Interpersonal Theory

1. Integration Of Peplau’s Theory
In Nursing Process
Malar Kodi.S
Assistant Professor
AIIMS, Rishikesh

2. Flow of presentation
This presentation will focus on :
o Introduction
o Major Concepts
o Interpersonal process
o Aim of this theory
o Phases
o Metaparadigms in Nursing
o Roles of Nurses
o Nursing Application
o Strengh/Limitations
8/2/2023

3. Hildegard E. Peplau’s
Interpersonal Relations in
Nursing- 1952
(1909-1999)Pennsylvania,USA

4. Introduction
 Focuses on the interpersonal
processes and therapeutic
relationship that develops between
the nurse and client.
 Understanding of ones own behavior
 To help others identify felt
difficulties
 To apply principles of human
relations to the problems that arise
at all levels of experience

5. Major Concept
In her book she discussed
o The phases of interpersonal process
o Roles in nursing situations
o Methods of interpersonal process.

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

7.  Nursing is an interpersonal process because it
involves interaction between two or more individuals
with a common goal
 The attainment of goal is achieved through the use
of a series of steps following a series of pattern.
 The nurse and patient work together so that both
become mature and knowledgeable in the process.

8. Basic Elements

9. Aim of this theory
The main is to –
 Use the nursing patient relationship
 To help patients, explore and understand the
meaning of their feelings in a way
 Offers the opportunity to identify with what is
happening and to be involved in care.

10. Phases

13. Phases of nurse-patient
relationships are:
Orientation:
 Client seeking assistance, meeting of nurse-patient
 Identifying the problem and services needed
( interview process), and guidance.
 Get familiar phase of the nurse-patient relationship.
 Parameters are established and met
 Early levels of trust are developed
 Roles begin to be understood

15. Identification:
 Identifying who is best to support needs, patient
addresses personal feelings about the experience
and is encouraged to participate in care to
promote personal acceptance and satisfaction.
 The client begins to identify problems to be
worked on within relationship
The goal of the nurse:
 Help the patient to recognize his/her own
interdependent/participation role and promote
responsibility for self .

16. Exploitation:
 Patient attempts to explore, understand and
deal with the problem, and gains independence
on achieving the goal
 Client’s trust of nurse reached full potential
 Client making full use of nursing services
Solving immediate problems
 Identifying and orienting self to [discharge]
goals

17. Resolution
Final phase of nurse-patient relationship
 Termination of the therapeutic
relationship to encourage emotional
balance for nurse and patient ( difficult
for both patient and nurse as
psychological dependence persists)
 Client met needs
 Mutual termination of relationship
 Sense of security is formed
 Patient is less reliant on nurse
 Increased self reliance to deal with own
problems.

18. Person/patient
Health
Symbolizes movement of the
personality and other ongoing
human processes that directs the
person towards creative,
constructive, productive and
community living.
Environment
Forces outside the organism and
Physiological, psychological and social
variability that may be illness-maintaining
or health-promoting
Nursing
Significant, therapeutic
interpersonal process. It
functions cooperatively with
human processes that present
health as a possible goal for
individuals.
Person, couple, group, community,
deserving of human care with dignity,
privacy, ethics

20. Benefits of Peplau’s theory to
Nursing Process
 Nurse gains confidence in higher understanding of self,
concepts, roles and processes
 Nurse’s own emotional needs should not interfere with the
needs of the patient.
 Improves therapeutic communication skills.
 Improves the nurse’s ability to interact with patient on a
more sensitive level.
 Requires critical thinking in order to adapt to changing
patient requirements.
 less stressful for patients and nurses. Provides a holistic
approach to treatment.

21. Roles of Nurses
Primary
 Stranger
 Teacher
 Resource person
 Counselor
 Surrogate
 Leader
Secondary
 Technical expert
 Mediator
 Safety agent
 Researcher
 Tutor
 Manager of environment

22. Nursing Application
Shared Concepts of Interpersonal Theory and
the Nursing Process
 Both are sequential and focus on therapeutic
relationship.
 Both use problem solving techniques for the nurse and
patient to collaborate on, with the end purpose of
meeting the patient’s needs.
 Both use observation, communication, and recording as
basic tools utilized by nursing.

23. Nursing
Process
Peplau's Theory of Interpersonal
Relationships
Assessment
•Data collection and analysis [continuous]
•May not be a felt need
Orientation
•Non continuous data collection
•Felt need
•Define needs
Care Plan with Nursing diagnosis
Planning
•Mutually set goals
Identification*
•Interdependent goal setting
Implementation
•Plans initiated towards achievement of
mutually set goals
•May be accomplished by patient, nurse or
family
Exploitation*
•Patient actively seeking and utilizing help
•Patient initiated
Evaluation
•Based on mutually expected behaviors
•May led to termination and/or initiation of
new plans
Resolution
•Occurs after other phases are completed
successfully
•Leads to termination of relationship

24. The nursing process for Mrs. Jyoti based on
Peplau’s theory is as follows:
Name-Mrs. Jyoti
Age-27 years
Diagnosis: Inter vertebral Disc Prolapse

25. Assessmen
t
(Orientati
on phase)
Nursing
diagnosi
s
Planning
(Identifica
tion
phase)
Implementation
(Exploitation phase)
Evaluati
on
(Resolut
ion
phase)
Mrs. Jyoti 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
Provided
have
improved
physical
mobility as
evidenced
by
participating
in self care
within the
limits.
Carried out plans mutually
agreed upon.
Patient will 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
Mrs. Jyoti
was free
to express
problems
regarding
difficulty
in
mobilizin
g.
She
expressed
satisfactio
n when
able to
move
without
difficulty

26. Assessmen
t
(Orientati
on phase)
Nursing
diagnosi
s
Planning
(Identifica
tion
phase)
Implementation
(Exploitation phase)
Evaluati
on
(Resolut
ion
phase)
Mrs.Jyoti
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
Pain
related to
degenerat
ive
changes
in the
lumbar
region.
Goal setting
was done
along with
patient
Mrs. JL will
have
reduction in
pain as
evidenced
by her
verbalizatio
n of
reduction in
pain
responses
Carried out plans mutually
agreed upon
Mrs. JL was Provided non
pharmacological measures
like diversion, massaging,
and pelvic traction.
free to
express
problems
of pain.
Expressed
that she
got slight
relief
from pain.

27. Assessmen
t
(Orientati
on phase)
Nursing
diagnosi
s
Planning
(Identificatio
n phase)
Implementation
(Exploitation
phase)
Evaluation
(Resolution
phase)
Mrs. Jyoti
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
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
Carried out plans
mutually agreed
upon.
Kept the articles
within t he reach of
the client
Mrs. Jyoti
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

28. Assessment
(Orientatio
n phase)
Nursing
diagnosi
s
Planning
(Identificatio
n phase)
Implementation
(Exploitation phase)
Evaluation
(Resolution
phase)
Mrs. Jyoti 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
knowledg
e 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
Carried out plans mutually
agreed upon.
Explained treatment
measures and the need for
follow up
Explained regarding the signs
of aggravation of disease
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.
Used simple and
understandable e terms for
explaining Clarified her
doubts Repeated the
information
Mrs. Jyoti
express
problems of
self care
She expressed
acquisition of
knowledge
regarding the
disease and
the signs of
aggravation of
illness

29. o The phases provide simplicity regarding the
natural progression of the nurse-patient
relationship.
o This simplicity leads to adaptability in any
nurse-patient interaction, thus providing
generalizability.
Strengths

30.  Intra family dynamics, personal
space considerations and
community social service
resources are considered less
 Health promotion and
maintenance were less
emphasized
 Cannot be used in a patient who
doesn’t have a felt need eg. With
drawn patients, unconscious
patients.
 Some areas are not specific
enough to generate hypothesis.
Limitation

31. Take home message
 Hildegard E. Peplau’s Interpersonal Relations in
Nursing- 1952
 Major concepts
• Person
• Health
• Environment
• Nursing
• Therapeutic Nurse-Client Relationship
 Four phases interrelate the different components of
each phase
 Six roles of nurse

32. References
 https://sites.google.com/site/peplautir/home/theory-of-
interpersonal-relationships/nursing-application
 S.ray chowdhary, sunanda.Textbook of nursing
research.kumar publishing house;2010:75-76.
 Parker E. Marilyn.Nursing theories and nursing
practice.F.A Davis publishers;2006:58-64.
 Olive selvin, Lynn basford. Theory and practice of
nursing .nelson thornes publishers;2003:547-548.
 URL-http://current nursing.com/nsg- theory/
interpersonal theory.html.