Hildegard Peplaus Theory of Interpersonal Relationships

Peplaus Theory of Interpersonal Relations and Her Impact on Nursing Today

Ferris State University Nursing 324
Jamie K. Dykstra

Hildegard Peplaus Theory of Interpersonal Relationships

Abstract
This paper explores the theoretical and clinical work of Hildegard Peplau. The work of Peplau
has laid a strong foundation upon which we base nursing today. Hildegard Peplau was
instrumental in creating a theory which empowers nurses to establish strong relationships with
patients. These relationships allow for accurate and intimate assessments, help the patients get
the best care, and help lead them to wellness. This paper examines the depth of Peplaus work
and her impact in nursing today.

Hildegard Peplaus Theory of Interpersonal Relationships

Nursing theory has impacted the nursing community greatly in the last fifty years by
stimulating growth of nursing education and literature. These increased educational
opportunities have in turn stimulated more structure to the training of nurses. Nursing was once a
vocational education that was focused on skillful completion of tasks (Tomey p.3) The
development of nursing theory has created nursing knowledge on which to base nursing
practice (Tomey, p.3). The Theory of Interpersonal Relations was developed by Hildegrad
Peplau. As Silas (2000) states Hildegard Peplau has been involved with and active in almost
every movement toward professionalism of the nursing profession (p. 29). The Theory of
Interpersonal Relations has impacted the role of the nurse to be that of a leader and an active part
of the healthcare team.
According to Fawcett (2005) Hildegard Peplaus educational, practice, and teaching
experiences led to an interest in clarifying what happens in a nurse-patient relationship
(Peplau, 1952, p.v). Through these experiences, Peplau developed the Theory of Interpersonal
Relations. Fawcett (2005) stated that: Pepelaus work is a middle-range descriptive
classification theory that focuses on the phases of the interpersonal process that occur when an ill
person and a nurse come together to resolve a health-related difficulty (p. 528). This
relationship is built between every patient who comes in contact with a nurse. Peplaus theory
lays the groundwork to build strong relationships. Merritt and Procter (2010, p. 2) state that the
Peplau model establishes a partnership between the nurse and patient, and with it a notion of
shared humanity between the nurse and patient (Peplau 1952, 1991, and 1997). This model is

Hildegard Peplaus Theory of Interpersonal Relationships

used in clinical practice at every encounter, and helps the nurse to set themselves in a position
that builds trust thus enabling a complete and thorough assessment.
Fawcett (2005 p. 531) uses Peplaus words to differentiate between nursing and medicine
by stating that:
Physicians are mainly concerned about the incidence, etiology, diagnosis and
treatment of disease. The information which their work requires obtains largely through
physical examination and tests which patients undergoMuch of the medical theoretical
framework flows from anatomy, pathology, physiology, biology, chemistry, genetics- the
hard sciences. The relationship (often brief) of physician to patient is largely scripted
by the treatment, based on diagnosis and laboratory findings. Nurses collaborate in
carrying out orders and in health teaching related to the medical treatment. However, the
nurse-patient relationship is unscripted. It is dependent largely upon the conceptual
knowledge which each nurse has about the patients presenting data and the phenomena
in the domain of nursing. This knowledge is in the nurses head, available for recall and
application during the interaction. It is this kind of intellectual work by nurses that can
transform nurse-patient interactions into a learning event for patients. Much of the
current nursing knowledge framework flow from the social sciences-the soft sciencespsychology, sociology, and the humanities, with some uses of other basic sciences, such
as biology. This may change when nursing science is fully developed (Peplau, 1997
pp.165-166).
Peplau was instrumental in identifying the importance of the nurse-patient relationship.
She argued that the purpose of the nurse-client relationship is to provide effective nursing care

Hildegard Peplaus Theory of Interpersonal Relationships

leading to health promotion and maintenance ( Courey, Martsolf, Draucker, &Strickland, 2008,
p. 137). Peplau laid the groundwork that has empowered nurses to seek out the opportunity to
build an influential relationship with her patients. According to Courey et al. (2008), in Peplaus
theory the nurse adopts one or more of six helping roles when providing care: stranger, resource
person, teacher, leader, surrogate, and counselor. According to Fawcett (2005) a seventh role of
technical expert was added later.
Many nursing care plans of today are designed to focus on the importance of this
relationship such as: disruption of family routine, spirituality, knowledge, and hopelessness.
Clearly, none of these areas would be able to be addressed without the nurse and patient having a
strong and trusting relationship. Today, nurses are taught in school the importance of this
relationship and it is often the primary focus of every nurse. Working in pediatrics, the nurse/
patient and nurse/family of the patient relationship plays an extremely important role. If a nurse
in todays society functioned as a nurse of the past and only used technical skills to care for
patients, not only would she not be successful in practice, but patients would not get the care
they deserve. Fawcett (2005, p. 530) used Peplaus work to conclude that Interpersonal
Relations enable nurses to understand the meaning of the experience that the patient is having.
(Peplau, 1952, p.41). Through this understanding, nurses are able to encourage the patient to
participate in identifying and assessing his problem and to engage him as an active partner in his
recovery. (Peplau, 1952, 23).
While it is obvious that Peplau made a tremendous impact on nursing of today with the
Theory of Interpersonal Realtions, it could be easy to confuse some of the roles and see where
boundaries may get blurred. As a nurse working in pediatrics, I have relationships with many of
the patients that I care for that I have had for my entire nursing career. Working in the roles of

Hildegard Peplaus Theory of Interpersonal Relationships

surrogate, leader and teacher for example have enabled me to become very close to these patients
and their families. It is often times considered almost a friendship however, it was formed by
using the roles that Peplau described. I have seen this turn into a co-dependent relationship, but
have also seen it lead patients on their way to wellness.
On the other hand, Peplaus Theory of interpersonal Realtions has led the way in
encouraging hospitals to develop care models such as Relationship Based Care (RBC). Hospitals
compete for patients by advertising the care model that they use. Healthcare consumers of today
look as these care models and see great value in things such as family centered care rounds and
nurse taught educational opportunities such as breastfeeding classes. Peplau was ahead of the
times in which she worked. Peplaus work was unique because when she worked in the 1950s
the nurse role was so technical. The models such as RBC have just become widespread in the
last several years. Peplau focused on the patient, their wellness, the factors surrounding their
wellness, health promotion and relationships at a time when the primary focus was supportive
care.

Hildegard Peplaus Theory of Interpersonal Relationships

References
Alligood, Martha Raile, and Tomey, Ann Marriner. (2010). Nursing Theorists and Their Work
(7thed.). Maryland Heights, MO: Mosby Elesvier.
Courney, Tamara J, Martsolf, Donna S., Draucker, Claire B., & Strickland, Karen M. (2008).
Hildegard Peplaus Theory and the Health Care Encounters of Survivors of Sexual
Violence. Journal of the American Psychiatric Nurses Association, 14 (2), 136-143. doi:
10.1177/1078390308315613
Fawcett, Jacqueline. (2005). Contemporary Nursing Knowledge: Analysis and Evaluation of
Nursing Models and Theories (2nd ed.). Philadelphia, PA: F.A. Davis Company.
Merrit, Michael K., and Procter, Nicholas G. (2010, March 27). Conceptualizing the Functional
Role of the Mental Health Consultation-Liason nurse in Multi-Morbidity, Using Peplaus
Nursing Theory [Contemporary Nurse Journal]. Retrived from http://www.contemporary
nurse.com/archives/vol34/issue/2/article/3589.
Silas, Grayce M. (2000). Pepelau and Professionalism: The Emergence of the Paradigm if
Professionalization. Journal of the American Psychiatric Nurses Association, 6(1), 2934. doi: 10.1177/107839030000600107

Hildegard Peplaus Theory of Interpersonal Relationships

Grading Rubric for Theory Paper

1. Introduction of theory/model
a. Introduction clear and well focused
b. History and significance of model

8
Possible

Points

points

Earned

5
5

2. Analysis of Model
a. Explain the model in terms of: Person, Environment, Health, 10
and Nursing.
b. Explain other concepts that are unique to the model.
c. Demonstrate how the model can be used in clinical practice.
d. Explain how the model can be used as a Framework for

10
10
10

patient assessment.
e. Explain the model within the context of nursing education.
f. Identify strengths and limitations of the model.
g. Analyze the model overall, demonstrating new insights

10
10
10

about the model.

3. Evidence of Academic Writing
a. Development of a clear, logical, well-supported paper;
demonstrating original thought and content.
b. Evidence of research with a minimum of 2 research articles

5
5

in addition to the course required texts. Correct acknowledgement

of sources using APA style referencing. Attaches APA checklist
c. Overall presentation; grammar, spelling, punctuation, clean

and legible.
d. Stays within page limit which includes: one cover page, one

reference page, body of paper is to have a maximum of 5 pages

and a minimum of 3 full pages.
Total Possible Points
Total Points Earned

100

Hildegard Peplaus Theory of Interpersonal Relationships

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1. Page Numbers: Did you number your pages using the automatic functions of your Word
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Hildegard Peplaus Theory of Interpersonal Relationships

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Space twice after punctuation marks at the end of a sentence. [p. 87-88]
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The variables that impact the etiology and the human response to various disease states
will be explored (Bell-Scriber, 2007, p. 1).
Please note where the quotation marks are placed, where the final period is placed, no first
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Patients respond to illnesses in various ways depending on a number of factors that will be
explored (Bell-Scriber, 2007). Do all paraphrased citations look like this? [p. 171 and
multiple examples in text on p. 40-59]

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C. Is your reference list double spaced with hanging indents? [p. 37]

PROOFREAD FOR GRAMMAR, SPELLING, PUNCTUATION, & STRUCTURE

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13. Did you follow the assignment rubric? Did you make headings that address each major
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or them. Also, in referring to a human, dont refer to the person as that, but rather
who. For example: The nurse that gave the injection. Should be The nurse who gave
the injection Did you check for subject agreement? Likewise, dont refer to us, we,
our, within the paperthis is not about you and me. Be clear in identifying. For example
dont say Our profession uses empirical data to support . . Instead say The nursing
profession uses empirical data..

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21. Did you check your sentences to make sure you did not end them with a preposition?
For example, I witnessed activities that I was not happy with. Instead, I witnessed
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26. Does your paper have sentence fragments? Do you have complete sentences?

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word it. Its = it is. Its is possessive.

Signing below indicates you have proofread your paper for the errors in the checklist:

Hildegard Peplaus Theory of Interpersonal Relationships

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_Jamie Dykstra_____________________________________________________
DATE:___4/1/2010_____________

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