Hildegard Peplau developed the theory of interpersonal relations in nursing. The theory focuses on the nurse-patient relationship and involves four phases: orientation, identification, exploitation, and resolution. Peplau proposed that nursing is an interpersonal process where nurses fulfill various roles to help patients through therapeutic communication and goal-setting. The theory provides a framework for understanding the nurse-patient dynamic and is still widely applied in psychiatric nursing and the nursing process.

1. PEPLAU’S THEORY
PRESENTED TO:
DR. BHAGYASHREE JOGDEO
B.V.CON-PUNE
PRESENTED BY:
MS. LOMA R WAGHMARE
F.Y.M.SC(NURSING)
B.V.CON-PUNE
ADVANCE NURSING PRACTICE

2. Hildegard E Peplau
WORK
AND
LIFE

3. Who was Hildegard E Peplau??
Early life
• Name: Hildegard E Peplau
• Nick name: Hilda
• Birth: Sept 1, 1909, Pennsylvania
• Died: March 17, 1999 in Sherman Oaks,
California
• Parents: Immigrants of German decent
Gustav Peplau(father) & Otyllie Peplau(mother)
• She was second daughter born for six children

4. Why Nursing……????
• In 1981, she witnessed the devastating flu
epidemic that greatly influenced her
understanding of the impact of illness and
death on families.

5. Educational Background
• 1931- Diploma program in Pottstown, Pennsylvania.
• 1943- BA in interpersonal psychology - Bennington
College.
• 1947- MA in psychiatric nursing from Colombia
University New York
• 1953- EdD in curriculum development
• Professor emeritus from Rutgers university
• Started first post baccalaureate program in nursing

6. Professional Work
• 1952- Published Interpersonal Relations in
Nursing
• 1968- Interpersonal techniques-the crux of
psychiatric nursing
• Worked as executive director and president of
ANA.
• Worked with W.H.O, NIMH and Nurse Corps.
• Theory of interpersonal relations is a middle
range descriptive classification theory.
• Peplau's theory is also referred as psychodynamic
nursing, which is the understanding of ones own
behavior.

7. MAJOR CONCEPT OF PEPLAU’S
THEORY
• The theory explains the purpose of nursing is
to help others identify their felt difficulties.
• Nurses should apply principles of human
relations to the problems that arise at all
levels of experience.
• Peplau's theory explains the phases of
interpersonal process, roles in nursing
situations and methods for studying nursing as
an interpersonal process

8. MAJOR CONCEPT OF PEPLAU’S
THEORY
• Nursing is therapeutic in that it is a healing art,
assisting an individual who is sick or in need of health
care.
• 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 both become
mature and knowledgeable in the process.

9. DEFINITION
• Person: A developing organism that tries
to reduce anxiety caused by needs.
• Environment: Existing forces outside the
organism and in the context of culture

10. DEFINITION
• Health: A word symbol that implies forward
movement of personality and other ongoing
human processes in the direction
of creative, constructive, productive, personal an
d community living.
• Nursing: A significant therapeutic interpersonal
process. It functions cooperatively with other
human process that makes health possible for
individuals in communities.

11. Peplau’s Seven Role of a Nurse
• STRANGER: One who receives the client in the
same way one meets a stranger in other life
situations provides an accepting climate that
builds trust.
• TEACHER: One who imparts knowledge in
reference to a need or interest
• RESOURCE PERSON : One who provides a
specific needed information that aids in the
understanding of a problem or new situation

12. Peplau’s Seven Role of a Nurse
• COUNSELORS : One helps to understand and
integrate the meaning of current life
circumstances ,provides guidance and
encouragement to make changes
• SURROGATE: One who helps to clarify
domains of dependence interdependence and
independence and acts on client’s behalf as an
advocate.

13. Peplau’s Seven Role of a Nurse
• LEADER : One who helps client assume
maximum responsibility for meeting
treatment goals in a mutually satisfying way
• TECHNICAL EXPERT: It provides physical care
by display clinical skill and operates
equipment

14. Additional Roles include:
• Technical expert
• Consultant
• Health teacher
• Tutor
• Socializing agent
• Safety agent
• Manager of environment
• Mediator
• Administrator
• Recorder observer
• Researcher

15. Lets see an example
• https://www.youtube.com/watch?v=4Qon7n
D3ISY

16. Four Sequential Phase in the
Interpersonal Relationship
ORIENTATION PHASE
IDENTIFICATION PHASE
EXPLOITATION PHASE
RESOLUTION
PHASE

17. ORIENTAION PHASE
• Problem defining phase
• Starts when client meets nurse as stranger
• Defining problem and deciding type of service
needed
• 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

19. IDENTIFICATION PHASE
• 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

20. EXPLOITATION PHASE
• Use of professional assistance for problem
solving alternatives
• Advantages of services are used is based on
the needs and interests of the patients
• Individual feels as an integral part of the
helping environment
• They may make minor requests or attention
getting techniques

21. EXPLOITATION PHASE
• 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

22. RESOLUTION PHASE
• Termination of professional relationship
• The patients needs have already been met by the
collaborative effect of patient and nurse
• 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

23. Interpersonal theory and 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 patients needs
• Both use observation communication and
recording as basic tools utilized by nursing

24. Assessment
Data collection and analysis
May not be a felt need
Orientation
Non continuous data collection
Felt need
Define needs
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 drawing
help
Patient initiated
Evaluation
Based on mutually expected behaviors
May led to termination and initiation
of new plans
Resolution
Occurs after other phases are
completed successfully
Leads to termination

25. Peplau’s work and characteristics of a
theory
INTER
REALTION
OF
CONCEPT
APLICABIL
ITY
LOGICAL
GENERALI
SABILITY
HYPOTHESIS
CAN BE
TESTED

26. Application of Theory to Area in
Nursing
Nursing Education
- Has an impact on the Psychiatric nursing
especially in the baccalaureate program in
nursing teaching CARE OF CLIENT WITH
MALADAPTIVE PATTERNSOF BEHAVIOR

27. Application of Theory to Area in
Nursing
Practice
• Focuses on the interpersonal processes and therapeutic
relationship that develops between the nurse and client.
• It requires that the nurse attends to the interpersonal
processes that occurs between the nurse and the client
• Interpersonal process is maturing force for personality. It
includes the nurse- client relationship, communication,
pattern integration and the role of the nurse.
• Psychodynamic nursing is understanding one’s own behavior
to help others identify felt and perceived difficulties and to
apply principles of human relations to the problems that arise
at all levels of experience

28. Application of Theory to Area in
Nursing
• Hays .D. (1961). Phases and steps of experimental
teaching to patients of a concept of anxiety:
Findings revealed that when taught by the
experimental method, the patients were able to
apply the concept of anxiety after the group was
terminated.
• Burd .S.F. Develop and test a nursing intervention
framework for working with anxious patients:
Students developed competency in beginning
interpersonal relationship.

29. Application with example
• The nursing process for Mrs Laxmi using
Peplau’s theory
• Mrs Laxmi with 27 years of age is diagnosed
with Inter vertebral disc prolapse. She is on
traction and complains of pain

30. Assessment
(Orientation)
Nursing
Diagnosis
Planning
(Identification)
Implementation
(Exploitation)
Evaluation
(Resolution)
Mrs Laxmi 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
- Provide active
and passive
exercise to all the
extremities to
improve the
muscle tone and
strength
- Provide articles
near to the
patient and
encourage doing
activities within
limits
Carried out plans
mutually agreed
upon
Provide active and
passive exercise to
all the extremities
Provide articles
within the reach
of the patient
Mrs. Laxmi
was free to
express
problems
regarding
difficulty in
mobilizing
She expressed
satisfaction
when able to
move without
difficulty

31. Lets see an example
• https://www.youtube.com/watch?v=4Qon7n
D3ISY

32. Evaluation of the theory
• With the help of the theory of interpersonal
relations, the clients need could be assessed
and identified.
• It helped her to achieve them within her limit.
This theory application helped in providing
comprehensive care to the client.

33. • Peplau’s theory helped later nursing
theorist and clinicians develop
more therapeutic interventions
regarding the roles that shows the
dynamic character typical 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
provide generalizability.

34. LIMITATIONS
• Less consideration of personal space and
community social service resources.
• Less emphasis on health promotion and
maintenance.
• Cannot be used in a client who doesn’t have a
felt need eg. For an unconscious patients
• Some areas are not specific enough to
generate hypothesis

35. To Summarize
• Hildegard E Peplau’s theory of
interpersonal relation is useful to
maintain the nurse patient relation
• The theory has four important phases
including orientation, implementation,
exploitation and resolution phase
• It goes hand in hand with the nursing
process
• There are 7 important role of nurses
according to Peplau’s including stranger,
teacher, resource person counselor,
surrogate, leader and technical expert
• This theory can be applicable in the daily
nursing practice to have good patient
outcome