THEORETICAL FOUNDATIONS IN NURSING (the 1st formal training school for

nurses) in Germany.
★ Historical Evolution in Nursing - This was where Florence Nightingale
❖ Period of Intuitive Nursing/Medieval received her 3-month course of study in
Period nursing.
- Nursing was untaught and instinctive.
- Performed out of compassion and wish to ❖ Period of Educated
help. Nursing/Nightingale Era /19th-20th
- No caregiving training, only through Century/Modern Nursing
observation and experience. - Development was strongly influenced by:
- A nurturing job and function belonged to Crimean, civil war
women. - Arousal of social consciousness
- Primitive men believed that illnesses came - Emancipation (freedom) of women
from the bad spirits - Increased educational opportunities
- Medicine man/Shaman had the power to offered to women.
heal using white magic, hypnosis etc.
❖ Period of Contemporary Nursing/20th
Trephining: drilling a hole in the skull using a Century
stone without anesthesia (last resort to drive ★ Florence NIGHTINGALE
away spirits) - An English lady from a wealthy family
during the Victorian era
Sickness is due to the active intervention of: - During the Crimean War- "Lady with the
- Human (witchcraft) Lamp
- Non-human (ghosts) - Her favorite dictum, "DO THE PATIENT
- Superhuman beings (superstitious) NO HARM"
- Where history of professional nursing
❖ Period of Apprentice Nursing/Middle
Ages/Renaissance The Nightingale Training School of Nurses
- Care given by crusaders, prisoners, ● Nightingale focus: vision of nursing was
developed by religious orders (Christian developing the profession within hospitals.
Church) ● Nurses should be taught in hospitals
- No formal education in Nursing and associated with medical schools and
people directed by more experienced curriculum should include both theory and
nurses (OJT) practice.
- Nursing went down to the lowest level ● It was the 1st school of nursing that
(Dark Period of Nursing 17th to 19th provided both theory-based knowledge
century) and clinical skill building.
- The wrath/anger of Protestantism; ● Nursing evolved as an art and science
confiscated properties of hospitals and ● Formal nursing education and nursing
schools connected with Roman service begun
Catholicism.
- Nurses fled their lives; a shortage of HISTORY OF NURSING THEORY
people to care for the sick Hundreds of - Development of nursing knowledge apart
hospitals closed, no provision (care) for from medical knowledge to guide nursing
the sick practice
- Nursing became the work of the least
desirable of women - prostitutes, ★ NURSING THEORY
alcoholics, prisoners - Conceptualization of reality invented or
- Pastor Theodore Fliedner and his wife, discovered that pertains to nursing.
Frederika established the Kaiserswerth - Are organized bodies of knowledge to
Institute for the training of Deaconesses define what nursing is, what nurses do,
and why they do it
 - Interrelated concepts from studies of - idea formulated by the mind and
discipline and experiences experience or describe a phenomenon
- Essence of care - Building blocks of and generates
- Improve quality of care theories
- Enhances capacity to understand and
PURPOSE OF NURSING THEORY: define
- Describes, Explains, Predicts, Prescribes - Used in conceptual or operational
definitions
USES OF NURSING THEORY:
1) To differentiate the focus of nursing from ● Abstract: indirectly or intangible,
other professions independent
2) To structure professional nursing into ● Concrete: directly or tangible
practice, education, and research
3) To help build a common nursing Definition: descriptions giving general meaning
terminology to use in communicating with reducing vagueness of concepts
other healthcare professionals ● Conceptual: meaning based on how
4) To enhance autonomy of nursing thru literature defines it (own pov)
defining its own independent functions ● Operational: meaning based on the
method how it was measured
FOCUS OF THE THEORY
1) CLIENT CENTERED Proposition: explains relationship of concepts
2) CLIENT-NURSE DYNAMICS
3) CLIENT-NURSE ENVIRONMENT Assumption: statement specifying relationship of
concepts or explains nature of concepts (hold as
NURSING PARADIGM factual)
- patterns or models used to show a clear
relationship among the existing theoretical
works in Nursing

4 COMPONENTS:
1. Person: The recipient of nursing care
2. Nursing: The actions of the person care
Nursing: focused in supporting communities in
3. Environment: The internal and external
achieving a state of optimum health concerned
conditions
with the quality of life.
4. Health: patient’s level of wellness

American Nursing Association (ANA):

Nursing Theory: explains the Science and Art of
diagnosis and treatment of human responses to
Nursing
actual or potential health problems
Nursing Science: melting-pot of different
International Council of Nurses (ICN):
knowledge, background of care and healing
- autonomous (freedom to govern itself)
collected and preserved
collaborative care of individuals of all
ages.
★ Theory:
- Promotion of health, prevention of illness,
- organized system of accepted knowledge
care of the ill, disabled, and dying people.
composed of concepts, propositions,
definitions, assumptions intended to
Henderson: assist clients in activities contributing
explain a set of fact, event or phenomena.
to health, recovery or peaceful death
- Creative and rigorous structuring of ideas
that projects a tentative, purposeful and
Association of Deans of Philippine Colleges of
systemic view of phenomena
Nursing (ADPCN):
- Dynamic discipline
Concept:
 - Art and science caring for individuals
towards promoting and restoring health
Grand theories: broad scope and complex Philosophy:
(occasional) - Next knowledge level after metaparadigm
Middle-range: researches are frequently based - Definition of metaparadigm concepts
on, discovery of concepts through analysis, reasoning, and logical
Critical: describe theories that clarify how social argument
structures influenced human experience
Science
Phenomenon: describes an idea, situation or - Scientia - knowledge
event - Systematic knowledge or practice
- Acquiring knowledge based on scientific
TYPES OF THEORIES: method/research
Descriptive (Factor-Isolating): know properties
and working 1) Observation: integration of knowledge
- Primary level 2) Gathering data: recognition and
- Identity and describe concepts collecting data
- Does not explain relationship of concepts 3) Forming hypothesis: attempt to explain
- Present a phenomenon based on the 5 or suggest nature of phenomenon
senses (testable)
4) Experimental investigation: set of
Explanatory (Factor-Relating): how properties examinations done to solve a query
related and affect 5) Conclusion of Theoretical explanation:
- Present relationship of concepts statement explaining a set of natural
- Provide information on how and why phenomena
concepts are related
- E.g. cause and effect Knowledge:
- Information, skills and expertise acquired
Predictive (Situation-Relating): relationship and through experiences
its occurrence - Abstract or workable understanding
- Relationships of concepts under a - Known to a discipline
condition are able to describe future - Facts and information
outcomes consistently - No agreed classification of knowledge
- Generated through experimental research
TYPES OF COGNITIVE PROCESS
Prescriptive (Situation-Producing): which 1) Perception: achieving understanding
conditions relationship occur 2) Association: combining concepts to form
- Nursing actions, test validity of new new
nursing intervention 3) Learning: acquiring experience, skills
4) Reasoning: mental process of seeking
Theoretical models: established set of concepts conclusions
(testable) 5) Communication: transferring data from
sender to receiver
Conceptual models: representations of idea
based on own understanding SOURCES OF KNOWLEDGE
(diagram/structure/paradigm) 1. Traditional: nursing practice passed
down
Nursing Paradigm: patterns or model to show 2. Authoritative: idea of a person of
clear relationship among theoretical works authority perceived true because of
expertise
Meta - with; paradeigma - pattern 3. Scientific: scientific method through
research
Phenomenon: sets of empirical data or - Functions cooperatively with human processes
experiences (physically observed/tangible) presenting health as a goal
- Nurses use interpersonal model to identify
the needs of others
Research: systematic methods to study a
phenomenon Person
- Man, an organism living in an unstable
balance of given system
Induction: specific to general; Deduction:
general to specific Health
- movement of the personality
Theory-generating research: discover and - for one’s health to be achieved and
maintained, his needs must be met such as
describe relationships without imposing notions physiological demands and interpersonal
(beliefs) conditions

Environment
Theory-testing research: determine accuracy of
- forces outside the organism in a socially-
theory describes a phenomenon approved way of living
- includes interpersonal process
Is theory proven?
Interpersonal Relations Theory
It can be tested to validate its
- nurse-patient relationship as four-phase
accurateness but even if a theory is accepted as phenomenon
fact, it remains a theory.
In science, theories never become facts
★ PHASES OF NURSE-PATIENT
but rather theories explain facts. RELATIONSHIP
Once it is accepted, it becomes a scientific
law. 1. Orientation
A theory is only ever assumed to be true - initial interaction
- there is a need and expresses desire for
until proved otherwise. professional assistance
- nurse assists patients in understanding
NURSING PHILOSOPHIES patient experience

★ HILDEGARD PEPLAU
“Interpersonal Relations Theory”
2. Identification
“The kind of person that the nurse becomes makes a - explore the experience and needs of
substantial difference in what each patient will learn as patient leading to feeling of relatedness
he or she receives nursing care” - reorienting and sustaining positive
environment
● Psychiatric Nurse of the Century
● American Journal of Nursing 3. Exploitation
● The Christiane Reimann Prize - full value of relationship from moving to a
dependent role to an independent role
- Born on September 1, 1909 - Goals are achieved through personal or self-
- Born in Reading, Pennsylvania effort, power is at the patient
- Paternalistic society: She would not leave
school, go to work and hand her wages to her 4. Resolution
family because she was raised to believe that - Earns independence over his care
they had to choose between marriage and - Experience leaves lasting impression
work.
- She save the American Nurses Association Interpersonal Therapeutic Process or
from bankruptcy Psychological Mothering
- Member of army corps - psychiatric patients becoming receptive for
- National Mental Health Act of 1946 therapy
- 1. Patient is accepted unconditionally as a
- She died at 89 on March 7, 1999 participant in a relationship satisfying his
needs
★ METAPARADIGM IN NURSING 2. A recognition of and response to the patient’s
- Psychiatric Nursing (Intrapsychic needs) readiness for growth and initiative
3. Power in the relationship ships to the patient
Nursing: because it is able to delay gratification and
- significant, therapeutic interpersonal process invest goal achievement
 ★ THEORY ANALYSIS
★ NURSING ROLES
Clarity:
Role of the: - The concepts of the phases in the
1. Stranger (Identification Phase) interpersonal relationship, the nurse’s roles
- Nurse and client are strangers and psychobiological experiments are well
- Nurses should treat patient with utmost defined, consistent and logically presented.
courtesy
Simplicity:
2. Resource Person - Inductive reasoning: specific observations
- Client assumes a dependent role, nurses and applies them
provide specific answers and simple - Discover patterns enabling nurse-patient
explanation relationship
- to appropriately change her responses to the - Meeting the quality and simplicity
client’s level of understanding Generality
- She believed that all nurses were able to use
3. Teaching Role her model effectively
- Teaches about the importance of self-care and - Her theory can only be used in situations
understanding the therapeutic plan requiring communication can be one sided
- Nurses should determine how the client (senile, comatose)
understands the subject - Evaluation standard is not met

4. Leadership Role Accessibility

- through cooperation and active - Theory based on reality using pure
participation, the nurse must you have clients observation (theoretical and empirical area)
best interest and enable him to make
decisions over his own care Importance
- One of the first theorists after Nightingale
5. Surrogate Role - Pioneering works
- The clients dependency for his care gives the - Her works touched the lives of people
nurse a surrogate (temporary caregiver) providing direction for nursing.
- The nurse must assess the clients to make
sure that her surrogate role is different and VIRGINIA HENDERSON
temporary Needs Theory: The unique function of the nurse is to
assist the individual, sick or well, in the performance of
6. Counseling Role those activities contributing to health or its recovery (or
- Greatest importance and emphasis in Nursing to peaceful death) that he would perform unaided if he
- Strengthens nurse-patient relationship by had the necessary strength, will or knowledge.
becoming a listening friend, understanding
family, and gives a sound advices ● First Lady of Nursing & International Nurse
- The client should remember and understand ● Nightingale of Modern Nursing
the experience and how it could be integrated ● Modern-day Mother of Nursing
in his daily life. ● 20th Century Florence Nightingale
● American Nurses Association Hall of Fame
★ ACCEPTANCE BY THE NURSING ● Sigma Theta Tau International Library
COMMUNITY ● Virginia Historical Nurse Leadership Award
● One of the 51 Pioneer Nurses in Virginia
PRACTICE
- Wasn’t widely accepted at first “The nurse is temporarily the consciousness of
- Give and take of nurse-patient relationship is the unconscious, the love of life for the suicidal, the leg
seen as new and revolutionary of the amputee, the eyes of the newly blind, a means
- It is in the interest of the profession and client of locomotion for the infant, knowledge and confidence
to use their interpersonal models for the mother, the multipiece for those too weak or
withdrawn to speak and so on”
EDUCATION
Interpersonal Relations in Nursing - 1952 (book) - Advocate of psychiatric nursing
- Emphasize the importance of the nurse-patient ● Nature of Nursing - Believe about the
relationship in providing healthcare essence of nursing and influence the hearts
- Manual of instruction to graduate nurses in and minds of the readers
establishing nurse-patient relationship

RESEARCH
- Client problems were within the person ★ METAPARADIGM OF NURSING
phenomena and dealt inside the nurse-patient
interaction studies Nursing
 - Nurses must promote the treatment plan 9. Avoid dangers in the environment and avoid
prescribed by the physician. injuring others
- They must act independently + coordination 10. Communicate with others in expressing
with the therapeutic plan to help both the sick emotions, needs, fear, or opinion
and well individual. 11. Worship according to one’s faith
- Must empower client to gain independence as 12. Work in such a way that there is a sense of
possible accomplishment
- A nurse must be knowledgeable in both 13. Play or participate in various forms of
biological and social sciences and have the recreation
ability to assess basic human needs. 14. Learn, discover or satisfy the curiosity that
- Her definition of nursing = the “signature” of leads to normal development and health, and
the profession. use the available health facilities

Person (Client)

- Individuals have basic health needs and - Nurses should and you client and his family as
require assistance to achieve health and a single unit
independence or a peaceful death.
- Concepts of the mind and body of a person The Nurse - Patient Relationship
are inseparable.
- To function properly, he must be able to 1. The nurse as a substitute for the client.
maintain physiological and emotional Help as to what the clients lacks (knowledge,
balance. will and strength) to make him complete,
whole and independent once again.
Health 2. The nurse as a helper to the client. Nurses
help clients to accomplish his basic needs to
- quality of life and is a basic for a person to achieve health and regain independence as
function fully. quickly as possible.
- Health requires independence and 3. The nurse as a partner with the patient. The
interdependence. influenced by both internal nurse and the client formulate the plan of care
and external factors together. Both as an advocate person and as
- Prioritizing health promotion is more important a resource person, the nurse can empower the
than care of the sick. client to make effective decisions regarding his
care plans. The client and the nurse see each
Environment other as partners whose interests are the
same having the client achieve health and
- Any place where the therapeutic interaction independence.
between patient and nurse occurs. 4. The Nurse-Physician Relationship. Nurses
- To manage the patients' surroundings to function independently from physicians.
protect patients from any harm or any Though the nurse and client, as partners,
mechanical injuries. formulate the plan of care, it must be
- Educated about safety and must be aware of implemented in such a way that will promote
different social customs and religious practices the physician’s prescribed therapeutic plan.
to assess dangers. - Nurses do not follow doctor’s orders; rather
- They should provide physicians data about the they follow a philosophy that allows physicians
safety needs as the latter use this as the basis to give orders to clients or other healthcare
in prescribing protective devices. team members.
- It is their responsibility to recommend changes
in order for him or her to minimize chances of
injury.
5. The Nurse as a MEMBER OF the Healthcare
Needs Theory: 14 Fundamental Needs of Humans Team For a team to work together in harmony,
every member must work interdependently
1. Breathe normally does not include taking other member’s role
2. eat and drink adequately and responsibilities.
3. eliminate body wastes
4. move and maintain a desirable position or
posture
5. sleep and rest ★ Acceptance by the nursing Community
6. Select suitable clothes
7. Maintain body temperature within a normal Practice
range by adjusting clothing and modifying
environment Nursing process: problem-solving process used to
8. Keep the body clean and well-groomed and answer client’s need
protect the integument (skin)
1) Assessment Phase - assessing the 14
fundamental needs of the clients and checking which
one is lacking or fully met. Accessibility

2) Planning Phase – giving the plan of care to meet The Needs Theory is focused on assisting individuals
the needs and personality of the client and serve as a to gain independence in relation to the performance of
record and must fit in the prescribed plan by the activities contributing to health or its recovery.
physician.
Abstract concepts - indirectly measurable
3) Implementation Phase – maintaining health, to (expressing emotions, needs, fears, worship according
recover from illness, or to aid in peaceful death. to one's faith and sense of accomplishment).

4) Evaluation Phase – the nurse and the client review Concrete concepts - directly measurable (breathing,
the relationship and decide whether the goals are met eating and drinking and eliminating body wastes).
or not.
Importance
EDUCATION
Importance of Nursing's independence from
1. First Phase – helping the client perform and interdependence on the different healthcare
activities of daily living. professions. Advocated curriculum development.
2. Second Phase – assisting clients achieve
their needs in times of marked body Her definition of the unique function of a nurse
disturbances or illness. is widely accepted in developing nursing to a
3. Third Phase – client and his family together professional scientific discipline.
with the dynamics affecting the relationship
inside the unit. JOYCE TRAVELBEE

Research “Human-to-Human Relationship Model”

She used this to improve the practice of nursing and - Born in 1926
insisted that it is the nurse’s responsibility to identify - Psychiatric nurse
problems, continuously validate her practice, improving - Passed away at 47
the methods used, and reassuring the effectiveness of ● Interpersonal Aspects of Nursing
her care. ● Intervention in Psychiatric Nursing:
Process in the One to One Relationship
Theory Analysis ★ METAPARADIGM IN NURSING
- conceptual
Virginia Henderson’s definition of nursing person, - wrote about illness, suffering, pain,
health and environment could be considered as a hope, communication, interaction,
grand theory of philosophy. empathy, sympathy, rapport, and
therapeutic use of self.
CLARITY
Nursing:
In her 14 Fundamental Needs all are clearly defined
and consistent, stated in a straightforward and direct - interpersonal process
manner. Her theory has no structural form or diagram, - Purpose: assisting an individual, family, or
only linear ideas. community to prevent or cope with the
experience of illness and suffering and to find
Simplicity meaning in these experiences.

Her concept of nursing is complex rather than Person

simplistic. The 14 basic needs have undergone several
revisions to make them clear, simple, and concise. - human being
- a human being is a unique, irreplaceable
The sixth edition of Henderson's book, "The Principles individual who is in the continuous process of
and Practice of Nursing" is comprehensive and well- becoming, evolving, and changing.
illustrated explanation that makes the basic needs
clear and more understandable. Health

Generality - Subjective health: state of well-being in

accord with self-appraisal of physical-
The definitions provided by Henderson are broad in emotional-spiritual status.
scope and cover all areas of nursing practice and - Objective health: absence discernible
could be applied in every setting. disease, disability, or defect measured by
physical examination, laboratory tests,
 assessment by a spiritual director, or - Understanding illness and suffering in the bus
psychological counselor.“ client do use it as self-actualizing life
experience.
Environment: - A dying person must find meaning in his or her
death before he or she can ever begin to
- human conditions and life experiences accept the actuality of death
encountered by all men as sufferings, hope,
pain, and illness. Education

HUMAN-TO-HUMAN RELATIONSHIP MODEL - Better assistance for nurses who help

individuals understand the meaning of illness
- Her theory was influenced by her Ida Jean and suffering. intervention in psychiatric
Orlando experiences and nursing education nursing: process in one-to-one relationship
and practice in Catholic charity institutions - Philosophy and Religion helpful in preparing
- The nurse and patient into relate with each nursing students to fulfill the purpose of
other and buy her description of the purpose of nursing sufficiently.
Nursing
- Travelbee concluded that the nursing care Research
rendered to clients in these institutions lacked
compassion. She thought that nursing care - Discovered how individuals with cancer
needed a "humanistic revolution" - a return to described their personal search for meaning
focus on the caring function towards the ill = spiritual and psychosocial process. No
person. other theory of Travelbee that would create
further development is available.
1. Original Encounter - first impression by the
nurse of the sick person and vice versa. The THEORY ANALYSIS
nurse and patient see each other in
stereotyped or traditional roles. - It is imperative for nurses to understand their
concept of what is human, for their relationship
2. Emerging Identities - perceiving each other with another human being will be otherwise
as unique individuals. The link of a determine by that concept
relationship begins to form.
Clarity
3. Empathy: ability to share in the person’s
experience - Not consistent in clarity and origin.
- Used different terms for the Same definition.
2 Qualities Enhancing Empathy Process - Focused more on adult individuals who are
sick and the nurse’s role in helping them to
1. Similarities of experience find meaning in their sickness and
2. Desire to understand another person. suffering.
- dealt with families and their needs but not the
4. Sympathy - nurse wants to lessen the cause community
of the client's suffering. It goes beyond
empathy. "When one sympathizes, one is
involved but not incapacitated by the
involvement." Nurses used discipline
Simplicity
intellectual approach with therapeutic use of
self
- Contains different variables (numerous)
- Simplicity is not that evident.
5. Rapport - Nursing interventions lessening
- Assist nurses appreciate and understand not
client's suffering. The sick person shows trust
only the client’s humanness
and confidence in the nurse. "A nurse is able
- Theory was not able to meet this criterion.
to establish rapport because she possesses
the necessary knowledge and skills required to
Generality
assist ill persons, and because she is able to
perceive, respond to, and appreciate the
uniqueness of the ill human being." - Has wide scope of application but applicable
only to those patients in distress and life
changing events.
★ ACCEPTANCE BY THE NURSING
COMMUNITY
Accessibility
Practice
- Low measures of empirical soundness result
from lack of simplicity defining concepts
- In a Hospice, nurse attempts to build a
theoretically but does not define them
working relationship with the client
operationally.
- The model has not been tested.
Importance

- Development of quality of caring.

- Ability to describe, explain, predict and control
a phenomena.
- explains the variables that affect the
establishment of a therapeutic relationship
between nurses and patients.
- lack of empirical precision = lack of
usefulness.
- Caring: major characteristic a nurse should
possess

Hildegard Peplau
“The Interpersonal Relations Theory”
- Psychiatric Nurse of the Century
 - Born on: September 1, 1909 with human processes that present health as a
- Birthplace: Reading, Pennsylvania possible goal for individuals.
- Daughter of immigrant parents of German HEALTH
descent, Gustav and -A word that symbolizes movement of the
- Otyllie Peplau personality and other ongoing human processes
- Raised in a Paternalistic family/ society that directs the person towards a creative,
- Diedon: March 17, 1999 constructive, productive, and community living.
PERSON
Education -Defined as a man who is an organism that lives
● 1931 - Pottstown Hospital School of in an unstable balance of a given system.
Nursing ENVIRONMENT
● 1943 - Bachelor of Arts in Interpersonal -The forces outside the organism and in the
Psychology from Bennington College, context of the socially-approved way of living,
Vermont from which vital human social processes are the
● 1947 - Master of Arts in Psychiatric derived such as norms, customs, and beliefs.
Nursing The four-phase phenomenon according to Peplau
● 1953 - Doctor of Education in Curriculum 1.) ORIENTATION
Development from Columbia The initial interaction between the nurse and the
patient wherein the latter has a felt need and
Hildegard Peplau's Contribution expresses the desire for professional assistance.
From the beginning of her career in late 1930s, The nurse assists the patient in recognizing and
Peplau left a remarkable stamp on the profession understanding the "patient" experience.
and on the lives of the mentally ill around the 3.) EXPLOITATION
world, some of her contributions includes: In this phase, the patient derives the full value of
Theory of Interpersonal relations the relationship as he moves on from a
Saved the American Nurse Association from the dependent role to an independent one. New goals
point of bankruptcy are projected by the nurse, but the power is
Member of the Army Nurse Corps shifted to the patient as these goals would be
National Mental Health Act of 1946 achieved through personal or self-effort.
Advocate professional, educational, and practice 2.) IDENTIFICATION
standards in nursing The patient and the nurse explore the experience
Participation in government policy-making and the needs of the patient which leads to a
The Interpersonal Relations in Nursing feeling of relatedness. It is very important in the
Published in 1952 relationship that the nurse assists the patient in
Focuses on the therapeutic nurse-client reorienting his feelings and sustaining a constant
relationship by using positive environment.
problem-solving techniques to meet the patient's 4.) RESOLUTION
needs. In its final stages, the patient earns independence
ivfluenced by the interpersonal relationship over his care as he gradually puts aside old goals
theories by Freud and formulates new ones. Even though the
Maslow, Sullivan, and by the contemporaneous patient and the nurse end the relationship, it is
pshycoanalytical model. very apparent that the experience leaves a lasting
Awarded in The Christiane Reimann Prize at the impression on the patient since illness and
International assuming a dependent role is a unique human
Council of Nurses Quadrennial Congress and a experience.
fellowship at Major Concepts
the American Academy of Nursing. of Interpersonal Relations Theory
The Metaparadigm in Nursing according to 1.
Peplau Nursing is an interpersonal process because it
NURSING involves interaction between two or more
-Described as a significant, therapeutic individuals with a common goal.
interpersonal process. It functions cooperatively 2.
The purpose of nursing is to help others identify self-care and in helping him understand the
their felt difficulties. therapeutic plan. In assuming this role, the nurse
3. must determine how the client understands the
Nurses should apply principles of human relations subject at hand. She must develop her discussion
to problems. around the interest of the client and his ability in
4. using the information provided.
Nursing is therapeutic or a healing art. Nursing Roles
5. Leadership Role
The goal is attained through series of steps Although dependent to the healthcare team over
following a series of pattern. his care, the client is still considered vital in
6. deciding as to what course his plan of care would
The nurse and patient work together and both take. The nurse as a leader must act in behalf of
become mature and knowledgeable in the the client's best interest and at the same time
process. enable him to make decisions his own care. This
Interpersonal Therapeutic Process is achieved through cooperation and active
The Interpersonal Therapeutic Process is based participation.
on the theory proposed by Peplau and particularly Nursing Roles
useful in helping psychiatric patients become Surrogate Role
receptive for therapy. Often referred by Peplau The client's dependency for his care gives the
as"Psychological Mothering”, it includes the nurse a surrogate (temporary care giver) role.
following steps: This creates the atmosphere wherein feelings
1. The patient is accepted unconditionally as a previously felt, such as feelings towards her
participant in a relationship that satisfies his mother. Some other relationships are reactivated
needs; and nutured, Although the client recognizes that
2. There is recognition of and response to the the nurse has similarities with the person whom
patient’s readiness for growth, as his initiative; he recalls in previous relationships, the nurse
and must assist the client to make sure that her
3. Power in the relationships shifts to the patient, surrogate role is different ang only temporary.
as the patient is able to delay gratification and to Nursing Roles
invest in goal achievement (Stuart & Laraia, Counseling Role
2005). Peplau believes that the counseling role has the
Nursing Roles greatest importance and emphasis in nursing.
Role of Stranger This role strengthens the nurse-patient
In their initial contact, the nurse and the client are relationship as the nurse becomes a listening
strangers to one another. As the nurse attempts friend, an understanding family member, and
to know the client better, she must treat him with someone who gives sound and emphatic advices.
outmost courtesy, which includes acceptance of The very core of the interpersonal technique is for
the client as a person and due respect over his the client to remember and to understand the
individuality. This role is coincides with the experience and how could it be integrated into his
Identification Phase. daily life.
Nursing Roles ACCEPTANCE BY THE NURSING COMMUNITY
Role of the Resource Person ACCEPTANCE BY THE NURSING COMMUNITY
As the client assumes a dependent role, the Practice
nurse provides specific answers to his queries Peplau introduced groundbreaking concepts in
which include health information, advices, and a nursing, emphasizing the importance of nurse-
simple explanation of the healthcare team's patient relationships and learning through
course of care. It is the responsibility of the nurse experiences. Her Interpersonal Relations Model,
to appropriately change her responses to the initially met with skepticism, later gained
client's level of understanding. recognition for its theoretical foundation in
Nursing Roles nursing. It paved the way for integrating other
Teaching Role scientific disciplines into nursing, particularly in
As the interaction progresses, the nurse assumes psychiatric nursing. Today, clinicians widely
a teaching role as she gives much importance for embrace her model, recognizing the value of
nurse-patient relationships. Researchers have return she also demonstrated how this model
found that nurses who build trust and maintain a could be used as a process when she it reduced
consistent approach empower clients. In the Four Phases of Nurse-patient Relationship.
psychiatric nursing, her model aids in counseling The different roles of the nurse added further
women with depression, enabling them to identify understanding on how nurses could effectively
negative thinking patterns and develop coping use the Interpersonal Model by identifying which
strategies. role is appropriate at the given phase or situation
ACCEPTANCE BY THE NURSING COMMUNITY in perfect harmony with the nursing process.
Education GENERALITY
Hildegard Peplau’s book “Interpersonal Relations Peplau believed that all nurses, regardless of
in Nursing” (1951) serves as an instructional their area or clinical setting, could effectively
guide for graduate nurses and students, fostering utilize her model. However, the theory can be
meaningful nurse-patient relationships across used only two situations that communication can
various settings. Critiques of her model emerged occur between the nurse and the client. The use
in academic circles, notably in psychiatric nursing, of the model is limited or impossible in working
with most comments appearing decades after her with senile, comatose, or newborn clients. In
initial work. Her theoretical ideas, encompassing these given situations, the nurse-patient
nursing concepts, psychodynamic theory, and relationship is often one-sided. Knowing this, the
methods, have become integral to the nursing nurse and the client cannot work together to
profession’s culture. develop goals and become more knowledgeable.
ACCEPTANCE BY THE NURSING COMMUNITY For the nurse to function as an educative,
Research therapeutic and maturing force, understanding the
The Interpersonal Model transformed nursing meaning of the experience to the patient is very
research, shifting from a focus on individual important. This evaluative standard is not met.
problems to considering broader social systems’ ACCESSIBILITY
impact on individuals. Peplau’s influence Peplau provided a theory based on reality. Her
extended to emerging nursing leaders, theory could be tested and observed using pure
particularly in psychiatric nursing, reshaping observation. The relationship between the
perceptions of the nurse’s role and anxiety’s theoretical area and the empirical data could be
significance in learning. Her conceptual validated and verified. Peplau functionally
framework led to the development of behavior categorizes the four phases of the interpersonal
scales to reduce client anxiety and stress. process, with the nurse's role taken into
Peplau’s work resolved uncertainty surrounding consideration together with a client's level of
nurse-patient relationships and provided a independence. We may consider Peplau's theory
systematic, scientific foundation for nursing to be precise but with continued research and
practice development, the degree of precision could be
THEORY ANALYSIS more increased.
CLARITY IMPORTANCE
The concepts related to the phase in the nurse- Peplau's works, thoughts, and ideas have greatly
patient relationship are enough for understanding touch the lives of many clients and nurses, from
the theory. It is noteworthy that the concepts of the students to practitioners. Although her work
the nurse role in the interpersonal process are has been published five decades ago, it never
also important because they complement the ceases in providing the directions for nursing
concept of the various phase. The concepts of the practice, education, and research. Peplau's work
phases in the interpersonal relationship, the has provided a significant contribution to the
nurse’s roles and psychobiological experiments profession.
are well define, consistent and logically
presented.
SIMPLICITY
The major focus of Peplau's theory, Interpersonal
Relations, is easily understood. The theory's
basic assumptions and key concepts were clearly
given, explained, broken down, and outlined in