Likewise, they are an essential part of the interpersonal relationship.
6. Roles are used during various times within the context of a situation and in different environments. They are used by nurses as a part of an interpersonal relationship in order to help patients achieve better health. A nurse might play a variety of roles depending on the patient’s needs during one stay in an institution.
7. Thinking occurs within every person. It is critical amongst nurses and is an attribute to be used in the nurse-patient relationship.
8. Learning occurs within persons, occurs within one’s environment, is a part of nursing, and occurs as a precursor to promote the positive improvement of a patient’s health.
9. Competencies are developed in nursing and can be helpful in the formation of an interpersonal relationship. They are crucial to the nursing environment, just as they are crucial in everyday life.
10. Anxiety occurs within a person and his environment. It causes problems with the interpersonal relationship and can be detrimental to nursing.

Major Assumption

Two major assumptions were identified in Peplau’s Theory of Interpersonal Relations. The first is that there will be a considerable difference in the kind of nursing care that a patient receives depending on the personality of the person that has decided to make nursing his or her career. Also, a large part of nursing and nursing education involves the maturity of one’s personality as it pertains to the field of nursing. This is achieved by the use of various methods and principles to help solve any interpersonal problems (Peplau, Interpersonal relations: A theoretical framework for application in nursing practice, 1992).

Context for Use

This is a universal approach for diverse cultures to learn and relate to the nurse-patient interpersonal relationship as well as learn to mature in regard to their own personalities.

Theoretical Definitions for Major Concepts

Nursing—a way of using education to promote health. Person—an individual who lives in an unstable environment and is often developed through interpersonal relationships. Environment—a person’s immediate area that surrounds him or her, which could promote good health or illness. Health—a forward movement in one’s living toward the direction of positive thinking and existence. Pattern Integration—the combination of patterns between more than one group or set of individuals. Interpersonal Relationships—the relationships that occur between more than one individual or group of individuals. Communication—a way of relaying information from one person to another through talking or using gestures, body language, or other symbolism. Roles—the various personas that a person acts out in order to help another person or assist with a problem or find the source to a solution (in the case of nursing and the patient-nurse relationship). Thinking—a cognitive process that is innate to each individual and may be different depending on a different set of circumstances or environmental conditions. Learning—the acquisition of something new that an individual did not previously know or understand (such as a task or certain phrase). Competencies—skills that an individual has acquired through the evolution of practice and performance, normally quite often. Anxiety—a negative innate energy that the body triggers in response to a threatened danger, whether physical or emotional.

Consistent Use of Concepts, Statements and Assumptions

Theory uses concepts consistently internally and also consistently in relation to Christian principles and biblical scripture.

Logical Organization

This theory is logical and presented in a clear and concise format by which every nurse should be capable of following.

Models/Diagrams

Models and graphic displays are used throughout this grand theory to explain linkages among major concepts and the intertwined relationships.

Theory Evaluation

Congruence with Nursing Standards

Foundations of this grand theory are indeed congruent with primary nursing ideals adhered to throughout nursing history.

Congruence with Current Nursing Interventions or Therapeutics and Evidence of Empirical Testing/Research Support/Validity

Although the Theory of Interpersonal Relations was published several years ago, the foundations of the theory have been practiced as far back in history as the Freudian era and have shown significant results in the application when basic principles were followed. There are positive applications in all areas of nursing where there is a need to form a relationship between the nurse and his or her patient, especially in the field of psychiatric nursing or long term care nursing.

Use by Nursing Educators, Nursing Researchers, or Nursing Administrators

The theory is significantly useful in any areas of psychiatric education, research, and/or administration.

Social and Transcultural Relevance

There is an unspoken relevance to transcultural and social implications because this theory concerns relationships and it is understood that relationships between nurses and patients will transcend all socioeconomic statuses and cultural boundaries.

Contribution to Nursing

Peplau’s (Peplau, Interpersonal relations: A theoretical framework for application in nursing practice, 1992) theory is a phenomenal contribution to the world of nursing in the regard that it explains the purpose of nursing as more than a medical necessity. It challenges nurses to use their knowledge and abilities in the area of human relations to work with patients on a variety of problems that may be encountered throughout the nurse-patient experience. The way to meet this goal is by being a teacher, a source for educational resources, a counselor, a surrogate, and a leader, thus ensuring trust between the nurse and patient so the patient will adhere to the medical regimen and improve his or her overall health.

Conclusions and Implications

Peplau (Peplau, Peplau’s Theory of Interpersonal Relations, 1997) believes that nursing is an interpersonal process because there is involvement between more than one person and there is a common goal to be achieved. She also believes nursing is therapeutic in itself because it is a healing art due to the fact nurses assist individuals who are sick and do not always assist them with the medical aspect, but rather sometimes meet their emotional needs as well. It is because of these beliefs that Peplau’s theory has gained such respect amongst the nursing community and has also gained a full understanding amongst those healers who do believe that, often, there is a need for emotional medication in addition to physical medication. The relationship formed via the Theory of Interpersonal Relations helps in this way because it allows the patient to feel comfortable in expressing his or her needs to someone who understands and is knowledgeable enough to meet those needs while ensuring that adequate medical care will also be given at the same time.

References

McEwen, M. & Wills, E. M. (2007). Theoretical basis for nursing (2^nd ed.). Philadelphia: Lippincott Williams & Wilkins.

Peplau, H. (1992). Interpersonal relations: A theoretical framework for application in nursing practice. Nursing Science Quarterly, 5(1), 13-18.

Peplau, H. (1997). Peplau’s Theory of Interpersonal Relations. Nursing Science Quarterly, 10(4), 162-167.

Reynolds, W. (1997). Peplau’s theory in practice. Nursing Science Quarterly, 10(4), 168-170.