SEMINAR

ON
PEPLAUS THEORY

SUBMITTED TO- SR.TESSY SEBASTIAN

MS.CHARLOTTE PAUL
PRINCIPAL

SUBMITTED BYM.Sc (N) I YEAR

SRMMCON.

SRMMCON

PRESENTED ON-

.04.2009

Subject - Advance Nursing Practice.

Topic - Peplaus theory.
Name of teacher - Ms. Charlotte Paul.
M. Sc (N) I year
Group - M. Sc (N) I year
A.V. aids charts, blackboard, transparency, flash cards.
Supervisor - Sr.Tessy Sebastian.
GENERAL OBJECTIVES At the end of the of seminar the group is able to understand Peplaus
theory and its application in various.

SPECIFIC OBJECTIVES At the end of the of seminar the group is able to 1. know the interpersonal relation or Peplaus theory.
2. understand the Peplaus theory.
3. know the concept of Peplaus theory.
4. enumerate the concept of Peplaus theory.
5. discuss the concept of Peplaus theory.
6. know the phases of Peplaus theory.
7. enumerate the phases of Peplaus theory.
8. understand phases of Peplaus theory.
9. describe the phases of Peplaus theory.
10. know the role of nurse related the theory.
11.
list the role of nurse.
12.
discuss the role of nurse.
13. Identify the role of nurse.
14.
Know the application of the theory in different areas.
15. List the areas application in nursing.
16. Identify the relation of the theory with the nursing process.
17. Apply the theory while giving nursing care.
18. Describe the relation of theory with nursing process.

HANDOUTS
Seminar Topic- Peplaus theory.

Supervisor - Sr.Tessy Sebastian

Submitted by- Ms.Charlotte

Paul
Principal

M.Sc (N) I Year

SRMMCON.

SRMMCON.
1. Introduction
2. Background of theorist.
3. Evolution of theory.
Concept Peplaus model evolves from psychodynamics of
Nursing. She defines psychodynamic nursing as being able to
understand ones own behavior to help others identify felt
difficulties and to apply principles of human relations to the
problems that arise at all levels of experiences.

Conceptual framework of theory.

4. Metaparadigm of the theory.

Human being, health, environment, and nursing.

5. Characteristics of the theory.

6. Nursing roles.
7. Phases of the theory.

There are 4 phases; orientation, identification, exploitation and resolution.

8. Relationship of interpersonal process with nursing process.

Orientation Assessment
Identification Goal setting, Planning
Exploitation Implementation
Resolution
-- Evaluation

9. Situation.
Mr. Bharat is 25 yrs. old boy, he is admitted in Male Medical ward with
Diagnosis of Gastritis , having abdomen pain, Nausea, discomfort and
anxiety.

10.

Evaluation of the theory.

Concepts are clear, consistent and defined easily understandable

Simple in nature, logical , systematic way of viewing nursing
Consistent with nursing values and mission
Holistic in nature
Can be used in any specialty and all areas of relationship
Can be learned with practice and easy to use
Contributes to nursing process

Easily accessible to practitioners to guide and improve practice.

11.

Limitations of the theory.

Narrow perception of the environment is major limitation of the theory.
Only focuses on the psychological task within a person.
Intra family dynamics, personal space considerations and community
social service resources are considered less
Health promotion and maintenance were less emphasized

Cannot be used in a patient who doesnt have a felt need eg. With
drawn patients, unconscious patients

Some areas are not specific enough to generate hypothesis

12. Conclusion.
Peplau,s has developed a very important theory which can be
easily understood and applied. This theory can be applied in nursing education,
nursing research, and nursing practice. Not only this, the theory is being applied
in nursing administration and management.

BIBLIOGRAPHY-

BOOKS1. George B. Julia , Nursing Theories- The base for professional

Nursing Practice , 3rd ed. Norwalk, Appleton & Lange.
;P
th
2. Basavanthappa B.T. Nursing Theories.4 ed. Jaypee
publication.Delhi.2004; P
3. Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing
Concepts Process & Practice 3rd ed. London Mosby Year Book;
P- 305
4. Vandemark L.M. Awareness of self & expanding consciousness:
using Nursing theories to prepare nurse therapists Ment
Health Nurs. 2006 Jul; 27(6) : P-605-15
5. Reed PG, The force of nursing theory guided- practice. Nurs Sci
Q. 2006 Jul;19(3): P-225
WEBSITEwww.google.com.peplaus theory

1. INTRODUCTION
Nursing profession is under an evolutionary phase. To evolve
nursing requires its own body of knowledge and when realization came it
brought into existence realization came it brought into existence various
theories. In 1952, based on the maturing force of personality it includes
nurse client relationship, communication and pattern integration. It is an
interaction oriented theory. This is theory of interpersonal relations by
Hildegard E. Peplau.

2.BACKGROUND OF THEORIST

1909 - Dr. Hildegard Peplau, born on 1 September, 1909, in Reading,

Pennsylvania.
1931 - Graduated from a diploma in nursing program in Pottstown,
Pennsylvania.
1943 graduated from Bennigton college with BA in Interpersonal
psychology from Columbia University in New York.
1947 MA in Psychiatric nursing.
1952 Published book Interpersonal relations in Nursing and wrote
articles in professional magazines.
1953 Ed.D in Curriculum development, Columbia, New York.
Experience includes working as private and general duty hospital
nursing, US Army Corps, Nursing research and private practice in
psychiatric nursing.
She taught graduate psychiatric nursing and is Professor Emeritus from
Rutgers University.
Certification in psychoanalysis for teachers.
She influenced the development of many nursing programs including
the creation of the first post baccalaureate nursing program in
Belgium.
She is nationally and internationally recognized as a nurse and leader
in health care.
She has served WHO, the national institute of mental health and in
World War II in Armed Nurses Corps.
She was Executive Director and President of The American Academy of
Nursing.
She served as Nursing Consultant to various foreign countries and to
the Surgeon General of the Air Force.
1974 She retired; but continued writing in journals and books.

1988 Her book Interpersonal relations in nursing. Was reissued by

Springer, New York.
First published nursing theorist in a century since Nightingale.
Died in 1999.

CONTRIBUTIONS AND ACHIVEMENTS

Created the nursing middle range theory of Interpersonal Relations

Created nursing curriculum including nurse patient interaction through
process recording
Transformed nursing from a group of skilled workers to a profession
Published book on Interpersonal Relations in 1952
Contributed to mental health reform and laws
Known as mother of psychiatric nursing
Professor emeritus
Ambassador for psychiatric education in nursing
Inspired generation of students
Had powerful vision to move nursing forward to a profession of respect
Left a legacy of dignified and healing relationship with patients.

INTERPERSONAL RELATIONS THEORYBasic elements

The patient
The nurse
The interaction between the patient and the nurse.

DEFINITIONS

Client/Patient
Person, couple, groups or community deserving of human care with dignity,
privacy and ethics
EnvironmentPhysiological, psychological and social fluidity that may be illness,
maintaining or health promoting.
Health
Forward movement of personality and other ongoing human process in the
direction of creative, constructive, personal and community living
Nurse
The medium of the art of nursing, a maturing force. The unique blend of
ideals, values, integrity, commitment to the well being of others

Nursing
Is an interpersonal process involving interaction between two or more
persons with a common goal
Nurse patient interaction is a therapeutic process. It is a healing art.

InteractionInteraction is a phenomenon that occur between people.

3.EVOLUTION OF THEORY

She worked on of Sullivans theory of Interpersonal relations.

She used the work of Harry Stack Sullivan, Percival Symonds, Freud,
Abraham Maslow, Bela Mittleman, and the psychoanalytic model
Published book Interpersonal relations in Nursing.
She refered her book as Partical theory for the practice of Nursing.
Synthesis, reorganization or extension of concepts drawn from the
basic and applied sciences was a new concept.
Knowledge borrowed from behavior sciences termed as, Psychological
mold.
Analysis of interaction of students with patients
Study of nurse patient interaction through process recording
Experience in psychiatric field
Own concept, values and beliefs about nursing.

ASSUMPTIONS 1. The kind of nurse each person becomes makes a difference in what
each client will learn as she or he is nursed throughout his or her
experiences with illness.
2. Fostering personality development in the direction of maturity is a
function of nursing and nursing education. It requires the use of
principles and method to deal with every day interpersonal problem or
difficulties.
3. Since illness provides opportunity for learning and growth, nursing can
assist clients to develop competencies through nurse client interaction
4. Nursing can take as its unique focus the reactions of clients to the
circumstance of their illness or health problems.
5. All human behavior is purposeful and goal seeking in terms of feelings
of satisfaction.
6. The interaction of nurse and client is fruitful when a method of
communication that identifies and uses common meanings is at work
in the situation.

7. Difficulties in interpersonal relations occur in varying intensities

throughout the life of everyone.
8. Patient is able to participate in an interpersonal relationship.
9. Interpersonal relations will enhance self maturity and/or self fulfillment.

4.CONCEPTS USED BY PEPLAUSPeplaus model evolves from psychodynamics of Nursing. She defines
psychodynamic nursing as being able to understand ones own behavior to
help others identify felt difficulties and to apply principles of human relations
to the problems that arise at all levels of experiences.
She develops the model by describing the structural concepts of the
interpersonal process the phases of nurse patient relationship. Four
sequential steps in interpersonal relationship orientation, identification,
exploitation and resolution. Each of these phases overlaps interrelates and
varies in duration as the process evolves towards a solution. Different roles
are assumed during the various phases.
According to Peplau Nursing is therapeutic because it is a healing art,
assisting an individual who is sick or in need of health care. The nurse
patients have a common goal while interacting, they respect each other and
both of them are learning and growing as a result of the interaction. An
individual learns when he/she selects stimuli in the environment and then
reacts to the stimuli. According to Peplau each individual is unique biologicalpsychological- spiritual sociological structure. This is due to the different
environment, mores, customs and beliefs of that individuals given culture.
The nurse has a broad range of nursing knowledge which leads to
greater understanding. The nurse patient continues relationship, understand
each others roles and problems. They collaborate and share in mutual goals
until problem is solved. Genevieve Burton agreed with Peplaus concept that
nursing is, maturing force and an educative instrument. And states that,
Behavior of others must be understood in light of self understanding.
BASIC
1. The
2. The
3. The

ELEMENTS
patient
nurse
interaction between the patient and the nurse.

CONCEPTUAL FRAMEWORK
Intrapersonal

Goal

achieved

Factors

Interpersonal
Factors

+ve

Teacher student
interaction

Interpersonal
relations

Environmental
Not achieved.
-ve

5.METAPARADIGM1. Human being an organism that strives in its own way to reduce tension
generated by needs.
2. Health a word symbol that implies forward movements of personality
and other ongoing human processes in the direction of creative,
constructive, protective, personal, and community living.
3. Society/ environment she does not directly address society/environment,
she does encourage the nurse to consider the patients culture and mores
when the patient adjusts to hospital routine.
4. Nursing significant therapeutic interpersonal process. She defines it as a
human relationship between an individual who is sick or in need of health
services and of nurse specialist educated to recognize and to respond to
the need for the health. The nurse assists the patient in this interpersonal
process.

6.CHARACTERISTICS OF THE THEORY1. Theories can interrelate concepts in such a way as to create a different
way of looking at a particular phenomenon.
2. Four phases interrelate the different components of each phase.
3. The nurse patient interaction can apply to the concepts of human being
,health, environment and nursing.
4. Theories must be logical in nature
5. Provides a logical systematic way of viewing nursing situations
6. Key concepts such as anxiety, tension, goals, and frustration are indicated
with explicit relationships among them and progressive phases
7. Theories should be relatively simple yet generalizable
8. It provides simplicity in regard to the natural progression of the NP
relationship.
9. Leads to adaptability in any nurse patient relationship.
10.

The basic nature of nursing still considered an interpersonal process

11.

Theories can be the bases for hypothesis that can be tested.

12.

Has generated testable hypotheses.

13. Theories contribute to and assist in increasing the general body of

knowledge within the discipline through the research implemented to
validate them.
14. In 1950s two third of the nursing research concentrated on N-P
relation ship.
15. Theories can be utilized by practitioners to guide and improve their
practice.
16.

Peplaus anxiety continuum is still used in anxiety patients

17. Theories must be consistent with other validated theories, laws, and
principles but will leave open unanswered questions that need to be
investigated.
18.

Consistent with various theories.

7.NURSING ROLES Role of nurse as assumed during the various phases

1. Teacher One who imparts knowledge concerning a need or interest.

2. Resource - One who provides specific, needed information that aids in
understanding of a problem or a new situation.
3. Stranger- The first role of stranger. Nurse patient are to each other.
4. Counselor- One who through the use of certain skills and facing, accepting
and resolving problems that are interfering the other persons ability to
live happily and effectively.
5. Leader One who carries out the process of initiation and maintenance of
group goals through interaction.
6. Technical expert One who provides physical care by displaying clinical
skills and operating equipment in this care.
7. Surrogate One who takes the place of another.
8. PHASES OF THE THEORYORIENTATION Nurse patient are strangers
Patient has a felt need and seeks assistance
Rapport is established
Mutually problem is clarified & defined
Anxiety is minimized
Active participation is encouraged.
FACTORS INFLENCING ORIENTATION PHASE-

THE OUTCOME OF INTERACTION Positive

Negative
Understanding
Misunderstanding
Openness
Closeness
No fear & anxiety
Fear & anxiety

IDENTIFICATION-

Identify problem
Both clarify perception and expectation
Level of dependence, independence and goal are decided
Selection of professional assistance
Begin to feel belonging & capable of dealing with problem
Patient recognizes participative roles

A Key To Effective CommunicationEffective communication (verbal and non verbal)

Interpersonal skill
Positive attitude
Observation and perception
Self scrutiny.

Outcome Of Nurse Patient RelationshipBoth learn and grow from this experience
Respect each other
Empowerment of both nurse and patient
Improves patient autonomy and maturity
Anxiety is converted into purposeful actions
Help patient to help themselves
Guide patients towards healing
Improved health outcome
High satisfaction for both
Healing and caring in less stressful environment
Increased sense of responsibility for self.

EXPLOITATION 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

RESOLUTION Client needs met

Mutual termination of relationship
Sense of security is formed
Patient has less reliance on nurse
Increased self reliance to deal with own problem.

9.INTERPERSONAL RELATIONS 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
Assessment
Data collection and
analysis [continuous]
May not be a felt need
Nursing diagnosis
Planning
Mutually set goals
Implementation
Plans initiated towards
achievement of
mutually set goals
May be accomplished
by patient , nurse or
family
Evaluation
Based on mutually
expected behaviors
May led to termination
and initiation of new
plans

Orientation
Non continuous data
collection
Felt need
Define needs
Identification
Interdependent goal
setting
Exploitation
Patient actively seeking
and drawing help
Patient initiated

Resolution
Occurs after other
phases are completed
successfully
Leads to termination

10.SITUATION

Mr. Bharat is 25 yrs. old boy, he is admitted in Male Medical ward with
Diagnosis of Gastritis , having abdomen pain, Nausea, discomfort and
anxiety.
S.N Orientation Identifica
Exploitation
Resolution
o
tion
1. Patient
having pain.
2. Assess the
location of
pain,
duration,
onset,
intensity,
discomfort,
restless.

Pain will
be
reduced.

3. Continuous
interaction.

Advise for rest.

Assess the
duration of the
pain, area of
pain.
Make
comfortable.
Make the
environment
calm and quiet
Plenty of oral
fluids
Allow only self
activity.
Give the
analgesics
according to
physician order.

Pain is
reduced as
evidenced by
patient feel
comfortable &
reduced
restlessness &
he performed
his self
activity.

CONTEMPORARY USE 1.
2.
3.
4.
5.
6.

Translated into multiple languages.

Used by psychiatric nurses and advanced nurse practitioners.
Has stood the test of time.
Used widely around the world.
Integrated to nursing practice and policy development.
Give reference to research.

PREVIOUS APPLICATION TO PRACTICEPatient health education

Psychiatric nursing
Home care
Nurse counseling
AIDS care
Quality of life

Oncology.

APPLICATION TO RESEARCH Home care

Depression
Patient education
Nature of nurse patient relation
Role expectation
Psychiatric practice.
APPLICATION TO NURSING EDUCATION Teaching and learning
In all areas of interpersonal relationship in educational setting
Teaching communication and interpersonal skills and interpersonal relation
theory and practicing it.
IMPORTANCE OF THE THEORY Understanding of ones own behavior
Helping others identify felt difficulty
Application of human relations to problems at all level of experience
Applicability in any nurse patient relationship to meet patient needs

EVALUATION OF THE THEORY Concepts are clear, consistent and defined easily understandable
Simple in nature, logical , systematic way of viewing nursing
Consistent with nursing values and mission
Holistic in nature
Can be used in any specialty and all areas of relationship
Can be learned with practice and easy to use
Contributes to nursing process
Easily accessible to practitioners to guide and improve practice.

LIMITATION
1. Narrow perception of the environment is major limitation of the theory.
2. Only focuses on the psychological task within a person.
3. Intra family dynamics, personal space considerations and community social
service resources are considered less
4. Health promotion and maintenance were less emphasized

5. Cannot be used in a patient who doesnt have a felt need eg. With drawn
patients, unconscious patients
6. Some areas are not specific enough to generate hypothesis.

CONCLUSIONPeplau,s has developed a very important theory which can be

easily understood and applied. This theory can be applied in nursing education,
nursing research, and nursing practice. Not only this, the theory is being applied
in nursing administration and management.

BIBLIOGRAPHYBOOKS6. George B. Julia , Nursing Theories- The base for professional

Nursing Practice , 3rd ed. Norwalk, Appleton & Lange.
;P
th
7. Basavanthappa B.T. Nursing Theories.4 ed. Jaypee
publication.Delhi.2004; P
8. Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing
Concepts Process & Practice 3rd ed. London Mosby Year Book;
P- 305
9. Vandemark L.M. Awareness of self & expanding consciousness:
using Nursing theories to prepare nurse therapists Ment
Health Nurs. 2006 Jul; 27(6) : P-605-15

10.
Reed PG, The force of nursing theory guided- practice.
Nurs Sci Q. 2006 Jul;19(3): P-225
WEBSITEwww.google.com.peplaus theory