L/O/G/O

Peplau’s Interpersonal
Relations Theory
Hildegard E. Peplau’s
Interpersonal Relations in Nursing

Born in Reading, Pennsylvania

[1909]
Graduated from a diploma program
in Pottstown, Pennsylvania in 1931.
Done BA in interpersonal
psychology from Bennington College
in 1943.
MA in psychiatric nursing from
Colombia University New York in
1947.
EdD in curriculum development in
1953.
Professor emeritus from Rutgers
university
• Psychodynamic nursing
• Understanding of one’s own behavior
• To help others identify felt difficulties
• To apply principles of human relations to the
problems that arise at all levels of experience
• In her book she discussed the phases of
interpersonal process, roles in nursing
situations and methods for studying nursing as
an interpersonal process.
• According to Peplau, 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.
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
• Six primary roles of the nurse
• Six secondary roles of the nurse
4 Phases of nurse-
patient relationship
❖ Orientation-client seeking
assistance, meeting of
nurse-patient, identifying
the problem and services
needed ( interview
process), and guidance.
❖ 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.
Phases cont.
❖Exploitation- patient attempts to explore,
understand and deal with the problem, and
gains independence on achieving the goal
❖ Resolution- termination of the
therapeutic relationship to encourage
emotional balance for nurse and patient (
difficult for both patient and nurse as
psychological dependence persists)
• Person :A developing organism that tries to reduce anxiety
caused by needs
• Environment : Existing forces outside the organism and in the
context of culture
• Health : 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.
• Nursing: A significant therapeutic interpersonal process. It
functions cooperatively with other human process that make
health possible for individuals in communities
Roles of Nurses
Primary Secondary
❖Stranger ❖Technical expert
❖Teacher ❖Mediator
❖Resource person ❖Safety agent
❖Counselor ❖Researcher
❖Surrogate ❖Tutor
❖Leader ❖Manager of
environment
Roles of Nurses
Primary Secondary
❖Stranger ❖Technical expert
❖Teacher ❖Mediator
❖Resource person ❖Safety agent
❖Counselor ❖Researcher
❖Surrogate ❖Tutor
❖Leader ❖Manager of
environment
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)
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.
 IDA JEAN ORLANDO
“NURSING PROCESS THEORY”
Theory of Deliberative Nursing Process
“NURSING PROCESS
THEORY”
• Ida Jean Orlando, a first-generation American of
Italian descent was born in 1926.
• She received her nursing diploma from New York
Medical College, her BS in public health nursing from
St. John's University, NY, and her MA in mental health
nursing from Columbia University, New York.
• Orlando was an Associate Professor at Yale School of
Nursing where she was Director of the Graduate
Program in Mental Health Psychiatric Nursing.
• The role of the nurse is to find out and meet
the patient's immediate need for help.
• The patient's presenting behavior may be a
plea for help; however, the help needed may
not be what it appears to be.
• Therefore, nurses need to use their
perception, thoughts about the perception, or
the feeling engendered from their thoughts to
explore with patients the meaning of their
behavior.
• MAJOR DIMENSIONS OF THE THEORY
• Function of professional nursing -
organizing principle
• Presenting behavior - problematic situation
• Immediate reaction - internal response
• Nursing process discipline – investigation
• Improvement - resolution
 DOMAIN CONCEPTS
1. Nursing
2. Process of care in an immediate experience.
3. Goal of nursing
4. Health
5. Environment
6. Human being
7. Nursing client
8. Nursing problem
9. Nursing process
10. Nurse – patient relations
11. Nursing therapeutics .
12. Indirect function
13. Nursing therapeutics
14. Automatic activities
JOYCE TRAVELBEE
“HUMAN TO HUMAN RELATIONSHIP
MODEL”

“A nurse does not only seek to alleviate

physical pain or render physical care – she
ministers to the whole person. The
existence of the suffering whether
physical, mental or spiritual is the proper
concern of the nurse.”
Person
• Person is defined as a human being.
• Both the nurse and the patient are human
beings.
• A human being is a unique, irreplaceable
individual who is in continuous process of
becoming, evolving and changing.
Health

• Health is subjective and objective.

• Subjective health—is an individually defined
state of well being in accord with self-appraisal
of physical-emotional-spiritual status.
• Objective health—is an absence of discernible
disease, disability of defect as measured by
physical examination, laboratory tests and
assessment by spiritual director or
psychological counselor.
Environment
• Environment is not clearly defined.
• She defined human conditions and life
experiences encountered by all men as
sufferings, hope, pain and illness.

• Illness – being unhealthy, but rather explored

the human experience of illness
• Suffering – is a feeling of displeasure which ranges from
simple transitory mental, physical or spiritual discomfort to
extreme anguish and to those phases beyond anguish—the
malignant phase of dispairful “not caring” and apathetic
indifference
Pain – is not observable. A unique experience. Pain is a lonely
experience that is difficult to communicate fully to another
individual.
Hope – the desire to gain an end or accomplish a goal
combined with some degree of expectation that what is desired
or sought is attainable

Hopelessness – being devoid of hope

 Nursing

• Nursing is an interpersonal process whereby

the professional nurse practitioner assists an
individual, family or community to prevent or
cope with experience or illness and suffering,
and if necessary to find meaning in these
experiences.”
MADELEINE LEININGER
Transcultural Theory
DEFINITIONS

• Transcultural Nursing Theory

• Transcultural nursing is a comparative study of

cultures to understand similarities (culture universal)
and difference (culture-specific) across human
groups
CULTURE
• Set of values, beliefs and traditions, that are held by
a specific group of people and handed down from
generation to generation.

• Culture is also beliefs, habits, likes, dislikes, customs

and rituals learn from one’s family.
• Culture is the learned, shared and transmitted values,
beliefs, norms and life way practices of a particular group
that guide thinking, decisions, and actions in patterned
ways.
• Culture is learned by each generation through both formal
and informal life experiences.
• Language is primary through means of transmitting
culture.
• The practices of particular culture often arise because of
the group's social and physical environment.
• Culture practice and beliefs are adapted over time but
they mainly remain constant as long as they satisfy
needs.
• Religion
Is a set of belief in a divine or super human power (or powers) to be
obeyed and worshipped as the creator and ruler of the universe.
• Ethnic
refers to a group of people who share a common and distinctive culture
and who are members of a specific group.
• Ethnicity
a consciousness of belonging to a group.
• Cultural Identify
the sense of being part of an ethnic group or culture
• Culture-universals
commonalities of values, norms of behavior, and life patterns that are
similar among different cultures.
• Culture-specifies
values, beliefs, and patterns of behavior that tend to be unique to a
designate culture.
Non-material culture
• refers to beliefs customs, languages, social
institutions.
• Subculture
• composed of people who have a distinct identity
but are related to a larger cultural group.
• Bicultural
• a person who crosses two cultures, lifestyles, and
sets of values.
• Diversity
• refers to the fact or state of being different.
Diversity can occur between cultures and within a
cultural group.
• Acculturation
People of a minority group tend to assume the attitudes,
values, beliefs, find practices of the dominant society
resulting in a blended cultural pattern.

• Cultural shock
the state of being disoriented or unable to respond to a
different cultural environment because of its sudden
strangeness, unfamiliarity, and incompatibility to the
stranger's perceptions and expectations at is differentiated
from others by symbolic markers (cultures, biology,
territory, religion).
• Ethnic groups
• share a common social and cultural heritage that
is passed on to successive generations.,
• Ethnic identity
• refers to a subjective perspective of the person's
heritage and to a sense of belonging to a group
that is distinguishable from other groups.
• Race
• the classification of people according to shared
biologic characteristics, genetic markers, or
features. Not all people of the same race have the
same culture.
• Cultural awareness
It is an in-depth self-examination of one's own
background, recognizing biases and prejudices
and assumptions about other people.
• Culturally congruent care
Care that fits the people's valued life patterns and
set of meanings -which is generated from the
people themselves, rather than based on
predetermined criteria.
 MAJOR CONCEPTS
• Illness and wellness are shaped by a various factors
including perception and coping skills, as well as the social
level of the patient.
• Cultural competence is an important component of nursing.
• Culture influences all spheres of human life. It defines health,
illness, and the search for relief from disease or distress.
• Religious and Cultural knowledge is an important ingredient
in health care.
• The health concepts held by many cultural groups may
result in people choosing not to seek modern medical
treatment procedures.
• Health care provider need to be flexible in the design of
programs, policies, and services to meet the needs and
concerns of the culturally diverse population, groups that are
likely to be encountered.
• Most cases of lay illness have multiple causalities and may
require several different approaches to diagnosis, treatment,
and cure including folk and Western medical interventions..
• The use of traditional or alternate models of health care
delivery is widely varied and may come into conflict with
Western models of health care practice.
• Culture guides behavior into acceptable ways for the people
in a specific group as such culture originates and develops
within the social structure through inter personal interactions.
• For a nurse to successfully provide care for a client of a
different cultural or ethnic to background, effective
intercultural communication must take place.
APPLICATION TO
NURSING
• To develop understanding, respect and
appreciation for the individuality and
diversity of patients beliefs, values,
spirituality and culture regarding illness, its
meaning, cause, treatment, and outcome.
• To encourage in developing and
maintaining a program of physical,
emotional and spiritual self-care introduce
therapies.
HEALTH PRACTICES IN
DIFFERENT CULTURES
• Use of Protective Objects
Protective objects can be worn or carried or hung in the home-
charms worn on a string or chain around the neck, wrist, or waist to
protect the wearer from the evil eye or evil spirits.

• Use of Substances .
It is believed that certian food substances can be ingested to
prevent illness.
• E.g. eating raw garlic or onion to prevent illness or wear them on the
body or hang them in the home.
• Religious Practices
Burning of candles, rituals of redemption etc..

• Traditional Remedies
The use of folk or traditional medicine is seen among people
from all walks of life and cultural ethnic back ground.
• Gender Roles
In many cultures, the male is dominant figure and often they take
decisions related to health practices and treatment. In some other
cultures females are dominant.
In some cultures, women are discriminated in providing proper
treatment for illness.
• Beliefs about mental health
Mental illnesses are caused by a lack of harmony of emotions or
by evil spirits.
Problems in this life are most likely related to transgressions
committed in a past life.
• Economic Factors
Factors such as unemployment, underemployment,
homelessness, lack of health insurance poverty prevent people from
entering the health care system.
• Time orientation
It is varies for different cultures groups
GOD Bless!
Concept Mapping

• Hidegard Peplau
• Ida Jean Orlando
• Joyce Travelbee
• Madeleine Leineinger