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Peplau’s Theory of Nurse-Patient Relationship


Peplau theorized the main goal of care is to create an interpersonal, therapeutic relationship to allow nurses to assist their clients in identifying their felt problems. The therapeutic relationship is considered a healing technique essential for providing professional assistance to clients. This professional relationship focuses on the client’s problems, needs, and feelings (Smith & Parker, 2015). It entails interaction between nurses and clients working together towards common goals (Hagerty et al., 2017). A nurse-patient relationship is achieved through a series of steps following a sequential pattern. The four phases include orientation, identification, exploitation, and resolution.

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Orientation Phase

The nurse-patient therapeutic relationship begins here. Nurses are expected to greet their clients with respect and positive interest, according to a stranger (Gonzalo, 2021). They provide the clients with basic information (name or professional roles) to build a sense of trust and foster open communication (Arabacı, 2019). Proper introduction help set the mood for interaction, especially when the patient is tense or unresponsive. Nonverbal communication techniques like eye contact and a handshake can help reinforce spoken words, which helps clients adjust to their current environment. This enables nurses to collect vital information to determine their problems.

Identification Phase

Patients work collaboratively with healthcare professionals. The relevant intervention goals are established to guide client actions and the nursing process. The nurse-patient conversation is centered on active problem-solving through assessing the needs and empowering clients to sincerely express feelings or issues that they are having (Hagerty et al., 2017). Nurses can opt to partially self-disclose information about themselves to relate to their patients. This allows patients to express their feelings and relate their experiences to what nurses have revealed. This enables patients to open up when they have difficulties sharing (Arabacı, 2019). Thus, this reduces the feeling of helplessness and hopelessness as well as addresses the issues they experience.

Exploitation Phase

It is considered the implementation stage of the nursing plan. Here the patients utilize what they learn to solve their main challenges. Nurses can help plan new goals for patients to accomplish through personal effort. This ensures that the power shifts from clinicians to clients, allowing them to independently achieve the newly set objectives (Hagerty et al., 2017). Nevertheless, the patients may still be offered assistance to aid them in solving other problems. This may require interview techniques to explore, understand and effectively address the underlying issues. Thus, nurses help their clients to exploit all avenues of professional assistance.

Resolution Phase

At this level, the care offered by healthcare professionals is no longer needed, and the nurse-patient therapeutic relationship is terminated. Here clinicians and patients evaluate the situation based on the previously set goals to determine whether they have been achieved (Hagerty et al., 2017). If the patient’s needs have been addressed, a healthcare professional severs their relationship with them. This promotes self-management or independence and allows for a healthier emotional balance and maturity. The patient gradually puts aside previous goals and sets new ones (Gonzalo, 2021). Thus, this phase is where patients free themselves from identifying with healthcare professionals.

Current Nursing Example Based on Peplau’s Theory

Mr. B is a 76-year-old diabetic patient. He can enquire about the condition and associated risk factors in the orientation phase. In the identification phase, the nurse and the patient collaboratively set goals that need to be achieved. The patient may join a rehabilitation program and receive lifestyle education. In the exploitation phase, the nurse may assist the patient in accomplishing all goals mutually agreed upon and recommend that Mr. B attends physical and emotional therapy classes. He can receive advice on managing risk factors, such as eating healthy, taking medicine as prescribed, and quitting smoking. The nurse may terminate the therapeutic relationship in the resolution phase, especially if Mr. B has changed his high-risk behaviors (smoking) and is confident to engage in lower-intensity activities (walking).


Peplau’s theory helps healthcare professionals design more sophisticated and therapeutic nursing interventions. The four phases (exploitation, identification, orientation, and resolution) are vital in establishing nurse-client relationships to meet unique priorities and healthcare needs. The theory demonstrates that nurses’ responsibility is caring and incorporating activities that positively influence patients’ health outcomes. In this case, Peplau’s theory can be applied to different roles in diverse situations. Cooperation may be hindered in a scenario where clients are unfit or unable to converse, for instance, unconscious or comatose patients. Nevertheless, the theory can ensure that patients receive safe, compassionate, competent, and optimal nursing care.

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Arabacı, L. (2019). Effect of using a Peplau’s interpersonal relation nursing model in the care of a juvenile delinquent. Journal of Psychiatric Nursing. Web.

Gonzalo, A. (2021). Hildegard Peplau: Interpersonal relations theory. Web.

Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s theory of interpersonal relations: An alternate factor structure for patient experience data? Nursing Science Quarterly, 30(2), 160–167. Web.

Smith, M., & Parker, M. (2015). Nursing theories and nursing practice. F. A. Davis Company.

Yip, J. (2021). Theory-based advanced nursing practice: A practice update on the application of Orem’s self-care deficit nursing theory. SAGE Open Nursing, 7, 23779608211011993. Web.

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