The interaction between the patient and the nurse is a key determiner of the quality of care process. The partnership between the patient and the healthcare provider is paramount as it helps in the development of effective therapeutic interventions. It is based on this concept that Hildegard Peplau developed Interpersonal Relations Theory. Peplau was an American nurse born on September 1, 1909, and died on March 17, 1999. She is credited for having advocated for humane treatment of people with behavior and personality disorders. Hildegard was born in Reading, Pennsylvania. One of the key occurrences during her early life was the flu epidemic that happened in 1918; this experience helped her understand the implication of illness and death to a family.
Peplau undertook her nursing diploma program in Pottstown, Pennsylvania School of Nursing and graduated in 1931. She had an interest in interpersonal relations; thus, she further studied at Bennington College in Vermont and graduated with a Bachelor of Arts degree in interpersonal psychology in 1943. She later enrolled for masters and doctoral degrees in Teachers College, Columbia University where she graduated in 1947. Peplau’s career in nursing started immediately after graduating in 1931. She worked as a staff nurse in New York City before becoming a school nurse at Bennington College in Vermont. It is during this job that she enrolled and earned a degree in interpersonal psychology. Her major focus was to advance Sullivan’s interpersonal theory. She was privileged to have worked as an executive director and president of American Nurses Association (ANA).
Analysis
The main concept of the Interpersonal Relations Theory is to ensure that there is quality care delivery by applying humane approaches that are symmetrical, i.e. taking into consideration the needs of the patient and the professional input of the care provider. According to Peplau, effective nursing entails collaboration between the sick person and the caregiver with the core aim of ensuring the success of the therapeutic process. It involves a mutual respect between the parties (Wayne, 2014). The theory is based on various assumptions. First is that the patient and nurse mature due to the therapeutic interaction, second, communication and interviewing are critical skills for nursing, and third, nurses should have a clear understanding of themselves in order to enhance the growth of the patients and avoid tendencies that limit the choices of patients to nurses’ preferences. As such, the theory outlines that the core purpose of a nurse is to aid the clients to identify their difficulties. This can be realized by nurses applying humane approaches to the problems the patients may be experiencing. As such, Peplau defined nursing as, “An interpersonal process of therapeutic interactions between an individual who is sick, or in need of health services, and a nurse specially educated to recognize and to respond to the need for help” (Wayne, 2014, para. 2).
One of the core concepts of the theory’s relationship is the communicative and interviewing roles of nurses. These roles have been found to have an influence on the quality of the nursing care process. As pointed out by Wayne (2014) there is the need not to limit the choices of patients; the interaction should be mutual where the two parties mature. It is based on such context that Fakhr-Movahedi, Rahnavard, Salsali, and Negarandeh (2016) conducted a study to explore the role of communication in enhancing the relationship between nurses and patients. The study participants included 23 nurses, patients, and their families. The data was collected by application of semi-structured interview and observation while the analysis was by the use of content analysis. The study found out that positive communicative behavior entails caring attention, enlightening of the patient informally, calming the patient and building trust between the client and the nurse. It is based on this communicative role that the interactions between the two parties in the therapeutic process can lead to patient-centered care which is a core tenet of the theory. Fakhr-Movahedi et al. (2016) established that in a clinical setting, the relationship should be designed based on the needs of the patient. Thus, it can be inferred that if the patient’s needs are established the positive relationship will be enhanced, and consequently result in high quality of care. The study emphasizes and provides an evidence-based scenario of the practicality of the concept of the interpersonal relationships in the care delivery.
It is worth noting that the relationship is not limited to nurse-patient relationship abut cut across the entire health care provision sector. For instance, Taube (2016) carried out a review to examine the patient-doctor relationship in dermatology. Through the review, Taube (2016) found out that there has been a shift from a case of patient compliance to concordance. Concerning the concordance, the central focus is the impacts of a mutual process between the patient and the doctor. As pointed out by Fakhr-Movahedi et al. (2016) and Taube (2016) the relationship should be two-sided, and thus decisions are supposed to emanate from the two players. This forms the basis of the theory that assumes that patient-nurse relationship exists and should be tailored in a manner that the nurse does not dictate the options for the patient.
Relevance
Taube (2016) points out the interpersonal relationship model “… requires rather an interaction and communication between the doctor and the patient, with the goal of attaining agreement on appropriate medical diagnostics/treatment as the shared responsibility of the patient and the doctor” (p. 217). This assertion denotes the significance of putting into consideration the individual patient factors and the application of medical evidence to ensure humane care (Brom et al., 2014). For instance, in a case of skin diseases, the doctor should put into consideration possible stigmatization effect. These studies denote the various roles that nurses should play such as that of counselor, leader, teacher, surrogate and the same time a stranger who should be sensitive to the needs of the patients.
Summary
Strengths
Peplau’s theory of interpersonal relationships has proved to be critical in the design of therapeutic nursing interventions. It can be ascertained that it provides simplicity concerning how nurses can achieve high-quality care. The theory is also consistent with other nursing principles and models such as patient-centered care. For example, from the nursing literature provided in this paper, it shows that the theory is applicable in real life situations to achieve mutually set goals. The other key strength of the theory is that it is based on humane approaches in the care delivery.
Limitations
The emphasis of the theory is that the nurse should endeavor to establish the needs of the patients. Bearing in mind that nurses operate in a complex work environment where there are personal, environmental and cultural issues, it may not be applicable across the board especially for withdrawn, unconscious and abandoned patients as such patients may not have felt needs. Also, it puts a lot of emphasis on the interpersonal relationships that may jeopardize the provision of evidence-based practices which are crucial in modern nursing practice.
References
Brom, L., Pasman, H. R., Widdershoven, G. A., van der Vorst, M. J., Reijneveld, J. C., & Onwuteaka-Philipsen, B. D. (2014). Patients’ preferences for participation in treatment decision-making at the end of life: Qualitative interviews with advanced cancer patients. PloS one, 9(6), Web.
Fakhr-Movahedi, A., Rahnavard, Z., Salsali, M., & Negarandeh, R. (2016). Exploring nurse’s communicative role in nurse-patient relations: A qualitative study. Journal of Caring Sciences, 5(4), 267-276.
Taube, K. M. (2016). Patient–doctor relationship in dermatology: From compliance to concordance. Acta Dermato-Venereologica, 96(217), 25-29.
Wayne, G. (2014). Theorists and theories: Hildegard Peplau’s interpersonal relations theory. Web.