Selection of theory
Peplau’s approach on interpersonal relations theory suggests that nursing aims to aid patients to realize their felt difficulties. The theory emphasizes the professional-patient relation as the foundation of clinical practice (Hagerty et al., 2017). This significant objective provides the incentive for the clinical therapeutic process in which the two respect one another as individuals. The process also accords them more learning & advancement as a result of the interaction. The components of the theory include
- Person who is referred to as the client with a felt need.
- Health refers to the client’ physical or mental condition.
- Environment- according to the theorist, the environment is critical to a patient’s wellbeing. Thereby emphasizing that nurses consider a patient’s culture to help them adjust to a hospital routine.
- Nursing- refers to the human relations between the sick and the nurse practitioner who helps to recognize and respond to the clinical need.
The therapeutic nurse-patient relationship focuses on patient needs with an interaction involving one or more individuals with a common goal Arabacı & Taş, 2019). A series of steps must be followed to attain the objective.
- Orientation phase- includes engaging patients in treatment by offering explanations, information, and answering questions.
- Identification step- occurs when a patient works along with a nurse, expressing their feelings, which leads them to begin feeling better.
- Exploitation step- the patient makes use of the clinical services rendered by the nurse.
- Resolution phase- is when termination of the services rendered by a nurse occurs as the collaborative impact of both parties has already met the patients’ needs.
Selection of clinical scenario
The clinical scenario involves John, a 25-year-old man who had been brought to a health facility with allegations of violence towards his family members. The patient had a history of alcohol overuse from the age of 15 years. It is also assumed that his father committed suicide after he was unable to provide for his family. Other than that, John’s developmental milestones are favourable, and he has no significant medical history. His performance in college was excellent, and he is also an outgoing young man. Nevertheless, he is easily irritated during interactions with family and friends. A mental evaluation found that the patient had tactile hallucinations. His physical assessment revealed that he had a scar on his right arm following a fight during a drunken event with unknown persons. No further findings were realized. A diagnostic impression of substance-induced psychosis was noted, and the client admitted in the psychiatric ward.
The treatment plan involved the use of antipsychotics, although the main focus in his treatment was to manage substance abuse (Ogoncho et al., 2017). During the first phase, the nurse’s stranger role occurred in the psychiatric unit, where the two first met during therapy sessions. During this phase, the nurse
- Was receptive to the patient as he welcomed him to his office and introduced himself in a friendly manner.
- The nurse then asked the patient on his reason for admission, listened to the patient narration with empathy which helped to facilitate initial trust.
- The goal of the nurse was to build trust and confidence with the patient, which would allow him to express his feelings and thoughts freely.
The nurse then requested the patient to allow for more discussion into the issue of alcoholism which
- Allowed for a mutual discussion and a chance for the practitioner to comprehend the lived experience and the impact alcohol had on John’s life.
- Thereafter, John recounted his experience with the alcohol issue as the nurse listened keenly.
From the narration, both defined the issue to be alcohol abuse. John demonstrated remorse and requested assistance to stop using alcohol. He also admitted that peer pressure was the major reason for abusing alcohol. The nurse explained the detrimental effects of alcohol abuse and the remedies that existed to help mitigate the issue. He also explained his expectations from John with regards to abstaining from alcohol use. The patient conveyed an understanding of the negative impacts of alcohol overuse and was willing to comply with the guidance provided to help resolve the issue.
How theory relates to the clinical scenario
Peplau’s interpersonal relations theory works as a framework that assists nursing professionals in understanding & managing individuals with substance-induced psychosis. The approach involves a therapeutic process that is collaboratively conducted by the nursing practitioner and the client towards resolving a recognized clinical condition. The nurse-client interaction occurs through three phases that entail:
- Orientation
- Working
The nursing practitioner role is to function as a stranger, counsellor, a leader, or resource person to assist the patient in adopting healthy behaviour. The goal for the nurse in the stranger role is to create rapport, build confidence, and trust with the patient. Hence, compassionate verbal and non-verbal communication is needed to ensure a respectful approach and non-judgmental behaviour. The patient can then be free to express their emotions, feelings, and thoughts regarding their ill health. As a result, this enhances a further understanding of the clinical issue and guides a practitioner in helping patients meet their health needs.
Also, a diversion towards an interpersonal relations theory tends to direct nurses from a disease and treatment approach to include patient experiences improving care. After a narration concerning a health issue, a nurse requires to explore their feelings & beliefs when dealing with the client. In this instance, a nurse understands that peer pressure is a significant contributor to substance abuse. Hence, a trusting association with a client improves the ability for a practitioner to offer education, support, & medical expertise regarding incorporating productive activities to engage in, which would reduce the pressure from his peers. It is also found that providing information regarding the negative impacts of alcohol abuse empowers patients to consider informed decisions regarding changing their behaviour. In this case, one can say that it was through a significant interpersonal relationship between the nurse and patient that led to improved outcomes.
Historical perspective/ background of the theorist
Peplau was an American nurse who was famous for her interpersonal relations theory. Her works helped to advance the scholarly careers of practising nurses. She also left a vast impact on the field of nursing and the livelihood of the mentally challenged individuals in the U.S. She became the founder of modern psychiatric nursing, educator, an advocate for the psychologically challenged, and a proponent of advanced education for nurses.
Peplau viewed nursing as therapeutic and referred to the profession as a healing art which involved assisting people in need of health care. According to her, the nursing profession is an interpersonal process as it consists of an association between two or more people with a common objective. A common goal provides the inducement for the therapeutic process in which both parties work together leading to improved patient outcomes.
Assumptions
The assumptions of Peplau’s theoretical approach are
- Nurses and patients can interact (Adams, 2017).
- Both nurse and patient develop knowledge as a result of the therapeutic interaction between them.
- Communication skills are an essential tool in the nursing profession.
- Nurses must look into their beliefs to promote patient outcomes and avoid limiting client preferences to those that they value.
Conclusion
- Peplau’s interpersonal relations theoretical approach provides for a therapeutic process via which a practitioner in a collaborative association with the client can help resolve a mutually agreed upon health issue.
- The clinical issues of people can be physical and also psychological, spiritual, and social. Hence, an application of this theoretical approach in psychosocial care is appropriate while improving the healthcare of patients.
- The nurse-patient interaction allows patients to express their emotions and thoughts about their presiding ill condition, which enhances more understanding of the disease and guides professionals to help patients meet their needs.
Therefore, nursing practice must divert its attention on strengthening interpersonal relationships with patients to improve healthcare outcomes.
References
Adams, L. Y. (2017). Peplau’s contributions to psychiatric and nursing knowledge. Journal of Mental Health and Addiction Nursing, 1(1), e10-e18.
Arabacı, L. B., & Taş, G. (2019). Effect of Using Peplau’s Interpersonal Relation Nursing Model in the care of a juvenile delinquent. Journal of Psychiatric Nursing/Psikiyatri Hemsireleri Dernegi, 10(3).
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.
Ogoncho, I. M., Sanga, P., & Halake, D. G. (2017). Case Management of Substance Induced Psychosis Using Peplau’s Theory of Interpersonal Relations.