Peplau’s Interpersonal Relations
Theory
Candace Creese
Wilmington University
Hildegard E. Peplau’s
Interpersonal Relations in
Nursing
Theory was published in
1953
Framework for
psychodynamic nursing
Theory was influenced
by Harry Stack Sullivan’s
theory of interpersonal
relations.
Middle range,
descriptive, classification
theory
Interpersonal Relations in Nursing
Theory
• Stresses the importance of nurses’ ability to
understand their own behaviors to help others
identify perceived difficulties.
• Emphasizes the focus on the interpersonal
processes and therapeutic relationship that
develops between the nurse and client.
• Four phases of the nurse-patient relationship are
identified
• Six primary roles of the nurse
• Six secondary roles of the nurse
4 Phases of nurse-patient relationship
 Orientation-client seeking
assistance, meeting of
nurse-patient, identifying
the problem and services
needed ( interview process),
and guidance.
 Identification- identifying
who is best to support
needs, patient addresses
personal feelings about the
experience and is
encouraged to participate in
care to promote personal
acceptance and satisfaction.
Phases cont.
Exploitation- patient attempts to explore,
understand and deal with the problem, and
gains independence on achieving the goal
 Resolution- termination of the therapeutic
relationship to encourage emotional balance
for nurse and patient ( difficult for both
patient and nurse as psychological
dependence persists)
Roles of Nurses
Primary
Stranger
Teacher
Resource person
Counselor
Surrogate
Leader
Secondary
Technical expert
Mediator
Safety agent
Researcher
Tutor
Manager of
environment
Application of Interpersonal Theory in
Nursing Practice
• An article in Current Nursing evaluated using the
theory in nursing practice
– Assessment= Orientation phase
– Nursing diagnosis
– Planning=Identification phase
– Implementing=Exploitation phase
– Evaluation=Resolution phase
(the theory allowed client’s needs to be assessed.
Application of the theory helped provide
comprehensive care to the client)
Research completed
• Urology Nursing used the theory to educate
newly diagnosed bladder cancer patients with
the need for a urinary diversion, and ensure
understanding.
Outcome shows that the scope of a patient’s needs
requires a competent nurse to assume the
changing roles in the four phases of the theory,
expressing the importance of involving the
patient in establishing goals and reviewing the
goals frequently.
Research completed
• British Journal of Nursing had an article researching
the credibility of Peplau’s theory, in mental health care,
due to the expansion of nursing knowledge and the
dynamics of a multidisciplinary team currently used in
today’s practice.
• Public Health Nursing did a study, in homecare visits,
(testing the use of Peplau’s theory) to work with multiproblem families, to identify interventions,
individualized for the members, to see if relationship
progression was increased within the family system
resulting in optimized care of the patient.
Application of theory in “MY” nursing
practice
• This theory would be useful with our newly diagnosed cancer patients and
their family. Resistance is met when trying to educate them about the
treatment, encouraging enrolment in studies, and education about how to
care for the patient in their home setting.
– Orientation-patient gets admitted to the unit, nurse helps the patient to
recognize and understand that they have cancer and the importance of
treatment.
– Identification-Patient takes the time to internalize the diagnosis, the nurse
participates in helping the patient to do so.
-- Exploitation-the nurse works to have the patient explore what help is needed
to meet goals, incorporating other disciplines to problem solve (oncologists,
therapists, alternative medicine, etc.).Patient test the limits of the nurses
availability, and the nurse encourages patient to evaluate ways to meet their
final goals.
-- Resolution-when in-patient treatment is complete, the nurse has to evaluate
feelings and remove themselves from the bond that is made, allowing the
patient and family to move on and regain balance in their own lives.