Question

1.Present an overview of peplau's nursing theory. Provide evidence that demonstrates support for the model's efficacy in nursing practice. Explain how the theory proves the conceptual model.

2.Explain how the peplau`s nursing theory incorporates the four metaparadigm concepts.

3 Provide three evidence-based examples that demonstrate how the peplau`s nursing  theory supports nursing practice. Provide support and rationale for each.

Answer 1

Hildegard Peplau’s theory of interpersonal relations is a middle range theory that focuses on the nurse – patient relationship and how the two work together toward the common goal of wellness. By working through a set of phases in a particular order, the nurse and patient can reach the goal toward wellness together and the patient can continue that journey after the relationship is terminated. This theory is important because the nurse needs to understand the importance of how the nurse-patient relationship can help the patient achieve a better understanding of the importance of their care.

Peplau defines Nursing Process as a deliberate intellectual activity that guides the professional practice of nursing in providing care in an orderly, systematic manner.
Peplau explains 4 phases such as:

• Orientation: Nurse and patient come together as strangers; meeting initiated by patient who expresses a “felt need”; work together to recognize, clarify and define facts related to need.

• Identification: Patient participates in goal setting; has feeling of belonging and selectively responds to those who can meet his or her needs.

• Exploitation: Patient actively seeks and draws knowledge and expertise of those who can help.

• Resolution: Occurs after other phases are completed successfully. This leads to termination of the relationship.

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.

Peplau`s nursing theory incorporate set of theories or ideas that provide structure for how a discipline should function. For a nursing discipline, these theories consist of four basic concepts that address the patient as a whole, the patient’s health and well-being, the patient’s environment and the nursing responsibilities. While there are several different nursing theories, these four basic nursing metaparadigms point to a holistic view of care where a person’s well-being and medical health is connected to four interactive components.

Person Component: The person component of the metaparadigm focuses on the receiver of care. However, the person connection also includes family members and other groups important to the patient. The care structure considers the person’s spiritual and social needs as well as health care needs. The resulting health outcome is attributed to how the person interacts with these physical and social connections. The premise is that the person is empowered to manage his health and well-being with dignity and self-preservation with positive personal connections.

Environment Component: The environment aspect of the nursing metaparadigms focuses on the surroundings that affect the patient. The environment consists of internal and external influences, and contends that how a person continuously interacts with her surroundings has a bearing on health and wellness. Interactions with family, friends and other people are part of the environment, as are physical and social factors such as economic conditions, geographic locations, culture, social connections and technology. This metaparadigm component theorizes that a person can modify her environmental factors to improve her health status.

Health Component: The health component of the four metaparadigms refers to the extent of wellness and health care access that a patient has. This health component is characterized as one with multiple dimensions in a constant state of motion. Health and wellness covers a person’s lifespan and genetic makeup, and how the physical, emotional, intellectual, social and spiritual well-being is integrated in health care for maximum health benefits

Nursing Component: The nursing component of the metaparadigm involves the delivery of optimal health outcomes for the patient through a mutual relationship in a safe and caring environment. The nursing component applies principles of knowledge, skills, technology, collaborations, professional judgement and communication to carry out duties and responsibilities for achieving the best possible scenario in patient health outcome. This nursing component values a high degree of service, and integrates with other metaparadigm components for patient well-being.

The recruitment and retention of participants for research studies is often a challenge. Nurse researchers have the ability, by the nature of their role, to be successful in this endeavor. Nurses are caring, provide comfort, and often are the persons whom persons trust most in the healthcare experience. Using the interpersonal relations theory by Peplau, the researchers were able to share strategies used to recruit, encourage participation, and retain women for the study and to illustrate how these strategies were used during the various phases (orientation, working, termination) of the nurse-participant relationship. Patients with chronic illness often have co-morbid depression and anxiety. Peplau’s theory is a framework that can easily be used in caring for these patients, but can also provide a sound basis for conducting successful research. Hildegard Peplau produced many accomplishments in her lifetime and her Theory of Interpersonal Relations still influences the field of nursing today. This theory emphasizes the close relationship a nurse and patient must make to have effective nursing care happen. This theory also connects on many levels with the Austin Peay School of Nursing concepts that influence the education of the numerous students attending. Learning about this theory can only positively affect how nursing students will enter into their clinical experience. With this theory in hand, student nurses and licensed nurses can have the opportunity to provide the care and communication needed to create the best nurse-patient relationship.