Hildegard Peplau developed the Interpersonal Relations Theory, which focuses on the nurse-patient relationship and its progression through four phases: orientation, identification, exploitation, and resolution. The theory emphasizes understanding interpersonal processes and developing therapeutic relationships. Peplau identified seven nursing roles to illustrate the dynamic character roles in clinical nursing, and her theory provides a framework for assessment, planning, intervention, and evaluation in caring for patients. Research has found the theory useful for educating oncology patients, ensuring understanding, and developing individualized care plans for families.

1. Peplau’s
Interpersonal
Relations Theory
Zafar Iqbal
Sr. lecturer
Jinnah College of Nursing

2. Hildegard E. Peplau’s Interpersonal
Relations in Nursing
Regarded as “mother of psychiatric nursing”
 Born in 1909 , Pennsylvania
Diploma from Pottstown Hospital School of
Nursing,
BA in interpersonal psychology from
Bennington College Pennsylvania in 1931.
 MA in psychiatric nursing from Colombia
University, New York in 1947
Her Theory was published in 1953
Framework for psychodynamic nursing

3. Continue…
Theory was influenced by Harry Stack Sullivan’s
theory of interpersonal relations.
Middle range, descriptive, classification theory
she led the way towards humane treatment of
patients with behavior and personality disorders.
Nurses, she thought, could facilitate this
through observation, description, formulation,
interpretation, validation, and intervention.
she taught interpersonal concepts and
interviewing techniques, as well as individual,
family, and group therapy.

4. Interpersonal Relations in Nursing
Theory
• Stresses the importance of nurses’ ability to
understand their own behaviors to help
others identify perceived difficulties.
• Emphasizes the focus on the interpersonal
processes and therapeutic relationship that
develops between the nurse and client.
• Four phases of the nurse-patient relationship
are identified

5. 4 Phases of nurse-patient
relationship
• 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

6. Phases cont.
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

7. Phases cont.
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

8. Phases cont.
Resolution- 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.

9. Peplau's Seven Nursing Roles
• Peplau's Seven Nursing Roles illustrate the dynamic
character roles typical to clinical nursing.
• Stranger role: Receives the client the same way one
meets a stranger in other life situations; provides an
accepting climate that builds trust.
• Resource role: Answers questions, interprets clinical
treatment data, gives information.
• Teaching role: Gives instructions and provides training;
involves analysis and synthesis of the learner's
experience.

10. Peplau's Seven Nursing Roles
• Counseling role: Helps client understand and
integrate the meaning of current life circumstances;
provides guidance and encouragement to make
changes.
• Surrogate role: Helps client clarify domains of
dependence, interdependence, and independence
and acts on clients behalf as advocate.
• Active leadership: Helps client assume maximum
responsibility for meeting treatment goals in a
mutually satisfying way.
• Technical expert role: Provides physical care by
displaying clinical skills; Operates equipment

11. Application of Interpersonal Theory in
Nursing Practice
• An article in Current Nursing evaluated using the
theory in nursing practice
– Assessment= Orientation phase
– Nursing diagnosis
– Planning=Identification phase
– Implementing=Exploitation phase
– Evaluation=Resolution phase
(the theory allowed client’s needs to be assessed.
Application of the theory helped provide
comprehensive care to the client)

12. Research completed
• Urology Nursing used the theory to educate
newly diagnosed bladder cancer patients with
the need for a urinary diversion, and ensure
understanding.
Outcome shows that the scope of a patient’s needs
requires a competent nurse to assume the
changing roles in the four phases of the theory,
expressing the importance of involving the
patient in establishing goals and reviewing the
goals frequently.

13. Research completed
• British Journal of Nursing had an article researching
the credibility of Peplau’s theory, in mental health
care, due to the expansion of nursing knowledge and
the dynamics of a multidisciplinary team currently
used in today’s practice.
• Public Health Nursing did a study, in homecare visits,
(testing the use of Peplau’s theory) to work with multi-
problem families, to identify interventions,
individualized for the members, to see if relationship
progression was increased within the family system
resulting in optimized care of the patient.

14. Application of theory in “MY” nursing
practice
• This theory would be useful with our newly diagnosed cancer patients
and their family. Resistance is met when trying to educate them about
the treatment, encouraging enrolment in studies, and education about
how to care for the patient in their home setting.
– Orientation-patient gets admitted to the unit, nurse helps the patient to
recognize and understand that they have cancer and the importance of
treatment.
– Identification-Patient takes the time to internalize the diagnosis, the nurse
participates in helping the patient to do so.
-- Exploitation-the nurse works to have the patient explore what help is
needed to meet goals, incorporating other disciplines to problem solve
(oncologists, therapists, alternative medicine, etc.).Patient test the limits of
the nurses availability, and the nurse encourages patient to evaluate ways
to meet their final goals.
-- Resolution-when in-patient treatment is complete, the nurse has to
evaluate feelings and remove themselves from the bond that is made,
allowing the patient and family to move on and regain balance in their own
lives.