In order to illustrate the importance of theory in nursing practice, I would like to consider Peplau's middle-range theory which " focuses on the interpersonal process and therapeutic relationship that develops between the nurse and client " ( Ranesh, 2013 ). The work of Hildegard. E. Peplau whose career began in psychiatric nursing was influenced by Henry Stack Sullivan, Percival Symonds, Abraham Maslow, and Neal Elger Miller and published in 1952. Subsequently, in 1968 Peplau's interpersonal techniques became the substance of psychiatric nursing underscoring four phases in a nurse-patient relationship as orientation, identification, exploitation, resolution while identifying six nurse's role: stranger, teacher, resource person, counselor, …show more content…
The last stage of this process is known as resolution bearing a connotation of termination when a person puts aside old goals and adapts new ones and feels empowered to be independent and comfortable to separate from a nurse. Although these four phases are essential in the Peplau's theory, it is crucial to keep in mind a nurse's roles which make the process achievable. Thus a brief discussion of a nurse's function is in order. First, a stranger role emphasizes the acceptance of the patient objectively, the second role as a teacher is self-explanatory explaining the role by offering information and serving as an aid to learning. The next function of a nurse, a resource person, assists in medical plan interpretation when the fourth role as counselor helps the patient to work on specific problems. The last two roles include surrogate and leadership which can be summarized as a patient advocate and lastly as a professional offering direction to the client. Conversely, every nursing theory revolves around four concepts: patient, health, environment and nursing. Hence, the Peplau's theory also addresses each and one of the concepts starting with a 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" (Gonzalo,
Peplau utilized both deductive and inductive reasoning in her theory development work (Reed & Shearer, 2011). The deductive reasoning methods used were that Peplau integrated ideas from a number of theories into her theory of interpersonal relations. Influenced by works of Sigmund Freud, particularly his interest in unconscious motivation as well as Harry S. Sullivan’s theory of interpersonal relations all contributed to her development of the theory of interpersonal processes in nursing, For example she refers to Sullivan’s concepts of anxiety, self-system and modes of experiencing. (Peterson & Bredow, 2017). She also incorporated into her theory some elements from developmental psychology and learning theory (Armstrong & Kelly, 1995) and some ideas of the humanistic psychologists, Abraham Maslow, Rollo May and Carl Rogers. (Peterson & Bredow, 2017). For example, Peplau’s systematic approach to establishment of nurse-patient relationship and therapeutic intervention are ideas that resonated with Martha Rogers' theoretical assumptions about human pattern and organization. (Armstrong & Kelly, 1995).
The purpose of this paper is to compare and contrast nursing theorists from the four categories which are identified by Meleis as: Needs, Interaction, Outcome and Caring. (Meleis, 2012, Chapter 9) I have chosen Faye Abdellah, Imogene King, Myra Levine and Jean Watson as the grand theorists that I would like to explore for this study in contrast and comparison. This decision was made, in part, due to the fact that all of these theorists were born and educated in the twentieth century and I felt that their theories might be more applicable to my nursing practice. The information contained in the tables was obtained from several sources in an
Peplau defines nursing as the therapeutic interpersonal, serial, goal- oriented process. A health-focused human relationship( Meleis, p 165, 2012)
The nurse understands she has the knowledge of the disease process, and the patient has the knowledge of how the disease affects himself. The second phase of the relationship is the working phase, where the patient identifies who can help them with their health care problem. The nurse looks at the health care problem from the patient perspective and begins educating the patient on their health care problem, therefore the educated patient is better able to collaborate with the nurse to determine what interventions are necessary and acceptable to the patient to achieve a patient centered health related goal. The termination phase is the final phase of the theory, the nurse and the patient determine how the patient will maintain their progress and continue to work on the health care goals independently without the assistance of nursing. (Deane, & Fain, 2016).
My personal definition of nursing is taking care of my patient as a whole; using my knowledge, being compassionate and caring, respectful and honest. Taking care of the; spiritual, physical and emotional aspect of the patient, and taking into consideration their family and environment. Learning about the different theorists I associate myself the most with Hildegard Peplau. Peplau believed that the relationship between the patient and the nurse was focus of attention, rather than the patient only as the unit of attention. (Chitty & Black p.314-315). Using Peplau’s theory my relationship begins with my patients as strangers and I try to
Hildegard Peplau’s middle-range theory, Interpersonal Relations, established in 1948 and highlighted the nurse-patient relationship as the groundwork of nursing practice. Peplau supports each role individually, the nurse and the patient, by ensuring that equal participation is implemented to reach a mutual goal. For example, the role of the patient reflects vulnerability and the expectation to be open to the health care providers throughout care and treatment plan. Subsequently, the nurse is supposed to facilitate a reciprocated relationship by noting the client’s behavior, defining the client’s illness, creating the most proper care for the client, understanding the physician’s treatment plan and confirming it, and intervening when required (Sue Penckofer, 2013).
Theory±practice relationship only will be offered here. The content of nurse practitioners ' discourse is the principal concern of this paper.
Middle range nursing theories are abstract, testable theories that contain a limited number of variables. According to Chinn and Kramer (2011), middle range nursing theories can lead to new practice approaches as well as examine factors that influence the desired outcomes in nursing practice. One beneficial and widely used middle range nursing theory is the theory of unpleasant symptoms, developed collaboratively by Lenz, Pugh, Milligan, Gift, and Suppe in 1995.
The theory contained four major concepts that can be considered theoretically simple. Although the theory can be considered simple, it does not fit the idea of parsimony because it mainly accounts for psychiatric nurses specifically. However, the theory can still be applied generally to relationships with clients and any healthcare profession. Another consideration is that the client has to be able to perceive difficulties and therefore an infant or young child, comatose client, or mentally disabled client limits the generality to whom it is applied. The accessibility of Peplau’s theory can be validated through the indicators of an effective interpersonal relationship with empathic linkages and progression through the stages. Being able to assess behaviors is an ability accessible to most, which can be accessible to nursing practice whether it is in the community setting or hospital setting. The importance of Peplau’s theory contributes to the valued nursing goal of wellness by improving relationships that strengthen self-worth, provide a sense of connectedness with others, and support self-confidence.
In comparison, Middle range theory is composed by clear propositions and can contain testable hypothesis (Armstrong, & Kelly, 1995). As a result, Peplau’s Interpersonal relationship theory is a middle range theory because the proposition of her theory are testable, specific and limited (Armstrong, & Kelly, 1995). In her theory, she applies the principle of human relationships and explained that the nurse and patient should work together to gain more knowledge in the care process (Gastmans, 1998). She used deductive reasoning in her theory because she integrated ideas of other theorists
A nurse-patient relationship is the basic requirements in all practice settings. Its usage is to manage communication between an organization and a public while maintaining boundaries in the therapeutic relationship. Based on Peplau’s interpersonal theory, communication takes place in a nurse-client relationship where therapeutic process occurs involving complex factors such as environment, attitudes, practices, and beliefs in the dominant culture (seu.edu, 2015). The actions of each person in a nurse-patient relationship is measured on the collaboration of their thoughts, feelings, and experiences. Nurse’s work to attain, maintain, and restore the patient’s health until patient have fulfilled the health care needs. Patient must be guided and provided a well-respected environment until a better health and specific needs are fully considered in the relationship. In this kind of setting, nurse’s must create relationship with patients by communicating receptivity, assimilating the concepts of empathy, trust, genuineness, respect, and confidentiality into their interactions.
In this concept nurses will look for all internal and external factors that affect the patient’s recovery. According to the patient needs nurse will modify or alter these factors. Nurse will assess the various aspects of the patient such as culture, family and other support system and coordinate the care according to the individual patient needs. In the nursing concept, it is an art, science and a practice discipline which involves caring. The nurses will provide care for the well and sick, assist the individuals in their self-care activities and help them to attain their human potentials. The nurse will place the client in a best condition so that the nature can restore their health. The nurse will develop a therapeutic relationship with client and family and work towards to meet the nursing goals. The nurse also work with individual, family and communities to maintain, enhance and recover health and reduce the effects of illness. The concept in the nursing metaparadigm is important in determining the philosophy of nursing and nursing practice. Learning what to do as a nurse will develop throughout the life. A greater knowledge in these concepts can improve the patient care and ongoing development of the nursing
By giving nurses a sense of identity, nursing theory can help patients, managers and other healthcare professionals to recognize the unique contribution that nurses make to the healthcare service (Draper 1990).Hildegard Peplau, one of the role model of nursing theorist, established a theory of interpersonal relationships in nursing. Her reason is the goal of the nurse-client relationship is to give a quality nursing care moving forward to health promotion and maintenance. The purpose of this paper is to conduct a basic assessment of her theory.
Research in the professional practice of nursing was built upon a wide variety of theories that were presented by many well-known nursing theorists. Nursing theories that may be recognized today include Florence Nightingale’s Environmental Theory, Dorothea Orem’s Self-Care Deficit Theory, Madeleine Leininger’s Cultural Care Theory, and Hildegard Peplau’s Interpersonal Process Theory. These individuals and their respective theories
Introduction According to Iyer (2010), every person that is alive is made up of cells. These cells are basically the practical component of all organisms that are known to live. Similarly, concepts are the essential components and the construction blocks of theory growth (George, 2010). As the cells begin to develop, divide, and grow into a life form that is complex, concepts (whichever experiential or abstract) when they have been examined tested and authorized with examination progresses into a body of awareness, control, or science (George, 2010). The objective for this essay is to be able to analyze and compare the essential concept descriptions of Hildegard E. Peplau's Interpersonal Relations in nursing theory and and also including that of Ida J. Orlando's theory of Nursing Process Discipline. This essay will also bring out the concept statement, philosophies, metaparadigms, and conceptual model of Madeleine M. Leininger's theory of Culture Care Diversity and Universality (also understand: Universality and Transcultural Nursing Theory and Theory of Culture Care Diversity were both being expended back and forth). This essay also talks about how and where the philosophy of Transcultural Nursing could be pertained to the nursing area. Comparison and Examination of the central ideas of Orlando's and Peplau's philosophies Peplau's concept of Interpersonal Associations in nursing and Orlando's Nursing Process