Peplau's Theory of Interpersonal Relations

REPLY TO THE BELOW DISCUSSON:
My specialty area of NP practice is psychiatric mental health. This specialty is different in the care provided to patients as compared to a more medically focused practice. One theory I found that relates to psychiatric mental health nurse practitioners is Peplau’s theory of interpersonal relations. Peplau’s theory of interpersonal relations was created by Hildegard Peplau in 1952. Peplau was a nursing theorist and practitioner that specialized in psychiatric nursing. Peplau proposed three phases in the interpersonal relationship process which include orientation, working, and resolution. The orientation phase includes the nurse introducing themselves, building a rapport, and the nurse investigating the issues of the patient. The working phase includes the nurse serving as an advocate, addressing specific problems, and the patient actively working for change with the nurse. The resolution phase is when the patient’s needs are met, and the nurse provides follow up teaching and health maintenance plans (Butts and Rich, 2018). This theory emphasizes the importance of nurse-patient relationships to the patient’s health outcomes with psychiatric disorders. The meaning of this theory is that the nurses primary focus should be to build a therapeutic relationship with the patient based on trust. This theory has a broad scope that offers a range of concepts that contribute to the nurse patient relationship based on active listening, therapeutic communication, and empathy.
Peplau’s theory of interpersonal relationship demonstrates logical adequacy by providing a comprehensive framework for the interaction between nurse and patient in the context of mental health and draws concepts from psychology and nursing. It is very useful in nursing, specifically psychiatric nursing, as it enhances therapeutic communication between nurses and patients through a patient centered holistic approach. In mental health, trust between the nurse and patient is very important to build a 2-way relationship to encourage the patient to participate in their treatment. With a healthy relationship, the nurse can have greater impact the behavior of the patient. This theory provides a simple framework since it uses basic concepts learned in nursing to improve communication and trust between the patient and nurse.
Although Peplau’s theory of interpersonal relations was developed for psychiatry, I believe it has a wide range of variability. A fundamental aspect of all nursing is interpersonal relationships between patient and nurse. This can be applied to a variety of different nursing settings to promote better nursing practice. However, I think there are limitations to this theory which include OR nursing or palliative care where conscious interaction between nurses and patients are limited.
Peplau’s theory of interpersonal relations can be testable but will have more subjective results. Once way to conduct research is to have a patient satisfaction survey from nurses who apply Peplau’s theory vs nurses who do not. This can give us a general result of patient perception of nurses who apply this theory. However, it would be more difficult to test patient outcomes in mental health with nurses who practice this theory vs not because mental health is a very gray area. According to Butts and Rich (2018), there is critique that Peplau’s theory has not been supported by efficient empirical research and has not been tested for its relevance for multidisciplinary or interprofessional practice.
I believe this theory can be used to improve the quality of practice in my care because it sets a framework for how to improve the interpersonal relationship between nurse and patient. In mental health nursing, patients often have gone through trauma or are dealing with personal psychological distress. This theory’s three phases can be applied in practice as a guideline of how to build a interpersonal relationship with the patient. A study by Hagerty et al. (2017), found that Peplau’s theory contributed an improvement to the experience of hospitalized patients as measured by surveys. A trustful relationship with the nurse can have the patient open up and share more feelings which can give the NP more information to help treat the patient and improve health outcomes.
References:
Butts, B. J. & Rich, L. K. (2018). Philosophies and theories for advanced nursing practice (3rd ed.). Jones & Bartlett Learning
Hagerty, T., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s theory of interpersonal relations. Nursing Science Quarterly, 30(2), 160–167. https://doi(dot)org/10.1177/0894318417693286