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PEPALU'S THEORY
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  PEPLAU’S THEORY OF INTERPERSONAL RELATIONSHIP INTRODUCTION Peplau’s theory focuses on the interpersonal processes and therapeutic relationship that develops between the nurse and the client. Interpersonal process include the nurse client relationship, communication, pattern integration and the role of nurse. This theory stressed the importance of nurses ability to understand own behaviour to help others identify  perceived difficulties.  Peplau’s Biography:      1909  –   Born in Reading, Pennsylvania    1931 - Graduated in diploma nursing program from Potts town.    1943  –   Done B.A in interpersonal psychology.    1947  –   Done M.A in psychiatric nursing from Columbia University.    1952 - Published model of Interpersonal Relations in Nursing.    1953  –   Awarded doctorate in nursing education.    Worked as executive director and president of ANA.    Worked with WHO, NIMH and nurse crops.    She has held positions in U.S. army.    She developed the first conceptual curriculum for the Bachelor of Science in nursing  program at Rutgers University.    1999 - died INTERPERSONAL RELATION MODEL    Peplau bases her model on psychodynamic nursing,  which is    Understanding of one’s own behaviour.      To help others identify their difficulties.    To applies principles of human relations to problems that arise at all level of human experience.    According to peplau,     Nursing is a therapeutic in that it is a healing art, assisting an individual who is sick or in need of the health care.     Nursing is an interpersonal process because it involves interaction between two or more individuals with a common goal.    The nurse and the patient work together so both become mature and knowledgeable in the process.  CONCEPTS OF PEPLAU’S THEORY     PERSON:    A developing organism that tries to reduce anxiety caused by needs.    Peplau does not include families, group, or communities.    Lives in an unstable equilibrium.  ENVIRONMENT:    Existing forces outside the organism and in the context of culture.    Is implied in that then nurse must consider culture and values when acclimating the  patient to the hospital environment, but Peplau does not address possible environmental influences on the patient.  HEALTH:    It is described as a concept that implies forward movement of personality and other on-going human processes towards creative, constructive, productive, and personal and community living.    Consists of interacting physiologic and interpersonal conditions.  NURSING:    Is a significant, therapeutic, interpersonal process that functions cooperatively with other human processes that make health possible.    Is a human relationship between an individual who is sick or who has a felt need and a nurse who is educated to recognize and respond to the need for help.    It functions cooperatively with other human process that make health possible for individuals in communities Peplau's Seven Nursing Roles Peplau's Seven Nursing Roles illustrate the dynamic character roles typical to clinical nursing. 1.   Stranger  role: Receives the client the same way one meets a stranger in other life situations; provides an accepting climate that builds trust. 2.   Resource  role: Answers questions, interprets clinical treatment data, gives information. 3.   Teaching  role: Gives instructions and provides training; involves analysis and synthesis of the learner's experience. 4.   Counseling  role: Helps client understand and integrate the meaning of current life circumstances; provides guidance and encouragement to make changes. 5.   Surrogate  role: Helps client clarify domains of dependence, interdependence, and independence and acts on clients behalf as advocate. 6.   Active leader ship: Helps client assume maximum responsibility for meeting treatment goals in a mutually satisfying way.  7.   Technical expert  role: Provides physical care by displaying clinical skills; Operates equipment PHASES OF INTERPERSONAL RELATIONS THEORY The four phases are orientation, identification, exploitation and resolutions. ORIENTATION PHASE    Problem defining phase.    Starts when client meet nurse as a stranger.    Defining problem and deciding type of service needed.    Client seeks assistance, conveys needs, ask questions, shares preconceptions and expectations of past experiences.     Nurse responds, explains roles to client, help to identify problems and to use available resources and services.    During this phase the individual has a “ FELT NEED ” .    The patient and the nurse work together to understand their reactions to each other, mindful of potential influencing factors, such as culture, religion, personal experiences and ideas.    Collaborative clarifying and defining of the problem allows the patient to direct energy away from the anxiety of unmet needs towards constructive activities. IDENTIFICATION PHASE    The patient responds selectively to the people who can meet the patient’s defined needs.      The patient and the nurse must continue to clarify each other’s perceptions and expectations because these determine their personal reactions.    The nurse’s expressed feelings can help an ill patient re spond with positive emotions and strengthened personality, which can provide needed satisfaction.    During this phase, the patient may begin to feel a sense of belonging and may gain confidence in dealing with the targeted problem.    These positive responses can decrease a sense of helplessness and hopelessness, creating an optimistic attitude that further promotes inner strength. EXPLOITATION PHASE    Use of professional assistance for problem solving alternatives.    The patient may use all available services based on personal interest and needs.    Individual feels as an integral part and more like a participant in the helping environment.    Patient may fluctuates on independence so the nurse must be aware about the various  phases of communication.    During this phase the patient attempts to derive full value from what is offered through the nurse patient relationship.     The nurse and can identify the new goals to be achieved through personal efforts and  power shifts from the nurse to the patient as the patient delays gratification to achieve the newly formed goal.    This shift could also result in the patient becoming more demanding, in which the nurse must use interview techniques to explore and understand the patient’s action.   RESOLUTION PHASE    Termination of professional relationship.    After the patient’s needs have been met by the collaborative efforts of the nurse and the  patient, the therapeutic relationship ends.    Resolution is achieved when the patient drifts away from identifying with the nurse and dissolves the nurse patient bond.    The patient puts aside old goals and adopts new goals.    Healthier emotional balance is demonstrated and both become mature individuals.    Successful resolution results directly from successful completion of the other three  phases. PEPLAU’ THEORY  AND NURSING PROCESS In nursing process the orientation phase parallels with assessment phase where both the  patient and the nurse are strangers; meeting initiated by patient who expresses a felt need. Conjointly , the nurse and the patient work together, clarifies and gather important information. Based on this assessment the nursing diagnosis are formulated, outcome and goals set. The interventions are planned, carried out and evaluation done based on mutually established expected behaviour. ASSESSMENT Data collection and analysis (continuous) May not be felt need ORIENTATION  Noncontinous data collection Felt need Define need DIAGNOSIS GOAL PLANNING IDENTIFICATION Interdependent goal setting IMPLEMENTATION Plans initiated towards achievements of mutually set goals May be accomplished by patient, nurse or family EXPLOITATION Patient actively seeking and drawing help Patient initiated EVALUATION Based on mutually expected behaviors May led to termination and initiations of new  plans RESOLUTION Occurs after other phases are completed successfully Leads to termination.
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