JOFRED M. MARTINEZ, RNGraduate SchoolUniversity of San AgustinGeneral Luna Street, Iloilo City
BACKGROUND OF THE THEORIST born September 1, 1909, in Reading,Pennsylvania second daughter of immigrantsGustav and Ottylie Peplau, and oneof their six children began her career in nursing in 1931as a graduate of the Pottstown,Pennsylvania, School of Nursing
worked as a staff nurse inPennsylvania and New York City became the school nurse atBennington College in Vermont whereshe earned a Bachelor’s Degree inInterpersonal Psychology in 1943 through field experiences at ChestnutLodge, she studied psychologicalissues with Erich Fromm, Frieda FrommReichmann, and Harry Stack Sullivan
from 1943 to 1945 she served in theArmy Nurse Corps and was assignedto the 312th Field Station Hospital inEngland, where the American Schoolof Military Psychiatry was located
worked to reshape the mental healthsystem in the United States throughthe passage of the National MentalHealth Act of 1946 Peplau held master’s and doctoraldegrees from Teachers College,Columbia University
she was also certified inpsychoanalysis at the William AlansonWhite Institute of New York City. In theearly 1950s she was a member of the faculty ofthe College of Nursing at RutgersUniversity from 1954 to 1974 she was a prolific writer and wasequally well known for herpresentations, speeches, and clinicaltraining workshops
• she received numerous awards like TheChristianne Reimann Prize atInternational Council of NursesQuadrennial Congress and afellowship at American Academy ofNursing• on the 17th of March 1999, HildegardPeplau died in her home at the age of89, ending a nursing career, whichspanned over fifty years
Psychodynamic Nursing is beingable to understand one’s behavior tohelp others identify felt difficulties, and toapply principles of human relations tothe problems that arise to all levels ofexperience.
Peplau describes four phases ofnurse – patient relationship; althoughseparate they overlap and occur overthe time of the relationship.
During the orientation phase, theindividual has a felt need and seeksprofessional assistance. The nurse helpsthe patient recognize and understandhis or her problem and determine his orher need for help.
The patient identifies with those whocan help him or her (relatedness). Thenurse permits exploration of feelings toaid the patient in undergoing illness asan experience that reorients feelingsand strengthens positive forces in thepersonality and provides neededsatisfaction.
During the exploitation phase, thepatients attempt to derive full value fromwhat he or she is offered through therelationship. The nurse projects newgoals to be achieved through personaleffort and power shifts from the nurse tothe patient as the patient delaysgratification to achieve the newlyformed goals.
The patient gradually puts aside oldgoals and adopts new goals. This is aprocess in which the patient frees himselfor herself from identification with thenurse.
Peplau described six nursing rolesthat emerge in the various phases of thenurse – patient relationship:
Peplau states that because thenurse and patient are strangers to eachother, the nurse should treat the patientwith ordinary courtesy, in other words,the nurse should not prejudge thepatient, but accept him or her as aperson.
The nurse provides specific answersto questions, especially regarding healthinformation, and interprets to the patientthe treatment or medical plan of care.
The teaching role is a combinationof all roles and “always proceeds fromwhat the patient knows and developsaround his interest in wanting and abilityto use information.
Peplau separates teaching into twocategories:1. Instructional, which consists largely ofgiving information and is the formexplain in educational literature.2. Experiential, which is using theexperience of the learner as a basisfrom which learning products aredeveloped.
The leadership role involves thedemocratic process. The nurse helps thepatient meet the tasks at hand througha relationship through a relationship ofcooperation and active participation.
The nurse’s behaviors and attitudescreate feeling tones in the patient thatreactivate feelings in a previousrelationship. The nurse’s function is to helpthe patient recognize similarities betweenthe nurse and the person recalled by thepatient. The nurse then helps see thedifferences between the nurse’s role andthat of the recalled person.
Counseling functions in the nursepatient relationship by the way nursesresponds to patients’ demands. Thepurpose of interpersonal techniques is tohelp the patient remember andunderstand fully what is happening tohim in the present situation, so that theexperience can be integrate rather thandissociated from other experiences inlife.
Four psychobiological experiences:• Needs• Frustrations• Conflict• Anxiety
On admissionDuring intensivetreatment periodConvalescence andrehabilitationDischarge
DEFINITION OF PERSON, HEALTHENVIRONMENT AND NURSING
Peplau defines person in term of aman. Man is an organism that lives in anunstable equilibrium.
Peplau defines health as a wordsymbol that implies forward movementof personality and other ongoing humanprocesses in the direction of creative,constructive, productive, and personaland community living.
Peplau also gave importance on thebelief that in order for one’s health to beachieved and maintained; his needsmust be fully met. These needs includeboth physiological and interpersonalconditions.
Peplau implicitly defines theenvironment in terms of existing forcesoutside the organism and in the contextof culture from which mores, customs,and beliefs are acquired.
Peplau describes nursing as asignificant, therapeutic interpersonalprocess. It functions cooperatively withother human processes that makehealth possible for individuals incommunities. When professional healthteams offer health services.
Nurses participate in theorganization of conditions that facilitateongoing tendencies in humanorganisms.Nursing is an educative instrument,a maturing force that aims to promoteforward movement of personality in thedirection of creative, constructive,productive, personal and communityliving.
IMPLICATIONS OF THE THEORY TO THENURSING COMMUNITY
Clinicians continue to use Peplau’smodels extensively. Several researches standout in the use ofPeplau’s theory to guide a program ofstudy that applies this theory to clinicalpractice.• In 1992, Forchuk initiated a prolificprogram of study that tested Peplau’stheory in clinical settings.
• Peden used Peplau’s process ofpracticed based theorydevelopment to direct a program ofresearch in the area of depression.
O’Toole and Welt stated that Peplau’stheoretical ideas, particularly herdefinition of nursing and nursingprocess, elaboration of anxiety andlearning, and her psychotherapeuticmethods, have become a part of thecollective culture of the discipline ofnursing.
Peplau wrote the book InterpersonalRelations in Nursing specifically as anaid to graduate nurses and nursingstudents.
Sills states that Peplau’s workinfluenced the direction of clinicalwork and studies. For more than 30 years, Peplau’smodel has formed the basis fornumerous applications of researchmethods.
Thomas, Bakers and Estes usedPeplau’s concept of anxiety as ameans to constructively resolve angryfeelings through experiential learningwithin the nurse – patient relationship. Hay’s describes a study teaching theconcept of anxiety that ispredominantly based on Peplau’sconcept of anxiety and used herconceptual model.
Assumptions from Peplau’s modelcontinue to be used in currentresearch. La Monica devised anempathy instrument using Peplau’smodel as the theoretical framework. Peplau made a significantcontribution to the nursing communitythrough the research done toevaluate, validate and make moreprecise the Theory of InterpersonalRelations.