Assessment 1: Theory Critique- Theory of Interpersonal Relationships
Capella University
NURS-FPX6203: Theory Development in Nursing
Instructor Name
July 2024
Theory Critique- Theory of Interpersonal Relationships
Background
During the orientation stage, the nurse and patient get acquainted, and the nurse evaluates the patient’s psychological requirements through effective communication and observation of verbal and nonverbal cues (Fathidokht et al., 2024). This phase is critical because a well-established orientation phase increases the likelihood of a successful working phase. During the working phase, the nurse spends time with the patient, conducting assessments, providing education, and implementing care plans. The trust established during the orientation phase aids the nurse and the patient in setting goals and accomplishing tasks.
Peplau’s theory states the termination phase begins when the nurse and patient concur that services are no longer needed (Lee & Son, 2022). At this stage, the patient has met their goals, and the nurse educates them on managing symptoms and recovery at home. Continuous communication throughout the phases is crucial for optimal outcomes. Introduced in 1952, Peplau’s theory was shaped by her experiences at Chestnut Lodge, her service as an Army Corps nurse, and the impact of the 1918 flu epidemic on her childhood (Fathidokht et al., 2024). These experiences highlighted the importance of trust between healthcare providers and patients, making her theory fundamental in modern nursing practice.
According to Ward et al. (2021), when Hildegard Peplau first published her work, neither nursing nor psychiatric nursing was recognized as a profession, and patients in psychiatric hospitals often needed more therapeutic relationships with their caregivers, raising concerns about care quality. Peplau’s theory demonstrated that establishing a therapeutic relationship and trust between nurses and patients could enhance treatment outcomes (Wasaya et al., 2021). Today, her theory is vital in nursing education, research, and practice, emphasizing the significance of relationships between nurses and patients. Peplau’s framework navigates patients through three distinct phases: orientation, working, and termination—to achieve health goals, with trust and rapport essential for smooth transitions and effective care (Pereira et al., 2022). The theory emphasizes the importance of a therapeutic relationship between nurse and patient in building trust and achieving patient health goals through holistic care.
Analysis
Hildegard Peplau’s interpersonal relations theory leverages inductive and deductive reasoning methodologies (Ward et al., 2021). Inductive reasoning involves forming general principles from particular observations, whereas deductive reasoning involves deriving general principles (Lee & Son, K, 2022). Peplau’s theory incorporates inductive reasoning, originating from her psychiatric work with patients and extending to various nursing specialties. It employs deductive reasoning by outlining a broad concept of the nurse-patient relationship, which is then detailed into specific phases: orientation, working, and termination/resolution. This combination of reasoning approaches facilitated the development and expansion of her theory.
The Phases and Components of the Theory
A core aspect of Peplau’s theory is guiding patients toward achieving their health goals. She delineates three stages in the relationship between nurse and patient, i.e., orientation, working, and termination/resolution(Ward et al., 2021). She identifies four key components within her theory: the person, the environment, health, and nursing. The person is described as an evolving being striving to alleviate anxiety; the environment encompasses external cultural forces; health is viewed as progress toward productive and constructive living; and nursing involves the therapeutic interaction between nurse and patient (Mersha et al., 2023). These components, integrated with the phases, help foster a trusting therapeutic relationship. In the orientation phase, the nurse and patient establish rapport, identify issues, and set goals. With trust established, the working phase begins, focusing on education, care, and maintaining trust. The patient works towards their goals while absorbing the provided information. Upon goal achievement, both parties transition to the termination phase, concluding their relationship, which can be emotionally challenging due to the bond formed.
Peplau’s theory is both theoretically and operationally defined. Theoretically, it adapts to various nursing approaches beyond psychiatric nursing (Yang et al., 2022). For instance, a Nurse Educator must build a strong nurse-patient relationship to ensure effective information retention. The theory can measure specific health outcomes, such as achieving a target blood pressure by a set date. However, the progression of the therapeutic relationship itself cannot be quantitatively measured. Peplau’s consistent terminology across her works provides a framework for future healthcare professionals to implement in various settings.
Evaluation
While Hildegard Peplau’s theory provides a clear and structured framework for the nurse-patient relationship and emphasizes the benefits of holistic care, some gaps still need to be in the theory. While Peplau emphasizes that the phases are designed to help patients achieve health, she does not explicitly define what “health” means (Yang et al., 2022). For instance, a patient with Type 1 Diabetes cannot be entirely cured of the condition but can receive the necessary education to manage it and lead a healthy life. Similarly, for another individual, the goal is to get out of bed and make the bed, which indicates progress toward better health, even if it is not a conventional health goal. Peplau’s theory provides broad definitions for each phase and the associated steps, making it adaptable to various aspects of nursing care (Su et al., 2024). However, this can leave healthcare providers uncertain about success within the nurse-patient relationship when specific goals are unclear.
Application
Peplau’s theory provides a comprehensive understanding of the nurse-patient relationship and the importance of holistic care (Ward et al., 2021). Psychiatric Establishing a therapeutic relationship enables the nurse to understand the patient’s needs and desires. This bond positions the nurse as an effective patient advocate, aiding in achieving the patient’s health goals. For patients, this relationship fosters trust and involvement in their care, making them more motivated to achieve goals they have helped set. Peplau’s theory promotes a collaborative, team-oriented approach to reaching shared health objectives (Pereira et al., 2022).
As a nurse educator, the interpersonal relations theory developed by Peplau can be applied to students and patients. In the classroom, the process begins with the orientation phase, during which the educator gets to know students and understands their goals for the semester or year. Based on this understanding, a tailored curriculum can be developed to help students achieve these goals. The working phase involves collaborative efforts in the classroom and during office hours, with regular check-ins to ensure students feel supported and trust that the educator is committed to their success. Once the students have reached their goals, the termination phase provides final guidance and support as they transition to their professional careers.
In a clinical setting, Peplau’s theory can be utilized to educate patients effectively. Initially, the focus is establishing trust and understanding the patient’s goals. Education tailored to the patient’s needs is provided, with steps taken to ensure the patient comprehends and retains the information by having them teach it back. This collaborative approach continues until patients feel confident in their knowledge and skills. By the end of the interactions, during the termination phase, the patient is ensured full comprehension of all provided information. Through this approach, both educational and clinical environments can benefit from the holistic care framework established by Peplau’s theory.
NURS FPX 6203 Assessment 1 Theory Critique- Theory of Interpersonal Relationships Conclusion
Peplau’s theory emphasizes the importance of a therapeutic nurse-patient relationship in achieving holistic care and optimal patient outcomes (Wiese & Bennett, 2022). Influenced by Peplau’s diverse experiences, the theory emphasizes trust and continuous communication throughout the orientation, working, and termination phases. By applying these principles, nurses can effectively advocate for their patients and support them in reaching their health goals. Peplau’s work has had a lasting impact on nursing education, research, and practice, ensuring that the human element remains at the forefront of patient care. Her contributions continue to shape how nurses interact with and support their patients, highlighting the enduring importance of interpersonal relations in healthcare.
NURS FPX 6203 Assessment 1 Theory Critique- Theory of Interpersonal Relationships References
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Lee, J., & Son, K. (2022). Effects of simulation problem-based learning based on Peplau’s interpersonal relationship model for cesarean section maternity nursing on communication skills, communication attitudes, and team efficacy. Nurse Education Today, 113, 105373. https://doi.org/10.1016/j.nedt.2022.105373
Fathidokht, H., Mansour, R., Darvishpour, A., & Maroufizadeh, S. (2024). The effect of communication using Peplau’s theory on satisfaction with nursing care in hospitalized older adults in cardiac intensive care unit: A quasi-experimental study. Journal of Education and Health Promotion, 12, 426. https://doi.org/10.4103/jehp.jehp_1677_22
Mersha, A., Abera, A., Tesfaye, T., Abera, T., Belay, A., Melaku, T., Shiferaw, M., Shibiru, S., Estifanos, W., & Wake, K. (2023). Therapeutic communication and its associated factors among nurses working in public hospitals of Gamo zone, southern Ethiopia: Application of Hildegard Peplau’s nursing theory of interpersonal relations. BMC Nursing, 22(1), 381. https://doi.org/10.1186/s12912-023-01526-z
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Su, E., Wu, H., He, H. F., Lin, L., Lin, S., & Weng, Q. (2024). The effect of multimodal care based on Peplau’s interpersonal relationship theory on postoperative recovery in lung cancer surgery: A retrospective analysis. BMC Pulmonary Medicine, 24(1), 59. https://doi.org/10.1186/s12890-024-02874-5
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