Hildegard Peplau, Nursing Theorist

Dozens of nursing theories have been created to guide nurses through rigorous and creative structuring of ideas to improve their understanding of different phenomena in a nursing care setting. One of the most influential nursing theorists is Dr. Hildegard Peplau. Dr. Peplau (1909-1999) was an American nurse and one of the first publishing nursing theorists (Deane & Faine, 2016). She created the interpersonal relations theory that emphasizes the importance of the nurse-patient relationship. The concepts of Peplau’s theory have been applied to enhance the quality of nurses’ interpersonal relationships in the workplace.

Overview of the Interpersonal Relations Model

The interpersonal relations theory is an interactionist model that focuses on fostering relations between the nurse and the patient. Peplau defined interpersonal relations as “the study of what goes on between two or more people, all but one of whom may be completely illusory” (Deane & Faine, 2016, p. 38). Nurses facilitate this relationship by interacting with the patient through listening, observation, validation, and intervention. The theory defines four phases of the nurse-client relationship; the orientation phase, the identification phase, the working phase, and the termination phase (Adams, 2017). The orientation phase is where the nurse and the patient get acquainted. In the identification phase, the client starts to identify issues that need to be managed in the relationship. During the working phase, the nurse and patient collaborate to achieve the patient’s full potential. Lastly, the nurse and patient end their relationship in the termination stage. Peplau identified different factors that might improve the quality of the nurse-client relationship in each phase.

Application of the Theory in Nursing Practice

Peplau’s theory has been applied in different nursing environments to improve the quality of nursing practice. For instance, this theory has been applied to improve holistic communication between nurses and patients. Deane and Fain (2016) examined how the phases of the nurse-client relationship can improve how nursing students communicate with older adults. As explained in Peplau’s theory, the phases of the nurse-patient relationship were an effective way of helping nurses improve holistic communication with their patients. For example, during the orientation phase, the nurses can create a loving environment for the patients that encourages them to be free to communicate issues affecting their health and wellness.

The interpersonal relations theory can also be used to improve patient participation in the care process. The patient’s participation is critical to the achievement of desired care outcomes. Fernandes and Naidu (2017) found that this model was effective in improving patient knowledge and self-care actions for patients with Diabetes Mellitus. The nurses used this interpersonal relations model to enhance their communication with patients and help them improve their self-care actions.

Peplau’s interpersonal relations model is also applied in the nursing process to make patients comfortable. The interaction between the patient and the nurse can be very awkward for some patients. During the process, they are expected to share much personal information; hence, some patients struggle to get comfortable. Peplau’s demystification of the nurse-patient relationship helps nurses figure out how to make their clients more comfortable. This theory helps nurses to understand how to make the patient feel comfortable enough to interact freely with the nurse. For example, Ikafa and Holmes (2020) reported that the Interpersonal Relations theory is important in the process of delivering care to immigrants. Healthcare professionals applied the details of the orientation phase of the relationship to help migrants get more comfortable in their care and resettlement process. The ability of the nurse to easily get acquainted with the patient helps the patient to get comfortable faster.

Peplau’s theory is also applied to enhance patient education. The interactions model helps nurses create an environment good enough for patients to learn the details of health promotion. In an effective nurse-client relationship, the patients listen and comprehend the details of education. For instance, Allam, Al Orapy, & Megrin (2017) found that using the interpersonal relations model helped improve schoolchildren’s understanding of hygiene management, reducing the incidence of intestinal parasites and anemia.

Conclusion

In conclusion, Peplau created one of the most influential theories in nursing practice. The theory creates a model for understanding the nurse-patient relationship and the characteristics of each phase of the relationship. Understanding the nurse-client relationship has helped to enhance how nurses communicate and interact with their patients to improve the quality of care that they provide.

References

Adams, L. Y. (2017). Peplau’s contributions to psychiatric and nursing knowledge. Journal of Mental Health and Addiction Nursing, 1(1), e10-e18.

Allam, N., Al Orapy, Z., & Megrin, W. A. A. (2017). Application of Peplau’s Theory Model to Overcome Intestinal Parasites and Anemia among Schoolchildren. American Journal of Nursing, 5(6), 209-218.

Deane, W. H., & Fain, J. A. (2016). Incorporating Peplau’s theory of interpersonal relations to promote holistic communication between older adults and nursing students. Journal of Holistic Nursing, 34(1), 35-41.

Fernandes, S., & Naidu, S. (2017). Promoting participation in self-care management among patients with diabetes mellitus: An application of Peplau’s Theory of Interpersonal Relationships. International Journal of Nursing Education, 9(4), 129-134.

Ikafa, I. N., & Holmes, C. A. (2020). Empowering migrants during the resettlement process: applying Peplau’s theory of interpersonal relations. Mental Health Practice, 23(5).

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