Hildegard Peplau developed the Interpersonal Relations Theory, which focuses on the nurse-patient relationship and identifies phases and roles in that relationship. The theory outlines four phases - orientation, identification, exploitation, and resolution - and seven nursing roles - stranger, resource, teacher, counselor, surrogate, leader, and colleague. Proper application of the theory helps nurses understand patients' needs, facilitate problem-solving, and ensure the relationship progresses appropriately towards termination.

1. Presentation
on
Paplau’s
Interpersonal
Relation Theory
Prepared by:
Sagar masne
f.y. msc N

2. NURSING THEORY :
 Is defined as ‘a creative and rigorous
structuring of ideas that project a
tentative, purposeful, and systematic
view of phenomena’.
 Theory refers to “a coherent group of
general propositions used as principles
of explanation"

3. IMPORTANCE OF NURSING THEORIES
 Importance of nursing theories: In the early
part of nursing’s history, knowledge was
awfully lacking and in general a difficult
task from the very beginnings of any nursing
education.
 There was a thirst and need to categorize
knowledge for this exact reason, so
people could evaluate client care situations
in order to connect in comprehensible and
essential ways.

4. CONT…
 Nursing theories give a plan for reflection
in which examines a certain direction in
where the plan needs to head.
 As new situations are encountered, this
framework provides an arrangement for
management, investigation and decision-
making.
 It’s important for researches, and as a
guideline for practical.

5. TYPES OF NURSING THEORIES
 Grand nursing theories
 Mid-range nursing theories
 Nursing practice theories

6. NURSING MODEL

7. BACKGROUND
 Hildegard Peplau (1909)
 Diploma program in Pottstown, PA, 1931
 BA in Interpersonal Psychology, Bennington
College, 1943
 MA in Psychiatric Nursing, Columbia
University, 1947
 EdD in Curriculum Development, Columbia
University, 1953
 Mother of psychiatric nursing

8. BACKGROUND
 Published Interpersonal Relations in
Nursing (1952)
 Professor emeritus from Rutgers University
 Started first post-baccalaureate program in
nursing
 Worked as Executive Director and President of
ANA
 Worked with WHO, NIMH and Nurse Corps
 Died peacefully in her sleep at home in
california-1999

9. PURPOSE OF THEORY
 Focus on nurse-patient relationship
 Identify different roles nurses take on when
working with patients

10. ASSUMPTIONS OF THEORY
HUMAN BEING
 Peplau defines man as an organism that “A
developing organism that tries to reduce
anxiety caused by needs .

11. HEALTH
 Health is defined as “a word symbol that
implies forward movement of personality
and other ongoing human processes in the
direction of creative, constructive,
productive, personal, and community living.”

12. SOCIETY OR ENVIRONMENT
 Existing forces outside the organism and in
the context of culture

13. NURSING
 Hildegard Peplau defines it as a “human
relationship between an individual who is
sick, or in need of health services, and a
nurse specially educated to recognize and
to respond to the need for help.

15. RELATIONSHIPS
Phases in nurse-patient relationships
 Orientation
 Identification
 Exploitation
 Resolution

16. ORIENTATION
 Problem defining phase
 Starts when client meets nurse as stranger
 Defining problem and client seeks assistance,
conveys needs ,asks questions, shares
preconceptions and expectations of past
experiences
 Nurse responds, explains roles to client, helps to
identify problems and to use available resources
and services

17. IDENTIFICATION PHASE
 The identification phase begins when the client
works interdependently with the nurse, expresses
feelings, and begins to feel stronger.
 Selection of appropriate professional assistance
 Patient begins to have a feeling of belonging and a
capability of dealing with the problem which
decreases the feeling of helplessness and
hopelessness

18. EXPLOITATION PHASE
 In the exploitation phase, the client makes full use
of the services offered.
 Use of professional assistance for problem solving
alternatives
 Advantages of services are used is based on the
needs and interests of the patients

19. CONT……
 Individual feels as an integral part of the helping
environment
 They may make minor requests or attention getting
techniques
 The principles of interview techniques must be used
in order to explore, understand and adequately deal
with the underlying problem
 Patient may fluctuates on independence
 Nurse must be aware about the various phases of
communication
 Nurse aids the patient in exploiting all avenues of
help and progress is made towards the final step

20. RESOLUTION PHASE
 In the resolution phase, the client no longer
needs professional services and gives up
dependent behavior. The relationship ends.
 Termination of professional relationship
 The patients needs have already been met
by the collaborative effect of patient and
nurse

21. CONT……
 Now they need to terminate their therapeutic
relationship and dissolve the links between them.
 Sometimes may be difficult for both as
psychological dependence persists
 Patient drifts away and breaks bond with nurse and
healthier emotional balance is demonstrated and
both becomes mature individuals

22. ROLES OF THE NURSE
 Stranger
 Resource person
 Teacher
 Counselor
 Surrogate
 Leadership

23. STANGER:
 Peplau states that when the nurse and
patient first meet, they are considered to be
strangers to one another.
 Therefore, the patient should be treated with
much respect, courtesy and equally as
anybody else.

24. RESOURCE ROLE:
 The nurse provides answers to questions
primarily on health information.
 The resource person is also in charge of
relaying information to the patient about the
treatment and plan of care

25. TEACHING ROLE:
 The teaching role is a role that is a
combination of all roles.
 Peplau determined that there are two
categories that the teaching role consists of:
Instructional and experimental.
 The instructional consists of giving a wide
variety of information that is given to the
patients and experimental is using the
experience of the learner

26. COUNSELING ROLE:
 Peplau believes that counseling has the
biggest emphasis in psychiatric nursing.
 The counselor role helps the patient
understand and remember what is going on
and what is happening to them in current
life situations. Also, to provide guidance
and encouragement to make changes.

27. SURROGATE ROLE:
 The patient is responsible for putting the
nurse in the surrogate role.
 The nurse’s behaviors and attitudes create
a feeling tone for the patient that trigger
feelings that were generated in a previous
relationship.

28. LEADERSHIP ROLE:
 Helps the patient assume maximum
responsibility for meeting treatment goals in
a mutually satisfying way.
 The nurse helps the patient meet these
goals through cooperation and active
participation with the nurse.

29. CHARACTERISTICS
 Interrelation of concepts
 Four phases interrelate the different components of
each phase.
 Applicability
 The nurse patient interaction can apply to the
concepts of human being, health, environment and
nursing.
 Theories must be logical in nature -
 This theory provides a logical systematic way of
viewing nursing situations
 Key concepts such as anxiety, tension, goals, and
frustration are indicated with explicit relationships
among them and progressive phases

30. CONT…
 Generalizability
 This theory provides simplicity in regard to the
natural progression of the NP relationship.
 Theories can be the bases for hypothesis that can
be tested
 Peplau's theory has generated testable
hypotheses.
 Theories can be utilized by practitioners to guide
and improve their practice.
 Peplau’s anxiety continuum is still used in
anxiety patients

31. CONT…
 Theories must be consistent with other validated
theories, laws, and principles but will leave open
unanswered questions that need to be investigated.
 Peplau's theory is consistent with various
theories

32. STRENGTHS
 Peplau’s theory helped later nursing
theorists and clinicians develop more
therapeutic interventions regarding the roles
in clinical nursing.
 Its phases provide simplicity regarding the
natural progression of the nurse-patient
relationship
 which leads to adaptability in any nurse-
patient interaction, thus providing
generalizability

33. LIMITATIONS
 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

34. APPLYING PEPLAU’S THEORY :
 A client JL (36 year old female) was referred to the
UOS hospital with a
Prolapsed Disc
of the lower lumbar spine (lower back). The pain in
her lower back was so great that it radiated down
the front of her thighs. She was unable to sit and
turn in bed (need assistance). The doctor decide to
do surgery, she is concern about her condition and
the surgery.

35. THE NURSE
*Introduces
herself
*Asks
questions
*Obtains
a health history and assessment
*Helps
to identify problem (pain in her lower back, need
assistance and is concern about her condition and
the surgery)
 - Roles:
Both patient and nurse are in the
stranger
role at this time and must gain mutual trust

36. ORIENTATION
Patient was initially reluctant to talk
due to pain
Patient was expressing that his health
condition is poor
Nurse established therapeutic
relationship with the patient

37. IDENTIFICATION
 Both Nurse and patient
identify
the problems to
address:
- Pain in her lower back
- Need assistance self care
- Concern about her condition and the
surgery

38. EXPLOITATION

For
pain:
-Provide non pharmacological measures
-Provide supine position to the client.
-Support the back during position change
-Use pillows to support the back.
-Administer analgesic to reduce pain

39. CONT…
 For assistance and self care:
-Keep the articles within the reach of the
client
-Frequently visit the patient and enquire for
any needs.
-Assist the client in doing her self care
activities

40. CONT….
 For her Concerns:
-Teach the family regarding the disease
process in local
-Allow the client and family members to ask
questions
-allow her and her husband expressed their
anxiety
-Allow the family members to frequently visit
the client

41. TERMINATION PHASE
Resolution -- problems are resolved
For pain
:Mrs. JL was free to express
problems of pain.
For self-care:
- Mrs. JL was free to express problems of
self care.
- She achieve and maintain her self care
activities within her limits

42. CONCLUSION…
 With the help of theory of interpersonal
relation the patient need could be
assessed.
 It helped him to achieve them within her
limits.
 The theory application helped in providing
comprehensive care to the client patient

43. SUMMARY

44.  The seven nursing roles, which show the
dynamic character roles typical in clinical nursing.
 It entails that a nurse’s duty is not just to care but
the profession also incorporates every activity
that may affect the client’s health.
 However, the idea of a nurse-client cooperation is
found narrow with those individuals who are unfit
and powerless in conversing, specifically those
who are unconscious and paralyzed.

45. CONT…..
 Studying Peplau’s Interpersonal Relations Theory
of Nursing can be very substantial especially to
those who are aspiring to be part of the
profession.
 Having the knowledge of the seven roles of nursing,
future nurses can apply different roles in different
situations, the best care possible, and along
treatment and recovery.

46. REFERENCES
 BT Basvanthappa (2007). Nursing Theories.
Jaypee brothers medical publisher 1st edition New
Delhi
 Timber BK. Fundamental skills and concepts in
Patient Care, 7th edition, LWW, N