Application of Interpersonal Theory in Nursing Practice (2022)

Application of Interpersonal Theory in Nursing Practice

Introduction

  • Peplau’s theory focuses on the interpersonal processes and therapeutic relationship that develops between the nurse and client.

  • The interpersonal focus of Peplau’s theory requires that the nurse attend to the interpersonal processes that occur between the nurse and client.

  • Interpersonal process is maturing force for personality. Interpersonal processes include the nurse- client relationship, communication, pattern integration and the roles of the nurse.

  • Psychodynamic nursing is being able to understand one’s own behavior to help others identify felt difficulties and to apply principles of human relations to the problems that arise at all levels of experience.

  • This theory stressed the importance of nurses’ ability to understand own behavior to help others identify perceived difficulties.

The four phases of nurse-patient relationships

1. Orientation
  • During this phase, the individual has a felt need and seeks professional assistance.

  • The nurse helps the individual to recognize and understand his/ her problem and determine the need for help.

2. Identification
  • The patient identifies with those who can help him/ her.

    (Video) Peplau's Theory - Application in Nursing Process

  • The nurse permits exploration of feelings to aid the patient in undergoing illness as an experience that reorients feelings and strengthens positive forces in the personality and provides needed satisfaction.

3. Exploitation
  • During this phase, the patient attempts to derive full value from what he/ she are offered through the relationship.

  • The nurse can project new goals to be achieved through personal effort and power shifts from the nurse to the patient as the patient delays gratification to achieve the newly formed goals.

4. Resolution
  • 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.

Peplau’s theory and nursing process

Peplau defines Nursing Process as a deliberate intellectual activity that guides the professional practice of nursing in providing care in an orderly, systematic manner.
Peplau explains 4 phases such as:

  • 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 need.

  • Identification: Patient participates in goal setting; has feeling of belonging and selectively responds to those who can meet his or her needs.

  • Exploitation: Patient actively seeks and draws knowledge and expertise of those who can help.

  • Resolution: Occurs after other phases are completed successfully. This leads to termination of the relationship.

    (Video) Hildegard Peplau - Interpersonal Theory

In Nursing Process, the orientation phase parallels with assessment phase where both the patient and nurse are strangers; meeting initiated by patient who expresses a felt need.

Conjointly, the nurse and patient work together, clarifies and gathers important information.

Based on this assessment the nursing diagnoses are formulated, outcome and goal set.

The interventions are planned, carried out and evaluation done based on mutually established expected behaviours.

Peplau’s theory application nursing process:

The nursing process for Mrs. JL based on Peplau’s theory is as follows:

  • Mrs. JL
  • 27 years
  • Diagnosis: Inter vertebral disc prolapse

Assessment (Orientation phase)

Nursing diagnosis

Planning (Identification phase)

Implementation (Exploitation phase)

Evaluation (Resolution
phase)

Mrs. JL is on pelvic traction and she is restricted to bed.

The need for bed rest and restriction was discussed.

Impaired physical mobility related to the presence of pelvic traction.

Goal setting was done along with patient

Patient will have improved physical mobility as evidenced by participating in self care within the limits.

Provide active and passive exercises to all the extremities to improve the muscle tone and strength.

Make the patient to perform the breathing exercises which will strengthen the respiratory muscle.

Massage the upper and lower extremities which help to improve the circulation.

Provide articles near to the patient and encourage doing activities within limits.

Provide positive reinforcement for even a small improvement to increase the frequency of the desired activity.

Carried out plans mutually agreed upon.

Provided active and passive exercises to all the extremities

Made the patient to perform breathing exercises

Massaged the upper and lower extremities
Provided article within the reach of the patient

Provided positive reinforcement to the patient

Mrs. JL was free to express problems regarding difficulty in mobilizing.

She expressed satisfaction when able to move without difficulty.

Assessment (Orientation phase)

Nursing diagnosis

Planning (Identification phase)

Implementation (Exploitation phase)

Evaluation (Resolution phase)

Mrs. JL expresses pain in the low back region.

Regarding pain, discussion was made to assess the severity and the type and duration of pain. Also the measures to reduce pain were discussed. Application of Interpersonal Theory in Nursing Practice (1)

Pain related to the degenerative changes in the lumbar region.

Goal setting was done along with patient

Mrs. JL will have reduction in pain as evidenced by her verbalisation of reduction in pain responses.

Provide non-pharmacological measures for pain relief such as diversional activity which diverts the patients mind.

Give the client a neutral position

Always use back support while turning the patient that reduces the strain on the back.

Support the areas with extra pillow to allow the normal alignment and to prevent strain.

Administer analgesics as prescribed by the physician.

Provide pelvic traction to the patient

Carried out plans mutually agreed upon.

Provided non pharmacological measures like diversion, massaging, and pelvic traction.

Provided supine position to the client
Supported the back during position change

Used pillows to support the back.

Administered Tab. Hifenac P and Cap. Myoril 4mg as prescribed.

Given pelvic traction and explained the need for traction

Mrs. JL was free to express problems of pain.

Expressed that she got slight relief from pain.

Assessment (Orientation phase)

Nursing diagnosis

Planning (Identification phase)

Implementation (Exploitation phase)

Evaluation (Resolution phase)

Mrs. JL expresses that she need assistance to get down from bed.

Regarding self care discussion was done and discussed regarding the measures to solve the problems.

Self care deficit related to the presence of pelvic traction.

Goal setting was done along with patient

Client will achieve and maintain self care activities with assistance of caregiver or within her limits.

Keep all the articles within the reach of the patient.

Provide a call bell to the patient to call in any emergency

Frequently visit the patient and enquire for any needs.

Assist the patient in doing her self care activities.

Remove the weight of the traction as needed by the patient.

Carried out plans mutually agreed upon.

Kept the articles within t he reach of the client

Frequently visited the patient and enquired for any needs

Assisted the client in doing her self care activities

Removed the weight as and when needed.

Mrs. JL was free to express problems of self care.

She used to call for the needs and all her needs were met appropriately

She achieved and maintained self care activities within her limits

Assessment (Orientation phase)

Nursing diagnosis

Planning (Identification phase)

Implementation (Exploitation phase)

Evaluation (Resolution phase)

Mrs. JL is enquiring about the disease condition, its outcome and need for surgery

Discussed with the client regarding the disease process and the findings in the client

Anxiety related to hospital admission as evidenced by verbalisation and client & family appearing withdrawn

Goal setting was done along with patient

Client will have reduced feeling of anxiety as evidenced by
asking fewer questions

Teach the family and client regarding the disease process.
Explain in simple understandable language of the client.

Allow and encourage the client and family to ask questions. Allow the client and family to verbalize anxiety.

Stress that frequent assessment are routine and do not necessarily imply a deteriorating condition.

Allow the family members to visit the client frequently

Carried out plans mutually agreed upon.

Taught the family regarding the disease process in simple Kannada

Allowed the client and family members to ask questions

She and her husband expressed their anxiety

Allowed the family members to frequently visit the client

Mrs. JL was free to express problems of self care.

She asked her doubts regarding the illness and the diagnostic procedures

She verbalized that her anxiety has reduced to some extent.

Assessment (Orientation phase)

Nursing diagnosis

Planning (Identification phase)

Implementation (Exploitation phase)

Evaluation (Resolution phase)

Mrs. JL is enquiring about the disease condition, its outcome and need for surgery

Discussed with the client regarding the disease process and the need for follow up

Deficient knowledge related to the treatment measures to be continued even after the discharge.

Goal setting was done along with patient

Patient will acquire adequate knowledge regarding the treatment and home care.

Explain the treatment measures to the patient and their benefits

Explain to the client the signs of aggravation of illness

Use simple and understandable terms

Clarify all the doubts of the patient of importance.

Repeat the information whenever necessary to reinforce learning.

Carried out plans mutually agreed upon.

Explained treatment measures and the need for follow up

Explained regarding the signs of aggravation of disease

Used simple and understandable terms for explaining
Clarified her doubts

Repeated the information

Mrs. JL was free to express problems of self care.

She expressed acquisition of knowledge regarding the disease and the signs of aggravation of illness

(Video) Peplaus Interpersonal Relations Model and its application in nursing process and research

Summary

1. Orientation phase
  • Client is initially reluctant to talk due to pain.

  • Client is expressing that while standing she is having much pain.

  • Client expressed without movement and supine position gave her relief from pain.

2. Identification
  • The client participates and interdependent with the nurse

  • Expresses the need for measure to get relief from pain

  • Expresses need for improving the mobility

  • Expresses need to know more about prognosis, discharge and home care and follow up.

3. Exploitation
  • Client explains that she gets relief of pain when lying down supine.

  • Cooperates and participates actively in performing exercises.

    (Video) Nursing Process Application : Betty Neuman, Part 3

  • Client mobilizes changes position and cooperates during position changes.

4. Resolution
  • Client expressed that pain has reduced a lot and she is able to tolerate it now

  • She has agreed upon to continue the exercises at home

  • She also expressed that she would come for regular follow up after discharge.

Evaluation of the theory of interpersonal relations by Peplau

  • With the help of the theory of interpersonal relations, the client's needs could be assessed.

  • It helped her to achieve them within her limits. This theory application helped in providing comprehensive care to the client.

References

  1. Chinn PL, and Kramer MK. Theory and nursing- a systemic approach. 3rd edition. Philadelphia: Mosby year book;1991.

  2. George JB. Nursing theories. 5th edition. New Jersey: Prentice hall; 2002.

  3. Alligood MR, Tomey AM. Nursing theory- utilization and application. 3rd edition. Missouri: Mosby Elsevier; 2006.

    (Video) Paplau's Interpersonal Theory

  4. Craven RF, Hirnle CJ. Fundamentals of nursing – human health and function. 5th edition. Philadelphia: Lippincott Williams and Wilkins; 2007.

  5. McQuiston CM and Webb AA. Foundations of nursing theory- Contributions of 12 key theorists. New Delhi: Sage Publications; 1995.

FAQs

How does the interpersonal relations theory benefit the nurse? ›

The theory explains nursing's purpose is to help others identify their felt difficulties and that nurses should apply principles of human relations to the problems that arise at all levels of experience.

How does Peplau's theory apply to nursing care? ›

Peplau theorized that nurse-patient relationships must pass through three phases in order to be successful: (a) orientation, (b) working, and (c) termination. During the brief orientation phase, hospitalized patients realize they need help and attempt to adjust to their current (and often new) experiences.

What is the first step for the nurse when applying Peplau's interpersonal relations theory? ›

A qualitative descriptive study based on the Peplau's Interpersonal Relationship theory, which methodologically follows four steps: (1) orientation, (2) identification, (3) exploitation and (4) resolution, which overlap and interrelate at the measure that the process evolves in the direction to a solution(6).

What is interpersonal relationship in nursing? ›

Interpersonal relationship in nursing care can be defined, based on a theory 1 , as the interaction between two or more people who communicate, transfer values and energy from their roles in society. Such interaction is continuing, ranging from a low to high effectiveness ratio in nursing care.

What is the concept of interpersonal theory? ›

the theory of personality developed by Harry Stack Sullivan , which is based on the belief that people's interactions with other people, especially significant others, determine their sense of security, sense of self, and the dynamisms that motivate their behavior.

How does the basic human needs theory apply to nursing care and nursing practice? ›

Maslow's theory suggests that once nurses' basic needs are met, their focus will shift toward achieving higher level needs, including their sense of belonging, self-esteem, and self-actualization.

What is the primary focus of Peplau's theory of interpersonal relationships in nursing care? ›

This theory emphasized the nurse-client relationship as the foundation of nursing practice and emphasizes the need for a partnership between nurse and client as opposed to the client passively receiving treatment. The theory explains the purpose of nursing is to help others identify their felt difficulties.

What is the primary focus of Peplau's theory of interpersonal relationships in nursing care quizlet? ›

The relationship one person has with another person. Peplau's theory focuses on this in relation to the patient, the nurse, and the nurse-patient interaction. Peplau identifies this as one of the main roles played by a nurse during a nurse-patient relationship.

What are the 4 components of Peplau's theory? ›

The nursing model identifies four sequential phases in the interpersonal relationship: orientation, identification, exploitation, and resolution.

Which theory is useful for developing interpersonal relationships? ›

Peplau's theory focuses on developing interpersonal relationships among the nurse, the patient, and the patient's family. Following this theory, the nurse acts as a counselor, a resource person, and a surrogate.

What are the interpersonal barriers to communication? ›

What are interpersonal barriers to communication? Interpersonal barriers are any negative patterns of behavior that hinder you from communicating or discourage others from communicating with you. In many cases, miscommunication is the product of unintentional verbal or non-verbal cues.

What are 3 important characteristics of the nurse-patient relationship? ›

The five key components of the therapeutic nurse-client relationship are professional intimacy, power, empathy, respect and trust. Regardless of the context, length of interaction and whether the nurse is the primary or secondary care provider, these components are always present.

Why is interpersonal skills important in healthcare? ›

Numerous studies have linked interpersonal communication in healthcare to improved patient outcomes, including: Higher patient satisfaction. Improved adherence to treatments. Reduction in psychological effects (depression/anxiety)

How can a nurse use effective communication and interpersonal skills? ›

For nurses, good communication in healthcare means approaching every patient interaction with the intention to understand the patient's concerns, experiences, and opinions. This includes using verbal and nonverbal communication skills, along with active listening and patient teach-back techniques.

What is the purpose of interpersonal relationship? ›

Interpersonal relationships are important for your overall physical and emotional happiness. Relationships help fight loneliness while also giving you a sense of purpose in life. For instance, the closeness you feel with family and friends is an essential part of your social support.

What are the stages of interpersonal theory? ›

His seven stages are infancy, childhood, the juvenile era, preadolescence, early adolescence, late adolescence, and adulthood.

How does interpersonal therapy work? ›

IPT is a short-term treatment option that typically consists of 12 to 16 one-hour weekly sessions. The therapist focuses on identifiable problems in how an individual interacts with or doesn't interact with others. When those problems are addressed, the patient realizes a benefit in their experience of symptoms.

What is the most basic interpersonal need According to the theory of Sullivan? ›

The most basic interpersonal need is tenderness. Tenderness is a general need because it is concerned with the overall wellbeing of a person. General needs, which also include oxygen, food, and water, are opposed to zonal needs, which arise from a particular area of the body.

Why it is important for nursing to understand the level of needs in Maslow's theory? ›

As you see Maslow's Hierarchy of Needs has an important role to play in nursing life. Without having nurses' needs met, it could be very difficult to achieve positive outcomes for both healthcare staff and the patients. It is crucial that our beloved nurses feel good at their workplace.

What are the four 4 major concepts in nursing theories? ›

Fawcett has named person, health, environment and nursing as the four main concepts of nursing that need to be comprehensively defined. The Human Caring Theory is significant because of its focus on the spiritual dimension of human beings.

When was the theory of nursing practice and career conducted? ›

In 1955, Virginia Henderson developed the nursing need theory, which outlines the nurse's role in helping patients meet 14 fundamental needs. In 1971, Imogene King created the theory of goal attainment, stating that the purpose of the nurse-patient relationship is to meet goals for good health.

What are interpersonal relationships? ›

What Is an Interpersonal Relationship? An interpersonal relationship is a social connection or affiliation between two or more people. Interpersonal relationships can include your partner, loved ones, close friends, acquaintances, co-workers, and many others who make up the social connections in your life.

What does the nurse strive to do in Peplau's theory quizlet? ›

What does the nurse strive to do in Peplau's theory? Receives the client in the same way one meets a stranger in other life situations. Provides an accepting climate that build trust.

Which type of theory addresses specific nursing practice problems? ›

Prescriptive theories guide nursing research to develop specific nursing interventions. Prescriptive theories address a specific phenomenon and reflect practice.

Which type of theory would be helpful to the nurse when gaining knowledge about the underlying pathology? ›

Which type of theory would be helpful to the nurse when gaining knowledge about the underlying pathology of a disease? Biomedical theory would be helpful when gaining knowledge about disease pathology. Biomedical theory explains causes of disease and principles related to physiology.

Which theory details nursing interventions for a specific phenomenon and the expected outcome of care? ›

A prescriptive theory details nursing interventions for a specific phenomenon and the expected outcome of the care. Box 4-1 summarizes goals of theoretical nursing models.

What are the 5 stages of nurse-patient relationship in order? ›

There are five components to the nurse-client relationship: trust, respect, professional intimacy, empathy and power. Regardless of the context, length of interaction and whether a nurse is the primary or secondary care provider, these components are always present.

What is Hildegard Peplau best known for? ›

Hildegard Peplau, the "mother of psychiatric nursing," was a true pioneer in the development of the theory and practice of psychiatric and mental health nursing.

What statement best describes the proper relationship between nursing theory and practice? ›

What statement best describes the proper relationship between nursing theory and practice? To provide nurses with perspective to organize care, To plan and implement care, To assist directing analysis and interpretation among data.

Why Peplau's theory is important? ›

Peplau's theory teaches the nurse how to interact with his or her patient so that the patient feels more in control of his treatment which can also give him the sense that the treatment can be done without the assistance of the nurse once the patient is discharged from her care.

What is the primary focus of Peplau's theory of interpersonal relationships in nursing care? ›

This theory emphasized the nurse-client relationship as the foundation of nursing practice and emphasizes the need for a partnership between nurse and client as opposed to the client passively receiving treatment. The theory explains the purpose of nursing is to help others identify their felt difficulties.

What did Dorothea Orem contribute to nursing? ›

In the nursing field, Dorothea Orem was one such influential thinker. Born in 1914, Orem worked all over the country as an expert nurse until her death in 2007. Her 1971 theory of self-care deficit is still taught today in nursing schools, and she helped shape the holistic approach nurses now take toward patient care.

What is the primary focus of Peplau's theory of interpersonal relationships in nursing care quizlet? ›

The relationship one person has with another person. Peplau's theory focuses on this in relation to the patient, the nurse, and the nurse-patient interaction. Peplau identifies this as one of the main roles played by a nurse during a nurse-patient relationship.

Which theory is useful for developing interpersonal relationships? ›

Peplau's theory focuses on developing interpersonal relationships among the nurse, the patient, and the patient's family. Following this theory, the nurse acts as a counselor, a resource person, and a surrogate.

What are 3 important characteristics of the nurse-patient relationship? ›

The five key components of the therapeutic nurse-client relationship are professional intimacy, power, empathy, respect and trust. Regardless of the context, length of interaction and whether the nurse is the primary or secondary care provider, these components are always present.

What are the 4 components of Peplau's theory? ›

The nursing model identifies four sequential phases in the interpersonal relationship: orientation, identification, exploitation, and resolution.

What are the interpersonal barriers to communication? ›

What are interpersonal barriers to communication? Interpersonal barriers are any negative patterns of behavior that hinder you from communicating or discourage others from communicating with you. In many cases, miscommunication is the product of unintentional verbal or non-verbal cues.

What are the stages of interpersonal relationship? ›

There are stages of relational interaction in which relationships come together (initiating, experimenting, intensifying, integrating, and bonding) and come apart (differentiating, circumscribing, stagnating, avoiding, and terminating).

Videos

1. Interpersonal Theory and Interpersonal Psychotherapy Model
(Leal Marielle)
2. Peplau's Nursing Theory of Interpersonal relations : Concepts, Assumptions, Phases, Metaparadigm
(Explore with Dr. Rohini)
3. Hildegard Peplau's Interpersonal Theory
(joemar pedron)
4. Hildegard Peplau Theory Presentation
(moreaboutmich)
5. Hildegard Peplau Theory
(Lindsay Sisler)
6. SULLIVAN'S INTERPERSONAL THEORY
(THE CLASSROOM)

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