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Published  October  01, 2021

Article Information

Volume: 34 issue: 4, page(s): 368-371

Issue published:  October 01  2021

DOI：10.1177/08943184211031573

Farah Wasaya , Qamraiz Shah , Aziza Shaheen , Karen Carroll , School of Nursing and Midwifery, The Aga Khan University, Karachi, SD, Pakistan , Ann , & , Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

Karen Carroll, RN; PhD, Director of Nursing Informatics & Innovation, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 East Chicago, Box #47, Chicago, IL 60611-2991, USA. Email: [email protected]

Vol 34, Issue 4, 2021

• Nonrelational Propositions
• Relational Propositions
• Hildegard Peplau: Interpersonal Relations in Nursing
• Figures & Tables
• Related Articles

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Farah Wasaya, Qamraiz Shah, Aziza Shaheen, Karen Carroll

Vol 34, Issue 4, pp. 368 - 371

Issue published date: October-01-2021

10.1177/08943184211031573

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• Open access
• Published: 27 January 2024

The effect of multimodal care based on Peplau’s interpersonal relationship theory on postoperative recovery in lung cancer surgery: a retrospective analysis

• Xue-e Su 1 , 3 ,
• Shan-hu Wu 3 ,
• He-fan He 3 ,
• Cui-liu Lin 1 ,
• Shu Lin 1 , 2 &
• Pei-qing Weng 3  

BMC Pulmonary Medicine volume  24 , Article number:  59 ( 2024 ) Cite this article

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Lung cancer remains a major global health concern due to its high incidence and mortality rates. With advancements in medical treatments, an increasing number of early-stage lung cancer cases are being detected, making surgical treatment the primary option for such cases. However, this presents challenges to the physical and mental recovery of patients. Peplau known as the “mother of psychiatric associations” has formulated a theory of interpersonal relationships in nursing. Through effective communication between nurses and patients over four periods, she has established a good therapeutic nurse-patient relationship. Therefore, this study aimed to explore the effect of perioperative multimodal nursing based on Peplau’s interpersonal relationship theory on the rehabilitation of patients with surgical lung cancer.

We retrospectively analyzed 106 patients with non-small cell lung cancer who underwent thoracoscopic lobectomy at our department between June 2021 and April 2022. Patients were categorized into two groups according to the different nursing intervention techniques. The Peplau’s group comprised 53 patients who received targeted nursing interventions, and the control group comprised 53 patients who received conventional nursing care. We observed the patients’ illness uncertainty, quality of life, and clinical symptoms in both groups.

Patients in the Peplau’s group had significantly lower illness uncertainty scores and a significantly higher quality of recovery than those in the control group. However, there were no significant differences in length of post-anesthesia care unit stay, complication rates, and visual analog scores between both groups.

The multimodal perioperative nursing based on Peplau’s interpersonal relationship theory not only reduces the illness uncertainty of patients with lung cancer surgery and improves their QoR but also expands the application of this theory in clinical practice, guiding perioperative nursing of patients with lung cancer.

Implications

These findings provide practical information for standardized care in a hectic anesthetic care setting.

The assessed anesthesia nursing model helps reduce uncertainty and promote early recovery in patients with cancer at various stages of their disease, which expands the scope of therapeutic practice and existing theories. It also serves as a guide for care in the anesthesia recovery room.

Reporting method

We adhered to the relevant Equator guidelines and the checklist of items in the case–control study report.

Patient or public contribution

Patients cooperated with medical staff to complete relevant scales.

Global contribution

•Demand for nursing care from patients with NSCLC at various stages of the disease varies and changes over time.

•The anesthesia nursing model based on Peplau’s interpersonal relationship theory helps to reduce uncertainty and promote early recovery in patients with cancer.

•This model has some viability and efficacy, which expands the scope of therapeutic practice and existing theories. It also serves as a guide for care in the anesthesia recovery room.

Peer Review reports

According to the latest medical information, lung cancer continues to exhibit high incidence and mortality rates worldwide, posing a serious threat to human health [ 1 ]. However, with the rapid advancements in modern medical treatments, an increasing number of lung cancers are being detected at an early stage. Surgical treatment is considered the primary treatment option for early-stage non-small cell lung cancer (NSCLC) [ 2 ]. Although surgical intervention can be lifesaving, patients also face enormous physiological and psychological pressure during the perioperative period, necessitating optimal nursing care throughout the treatment process to improve patient outcomes.

While pertinent literature has contributed to the advancement of anesthesia care during the rapid development of modern anesthesia medicine in China, several anesthesia nursing procedures remained in the exploratory stage when rules and regulations were being established. Therefore, medical professionals should provide appropriate nursing care to assist patients throughout the treatment process and improve their prognosis.

Numerous studies have demonstrated that effective health intervention can lead to positive mood enhancement, reduced complication, and improved quality of life in patients with NSCLC [ 3 , 4 , 5 , 6 ]. However, compared to developed countries, anesthesia nursing started relatively late in China, and related anesthesia nursing service models were immature. Currently, the implementation of health nursing intervention measures still lacks anesthesia nurse-led care, particularly for patients undergoing surgical treatment. Thus, exploring related nursing models is essential for the development of continuous nursing. Additionally, traditional health education in China is disease-focused and frequently disregards the unique requirements of patients with varying stages of disease. This frequently results in prejudice while giving and receiving medical information, which partially lessens the efficiency of health education. The timing and content of pertinent health education materials are inconsistent with the current nursing needs of patients. Furthermore, health interventions for perioperative patients in China are relatively limited in scope, overly simplistic in form, and lack dynamic psychological assessment and intervention.

Hildegard E. Peplau, a renowned nursing theorist, proposed Peplau’s theory of interpersonal relationships [ 7 ]. It emphasizes the establishment of a harmonious, mutually understanding, and respectful nurse-patient relationship to gain a broader understanding of patient problems and proposes practical approaches, through the following four dynamic stages of nurse-patient communication: recognition, determination, progress, and resolution [ 8 ]. Although this theory has been widely applied to patients with chronic diseases and nursing education, its application in perioperative patients, particularly in anesthesia nurse-led care for lung surgery patients, remains scarce.

Therefore, based on the role of Peplau’s interpersonal relationship theory, the physiological and psychological rehabilitation needs of patients with surgical lung cancer during the perioperative period, and the background of anesthesia nursing work, we proposed the following scientific hypothesis: multimodal perioperative anesthesia nursing based on Peplau’s interpersonal relationship theory can promote the physiological and psychological rehabilitation of patients with lung cancer. To verify the above hypothesis, we conducted a retrospective study to observe the impact of multi-modal anesthesia nursing under the guidance of this theory on illness uncertainty, quality of recovery (QoR), and clinical symptoms in patients with lung cancer. This study holds great significance for the application of this theory in the field of anesthesia nursing and the rehabilitation of patients with lung cancer.

In this study, we adopted Peplau’s interpersonal theory as a framework to focus on the care needs of perioperative patients. We intended to understand the effectiveness of this care model on the health outcomes of these patients. Additionally, we aimed to improve the clinical outcomes of patients by reducing their illness uncertainty and enhancing early recovery while providing a theoretical and practical basis for the application of Peplau’s interpersonal theory in perioperative anesthesia care.

This study used a retrospective observational design involving a retrospective analysis of patients who underwent radical lung cancer resection.

Study setting and sampling

One hundred and six patients who underwent radical lung cancer resection at the Second Hospital of Fujian Medical University between June 1, 2021, and April 30, 2022, were retrospectively selected (Fig.  1 ). These patients were categorized into two groups due to the implementation nodes of multimodal perioperative nursing based on Peplau’s interpersonal relationship theory. The Peplau’s group (PG) comprised 53 patients who received multimodal care based on Peplau’s interpersonal relationship theory, while the control group (CG) comprised 53 individuals who received conventional nursing interventions. Specific intervention measures are detailed in Table  1 .

Flow chart of the included patients

Inclusion criteria

To be included in this study, patients had to meet the following criteria: confirmed diagnosis of NSCLC through pathological analysis, stages I–II (T 1 − 3 N 0 M 0 and T 1 − 2 N 1 M 0 ); age between 18 and 80 years; stable vital signs and complete baseline data; thoracoscopic lobectomy without prior treatment, chemotherapy, or other adjuvant medication; and normal cognitive function and verbal communication to understand and complete the assessment scale.

Exclusion criteria

The following patients were excluded from the study: those merged with other cancers; major systemic diseases affecting the heart, brain, kidney, or other organs; psychiatric and cognitive disorders; concurrent serious infectious diseases; and those who withdrew from the study for various reasons or were unable to cooperate.

Nursing care methods

In the CG, patients received the following routine nursing care: (1) active pre-operative conversation with the patient, explaining anesthetic instructions, and encouraging active participation in the procedure; (2) good preparation for anesthesia and regular intraoperative observation of changes in the patient’s vital signs; (3) administration of multimodal complex analgesia and continuous monitoring of the patient’s vital signs in the recovery area after anesthesia; and (4) follow-up visits to the ward to address the patient’s pain.

In the PG, patients received specialized care in four phases as follows:

Recognition: preoperative ward assessment

A day prior to the surgery, a nurse anesthetist visited the ward to conduct a pre-anesthetic examination. This bedside communication included a comprehensive assessment of the patient’s respiratory and cardiovascular system, enabling both nurses and patients to fully understand the risks associated with anesthesia [ 9 ]. Psychological care was provided to the patients and their families to further explain the general process of anesthesia and address matters related to cooperation. Successful cases were shared to alleviate psychological burdens, minimize uncertainty about the disease, build trust between patients and nurses, increase patient confidence, and promote positive cooperation. Additionally, clear instructions on coughing and deep breathing were provided to help patients recover quickly, which benefits both recovery from anesthesia and the disease. This period is the beginning stage of therapeutic nurse-patient relationships based on the Peplau theory, and nurses should focus on building trust relationships with patients.

Determination: evaluation of the anesthesia preparation room

The anesthetic preparation room serves as the setting where the anesthetist and the nurse prepare for anesthesia. Under the guidance of the anesthetist and considering the patient’s risk factors, the anesthetic nurses prepared drugs, performed venous and arterial punctures, and monitored vital signs. Nurses ensured that patients received reassurance and addressed their main concerns to alleviate any anxiety that may arise in an unfamiliar environment, which particularly emphasized that the nurse who conducted preoperative visits to the patient the day before reappeared to answer patient’s questions and alleviate their anxiety in unfamiliar environments.

Progression: nursing care in the postoperative anesthesia monitoring room

The recovery room, functioning as a central monitoring unit, plays a crucial role in perioperative patients care [ 10 ]. Despite continuous monitoring, there is a high potential for issues in patients during their stay in this area, mainly due to prior anesthesia and surgery. Therefore, nurses in the recovery room adjust the room temperature and provide thermal blankets and heaters to avoid complications, shivering, and awakening based on each patient’s preoperative vital signs, including temperature, pulse, respiration, blood pressure, and other factors such as the preoperative situation, particular anesthetic situation, and the current status of the operation. Additionally, as the primary caregivers during the immediate postoperative period, nurses pay close attention to the patient’s pain management and care of drainage tubes. Once the patient awakens and meets the discharge criteria based on modified Aldrete or Steward scoring(the scoring criteria used to evaluate the recovery status of patients undergoing general anesthesia surgery, including indicators such as consciousness, breathing, and circulation), the nurse accompanies the patient back to the ward and provides detailed explanations to both the patient and their family members, ensuring the continuity of nursing care. During this period, it is particularly emphasized that nurses carry out nursing based on the trust established during preoperative visits and preparation with patients, meet the needs of patients during anesthesia recovery, and further establish a sense of trust.

Resolution: postoperative ward visit

Postoperative visits are essential for implementing a multidisciplinary approach to comprehensive care. Although the reduction in the incidence of postoperative pain is significantly lower using multimodal analgesia, it remains a major concern for patients. Therefore, anesthetic nurses prioritize pain management during follow-up [ 11 ], including the interpretation and management of common complications, such as nausea and vomiting. Patients gradually recovered from surgery starting from the first day until their discharge from the hospital, allowing them to interact regularly with nurses. In the late 1990s the American Baptist Memorial Hospital pioneered the use of AIDET (A: acknowledge; I: introduce; D: duration; E: explicit; T: thank you) as a form of communication, which was later adopted in China for anesthetic pain management. This approach not only effectively controls pain but also enhances mutual trust between nurses and patients while increasing patients’ and doctors’ engagement in pain management [ 12 ]. Our anesthetic nurses used the AIDET standardized communication model for postoperative follow-up. They addressed individual patients’ concerns and focused on preventing complications and facilitating rehabilitation after discharge. During this period, the therapeutic nurse-patient relationship between nurses and patients tends to come to an end, and special emphasis should be placed on gratitude for patient cooperation, encouraging patients to actively recover and gradually return to normal life.

Outcome measures

Illness uncertainty scores.

Illness uncertainty refers to a person’s inability to comprehend events related to their illness and has been identified as a prevalent source of psychological stress in chronic diseases. According to illness uncertainty theory, patients may experience uncertainty when they are unable to categorize the significance of events linked to their condition, such as symptoms and treatment outcomes [ 13 ]. This outcome was measured using the Mishel Uncertainty in Illness Scale (MUIS) [ 14 ]. The MUIS comprises of 33 items categorized into four dimensions as follows: uncertainty regarding sickness status (13 items), complexity (7 items), lack of information (7 items), and unpredictable course and outcome of illness (5 items). Each item was scored on a 5-point Likert scale, with 1 indicating strong disagreement and 5 representing strong agreement. Higher scores reflected a higher level of disease uncertainty. The overall scores range from 32 to 160, categorized into low (32–74.7), moderate (74.8–117.4), and high (117.5–160) [ 15 ]. The scores were collected indicators from patients after surgery and the day before discharge.

Quality of recovery

Quality of recovery (QoR) is a fundamental concept in perioperative patient care. The QoR-15 is a questionnaire that evaluates QoR in five areas: pain, physical independence and comfort, psychological support, and emotional state. It has been validated for assessing inpatient and ambulatory anesthesia during the intermediate recovery period [ 16 , 17 ]. The QoR-15 score ranges from 0 to 150 representing poor to excellent recovery. The scores are categorized as excellent, medium, moderate, and poor recovery [ 18 ]. According to patients, clear communication, active participation in healthcare decisions, and compassion from healthcare professionals are considered important elements of the quality of their recovery. The scores were collected indicators from patients after surgery and the day before discharge.

Clinical outcomes

We recorded the length of post-anesthesia care unit (PACU) stay, length of hospital stay, visual analog scale (VAS) scores, and occurrence of PACU and postoperative complications. Early hypoxemia is the most frequent complication in the radical resection of lung cancer. Previous studies have shown that hypoxemia is more severe on post-operative days 1 and 3 [ 19 , 20 ]. Emergence agitation, characterized by inappropriate behavior during the awakening period from general anesthesia, is another common complication of anesthesia, reported in 11–51% of cases [ 21 , 22 ]. The VAS scores were collected from patients at 24, 48 and 72 h postoperatively.

Data collection and analysis

The data were analyzed using IBM SPSS Statistics for Windows, version 20.0 (IBM Corp., Armonk, N.Y., USA) to ensure accuracy. The Shapiro–Wilk test was applied to establish normal distribution. Descriptive statistics were presented using the median for non-normally distributed data, while the mean (X̄) ± standard deviation (SD) was used for variables with a normal distribution. Categorical variables were presented as numbers and percentages. The significance of the difference between the two means for the continuous variables was assessed in the PG and CG using the Student’s t -test, a parametric test for normally distributed values, and the Mann–Whitney U test for non-normally distributed data. The analysis of categorical variables employed Pearson’s chi-square test. Statistical significance was set at P  < 0.05.

Ethical considerations

This study was conducted in compliance with the principles of the Declaration of Helsinki. Owing to the retrospective nature of this study, the need for informed consent was waived by the Medical Ethics Committee of the Second Affiliated Hospital of Fujian Medical University, and the study design was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Fujian Medical University on January 7,2023 (No. 2,023,125).

Patients characteristics

The PG comprised patients aged 27–75 years, with an average of (53.62 ± 11.43) years, whereas the CG included those aged 28–80 years, with a mean age of (56.24 ± 12.28) years. The differences in mean age, body mass index, sex, Tumor Node Metastasis (TNM) stage, education, smoking history, family history, and alcohol consumption between the PG and CG were not significant (all P  > 0.05; Table  2 ).

Comparison of illness uncertainty scores after intervention in both the groups

Illness uncertainty was observed in both the groups. The results indicated that the post-operative scores were significantly lower in both groups, and disease uncertainty, complexity, lack of information, and unpredictability scores were significantly lower in the PG than those in the CG ( P  < 0.05; Table  3 ).

Comparison of the quality-of-life levels between both groups after the intervention

The rehabilitation levels of both groups were evaluated after the intervention. The results indicated that the QoR score was 97 (94–100) and 93 (92–97) in the PG and CG, respectively. The comparison showed that the QoR in the PG was significantly higher than that in the CG ( P  < 0.05; Table  4 ).

Clinical symptoms of patients in both groups after the intervention

Clinical symptoms were observed in both the groups. No significant differences were observed between the two groups in terms of the length of PACU stay, hospital stay, complication rate, and VAS scores (Table  5 ; Fig.  2 ).

Patient’s postoperative pain score

This retrospective study revealed that compared to patiens receiving routine care, those who received multimodal perioperative care based on Peplau’s interpersonal relationship theory exhibited significantly improved illness uncertainty and QoR in the subjects. However, the multimodal perioperative care based on Peplau’s interpersonal relationship theory was not statistically significance for the patient’s length of PACU stay, length of hospitalization, postoperative VAS score, PACU complications, and incidence of postoperative complications.

During the second half of the 19th century, anesthesia care flourished in the United States owing to a lack of qualified anesthesiologists [ 23 ]. China started anesthesia nursing relatively late and has recently released a detailed strategy to improve the standards of anesthetic care and ensure patient safety and comfort. Consequently, nursing anesthetists are receiving increasing attention, emphasizing the importance of creating and implementing targeted training and clinical practice [ 24 ]. Therefore, it is crucial to establish a standardized approach to anesthesia care to inform the anesthesia care profession and improve the consistency, quality, and efficiency of care.

An individual’s inability to explain disease-related events, known as illness uncertainty, has been identified as a common source of psychological stress in chronic diseases. Patients with lung cancer often face challenges related to higher levels of physical symptom distress, mental health and daily living challenges, and burdensome symptoms compared to patients with other types of cancer. This is due to the high morbidity and mortality associated with lung cancer during and after treatment [ 25 , 26 ]. All the respondents experienced frustration upon learning about their cancer diagnoses. It heralds the transition from a healthy person to a patient and to a time of perpetual change and difficulty. In addition, the extensive pre-operative testing that patients undergo upon hospital admission leads to increased levels of anxiety and stress. Most studies (65%) found that interventions targeting disease uncertainty management had favorable effects on uncertainty outcomes. Multicomponent therapies, which integrate informational and emotional support, appear to be the most successful approach to managing illness uncertainty in patients with cancer and their family caregivers [ 27 , 28 ]. Therefore, a new and effective intervention model for peripheral surgical anesthesia is urgently needed.

Peplau’s theory of interpersonal relationships is partly based on the relationships between interpersonal theories. It aims to help patients and caregivers build positive interpersonal relationships based on mutual respect and trust, assist patients in overcoming negative emotions, and break bonds of low self-esteem. By utilizing observational, empirical, and reflective approaches to structured and unstructured interactions, Peplau’s theory provides nurses with guidance in constructing strategic communication with patients. Anxiety plays a significant role in the interpersonal interaction process created by Peplau, and, if carefully addressed, can be the key to addressing a patient’s health issues [ 29 ]. Through the four stages of “recognition,” “determination,” “progression,” and “resolution,” dynamic communication can fill in the gaps in the patients’ knowledge about the disease, alleviate their concerns about upcoming anesthesia and surgery, and restore their confidence in their ability to overcome the illness. Nurses, especially nursing anesthetists assisting patients undergoing lung cancer surgery, play a critical role in the care of patients with lung cancer. They play a role in early task disclosure, patient care during surgery, escorting during wakefulness, post ward follow-up, and dynamic care that can readily address the patients’ first questions.

In summary, multimodal perioperative nursing based on Peplau’s interpersonal relationship theory may maintain a good nurse-patient relationship, dynamic communication, meet patient needs, reduce patient anxiety, and reduce disease uncertainty through comprehensive and personalized nursing between nurses and patients. A good psychological state of the patient will inevitably promote the physiological recovery of the body. Therefore, under this multimodal nursing plan, the postoperative rehabilitation quality indicators of patients in the PG patients also showed statistical significance. In addition to pain and physical comfort, physical comfort also demonstrated a good recovery trend. Previous studies have demonstrated that illness uncertainty is closely related to the patients’ quality of life [ 15 , 30 , 31 ]. These studies have found a negative correlation between illness uncertainty and quality of life, which can directly or indirectly affect the QoR of patients through perceived stress, depression, social support, and coping mechanisms. However, no significant difference was found in pain, length of PACU and hospital stay, and incidence of complications among patients. This could be attributed to the fact that the included patients were those with early-stage lung cancer, with relatively small surgical trauma and good rehabilitation effects. Additionally, the popularity of multimodal analgesia may be another reason, therefore, there was no statistically significant difference in pain scores between the two groups of patients.

This study had some limitations. Firstly, this is a retrospective study with a single center and small sample size. Due to non matching studies, there are many confounding factors, and the explanatory power of some observation indicators is insufficient. Secondly, a multimodal perioperative nursing observation based on Peplau’s interpersonal relationship theory was only carried out for a specific population of patients with surgical lung cancer. The population is limited, and the number of patients included in this study tends to be younger, which limits the generalizability and application of this nursing plan. Finally, implementing multimodal perioperative care based on Peplau’s interpersonal relationship theory may result in additional labor and time costs. Therefore, in the future, large sample, prospective, multicenter, randomized controlled studies are needed to confirm the effectiveness of this nursing model and evaluate its feasibility as a perioperative nursing plan.

Conclusions

The multimodal perioperative nursing based on Peplau’s interpersonal relationship theory not only reduces the illness uncertainty of patients with lung cancer surgery and improves their QoR but also expands the application of this theory in clinical practice, guiding perioperative nursing of patients with lung cancer. However, due to the limitations of single center, small sample, and retrospective studies, further research is needed to verify the widespread clinical application of a multimodal perioperative nursing plan based on this theory.

Data availability

The authors confirm that the data supporting the findings of this study are available within the article.

Abbreviations

Non-small cell lung cancer

Peplau’s group

Control group

Acknowledge; introduce; duration; explicit; thank you

Mishel uncertainty in illness scale

Visual analog scale

Emergence agitation

Standard deviation

Tumor Node Metastasis

Post-anesthesia care unit

Sung H, et al. Global Cancer statistics 2020: GLOBOCAN estimates of incidence and Mortality Worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.

Article   PubMed   Google Scholar  

Allehebi A, et al. Management of early-stage Resected Non-small Cell Lung Cancer: Consensus Statement of the lung cancer Consortium. Cancer Treat Res Commun. 2022;31:100538.

Yu J, et al. Effect of Nursing Method of Psychological Intervention Combined with Health Education on Lung Cancer patients undergoing chemotherapy. J Healthc Eng. 2022;2022:2438612.

Article   PubMed   PubMed Central   Google Scholar  

Sun Y, et al. Influence of psychological nursing and health education on depression, anxiety and life quality of elderly patients with lung cancer. Psychogeriatrics. 2021;21(4):521–7.

Tan X, et al. Effects of cognitive education on the perceived control and symptom distress of lung cancer patients receiving chemotherapy: a randomised controlled trial. Eur J Cancer Care (Engl). 2019;28(5):e13120.

Sui Y, Wang T, Wang X. The impact of WeChat app-based education and rehabilitation program on anxiety, depression, quality of life, loss of follow-up and survival in non-small cell lung cancer patients who underwent surgical resection. Eur J Oncol Nurs. 2020;45:101707.

Peplau HE. Peplau’s theory of interpersonal relations. Nurs Sci Q. 1997;10(4):162–7.

Article   PubMed   CAS   Google Scholar  

Barker P. The future of the theory of interpersonal relations? A personal reflection on Peplau’s legacy. J Psychiatr Ment Health Nurs. 1998;5(3):213–20.

Bagheri H, et al. Effectiveness of Preoperative Visitation on Postanesthesia complications. J Perianesth Nurs. 2018;33(5):651–7.

Ludbrook G, et al. The effect of advanced recovery room care on postoperative outcomes in moderate-risk surgical patients: a multicentre feasibility study. Anaesthesia. 2021;76(4):480–8.

Marshall K, McLaughlin K. Pain Management in thoracic surgery. Thorac Surg Clin. 2020;30(3):339–46.

Li L et al. A Cohort Study of the Effects of Integrated Medical and Nursing Rounds Combined with AIDET Communication Mode on Recovery and Quality of Life in Patients Undergoing Percutaneous Coronary Intervention Comput Math Methods Med, 2022. 2022: p. 9489203.

Zhang Y. Uncertainty in illness: theory review, application, and extension. Oncol Nurs Forum. 2017;44(6):645–9.

Mishel MH. Uncertainty in illness. Image J Nurs Sch. 1988;20(4):225–32.

Zhang N, et al. Illness uncertainty, self-perceived burden and quality of life in patients with chronic myeloid leukaemia: a cross-sectional study. J Clin Nurs. 2022;31(19–20):2935–42.

Wessels E, et al. Quality of recovery in the perioperative setting: a narrative review. J Clin Anesth. 2022;78:110685.

Stark PA, Myles PS, Burke JA. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology. 2013;118(6):1332–40.

Kleif J, Gögenur I. Severity classification of the quality of recovery-15 score-An observational study. J Surg Res. 2018;225:101–7.

Filaire M, et al. Prediction of hypoxemia and mechanical ventilation after lung resection for cancer. Ann Thorac Surg. 1999;67(5):1460–5.

Wang ML, et al. Nasal high-flow oxygen therapy improves arterial oxygenation during one-lung ventilation in non-intubated thoracoscopic surgery. Eur J Cardiothorac Surg. 2018;53(5):1001–6.

Hoch K. Current evidence-based practice for Pediatric Emergence Agitation. Aana j. 2019;87(6):495–9.

PubMed   Google Scholar  

McDaniel M, Brudney C. Postoperative delirium: etiology and management. Curr Opin Crit Care. 2012;18(4):372–6.

Ray WT, Desai SP. The history of the nurse anesthesia profession. J Clin Anesth. 2016;30:51–8.

Fang YL, et al. Nurse anesthetist training Center on IFNA standards in Mainland China. Nurse Educ Today. 2021;99:104775.

Kurita K, et al. Uncertainty and psychological adjustment in patients with lung cancer. Psychooncology. 2013;22(6):1396–401.

Shi Q, et al. Symptom burden in cancer survivors 1 year after diagnosis: a report from the American Cancer Society’s studies of Cancer survivors. Cancer. 2011;117(12):2779–90.

Lebel S, et al. Addressing fear of cancer recurrence among women with cancer: a feasibility and preliminary outcome study. J Cancer Surviv. 2014;8(3):485–96.

Guan T, Qan’ir Y, Song L. Systematic review of illness uncertainty management interventions for cancer patients and their family caregivers. Support Care Cancer. 2021;29(8):4623–40.

Pereira CF, de Vargas D, Beeber LS. An anxiety management intervention for people with substance use disorders (ITASUD): an intervention mapping approach based on Peplau’s theory. Front Public Health. 2023;11:1124295.

Ahadzadeh AS, Sharif SP. Uncertainty and quality of life in women with breast Cancer: moderating role of coping styles. Cancer Nurs. 2018;41(6):484–90.

An Y, et al. The relationship between uncertainty in illness and quality of life in patients with heart failure: multiple Mediating effects of Perceived stress and coping strategies. J Cardiovasc Nurs. 2022;37(3):257–65.

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Acknowledgements

We would like to thank Editage ( www.editage.cn ) for English language editing.

This work was supported by the Nursery Fund Project of the Second Affiliated Hospital of Fujian Medical University (No. 2021MP25), the Fujian Provincial Clinical Key Specialty Construction Project (No. HLZDZK202307).

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Xue-e Su, Cui-liu Lin & Shu Lin

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Department of Anesthesia, The Second Affiliated Hospital of Fujian Medical University, No.34 North Zhongshan Road, Quanzhou, Fujian Province, 362000, China

Xue-e Su, Shan-hu Wu, He-fan He & Pei-qing Weng

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Contributions

XES, HFH, SL and PQW contributed to study design. XES, SHW and CLL performed the searches and contributed to data collection and data analysis. Any disagreements were settled by a third author (SL or PQW). XES, HFH and CLL drafted the article. All authors approved the final report.

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Correspondence to Shu Lin or Pei-qing Weng .

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Ethical approval and consent to participate.

Owing to the retrospective nature of this study, the need for informed consent was waived by the Medical Ethics Committee of the Second Affiliated Hospital of Fujian Medical University, and the study design was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Fujian Medical University on January 7,2023 (No. 2023125).

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Su, Xe., Wu, Sh., He, Hf. et al. The effect of multimodal care based on Peplau’s interpersonal relationship theory on postoperative recovery in lung cancer surgery: a retrospective analysis. BMC Pulm Med 24 , 59 (2024). https://doi.org/10.1186/s12890-024-02874-5

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Received : 11 August 2023

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Published : 27 January 2024

DOI : https://doi.org/10.1186/s12890-024-02874-5

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Peplau's Theory of Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data?

Affiliations.

• 1 1 Adjunct Professor, LaGuardia Community College, New York, NY, USA.
• 2 2 Director of Assessment and Accreditation, College of Staten Island, Staten Island, NY, USA.
• 3 3 Postdoctoral Fellow, New York State Psychiatric Institute and Columbia University, New York, NY, USA.
• 4 4 Professor, College of Staten Island, Staten Island, NY, USA.
• PMID: 28899257
• PMCID: PMC5831243
• DOI: 10.1177/0894318417693286

A confirmatory factor analysis of data from the responses of 12,436 patients to 16 items on the Consumer Assessment of Healthcare Providers and Systems-Hospital survey was used to test a latent factor structure based on Peplau's middle-range theory of interpersonal relations. A two-factor model based on Peplau's theory fit these data well, whereas a three-factor model also based on Peplau's theory fit them excellently and provided a suitable alternate factor structure for the data. Though neither the two- nor three-factor model fit as well as the original factor structure, these results support using Peplau's theory to demonstrate nursing's extensive contribution to the experiences of hospitalized patients.

Keywords: HCAHPS; Peplau; confirmatory factor analysis; patient experience.

• Hospitalization
• Interpersonal Relations*
• Length of Stay
• Middle Aged
• Models, Nursing*
• Nurse-Patient Relations
• Nursing Care / methods*
• Nursing Theory*
• Surveys and Questionnaires

Grants and funding

• T32 MH019139/MH/NIMH NIH HHS/United States

Peplau’s Theory of Interpersonal Relations: A Case Study

Abstract: theoretical frameworks offer guiding principles to guide nursing practice on well-defined nursing knowledge. peplau’s theory of interpersonal relationship empowers nurses in their work for regaining health and well-being for people. understanding the theory and the connectedness that arises from this theory provides a structure for nurse-patient relations, even working through a language barrier as evidenced by the case scenario detailed in this article..

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References 2 publication s, the effect of professional nursing practice model training (mpkp) with the implementation of pillar iv nursing care delivery system (pillar iv ncds) at a hospital in kotamobagu, indonesia.

Background: Professional Nursing Practice Model Training (Model Praktik Keperawatan Profesional; MPKP) is one of the efforts to improve the quality of service in hospitals in nursing services to minimize errors or omissions that can occur. The training carried out is expected to be able to improve the implementation of pillar IV NCDS in hospitals. Aims: This study aimed to determine the effect of MPKP training with the application of pillar IV NCDS at the General Hospital of the Evangelical Masehi Church Bolaang Mongondow Monompia Kotamobagu. Methods: This research is a quantitative research type with a pre-experimental research design one group pre-test post-test design. This research was conducted in August 2022 as many as 52 nurse respondents working at the Monompia GMIBM Hospital Kotamobagu. Results: From the survey, it shows that the intervention will increase the number of nurses implementing the Pillar IV Nursing Care Delivery System (Pillar IV NCDs) including the assessment element (from 76.9% to 90.4%), nursing diagnosis (from 36.5% to 75.0%), planning (from 51.9% to 88.5%), action or measurement (from 84.6% and 92.3%), evaluation (from 46.2% to 90.4%), and nursing care notes (78.8% and 98.1%). There are differences in the implementation of pillar IV NCDS before and after being given MPKP training (p-value: <0.001). it is known that education level and the work experience of the nurses will significantly determine the success of the training, respectively with p value of <0.001 and 0.004. Conclusion: From the survey, we may note how the Professional Nursing Practice Model Training (MPKP) affecting the number of nursing implementing the Pillar IV NCDs. Data from the results can be used as recommendation to the hospitals’ human resources department in designing their program in order to increase the nurses’ competences.

Validación psicométrica de la «Escala de habilidades comunicacionales aplicada por paciente estandarizado» para la simulación clínica

No abstract

Advancing Nursing Practice Through Mentoring and Teaching-Learning

In the article that follows this introduction, there are insights into the importance of a theoretical framework for nursing practice. The authors detail the impact to nursing practice a theoretical framework provides by using a case study approach. The introductory thoughts in this article focus on inspiring mentoring models and teaching learning models within theoretically based nursing science and practice.

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• Hildegard Peplau: Interpersonal Relations Theory

Hildegard Peplau is a nurse theorist who created the Theory of Interpersonal Relations . Get to know Peplau’s theory and biography in this nursing theories study guide .

Table of Contents

Career and appointments of hildegard peplau, interpersonal relations theory, awards and honors, description, assumptions, society or environment, 1. orientation phase, 2. identification phase, 3. exploitation phase, 4. resolution phase, subconcepts of the interpersonal relations theory, four levels of anxiety, interpersonal theory and nursing process, recommended resources, external links, biography of hildegard e. peplau.

Hildegard Elizabeth Peplau (September 1, 1909 – March 17, 1999) was an American nurse who is the only one to serve the American Nurses Association (ANA) as Executive Director and later as President. She became the first published nursing theorist since Florence Nightingale .

Peplau was well-known for her Theory of Interpersonal Relations , which helped to revolutionize nurses’ scholarly work. Her achievements are valued by nurses worldwide and became known to many as the “Mother of Psychiatric Nursing” and the “Nurse of the Century.” 

Hildegard Peplau was born on September 1, 1909. She was raised in Reading, Pennsylvania, by her parents of German descent, Gustav and Otyllie Peplau. She was the second daughter, having two sisters and three brothers. Though illiterate, her father was persevering while her mother was a perfectionist and oppressive. With her young age, Peplau’s eagerness to grow beyond traditional women’s roles was precise. She considers nursing was one of few career choices for women during her time. In 1918, she witnessed the devastating flu epidemic that greatly influenced her understanding of the impact of illness and death on families.

When the autonomous, nursing-controlled, Nightingale era schools came to an end in the early 1900s, schools then were handled by hospitals, and the so-called formal “book learning ” was put down. Hospitals and physicians considered women in nursing as a source of free or inexpensive labor . Exploitation was widespread by nurse’s employers, physicians, and educational providers.

In 1931, she graduated from Pottstown, Pennsylvania School of Nursing. Peplau earned a Bachelor’s degree in interpersonal psychology in 1943 at Bennington College in Vermont. She studied psychological issues with Erich Fromm, Frieda Fromm-Reichmann, and Harry Stack Sullivan at Chestnut Lodge, a private psychiatric hospital in Maryland. Peplau held master’s and doctoral degrees from Teachers College, Columbia University, in 1947.

After graduating in Pennsylvania, Hildegard Peplau then worked as a staff nurse in her place and New York City. A summer position as a nurse for the New York University summer camp led to a recommendation for Peplau to become the school nurse at Bennington College in Vermont, where she earned a Bachelor’s degree in interpersonal psychology. Peplau’s lifelong work was largely focused on extending Sullivan’s interpersonal theory for use in nursing practice.

She served in the Army Nurse Corps and was assigned to the 312th Field Station Hospital from 1943-1945 in England, where the American School of Military Psychiatry was located. She met and worked with all the leading figures in British and American psychiatry. After the war, Peplau was at the table with many of these same men as they worked to reshape the mental health system in the United States through the passage of the National Mental Health Act of 1946.

“Nursing has made great progress from being an occupation to becoming a professional in the 20th. Century. As the 21st. Century approaches, further progress will be reported and recorded in Cyberspace – The Internet being one conduit for that. Linking nurses and their information and knowledge across borders – around the world – will surely advance the profession of nursing much more rapidly in the next century.” – Hildegard Peplau

Peplau was certified in psychoanalysis by the William Alanson White Institute of New York City. In the early 1950s, she developed and taught the first classes for graduate psychiatric nursing students at Teachers College. Peplau was a member of the College of Nursing faculty at Rutgers University from 1954 until her retirement in 1974. She was a professor emeritus at the said university.

At Rutgers University, she created the first graduate-level program to prepare clinical specialists in psychiatric nursing. She was a prolific writer and was equally well known for her presentations, speeches, and clinical training workshops. Peplau vigorously advocated that nurses should become further educated to provide truly therapeutic care to patients rather than the custodial care that was prevalent in the mental hospitals of that era.

During the 1950s and 1960s, she supervised summer workshops for nurses throughout the United States, mostly in state psychiatric hospitals. In these seminars, she taught interpersonal concepts and interviewing techniques and individual, family, and group therapy. Peplau was an advisor to the World Health Organization and was a visiting professor at universities in Africa, Latin America, Belgium, and throughout the United States. A strong advocate for graduate education and research in nursing, Peplau served as a consultant to the U.S. Surgeon General, the U.S. Air Force, and the National Institute of Mental Health . She participated in many government policy-making groups.

Peplau was devoted to nursing education at the full length of her career. After she retired from Rutgers, she served as a visiting professor at the University of Leuven in Belgium in 1975 and 1976. There she helped establish the first graduate nursing program in Europe.

She was the only nurse who served the ANA as executive director and later as president. She served two terms on the Board of the International Council of Nurses (ICN). And as a member of the New Jersey State Nurses Association, she actively contributed to the ANA by serving on various committees and task forces.

Her fifty-year career in nursing left an unforgettable mark on the field and the mentally challenged lives in the United States. During the peak of her career, she became the founder of modern psychiatric nursing, an innovative educator, advocate for the mentally ill, proponent of advanced education for nurses, Executive Director and then President of the ANA, and prolific author.

Like any other famous personalities, her life was often marked with controversy, which she faced with boldness, prowess, and conviction.

In 1952, Hildegard Peplau published her Theory of Interpersonal Relations influenced by Henry Stack Sullivan, Percival Symonds, Abraham Maslow , and Neal Elgar Miller.  Her theory is discussed further below.

Some of Hildegard Peplau’s works include: Interpersonal Relations In Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing , Interpersonal Theory in Nursing Practice: Selected Works of Hildegard E. Peplau , Basic principles of patient counseling: Extracts from two clinical nursing workshops in psychiatric hospitals, A Glance Back in Time: An article from Nursing Forum, On Semantics (psychiatric nursing): An article from Perspectives in Psychiatric Care, The Psychiatric Nurse–Accountable? To Whom? For What?: An article from Perspectives in Psychiatric Care and Psychotherapeutic Strategies: An article from Perspectives in Psychiatric Care.

Her book on her conceptual framework, Interpersonal Relations in Nursing, was completed in 1948. Publication took four additional years because it was groundbreaking for a nurse to contribute this scholarly work without a co-authoring physician.

Peplau’s original book from 1952 has been translated into nine languages and in 1989 was reissued in Great Britain by Macmillan of London. In 1989, Springer published a volume of selected works of Peplau from previously unpublished papers. Her ideas have, indeed, stood the test of time. The archives of her work and life are housed at the Schlesinger Library at Harvard University.

Peplau was acknowledged with numerous awards and honors for her contributions to nursing and held 11 honorary degrees. She was awarded honorary doctoral degrees from universities including Alfred, Duke, Indiana, Ohio State, Rutgers, and the University of Ulster in Ireland.

She was named one of “50 Great Americans” in Who’s Who in 1995 by Marquis. She was also elected fellow of the American Academy of Nurse and Sigma Theta Tau, the national nursing honorary society.

In 1996, the American Academy of Nursing honored Peplau as a “Living Legend.” She received nursing’s highest honor, the “Christiane Reimann Prize,” at the ICN Quadrennial Congress in 1997. This award is given once every four years for outstanding national and international contributions to nursing and healthcare. And in 1998, the ANA inducted her into its Hall of Fame .

On March 17, 1999, Peplau died peacefully in her sleep at home in Sherman Oaks, California. She is survived by Dr. Leitia Anne Peplau and her husband, Dr. Steven Gordon, and their son, David Gordon of Sherman Oaks, CA; sister, Bertha Reppert (Byron), Mechanicsburg, PA; brother, John D. Forster (Dorothy), Reading, PA; niece, Dr. Carolynn Sears (Phillip) and children, Jessica and Jacob Sears, Pound Ridge, NY; niece Majorie Reppert, Jim Thorpe, PA; niece, Nancy Reppert, Mechanicsburg, PA; niece, Susanna Reppert (David Brill), Mechanicsburg, PA; niece, Karen Bently (William) and son, William, Sudbury, MA; and nephew, Carl Peplau, Hopewell Junction, NY.

The family requested that memorial contributions be made to the Peplau Research Fund through the American Nurses Foundation.

The need for a partnership between nurse and client is very substantial in nursing practice. This definitely helps nurses and healthcare providers develop more therapeutic interventions in the clinical setting. Through these, Hildegard E. Peplau developed her “Interpersonal Relations Theory” in 1952, mainly influenced by Henry Stack Sullivan, Percival Symonds, Abraham Maslow, and Neal Elgar Miller.

According to Peplau (1952/1988), nursing is therapeutic because it is a healing art, assisting an individual who is sick or in need of health care. Nursing can be viewed as an interpersonal process because it involves interaction between two or more individuals with a common goal. In nursing, this common goal provides the incentive for the therapeutic process in which the nurse and patient respect each other as individuals, both of them learning and growing due to the interaction. An individual learns when she or he selects stimuli in the environment and then reacts to these stimuli.

Hildegard Peplau’s Interpersonal Relations Theory

Hildegard Peplau’s Interpersonal Relations Theory emphasized the nurse-client relationship as the foundation of nursing practice. It emphasized the give-and-take of nurse-client relationships that was seen by many as revolutionary. Peplau went on to form an interpersonal model emphasizing the need for a partnership between nurse and client as opposed to the client passively receiving treatment and the nurse passively acting out doctor’s orders.

The four components of the theory are person , which is a developing organism that tries to reduce anxiety caused by needs; environment , which consists of existing forces outside of the person and put in the context of culture; health , which is a word symbol that implies a forward movement of personality and nursing , which is a significant therapeutic interpersonal process that functions cooperatively with another human process that makes health possible for individuals in communities.

The nursing model identifies four sequential phases in the interpersonal relationship: orientation , identification , exploitation , and resolution .

It also includes seven nursing roles: Stranger role, Resource role, Teaching role, Counseling role, Surrogate role, Active leadership, and Technical expert role.

Hildegard E. Peplau’s theory defined Nursing as “An interpersonal process of therapeutic interactions between an individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help.” It is a “maturing force and an educative instrument” involving an interaction between two or more individuals with a common goal.

In nursing, this common goal provides the incentive for the therapeutic process in which the nurse and patient respect each other as individuals, both of them learning and growing due to the interaction. An individual learns when she or he selects stimuli in the environment and then reacts to these stimuli.

Hildegard Peplau’s Interpersonal Relations Theory’s assumptions are: (1) Nurse and the patient can interact. (2) Peplau emphasized that both the patient and nurse mature as the result of the therapeutic interaction. (3) Communication and interviewing skills remain fundamental nursing tools. And lastly, (4) Peplau believed that nurses must clearly understand themselves to promote their client’s growth and avoid limiting their choices to those that nurses value.

Major Concepts of the Interpersonal Relations Theory

The theory explains nursing’s purpose is to help others identify their felt difficulties and that nurses should apply principles of human relations to the problems that arise at all levels of experience.

Peplau defines man as an organism that “strives in its own way to reduce tension generated by needs.” The client is an individual with a felt need.

Health is defined as “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.”

Although Peplau does not directly address society/environment, she does encourage the nurse to consider the patient’s culture and mores when the patient adjusts to the hospital routine.

Hildegard Peplau considers nursing to be a “significant, therapeutic, interpersonal process.” She defines it as a “human relationship between an individual who is sick, or in need of health services, and a nurse specially educated to recognize and to respond to the need for help.”

Therapeutic nurse-client relationship

A professional and planned relationship between client and nurse focuses on the client’s needs, feelings, problems, and ideas. It involves interaction between two or more individuals with a common goal. The attainment of this goal, or any goal, is achieved through a series of steps following a sequential pattern.

Four Phases of the therapeutic nurse-patient relationship:

The nurse’s orientation phase involves engaging the client in treatment, providing explanations and information, and answering questions.

• Problem defining phase
• It starts when the client meets the nurse as a stranger.
• Defining the problem and deciding the type of service needed
• Client seeks assistance, conveys needs, asks questions, shares preconceptions and expectations of past experiences.
• Nurse responds, explains roles to the client, identifies problems, and uses available resources and services.

The identification phase begins when the client works interdependently with the nurse, expresses feelings, and begins to feel stronger.

• Selection of appropriate professional assistance
• Patient begins to have a feeling of belonging and a capability of dealing with the problem, which decreases the feeling of helplessness and hopelessness .
• In the exploitation phase, the client makes full use of the services offered.
• Use of professional assistance for problem-solving alternatives
• Advantages of services are used based on the needs and interests of the patients.
• The individual feels like an integral part of the helping environment.
• They may make minor requests or attention-getting techniques.
• The principles of interview techniques must be used to explore, understand and adequately deal with the underlying problem.
• Patient may fluctuate on independence.
• Nurse must be aware of the various phases of communication.
• Nurse aids the patient in exploiting all avenues of help, and progress is made towards the final step.
• In the resolution phase, the client no longer needs professional services and gives up dependent behavior. The relationship ends.
• Termination of professional relationship
• The patient’s needs have already been met by the collaborative effect of patient and nurse.
• Now they need to terminate their therapeutic relationship and dissolve the links between them.
• Sometimes may be difficult for both as psychological dependence persists.
• The patient drifts away and breaks the nurse’s bond, and a healthier emotional balance is demonstrated, and both become mature individuals.

Peplau’s model has proved greatly used by later nurse theorists and clinicians in developing more sophisticated and therapeutic nursing interventions.

The following are the roles of the Nurse in the Therapeutic relationship identified by Peplau:

Stranger: offering the client the same acceptance and courtesy that the nurse would respond to any stranger

Resource person: providing specific answers to questions within a larger context

Teacher: helping the client to learn formally or informally

Leader: offering direction to the client or group

Surrogate: serving as a substitute for another such as a parent or a sibling

Counselor: promoting experiences leading to health for the client such as expression of feelings

Technical Expert: providing physical care for the patient and operates equipment

Peplau also believed that the nurse could take on many other roles, but these were not defined in detail. However, they were “left to the intelligence and imagination of the readers.” (Peplau, 1952)

Additional roles include:

• Technical expert
• Health teacher
• Socializing agent
• Safety agent
• Manager of environment
• Administrator
• Recorder observer

Anxiety was defined as the initial response to a psychic threat. There are four levels of anxiety described below.

Mild anxiety is a positive state of heightened awareness and sharpened senses, allowing the person to learn new behaviors and solve problems. The person can take in all available stimuli (perceptual field).

Moderate anxiety involves a decreased perceptual field (focus on the immediate task only); the person can learn a new behavior or solve problems only with assistance. Another person can redirect the person to the task.

Severe anxiety involves feelings of dread and terror. The person cannot be redirected to a task; he or she focuses only on scattered details and has physiologic symptoms of tachycardia, diaphoresis, and chest pain .

Panic anxiety can involve loss of rational thought, delusions, hallucinations , and complete physical immobility and muteness. The person may bolt and run aimlessly, often exposing himself or herself to injury .

Peplau’s Interpersonal Relations Theory and the Nursing Process are sequential and focus on the therapeutic relationship by using problem-solving techniques for the nurse and patient to collaborate on to meet the patient’s needs. Both use observation communication and recording as basic tools utilized by nursing.

Peplau conceptualized clear sets of nurse’s roles that every nurse can use with their practice. It implies that a nurse’s duty is not just to care, but the profession encompasses every activity that may affect the patient’s care.

The idea of a nurse-client interaction is limited to those individuals incapable of conversing, specifically those who are unconscious.

The concepts are highly applicable to the care of psychiatric patients considering Peplau’s background. But it is not limited to those sets of individuals. It can be applied to any person capable and has the will to communicate.

The phases of the therapeutic nurse-client are highly comparable to the nursing process , making it vastly applicable. Assessment coincides with the orientation phase; nursing diagnosis and planning with the identification phase, implementation as to the exploitation phase, and evaluation with the resolution phase.

Peplau’s theory helped later nursing theorists and clinicians develop more therapeutic interventions regarding the roles that show the dynamic character typical in clinical nursing.

Its phases provide simplicity regarding the nurse-patient relationship’s natural progression, which leads to adaptability in any nurse-patient interaction, thus providing generalizability.

Though Peplau stressed the nurse-client relationship as the foundation of nursing practice, health promotion and maintenance were less emphasized.

Also, the theory cannot be used in a patient who doesn’t have a felt need, such as with withdrawn patients.

Peplau’s theory has proved greatly used to later nurse theorists and clinicians in developing more sophisticated and therapeutic nursing interventions, including the seven nursing roles, which show the dynamic character roles typical in clinical nursing. It entails that a nurse’s duty is not just to care, but the profession also incorporates every activity that may affect the client’s health.

However, the idea of nurse-client cooperation is found narrow with those individuals who are unfit and powerless in conversing, specifically those who are unconscious and paralyzed.

Studying Peplau’s Interpersonal Relations Theory of Nursing can be very substantial, especially to aspiring to be part of the profession. Knowing the seven nursing roles, future nurses can apply for different roles in different situations, which will guarantee their patients acquire the best care possible and ultimately speed along with treatment and recovery.

Recommended books and resources to learn more about nursing theory:

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy .

• Nursing Theorists and Their Work (10th Edition) by Alligood Nursing Theorists and Their Work, 10th Edition provides a clear, in-depth look at nursing theories of historical and international significance. Each chapter presents a key nursing theory or philosophy, showing how systematic theoretical evidence can enhance decision making, professionalism, and quality of care.
• Knowledge Development in Nursing: Theory and Process (11th Edition) Use the five patterns of knowing to help you develop sound clinical judgment. This edition reflects the latest thinking in nursing knowledge development and adds emphasis to real-world application. The content in this edition aligns with the new 2021 AACN Essentials for Nursing Education.
• Nursing Knowledge and Theory Innovation, Second Edition: Advancing the Science of Practice (2nd Edition) This text for graduate-level nursing students focuses on the science and philosophy of nursing knowledge development. It is distinguished by its focus on practical applications of theory for scholarly, evidence-based approaches. The second edition features important updates and a reorganization of information to better highlight the roles of theory and major philosophical perspectives.
• Nursing Theories and Nursing Practice (5th Edition) The only nursing research and theory book with primary works by the original theorists. Explore the historical and contemporary theories that are the foundation of nursing practice today. The 5th Edition, continues to meet the needs of today’s students with an expanded focus on the middle range theories and practice models.
• Strategies for Theory Construction in Nursing (6th Edition) The clearest, most useful introduction to theory development methods. Reflecting vast changes in nursing practice, it covers advances both in theory development and in strategies for concept, statement, and theory development. It also builds further connections between nursing theory and evidence-based practice.
• Middle Range Theory for Nursing (4th Edition) This nursing book’s ability to break down complex ideas is part of what made this book a three-time recipient of the AJN Book of the Year award. This edition includes five completely new chapters of content essential for nursing books. New exemplars linking middle range theory to advanced nursing practice make it even more useful and expand the content to make it better.
• Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice This book offers balanced coverage of both qualitative and quantitative research methodologies. This edition features new content on trending topics, including the Next-Generation NCLEX® Exam (NGN).
• Nursing Research (11th Edition) AJN award-winning authors Denise Polit and Cheryl Beck detail the latest methodologic innovations in nursing, medicine, and the social sciences. The updated 11th Edition adds two new chapters designed to help students ensure the accuracy and effectiveness of research methods. Extensively revised content throughout strengthens students’ ability to locate and rank clinical evidence.

Recommended site resources related to nursing theory:

• Nursing Theories and Theorists: The Definitive Guide for Nurses MUST READ! In this guide for nursing theories, we aim to help you understand what comprises a nursing theory and its importance, purpose, history, types or classifications, and give you an overview through summaries of selected nursing theories.

Other resources related to nursing theory:

• Betty Neuman: Neuman Systems Model
• Dorothea Orem: Self-Care Deficit Theory
• Dorothy Johnson: Behavioral System Model
• Faye Abdellah: 21 Nursing Problems Theory
• Florence Nightingale: Environmental Theory
• Ida Jean Orlando: Deliberative Nursing Process Theory
• Imogene King: Theory of Goal Attainment
• Jean Watson: Theory of Human Caring
• Lydia Hall: Care, Cure, Core Nursing Theory
• Madeleine Leininger: Transcultural Nursing Theory
• Martha Rogers: Science of Unitary Human Beings
• Myra Estrin Levine: The Conservation Model of Nursing
• Nola Pender: Health Promotion Model
• Sister Callista Roy: Adaptation Model of Nursing
• Virginia Henderson: Nursing Need Theory
• Hildegard Peplau (1909-1999) 1998 Inductee. (n.d.). . Retrieved July 1, 2014, from https://www.nursingworld.org/HildegardPeplau
• Sills, G. (n.d.). Hildegard Peplau.  Nursing Theorist Homepage . Retrieved January 3, 2014, from https://publish.uwo.ca/~cforchuk/peplau/obituary.html
• George B. Julia, Nursing Theories- The base for Professional Nursing Practice, 3rd ed. Norwalk, Appleton & Lange.
• Peplau, H. E. (1952). Interpersonal relations in nursing. In George, J. (Ed.).  Nursing theories: the base for professional nursing practice. Norwalk, Connecticut: Appleton & Lange.
• Peplau, H.E. (1988). The art and science of nursing: Similarities, differences, and relations. Nursing Science Quarterly, 1, 8-15. In George, J. (Ed.). Nursing theories: the base for professional nursing practice.  Norwalk, Connecticut: Appleton & Lange.
• Peplau Research Fund  – Supports research scholars in the ANF Nursing Research Grants Program.
• The Nurse Theorists – Hildegard Peplau Promo  – A video interview with Peplau
• Interpersonal Relations In Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing
• Interpersonal Theory in Nursing Practice: Selected Works of Hildegard E. Peplau

With contributions by Wayne, G., Ramirez, Q.

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Peplau's Theory of Interpersonal Relations

Peplau published her Theory of Interpersonal Relations in 1952, and in 1968, interpersonal techniques became the crux of  psychiatric nursing . The Theory of Interpersonal Relations is a middle-range descriptive classification theory. It was influenced by Henry Stack Sullivan, Percival Symonds, Abraham Maslow, and Neal Elger Miller.

The four components of the theory are: person, which is a developing organism that tries to reduce anxiety caused by needs; environment, which consists of existing forces outside of the person, and put in the context of culture; health, which is a word symbol that implies forward movement of personality and other other human processes toward creative, constructive, productive, personal, and community living.

The nursing model identifies four sequential phases in the interpersonal relationship: orientation, identification, exploitation, and resolution.

The orientation phase defines the problem. It starts when the nurse meets the patient, and the two are strangers. After defining the problem, the orientation phase identifies the type of service needed by the patient. The patient seeks assistance, tells the nurse what he or she needs, asks questions, and shares preconceptions and expectations based on past experiences. Essentially, the orientation phase is the nurse’s assessment of the patient’s health and situation.

The identification phase includes the selection of the appropriate assistance by a professional. In this phase, the patient begins to feel as if he or she belongs, and feels capable of dealing with the problem which decreases the feeling of helplessness and hopelessness. The identification phase is the development of a nursing care plan based on the patient’s situation and goals.

The exploitation phase uses professional assistance for problem-solving alternatives. The advantages of the professional services used are based on the needs and interests of the patients. In the exploitation phase, the patient feels like an integral part of the helping environment, and may make minor requests or use attention-getting techniques. When communicating with the patient, the nurse should use interview techniques to explore, understand, and adequately deal with the underlying problem. The nurse must also be aware of the various phases of communication since the patient’s independence is likely to fluctuate. The nurse should help the patient exploit all avenues of help as progress is made toward the final phase. This phase is the implementation of the nursing plan, taking actions toward meeting the goals set in the identification phase.

The final phase is the resolution phase. It is the termination of the professional relationship since the patient’s needs have been met through the collaboration of patient and nurse. They must sever their relationship and dissolve any ties between them. This can be difficult for both if psychological dependence still exists. The patient drifts away from the nurse and breaks the bond between them. A healthier emotional balance is achieved and both become mature individuals. This is the evaluation of the nursing process . The nurse and patient evaluate the situation based on the goals set and whether or not they were met.

The goal of psychodynamic nursing is to help understand one’s own behavior, help others identify felt difficulties, and apply principles of human relations to the problems that come up at all experience levels. Peplau explains that nursing is therapeutic because it is a healing art, assisting a patient who is sick or in need of health care. It is also an interpersonal process because of the interaction between two or more individuals who have a common goal. The nurse and patient work together so both become mature and knowledgeable in the care process.

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The nurse has a variety of roles in Hildegard Peplau’s nursing theory. The six main roles are: stranger, teacher, resource person, counselor, surrogate, and leader.

As a stranger, the nurse receives the patient in the same way the patient meets a stranger in other life situations. The nurse should create an environment that builds trust. As a teacher, the nurse imparts knowledge in reference to the needs or interests of the patient. In this way, the nurse is also a resource person, providing specific information needed by the patient that helps the patient understand a problem or situation. The nurse’s role as a counselor helps the patient understand and integrate the meaning of current life situations, as well as provide guidance and encouragement in order to make changes. As a surrogate, the nurse helps the patient clarify the domains of dependence, interdependence, and independence, and acts as an advocate for the patient. As a leader, the nurse helps the patient take on maximum responsibility for meeting his or her treatment goals. Additional roles of a nurse include technical expert, consultant, tutor, socializing and safety agent, environment manager, mediator, administrator, record observer, and researcher.

Some limitations of Peplau’s theory include the lack of emphasis on health promotion and maintenance; that intra-family dynamics, personal space considerations, and community social service resources are less considered; it can’t be used on a patient who is unable to express a need; and some areas are not specific enough to generate a hypothesis.

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Clinical Practice

p-ISSN: 2326-1463    e-ISSN: 2326-1471

2017;  6(2): 33-36

doi:10.5923/j.cp.20170602.03

Case Management of Substance Induced Psychosis Using Peplau’s Theory of Interpersonal Relations

Isaac Machuki Ogoncho , Philip Sanga, Dabo Galgalo Halake

Department of Nursing Sciences, University of Kabianga, Kericho, Kenya

Copyright © 2017 Scientific & Academic Publishing. All Rights Reserved.

Substance induced psychosis is a form of psychosis that develops from the use of alcohol or other drugs. The symptoms for this form of psychosis can resolve within days or weeks though tendencies of relapsing occur with persistent use of the drugs. The purpose of this article was to examine Peplau’s theory of interpersonal relations as a framework to assist nurses in understanding and managing patients with substance induced psychosis. The theory involves a therapeutic process that is collaboratively undertaken by both the nurse and the patient towards resolving an identified health problem. The nurse-patient relationship evolves through three phases of orientation, working and termination. The nurse may function as a stranger, leader, teacher, resource person, surrogate and counsellor in helping the patient adopt a healthier behaviour. The nurse-patient relationship allows the patient to freely express their emotions, feelings and thoughts about a given health problem. This enhances understanding of the health problem and guides nurses to helping the patients meet their individual needs. Nursing practice should focus on strengthening interpersonal relationships with patients to improve health outcomes.

Keywords: Substance abuse, Psychosis, Peplau’s theory, Interpersonal relations

Cite this paper: Isaac Machuki Ogoncho, Philip Sanga, Dabo Galgalo Halake, Case Management of Substance Induced Psychosis Using Peplau’s Theory of Interpersonal Relations, Clinical Practice , Vol. 6 No. 2, 2017, pp. 33-36. doi: 10.5923/j.cp.20170602.03.

Article Outline

1. introduction, 2. hildegard peplau’s theory of interpersonal relations, 3. case summary, 4. application of the theory in managing a patient with substance induced psychosis, 5. conclusions.

Hildegard Peplau’s theory of Interpersonal Relations

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Hildegard Peplau’s theory of interpersonal relations, also known as Peplau’s nursing theory, emphasizes the nurse’s active role in patient care and the importance of the nurse-patient relationship in promoting health and wellbeing.

Background information on Peplau’s Nursing Theory

Peplau’s Nursing Theory, categorized as a mid-range theory, is known for its agitation for integrating the human relationship into nursing endeavours. Hildegard Elizabeth Peplau was a practising nurse in the Army during the Second World War. Peplau’s nursing theory is considered one of the most comprehensive nursing theories that provide a holistic perspective on patient care. The theory focuses on the nurse-patient relationship and the role of nursing in promoting patient healing and recovery. 

A central tenet of the theory is that the nurse and patient interaction should be one of giving and taking. Peplau argued that the nurse-patient relationship should be interactional, considering that both the professional and their client have vital information to achieve a common goal: to help the patient in their right state of health.

The theorist opines that the work of a nurse is to help individuals realize their problems, which can only be realized if human relationships and interactions are healthy. 

Having been a nurse in the Army during World War II (WW2), Peplau was motivated to develop a theory where the nurse-patient relationship was central to therapeutic nursing interventions.

In her ideal world, the nurse felt that nursing staff should acquire more knowledge on offering better services to the patients.

In this article, we will examine the application of Peplau’s nursing theory in clinical practice and its impact on patient outcomes.

Importance of the theory in nursing practice

Peplau’s mid-range theory emphasizes the significance of utilizing human relations skills and competencies in care. It applies to the various clinical scenarios nurses encounter in everyday duties and responsibilities. 

The theory also underpins the importance of nurturing patient-nurse interactions that are healthy. Furthermore, the theory is also keen on enhancing the metaparadigm nursing environment. 

Considering the most universal concept of nursing discipline, the metaparadigm refers to global concepts that identify the phenomena of central interest to the discipline in context, the world propositions that define it, and the world propositions that state the relations among concepts.

 As such, the metaparadigm concepts of the discipline of nursing comprise the individual or human, their environment, health, and nursing

These four concepts are intertwined in Peplau’s theory since the running theme of this theory is that the work of a nurse is to assist their patients in identifying their problems with specific emphasis on those having mental health issues.

Overview of Peplau’s Nursing Theory

Peplau’s theory chiefly employs inductive reasoning, manifested in human relations as the nurse and the patient interact. The theory stipulates the significance of human relationships in all nursing endeavors and points out the inductive manner in which the rationale informs the theory commences with orientation.

The overriding goal of orientation is to determine what the problem is to help define the relevant course of action that should be taken to help the patient. Identification follows with the singular intention of identifying the most appropriate help at the professional level, which would be applicable within the given context. 

At step three, exploitation entails the nurse unleashing their professional skills and competencies derived from the accumulated body of evidence, leading to the emergence of an optimal approach to handle the specific case. The fourth and last of the steps is known as the resolution phase, where having met the goal, the relationship has to come to an end. The resolution, just like the orientation phase, has to be formulated on how best to bring the relationship to an end.

 In a nutshell, the four steps of orientation, identification, exploitation, and resolution concisely delineate Peplau’s theory as an inductive theory.

Major Concepts of Peplau’s Nursing Theory

The fundamental concept of the theory is hinged on the fact that nursing involves helping other people to define their problems, then goes a step further to call for the individual nurse’s reconciliation with themselves to serve others. 

The next concept contends that nursing professionals must integrate the human relations dimension in all their undertakings. Most importantly, the theory holds that the patient-nurse relationship should be therapeutic and should be of help to clients who come seeking both medical and nursing care.

 Simultaneously, the conceptual underpinnings of Peplau’s theory contend that nursing is an interpersonal undertaking whose exchange occurs when two parties seek a typical objective to meet. The theory further propagates that the achievement of nursing goals emanates from coordinated steps. 

The theory highly regards the collaborative working between the availed nurse and their patients, leading each of the parties to acquire knowledge with time (Olofunike, n.d).

The operational definitions of these concepts stem from the logic that all are action-oriented and engage the nurse at different levels.

• For example, by calling on nurses to uphold human relations in their undertakings with patients, only then can the therapeutic requirements be availed in a manner that helps the patients within the specific environment they find themselves in. 
• The theorist’s consistency in the utilization of the concepts is evident since all the concepts indicate purposive steps of nurturing the interactional nature of nursing. A case in point is the call for nursing staff to maintain human interaction in their interpersonal process. The nurse has to continually engage the patient so that the patient’s improved health is achieved. 
• Peplau’s theory acknowledges that the essence of nursing should be a mandatory interaction-based endeavor.

The concept of relationship contains overtones of the standard codes of human relations and interpersonal interactions. It is instructive to note that the concept of helping others to identify their problems is closely linked to the other concept that requires one to ensure interpersonal relation is nurtured through the care process. 

The need to have a healthy relationship primarily guides the individual to identify with another individual’s problem and empathize with the latter’s problems and therefore be able to help them find a way out. 

The nurse should never forget that a therapeutic environment is only realized through properly understanding what constitutes a therapeutic environment. While other scholars may advance differing standpoints on the concept relationship within Peplau’s Nursing Theory, the above approach demonstrates how these concepts are interlinked.

Evaluation of Peplau theory of iunterpersonal relations

Peplau used four major assumptions to prop up her theory (peplau’s theory of interpersonal relations). 

• The first was that the nurse and the patient could and do interact. 
• She also assumed that the therapeutic interaction helped both the nurse and the patient to mature and that communication and interviewing skills remain primary nursing tools; 
• The other assumption was based on Peplau’s belief that nurses must clearly understand themselves to promote the patient’s growth and avoid curtailing their patients’ choices to those the nurse preferred. 
• Lastly, the theory assumes that the kind of nurse one ends up playing a crucial role in determining what the patients will learn during their ill health.

One can also note that nursing comprises the development of a personality that can cope with daily interpersonal challenges by ensuring they have a stable self to serve others better.

 Theory’s Four Concepts of Nursing Metaparadigm

Peplau’s theory embraces the four nursing metaparadigms of the person, the environment, nursing, and health.

• The person or human being refers to individuals, families, communities, and other groups participating in the nursing process.  
• The environment or surroundings is premised on the fact that human beings’ significant others, as well as the physical surroundings at the global, national, regional, and local level, impact on them an individual’s health. The influence results from the political, socioeconomic, and cultural conditions one finds oneself (Arabaci et al., 2019).
•  The health dimension covers the life continuum from birth to death and relates to living and dying. The fourth concept is nursing, where the profession is defined as all actions taken by a trained nurse on behalf or in conjunction with other individuals and the goals or outcomes of the nursing action. 
• The nursing process should include assessment, diagnosis, planning, intervention, and evaluation.

The message package in Peplau’s theory is candid and explicit, with the primary responsibility to uphold human relations in nursing. 

According to Deane & Fain (2016), one should also understand that insightful analysis of how the interpersonal relationship is formed and ended demonstrates the theory’s coherence. 

The rationale of the theory to call for human action between two individuals largely depends on the information available. In this way, the theory is candidly illustrated in terms of phases involved in developing an interpersonal relationship that is important to nursing.

Application of Peplau’s Theory

The theory offers a sound and diligent framework on to base all nursing actions on. The efficacy of the theory in human relations is evidenced by the way the nurses handle different cases in clinical practice. The viability of the theory emerges inappropriate diagnosis where the patient’s input in terms of availing information pertinent to the case. 

Using the available information helps the nurse act promptly, particularly those stationed in the Emergency Department . The timeliness of the nursing care offered facilitates the handling of severe cases early enough so that the patient’s lives are saved and the chances of regaining good health are optimized. The nursing component to nurture a therapeutic environment for the patient means the patient’s recovery speed is enhanced. 

The nurse involved in inpatient care is considered an essential tool, and the exchange between the two is required for optimal conditions to be realized.

Offering healthc are services to family members across the lifespan is the chief goal of a family nurse practitioner in this nursing specialty area. Guided by Peplau’s theory, the FNP should have a handy tool to navigate and resolve the various challenges that emerge when offering care to these members. 

The FNP finds it essential to create a healthy relationship and one that facilitates effective communication so that the right decision is made at the right time. Having demonstrated the importance of creating a therapeutic environment, as Peplau’s Nursing Theory pointed out, the same spirit should guide the nursing process to create an enabling environment where all family members enjoy good health.

Theoretical Framework of Peplau’s Nursing Theory

Peplau’s theory is based on the concept of interpersonal relations, which emphasizes the importance of the nurse-patient relationship in promoting health and wellbeing.

It also draws on psychoanalytic theory and views the nurse-patient relationship as a type of psychotherapy.

The theory suggests that the nurse has a unique role in the healthcare system, one that is distinct from other healthcare professionals.

Comparison and contrast with other nursing theories:

• Peplau’s theory is different from the traditional medical model, which views the nurse as a passive care provider and the patient as an object of care.
• It is also different from other nursing theories, such as Orem’s Self-Care Deficit Theory, that focus on the patient’s ability to care for themselves.
• Peplau’s theory emphasizes the nurse’s active role in the patient’s care and the importance of the nurse-patient relationship in promoting health and wellbeing.

Phases of the Nurse-Patient Relationship:

• Orientation: The patient and nurse initially meet and begin to establish a relationship.
• Identification: The patient recognizes the nurse as someone who can help them resolve their health problems.
• Exploitation: The patient begins to rely on the nurse for assistance in resolving their health problems.
• Resolution: The patient’s health problems are resolved, and the nurse-patient relationship comes to an end.

Interpersonal relationships play a crucial role in nursing care, as they provide the foundation for effective communication and collaboration between patients and nurses. This is where Peplau’s Theory of Interpersonal Relations comes in, offering a comprehensive framework to understand and apply the principles of therapeutic relationships in nursing practice. In this article, we’ll explore the key concepts, phases, and significance and its practical applications in real-life nursing scenarios.

Peplau’s Theory of Interpersonal Relations was developed by Hildegard Peplau in 1952 and is considered one of the first nursing theories to address the interpersonal aspect of nursing care. Peplau’s theory defines nursing as a human-to-human relationship in which the nurse serves as a helper to the patient who is seeking assistance to meet their needs and goals.

Importance of Interpersonal Relations in Nursing Care

Interpersonal relationships play a vital role in the success of nursing care . They provide a supportive environment in which patients feel heard, understood, and empowered to take an active role in their care. Furthermore, effective interpersonal relationships can foster trust and open communication, improving patient outcomes and satisfaction.

Understanding Peplau’s Theory of Interpersonal Relations

Key concepts of peplau’s theory.

Peplau’s theory identifies four key concepts that define the nature of the interpersonal relationship between patients and nurses:

• Common goal – The patient and nurse share a common goal of resolving the patient’s health issue or need.
• Mutual trust and respect – The relationship is based on mutual trust and respect, fostering open communication and collaboration.
• Interdependence – Both parties rely on each other to achieve their shared goal.
• Personal growth – The relationship provides opportunities for personal growth and development for the patient and nurse.

The Five Phases of Peplau’s Theory

Peplau’s theory outlines five distinct phases of the interpersonal relationship in nursing care:

• Orientation – In this phase, the patient seeks assistance, and the nurse begins assessing the patient’s needs and goals.
• Identification – In this phase, the patient and nurse establish a relationship and work together towards their shared goal.
• Exploitation – In this phase, the patient and nurse collaborate to resolve the patient’s health issue or need.
• Resolution – In this phase, the patient’s health issue is resolved, and the relationship ends.
• Termination – In this phase, the relationship ends, and both parties can move on to their next phase in life.

Significance of Interpersonal Relations in Nursing Care

The role of interpersonal relations in patient-nurse relationships.

Peplau’s theory highlights the importance of interpersonal relationships in patient-nurse relationships . By establishing a therapeutic relationship, nurses can help patients feel heard, understood, and empowered to take an active role in their care. This can lead to improved patient outcomes and satisfaction, as patients are more likely to follow through with their care plans and be more engaged in their own health.

How Interpersonal Relations Impact Patient Outcomes

Effective interpersonal relationships can significantly impact patient outcomes. By fostering trust and open communication, patients are more likely to feel heard, understood, and empowered to take an active role in their own care. Furthermore, improved patient-nurse relationships can lead to better adherence to care plans, improved health outcomes, and higher levels of patient satisfaction .

Peplau’s Theory in Nursing Practice

Peplau’s Theory of Interpersonal Relations can be applied in various nursing scenarios to improve patient outcomes and enhance the quality of care. The following are some of the real-life nursing scenarios where the theory can be applied:

• Patient-Nurse Relationships: The therapeutic relationship between the patient and nurse is essential to nursing care. Peplau’s theory can be applied to establish and maintain a therapeutic relationship between the patient and nurse. The theory emphasizes the need for mutual trust, respect, and collaboration between the patient and nurse, which are crucial components of a therapeutic relationship.
• Treatment Planning and Implementation: The five phases of Peplau’s theory provide a roadmap for the nurse to assess the patient’s needs, plan and implement care, and evaluate its effectiveness. Following the five phases, the nurse can develop a personalized care plan that meets the patient’s specific needs and expectations.
• Mental Health Nursing: Peplau’s theory can be particularly useful in mental health nursing as it emphasizes the importance of interpersonal relationships in promoting patient well-being and recovery. By establishing a therapeutic relationship with the patient, the nurse can help them manage their mental health issues and facilitate recovery.

Best practices for utilizing Peplau’s Theory in nursing care include:

• Building Therapeutic Relationships: The nurse should make an effort to establish a therapeutic relationship with the patient by being empathetic, respectful, and supportive. This will help to build trust and mutual understanding between the patient and the nurse.
• Assessing Patient Needs: The nurse should assess the patient’s needs, preferences, and expectations by openly and honestly communicating with the patient. This information will inform the nurse’s care plan and ensure that it is tailored to the patient’s specific needs.
• Collaborating with the Patient: The nurse should involve the patient in the care process by inviting their input and actively listening to their concerns. This will help to build trust and collaboration between the patient and nurse and promote patient engagement in their care.
• Evaluating Care Effectiveness: The nurse should regularly evaluate the effectiveness of the care plan and make adjustments as necessary. This will ensure that the care plan remains relevant and meets the patient’s evolving needs.

Peplau’s Theory of Interpersonal Relations is a valuable nursing theory that has impacted the nursing field. It emphasizes the importance of interpersonal relationships in nursing care and provides a roadmap for establishing and maintaining therapeutic relationships with patients. By applying Peplau’s theory in their practice, nurses can improve patient outcomes and enhance the quality of care.

Role of the Nurse per Peplau’s Nursing Theory

Peplau’s theory emphasizes the importance of the nurse-patient relationship and the nurse’s role as a therapeutic collaborator.

• The nurse is responsible for helping the patient understand their health problems and develop a plan to resolve them.
• The nurse also helps the patient understand the implications of their health problems and the impact they may have on their life.
• The nurse plays an active role in promoting the patient’s health and wellbeing, and in helping the patient achieve their health goals.

Key Principles of Peplau’s Nursing Theory

Peplau’s nursing theory is based on four key principles, namely: the nurse-patient relationship, the therapeutic process, the phases of the nurse-patient relationship, and the role of the nurse.

• The nurse-patient relationship is the cornerstone of Peplau’s theory, where the nurse and the patient work together to achieve a common goal. The nurse acts as a teacher, counselor, and advocate to support the patient in their journey towards recovery.
• The therapeutic process refers to the series of actions taken by the nurse and the patient to achieve the common goal. This process involves the nurse’s assessment of the patient’s needs, the development of a plan of care, and the implementation of the plan.
• The phases of the nurse-patient relationship are defined as orientation, identification, exploitation, and resolution. These phases help to establish a therapeutic relationship between the nurse and the patient, leading to a successful outcome.
• The role of the nurse is to provide patient-centered care, empowering the patient to take an active role in their own healing. The nurse acts as a facilitator and advocate, helping the patient to make informed decisions about their care.

How is Peplau’s Nursing Theory Applied in Clinical Practice?

Peplau’s nursing theory can be applied in various clinical settings, including hospitals, long-term care facilities, and community health centers. The theory emphasizes the importance of the nurse-patient relationship, making it a valuable tool in the delivery of patient-centered care.

In Hospital Settings

In hospital settings, the application of Peplau’s nursing theory can improve patient outcomes by promoting a therapeutic relationship between the nurse and the patient. The nurse can use the theory to assess the patient’s needs, develop a care plan, and implement the plan to achieve a successful outcome. By taking a patient-centered approach, the nurse can empower the patient to take an active role in their own healing and recovery. 

In Long-Term Care Facilities

Long-term care facilities can benefit from the application of Peplau’s nursing theory by promoting a therapeutic relationship between the nurse and the patient. This can improve patient outcomes by reducing the risk of depression and improving the patient’s overall quality of life. The nurse can use the theory to assess the patient’s needs, develop a care plan, and implement the plan to achieve a successful outcome.

In Community Health Centers

Community health centers can use Peplau’s nursing theory to provide patient-centered care to underserved populations. The theory can be used to promote a therapeutic relationship between the nurse and the patient, leading to improved patient outcomes. The nurse can assess the patient’s needs, develop a care plan, and implement the plan to achieve a successful outcome, empowering the patient to take an active role in their own healing.

V. Strengths and Weaknesses of Peplau’s Nursing Theory

A. Strengths: Emphasis on the nurse-patient relationship, patient-centered care, and collaboration

B. Weaknesses: Limited attention to the physical aspects of care and lack of empirical support

VI. Conclusion

A. Summary of key points

B. Significance of Peplau’s Nursing Theory in current nursing practice

C. Final thoughts and recommendations for further reading

Q: What is Peplau’s nursing theory and what are its key principles?

A: Peplau’s nursing theory is a comprehensive nursing theory that focuses on the nurse-patient relationship and the role of nursing in promoting patient healing and recovery. It is based on four key principles: the nurse-patient relationship, the therapeutic process, the phases of the nurse-patient relationship, and the role of the nurse.

Q: How is Peplau’s nursing theory applied in clinical practice?

A: Peplau’s nursing theory can be applied in various clinical settings, including hospitals, long-term care facilities, and community health centers. The theory emphasizes the importance of the nurse-patient relationship and can be used to promote a therapeutic relationship, assess patient needs, develop a care plan, and implement the plan to achieve a successful outcome.

Q: What is the impact of Peplau’s nursing theory on patient outcomes?

A: The application of Peplau’s nursing theory in clinical practice can have a positive impact on patient outcomes by promoting a therapeutic relationship between the nurse and the patient. This can lead to improved patient satisfaction, reduced risk of depression, and improved overall quality of life.

Peplau’s Theory’s and the Four Concepts of Nursing Metaparadigm

Peplau’s theory embraces the four nursing metaparadigms of the person, the environment, nursing, and health. 

• The environment or surroundings is premised on the fact that humans beings’ significant others, as well as the physical surroundings at the global, national, regional, and local level, impact on them an individual’s health. The influence results from the political, social-economic, and cultural conditions one finds oneself in (Arabaci et al., 2019). 
• The health dimension covers the life continuum from birth to death and relates to living and dying. 
• The fourth concept is nursing, where the profession is defined as all actions taken by a trained nurse on behalf or in conjunction with other individuals and the goals or even outcomes of the nursing action. The nursing process should include assessment, diagnosis, planning, intervention, and evaluation.

The message package in Peplau’s theory is candid and explicit, with the primary responsibility to uphold the human relation in nursing. According to Deane & Fain (2016), one should also understand that insightful analysis of how the interpersonal relationship is formed and ended demonstrates the theory’s coherence. 

Application of Peplau’s Theory As a Family Nurse Practitioner

The theory offers a sound and diligent framework to base all nursing actions on. The efficacy of the theory in human relations is evidenced by how the nurses handle different cases in clinical practice. 

The viability of the theory emerges inappropriate diagnosis where the patient’s input in terms of availing information pertinent to the case. Using the available information helps the nurse act promptly, particularly those stationed at the Emergency Department. 

The timeliness of the nursing care offered facilitates the handling of severe cases early enough so that the patient not only has their lives saved but the chances of regaining their good health are optimized. The nursing component to nurture a therapeutic environment for the patient means the patient’s speed of recovery is enhanced.

The nurse involved in inpatient care is considered an essential tool where the exchange between the two is required for optimal conditions to be realized.

As a Family Nurse Practitioner, offering healthcare services to family members across the lifespan is one’s chief goal in this nursing specialty area.  Guided by Peplau’s theory, the FNP should have a handy tool to navigate and resolve the various challenges that emerge when offering care to these members. 

The FNP not only finds it essential to create a healthy relationship but also one that facilitates effective communication so that the right decision is made at the right time. Having demonstrated the importance of creating a therapeutic environment, as pointed out by Peplau’s Nursing Theory, the same spirit should guide the nursing process to create an enabling environment where all family members enjoy good health.

To sum up, Peplau’s nursing theory is an example of a comprehensive mid-range theory that offers good d and insightful principles that, if utilized, would see nurses offer better services to their patients. 

The theory’s applicability spans across nursing specialities and levels of settings. Still, this aspect of the theory is only useful for those nursing professionals who are ready and willing to try it out in their specific settings. 

Only by applying the theory in evidence-based patient care that also focuses on the patient will better patient outcomes.

Peplau’s nursing theory provides a comprehensive and holistic perspective on patient care, emphasizing the importance of the nurse-patient relationship. The theory can be applied in various clinical settings, including hospitals, long-term care facilities, and community health centers. 

By promoting a therapeutic relationship, the application of Peplau’s nursing theory in clinical practice can improve patient outcomes, leading to improved patient satisfaction, reduced risk of depression, and improved overall quality of life. 

The theory continues to be a valuable tool for nurses in their efforts to provide patient-centred care.

Hildegard Peplau’s theory of interpersonal relations Journal Articles

• Arabacı, L. B., & TAS, G. (2019). Effect of Using Peplau’s Interpersonal Relations Nursing Model in the care of a juvenile delinquent. Journal of Psychiatric Nursing/Psikiyatri Hemsireleri Dernegi, 10(3).
• 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.
• Franzoi, M. A. H., Lemos, K. C., Jesus, C. A. C., Pinho, D. L. M., Kamada, I., & Reis, P. E. D. (2016). Peplau’s interpersonal relations theory: na evaluation based on Fawcett’s criteria. Rev. Enferm. UFPE on line [Internet], 10(4), 3653-3661.
• Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s Theory of Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data? Nursing science quarterly, 30(2), 160-167.
• Olufunke, O. C. Peplau’s Theory of Psychodynamic Nursing and the Nurse-Patient Interaction: A Literature Review. 

In conclusion, Peplau’s nursing theory is an example of a comprehensive mid-range theory that offers good d and insightful principles that, if utilized, would see nurses offer better services to their patients. 

The theory’s applicability spans nursing specialties and levels of settings. Still, this theory aspect is only useful for those nursing professionals who are ready and willing to try it out in their specific settings.

Only applying the theory in evidence-based patient care that focuses on the patient will result in better patient outcomes.

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