Capella University
NURS-FPX6203 : Theory Development in Nursing
Instructor Name
October 2024
Theory Critique- Theory of Interpersonal Relationships
During the orientation stage, the nurse and the patient introduce themselves and explore the patient’s psychological needs through interviews The psychological needs are identified through interviews and observation of the patient’s verbal and nonverbal response (Wasaya et al., 2021). This phase is often important because proper orientation increases the chances of a positive working phase. As reported in the working phase the nurse works with the patient, performs the assessment; delivers education; and puts into practice the care plans (Matney et al., 2020). Confidence during the orientation phase helps the nurse and the patient in achieving goals and performing tasks.
Peplau’s theory of interpersonal relations organized nursing around four phases of the nurse-patient relationship: initial, working, intermediate, and termination (Shim et al., 2021). At the termination phase, both the nurse and patient agree that the services are no longer required because the patient has achieved their objectives, and the nurse teaches the patient about managing symptoms and recovery at home (Shim et al., 2021). While communicating during the phases is paramount, the relationship may be interrupted for a while in the intermediate phase. Formulated in
The study shows that, at the time when Hildegard Peplau published her first work, nursing, and psychiatric nursing did not exist, and patients in psychiatric hospitals required additional therapeutic interpersonal relationships with their caregivers, which questioned the quality of care. Nurses knew from Peplau’s theory that the nurse-patient relationship and trust would improve treatment results (Matney et al., 2020). Today, her theory is of significance in nursing education, research, and practice especially in stress on relationships between the nurse and the patient. Peplau’s framework navigates patients through three distinct phases: working, orientation, and termination, with trust and rapport as crucial factors that will enable individuals within these settings to attain their health objectives. In this perspective, Douglass asserts that the theory lays priority in a trustworthy relationship between nurses and the patients in a bid to foster health goals and promote healthy caring for the patient.
Analysis
Interpersonal relations theory was developed by Hildegard Peplau and leverages inductive reasoning and deductive reasoning. Inductive reasoning takes place when general principles are forced from particular observations while deductive reasoning takes place when the general principles are drawn (Wasaya et al., 2021). Peplau’s theory includes the use of inductive reasoning which began from the author’s psychiatric work with patients and later on inclusive of numerous areas of nursing. It employs deductive reasoning by outlining a broad concept of the nurse-patient relationship, which is then detailed into specific phases: Planned change requires orientation, working, and termination/resolution (Shim et al., 2021). The application of both overt and covert reasoning approaches helped in building and enlarging her theory.
The Phases and Components of the Theory
The further critical element of Peplau’s theory states that a nurse facilitates the process of patients getting to the state in which they can accomplish health-related tasks. She identifies and describes three phases: orientation, work, and termination/resolution of the relationship in a nurse-patient interaction (Mersha et al., 2023). She identifies four key components within her theory: The four components of the theory are the person, environment, health, and nursing (Clark, 2023). The person is seen as a becoming who wants to diminish anxiety; culture realistically refers to the extra-personal conventional cultural variables; health is defined as a movement toward efficient and constructive existence; and nursing is the interpersonal process between the nurse and the patient.
These components along with the phases enable the creation of a therapeutic client relationship or rapport. In the orientation phase, the nurse and the patient come to understand each other, evaluate the situation, and consider expected outcomes. With the working phase established, it just educates, cares, and builds on trust as its tools of practice. While developing his or her own goals, the patient integrates the information given to him or her (Clark, 2023). Upon the accomplishment of the set goal, both parties move to the final phase, which entails ending a relational contract quantity, which may cause some emotional upset. Peplau’s theory of communication is well supported and developed at both theoretical and operational levels. In theory, it can relate to the different nursing practice models of nursing apart from Psychiatric nursing (Wasaya et al., 2021). For example, a Nurse Educator needs to develop a good nurse-patient care relationship to facilitate information storage and recall. The theory supports measuring particular health outcomes such as reaching a certain level of mean arterial pressure by a certain time (Mersha et al., 2023). 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
Despite the comprehensiveness of Hildegard Peplau’s theory, an understanding of the nurse-patient relationship, and enhanced attentiveness to the importance of the holistic approach, some areas should be added to the theory (Sarami et al., 2023). Although Peplau focuses a lot on the fact that the phases are supposed to assist the patient in gaining health, she does not elaborate on what is meant by this term. For instance, a patient with Type 1 Diabetes can never be fully treated for that disease but can be empowered with the knowledge and tools necessary to care for herself and her health accordingly.
Likewise, for another person, the goal of getting out of bed and making the bed shows a health improvement, however, this is not a traditional health goal (Fathidokht et al., 2024). Each phase of Peplau’s theory is defined broadly and the steps involved are also broad enough to fit any aspect of nursing care (Mersha et al., 2023). However, this seems to lead to doubt regarding success within the nurse-patient when objectives are not well understood.
Application
In its current state, Peplau’s theory is well suited for a description of the nature of the nurse-patient relationship, as well as the significance of a more general concept of patient care (Wasaya et al., 2021). Psychiatric The principle of relationship involves developing a rapport with the patient to identify what he or she wants. This bond makes the nurse an efficient patient advocate to help in the accomplishment of the patient’s target health (Finley et al., 2023). For patients, such a relationship creates trust and engagement in the process giving them the morale to work towards the goals that were set down by them (Fathidokht et al., 2024). Like other theories, Peplau’s theory supports goal-directed interdependence to achieve group objectives underlying health goals.
When it comes to students and patients, Peplau‘s interpersonal relations theory can be implemented as a nurse educator. In the classroom, the process starts with the orientation phase, in which the educator introduces himself/herself and beats the bushes to find out the student’s objectives for the semester or the year (Sarami et al., 2023). From this perspective, the concept of curriculum can be personalized to enable students to achieve those goals. Therefore, it is possible to design a curriculum that will enable the students to achieve the above goals. In the working phase, Quiz Homework, collaboration is within the classroom further during office hours and student check-ins to guarantee that the student feels comfortable and confident with the educator’s efforts toward their success (Fathidokht et al., 2024). After students achieve the learning objectives the termination stage maintains the process which assists students in their professional lives.
In the clinical situation, it is possible to use Peplau’s theory as the basis for patient education (Fathidokht et al., 2024). The first step is to gain the patient’s confidence and get familiar with the patient’s expectations. Patient education is done according to the patients; due process is followed to ensure the patient understands and can retain what he or she has been taught by asking them to explain. These blended efforts are pursued until such time that the patients are confident with their acquired learning and mentoring (Mersha et al., 2023). In the termination phase of the interactions, the patient is also checked and a guarantee is made that he or she understood everything that was said (Fathidokht et al., 2024). In this manner, frameworks of the comprehensive care strategy fostered via Peplau’s theory can be helpful in both educational and clinical settings.
NURS FPX 6203 Assessment 1 Conclusion
Peplau’s theory focuses on the accurate nurse-patient relationship as being central to the patient’s holistic care and the best outcomes. This is because, like in Peplau’s experience, the theory focuses on trust and communication during the orientation, working, and termination stages. With these principles applied, a nurse will be able to support his or her patients to help them achieve their health-related objectives (Finley et al., 2023). Peplau’s theory continues to shape how nursing is taught, studied, and practiced to keep the face of nursing human. More to the point, her contributions remained essential for understanding how nurses can engage and care about their patients while reflecting on the interpersonal relations approach in this sphere.
NURS FPX 6203 Assessment 1 References
Clark G. (2023). A history of the concept of interpersonal relations in nursing based on the psychiatric nursing textbook literature. Issues in Mental Health Nursing, 44(1), 48–54. https://www.tandfonline.com/doi/full/10.1080/01612840.2022.2108948
Fathidokht, H., Mansour-Ghanaei, 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://journals.lww.com/jehp/fulltext/2023/12220/the_effect_of_communication_using_peplau_s_theory.426.aspx
Finley, B. A., Shea, K. D., Gallagher, S. P., Palitsky, R., & Gauvin, J. (2023). A theoretical framework for conducting psychiatric mental health nursing virtual care & research. Issues in Mental Health Nursing, 44(10), 1002–1008. https://www.tandfonline.com/doi/full/10.1080/01612840.2023.2258213
Matney, S. A., Avant, K., Clark, L., & Staggers, N. (2020). Development of a theory of wisdom-in-action for clinical nursing. ANS. Advances in Nursing Science, 43(1),2841. https://journals.lww.com/advancesinnursingscience/abstract/2020/01000/development_of_a_theory_of_wisdom_in_action_for.4.aspx
Mersha, A., Abera, A., Tesfaye, T., Abera, T., Belay, A., Melaku, T., Shiferaw, M., Shibiru, S., Estifanos, W., & Wake, S. 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://bmcnurs.biomedcentral.com/articles/10.1186/s12912-023-01526-z
Sarami, B., Myrfendereski, S., Salehi Tali, S., Hasanpour-Dehkordi, A., & Reisi, H. (2023). The effect of implementing Peplau’s theory of interpersonal communication on the quality of life of patients with acquired immunodeficiency syndrome. Przeglad Epidemiologiczny, 77(1), 101–107. https://www.przeglepidemiol.pzh.gov.pl/The-effect-of-implementing-Peplau-s-theory-of-interpersonal-communication-on-the,181116,0,2.html
Shim, Y., Choe, K., Kim, K. S., Kim, J. S., & Ha, J. (2021). The applicability of the interpersonal-psychological theory of suicide among community-dwelling older persons. Suicide & Life-Threatening Behavior, 51(4), 816–823.
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Wasaya, F., Shah, Q., Shaheen, A., & Carroll, K. (2021). Peplau’s theory of interpersonal relations: A Case Study. Nursing Science Quarterly, 34(4), 368–371. https://journals.sagepub.com/doi/10.1177/08943184211031573
