Hildegard E. Pepalu IPR Theory
Hildegard E. Pepalu IPR Theory
- Name: Hildegard Elizabeth Peplau \
- Nickname: Hilda
- Birthday: September 1, 1909
- Died: March 17, 1999 in Sherman Oaks, California
- Birthplace: Reading, Pennsylvania
- Parents: immigrants of German descent
- Father: Gustav Peplau (illiterate but hard-working)
- Mother: Otyllie Peplau (oppressive and perfectionist)
- Birth Order: She was the second daughter born of six children
- Strong motivation
- Has a vision to grow beyond traditional women’s roles
- Wanted more out of life
Nursing was one of few career choices for women in her day. As a child, she witnessed the devastating flu epidemic of 1918, a personal experience that greatly influenced her understanding of the impact of illness and death on families.
- 1931 - Diploma program in Pottstown, Pennsylvania
- 1943 BA in interpersonal psychology - Bennington College
- 1947 - MA in psychiatric nursing from Colombia University, New York
- 1952 - Published Interpersonal Relations in Nursing
- 1953 - EdD in curriculum development in 1953 Professor emeritus from Rutgers university Started first post baccalaureate program in psychiatric nursing
- 1968 - interpersonal techniques - the crux of psychiatric nursing
- Worked as executive director for ANA
- President of ANA from 1970-1972
- Vice-President of ANA from 1972-1974
- Worked with W.H.O., NIMH and Nurse Corps.
- She was the first published nursing theorist since Florence Nightingale
- Created the middle-range nursing theory of interpersonal relations, which helped to revolutionize the scholarly work of nurses
- Staff Nurse in Pennsylvania and New York City
- School Nurse at Bennington College, VT
- Certified in Psychoanalysis at the William Alanson White Institute of New York City
- Faculty of the College of Nursing at Rutgers University
- Created first graduate level program for the preparation of clinical specialists in Psychiatric Nursing
- Therapeutic Care vs Custodial Care in mental hospitals
- Strong advocate for graduate education and research in nursing
- She is the primary contributor to mental health law reform, leading the way towards humane treatment of patients with behavior and personality disorders
- Interpersonal Relations Model
- Psychodynamic Nursing
- Using an understanding of one’s own behavior to help others identify their difficulties
- Applies principles of human relations
- Patient has a felt need
- Emphasized the nurse-client relationship as the foundation of nursing practice
- The interpersonal model emphasizes 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).
- Shared experience - Nurses could facilitate this through Observation, description, formulation, interpretat ion, validation, and intervention
- The theory explains the purpose of nursing is to help others identify their felt difficulties.
- Nurses should apply principles of human relations to the problems that arise at all levels of experience.
- Peplau's theory explains the phases of interpersonal process, roles in nursing situations and methods for studying nursing as an interpersonal process.
- Nursing is therapeutic in that it is a healing art, assisting an individual who is sick or in need of health care.
- Nursing is an interpersonal process because it involves interaction between two or more individuals with a common goal.
- The attainment of goal is achieved through the use of a series of steps following a series of pattern.
- The nurse and patient work together so both become mature and knowledgeable in the process.
- Theory of interpersonal relations is a middle range descriptive classification theory
- The theory was influenced by Harry Stack Sullivan's theory of inter personal relations (1953)
- The theorist was also influenced by Percival Symonds, Abraham Maslow's and Neal Elger Miller
- Peplau's theory is also referred as psychodynamic nursing, which is the understanding of ones own behavior
- An individual
- A developing organism that tries to reduce anxiety caused by needs.
- Lives in stable equilibrium
- Existing forces outside the organism and in the context of culture
- 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
- A significant therapeutic interpersonal process.
- It functions cooperatively with other human process that make health possible for individuals in communities.
- Involves problem-solving
Peplau’s Seven Roles of a Nurse
- Stranger: receives the client in the same way one meets a stranger in other life situations provides an accepting climate that builds trust.
- Teacher: who imparts knowledge in reference to a need or interest
- Resource Person : one who provides a specific needed information that aids in the understanding of a problem or new situation
- Counselor : helps to understand and integrate the meaning of current life circumstances, provides guidance and encouragement to make changes
- Surrogate: helps to clarify domains of dependence interdependence and independence and acts on clients behalf as an advocate.
- Leader : helps client assume maximum responsibility for meeting treatment goals in a mutually satisfying way
- Technical Expert: provides physical care by displaying clinical skills and operates equipment
- Health teacher
- Socializing agent
- Safety agent
- Manager of environment
- Recorder observer
Four Sequential Phases in the Interpersonal Relationship
- Problem defining phase
- Starts when client meets nurse as stranger
- Defining problem and deciding type of service needed
- Client seeks assistance, conveys needs, asks questions, shares preconceptions and expectations of past experiences
- Nurse responds, explains roles to client, helps to identify problems and to use available resources and services
- Get acquainted phase of the nurse-patient relationship.
- Preconceptions are worked through
- Parameters are established and met
- Early levels of trust are developed
- Roles begin to be understood
- 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
- The client begins to identify problems to be worked on within relationship
- The goal of the nurse: help the patient to recognize his/her own interdependent/participation role and promote responsibility for self
- Use of professional assistance for problem solving alternatives
- Advantages of services are used is based on the needs and interests of the patients
- Individual feels as an integral part of the helping environment
- They may make minor requests or attention getting techniques
- The principles of interview techniques must be used in order to explore, understand and adequately deal with the underlying problem.
- Patient may fluctuates on independence
- Nurse must be aware about the various phases of communication
- Nurse aids the patient in exploiting all avenues of help and progress is made towards the final step
- Client’s trust of nurse reached full potential
- Client making full use of nursing services
- Solving immediate problems
- Identifying and orienting self to [discharge] goa
- Termination of professional relationship
- The patients 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
- Patient drifts away and breaks bond with nurse and healthier emotional balance is demonstrated and both becomes mature individuals
- Client met needs
- Mutual termination of relationship
- Sense of security is formed
- Patient is less reliant on nurse
- Increased self reliance to deal with own problems.
- The patient gradually puts aside old goals and adopts new goals. This is a process in which the patient frees himself from identification with the nurse.
Interpersonal Theory and Nursing Process
- Both are sequential and focus on therapeutic relationship
- Both use problem solving techniques for the nurse and patient to collaborate on, with the end purpose of meeting the patients needs
- Both use observation communication and recording as basic tools utilized by nursing
Application of Theory to Areas in Nursing
- Has an impact on the Psychiatric Nursing especially in the baccalaureate program in nursing teaching CARE OF CLIENTS WITH MALADAPTIVE PATTERNS OF BEHAVIOR (NCM 105) composed of 72 hours lecture and 102 hours RLE
- Focuses on the interpersonal processes and therapeutic relationship that develops between the nurse & client.
- It requires that the nurse attends to the interpersonal processes that occur between the nurse and client.
- Interpersonal process is maturing force for personality.It includes the nurse- client relationship, communication, pattern integration and the roles of the nurse.
- Psychodynamic nursing is understanding one’s own behavior to help others identify felt and perceived difficulties and to apply principles of human relations to the problems that arise at all levels of experience.
Research Based on Peplau’s Theory
- Hays, D. (1961). Phases and steps of experimental teaching to patients of a concept of anxiety: Findings revealed that when taught by the experimental method, the patients were able to apply the concept of anxiety after the group was terminated.
- Burd, S.F. Develop and test a nursing intervention framework for working with anxious patients: Students developed competency in beginning interpersonal relationship.