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Hildegard Peplau's Nursing Theory

Aug 17, 2025

Overview

This lecture covers Hildegard Peplau's Interpersonal Relations Theory, focusing on key concepts, phases, nurse roles, and its relevance in nursing practice.

Hildegard Peplau: Background

  • Born September 1, 1909, in Pennsylvania, USA.
  • Graduated from Pennsylvania's School of Nursing in 1931.
  • Certified psychoanalyst and leader in psychiatric nursing education.
  • Developed graduate psychiatric nursing classes and served as an advisor for the World Health Organization.

Interpersonal Relations Theory: Core Concepts

  • The nurse-patient relationship is the foundation of nursing as a partnership.
  • Four main concepts: person, environment, health, and nursing.
  • Person—organism seeking to reduce anxiety caused by needs.
  • Environment—external forces acting on the person.
  • Health—forward movement of personality toward growth.
  • Nursing—therapeutic interpersonal process enabling health.

Four Phases of the Nurse-Patient Relationship

  • Orientation: Nurse and patient meet as strangers; patient expresses needs; both define and clarify the issues.
  • Identification: Patient and nurse partner to set goals; patient starts engaging in the process.
  • Exploitation: Patient actively uses nurse's expertise to meet needs through collaboration.
  • Resolution: Patient’s needs are met; dependency ends; patient moves on, both having matured.

Seven Key Nursing Roles (Peplau)

  • Stranger: Nurse treats the patient with acceptance as a new acquaintance.
  • Resource: Nurse provides information and answers within context.
  • Teacher: Nurse helps patient learn, formally or informally.
  • Leader: Nurse directs patient or group.
  • Surrogate: Nurse acts as a substitute for another figure (parent, sibling).
  • Counselor: Nurse facilitates experiences that promote health.
  • Technical Expert: Nurse provides physical care and operates relevant equipment.

Assumptions and Limitations

  • Effective nurse-patient interaction requires communication and willingness to grow.
  • Nurses should facilitate patient growth without imposing their beliefs.
  • Theory is mainly applicable where conversation is possible, limiting use in non-communicative patients.
  • Not limited to psychiatric nursing, but roles can be adapted across settings.
  • Does not focus on health promotion or patients unaware of their needs.

Key Terms & Definitions

  • Interpersonal Relations Theory — A nursing theory emphasizing the therapeutic nurse-patient relationship.
  • Orientation Phase — Initial meeting where needs are identified.
  • Exploitation Phase — Patient utilizes available resources to meet their needs.

Action Items / Next Steps

  • Review Peplau’s four phases and seven roles.
  • Consider how to apply the theory in different nursing scenarios.
  • Reflect on situations where communication barriers limit theory application.