Peplau and professionalism: the emergence of the paradigm of professionalization

We asked Dr Grayce Sills, a long-time collegue and friend of Dr Hildegard Peplau, to write a historical paper to assist in understanding the contributions of Dr Peplau to the professionalization of nursing. This historical reflection reveals insights into Dr Hildegard Peplau as a person, her leadership and her scholarly abilities. Dr Peplau's theorizing is largely inductive and based on keen observations of her clinical work and her environment. This insight into her inductive curiosity is further revealed in the papers that follow.     

Interpersonal relations in nursing: a philosophical-ethical analysis of the work of Hildegard E. Peplau

Interpersonal relations in nursing: a philosophical-ethical analysis of the work of Hildegard E. Peplau ¶ Nursing typically has been viewed as a moral practice, for instance by new developments in the ethics of care. Nevertheless, many philosophical-ethical presuppositions of nursing theories remain to be clarified. This paper presents a philosophical-ethical analysis of the work of Hildegard E. Peplau. Analysis of the philosophical-ethical background of Peplau's works illuminates a view on nursing practice that is relevant today. Three main components are analysed more deeply, i.e. the professionalization of nursing, the philosophical underpinnings of Peplau's view on nursing science, and the nurse–patient relationship as the central event in nursing.     

The evolution of an intervention — the use of Peplau's process of practice-based theory development

In 1969, at the first Nursing Theory Conference, Hildegard Peplau proposed a research methodology that would guide the development of nursing knowledge. To direct nurses in the development of practice-based theory, Peplau proposed a three-step process that would assist in this pursuit. The purpose of this paper is to describe the use of Peplau's process of practice-based theory development as it has directed a program of research in the area of depression. Peplau's ideas related to practice-based theory development came at a time in nursing when grand theories were being developed and theoretical nursing was highly valued. Peplau, ahead of her time, proposed an approach that valued the development of nursing knowledge in practice, while also combining both qualitative and quantitative methods. This research methodology deserves recognition today, as one that can guide knowledge development in psychiatric nursing.     

Hildegard E. Peplau: The psychiatric nursing legacy of a legend

Hildegard Peplau is remembered by nurses worldwide as the “mother of psychiatric nursing.” Her scope of influence transcended her psychiatric nursing specialty and had a profound effect on the nursing profession, nursing science, and nursing practice. Peplau played a leadership role by influencing and emphasizing the advancement of professional, educational, and practice standards, and the importance of professional self-regulation through credentialing. She made a major contribution to nursing science, professional nursing, and, of course, to the psychiatric nursing specialty through development of the Interpersonal Relations paradigm, a mid-range theory that has influenced the importance with which the nurse-patient relationship is regarded. The essential nature of the nurse-patient relationship and its significance as a therapeutic modality operationalizes Peplau's scholarship and provides the basis for both the art and science of nursing practice. Peplau would challenge psychiatric nurses to thrive in the new millennium through continued commitment to the importance of the nurse-patient relationship, engagement in evidence-based practice, support of competence in information technology, and provision of leadership in influencing the health care paradigm shift to community-based health care delivery.     

A Glance Back in Time: Nurse-Doctor Relationships

As individuals, we have history, the present, and the future. Dr. Hildegard Peplau, the "mother of psychiatric nursing, "developed the role of the nurse in the nurse-patient relationship. When she died in March of this year, she left a great legacy to the nursing profession. We reprint here, almost in its entirety, this article from Nursing Forum, 1966,5(1), 60-75, in which Dr. Peplau traces the nurse-doctor relationship from the beginning of this century. Her conclusions, written more than 30 years ago, are valid today.     

Transforming Practice Knowledge into Nursing Knowledge—A Revisionist Analysis of Peplau

Nursing practice typically has been viewed as applying knowledge. However, currently, there is increasing awareness that nursing practice is also a process of knowledge development. Still, research and practice are not always connected. Analysis of Peplau's works illuminates a scholarship of nursing practice that is relevant today. This paper focuses on a specific strategy and philosophic perspective, as derived from Peplau, for integrating nursing practice more fully into today's knowledge development. Emphasis is on the need for nursing practice-based theory, as well as nursing theory-based practice.     

Peplau人际关系模式在实习护生管理中的应用

目的探讨Peplau人际关系模式在实习护生管理中的应用效果。方法按照Peplau人际关系模式中认识期、确认期、进展期、解决期4个阶段对护生进行管理，并对实施与未实施人际关系模式护生实习成绩及护生对临床带教老师的评价进行对比。结果实施人际关系模式的护生实习成绩及护生对临床带教老师评价均高于未实施组（P〈0．01或P〈0．05）。结论Peplau人际关系模式的应用实现了临床带教工作的系统化、科学化、规范化，提高了实习护生的理论成绩、临床实践能力及临床带教老师的专业素质。     

A comparison of the works of Peplau and Orlando

Peplau and Orlando have had a great impact on the past and current practice of mental health nursing. Their works represent some of the first attempts at theory development in nursing. This article compares and critiques the works of these two theorists. The emphasis on the interpersonal relationship is a major focus of both theorists. Peplau has a greater emphasis on the development of the individual, while Orlando focuses on the immediate needs of the client. They both contribute greatly to the development of nursing science. Appreciating their work only for its historical significance would be a major oversight.     

Interpersonal relations: a theoretical framework for application in nursing practice.

Peplau discusses major features of the theory of interpersonal relations. She describes her theory as among the most useful to apply during nursing practice in order to understand nurse-patient interactive phenomena. Peplau addresses how she derived constructs from clinical data and identified their congruence with nursing practice. She further addresses the specific concepts of her theory and their relations, and specific uses of the theory in practice.     

Peplau人际关系理论在护理实践中的应用现状

阐述Peplau人际关系理论的核心内容,综述Peplau人际关系理论在国内外护理实践中的应用现状。     

Explorations in body image care: Peplau and practice knowledge

Practitioners in mental health care have long utilized the work of Hildegard Peplau, both for nursing discourse and for practice. At a time when the role of theory in practice is once more being debated, and when theories are being applied in new contexts, this paper examines the contribution that Peplau's work may have to offer altered body image nursing care. A case study is used to highlight concepts in practice, the paper examining the ways in which Peplau's Theory of Interpersonal Relations complement the other elements of practice knowledge that the nurse uses to assist patients and lay carers alike.     

Nurse bait: strategies hospitalized patients use to entice nurses within the context of the interpersonal relationship

Patients on medical-surgical and psychiatric inpatient units long for more and deeper connections with nurses. Patients' dependence on the nursing staff, as well as their perceived powerlessness, creates a situation where patients believe they have to actively find ways to seek needed nursing care. This paper will describe active strategies used by medical-surgical patients to entice nurses within the context of the nurse-patient relationship; strategies designed to mitigate vulnerability and increase interpersonal connection. Implications for nursing practice and for Peplau 's Theory of Interpersonal Relations will be presented.     

Awareness of self and expanding consciousness: using nursing theories to prepare nurse-therapists

Psychotherapy is an accepted role of the advanced practice psychiatric nurse. Nursing theorists, notably Hildegard Peplau and Margaret Newman, offer guidance on the psychological and professional development of the nurse. This paper examines Newman's theory of health as expanding consciousness and the concept of awareness of self in Peplau's theory, and suggests that psychiatric advanced practice nursing programs consider the need for nurses to develop self-knowledge to facilitate the nurse-patient relationship and to improve outcomes of patient care in psychotherapy.     

Perspectives on the hallucinatory process

Hallucinations are common psychiatric symptoms and the hallucinating patient presents a number of nursing problems. Although psychiatric nurses have written fairly extensively about hallucinations as a clinical problem, little nursing research has tested commonly recommended nursing interventions. This paper presents a review of interdisciplinary research on hallucinations and synthesizes findings with clinical observations to suggest a number of areas needing greater stress in nursing practice and research. Aspects of a model proposed by Peplau (1963), Rector (1982), and Field (1985) are questioned. Improved assessments of hallucinating patients are recommended, with exploration of subtleties in the hallucinatory experience; and factors needing assessment are identified. Major emphasis is placed on the need to explore patient efforts at controlling hallucinations as a foundation for promoting patient self-monitoring and self-regulation of hallucinatory experience.     

The future of the Theory of Interpersonal Relations? A personal reflection on Peplau's legacy

The work of Hildegard Peplau represents the most significant influence, worldwide, on the development of psychiatric nursing practice. Her use of the Theory of Interpersonal Relations created the basis for defining the potential significance of the psychiatric nurse's role as a therapeutic agent. Forty years later she has indicated the means by which nurses might sharpen their focus on the person often overshadowed by the 'patient' label. Peplau's writings have, over this 40-year period, helped clarify the broad range of roles required of the nurse in general and in particular, within psychotherapeutic nursing.     

Control and restraint in contemporary psychiatric nursing: some ethical considerations

Nursing theories which have evolved from mental health-psychiatric nursing have focused on the individual nurse-client relationship Other nursing theories generally focus on the individual as client Therefore, nurses working with families may have difficulty in applying these frameworks to their practice Nursing theories need to be expanded to include families, groups and communities more explicitly The well established theory of Hildegard Peplau, which previous studies have found to be the theory most frequently used by psychiatric nurses, and the family systems nursing theory of Wright and Leahey share a complementary focus Both theories form part of the interpersonal paradigm of nursing, both view nursing from an interactional perspective, rather than focusing on individuals Use of a combined theoretical approach offers several advantages The approach explicitly considers both the individual and the family The combination provides grounding for family work in an articulated nursing theory     

Interpersonal mental health nursing: research issues and challenges

Since Peplau outlined her perceptions of psychiatric/mental health nursing in (1952) interpersonal relationships has been considered by many as the core of practice. In the intervening period of almost a half century many researchers and theorists have endeavoured to develop and integrate Peplau's framework into day-to-day nursing activity. However, more recently, as a result of the fusion between the professional nursing agenda and the wider political agenda, the importance of interpersonal relationships and the individuality of psychiatric/mental health nursing is being questioned. This questioning is represented in the debate about the aetiology of mental illness, the choice of research methods to determine treatment outcomes and by association the role and value of the psychiatric/mental health nurse. This paper will focus on the interpersonal nature of psychiatric/mental health nursing and explore possible research approaches aimed at explicating its core. Attention will be given to the necessity of using pluralistic methodology in order to do so.     

A naturalistic test of Peplau's theory in home visiting

Nurse-client relationships have been considered the foundation of successful home-visiting programs for vulnerable families. Even though nurse-client relationships are important when working with multiproblem families, relationship theory has not been used to guide interventions in home visiting. Identification of a fitting theory could provide direction for tailoring interventions to families at a "dose" individualized to meet their needs. This article reports a small study that tested the applicability of Peplau's theory of interpersonal relations in nursing (Peplau, 1952/1991) in the context of home visiting. Five prenatal clients and public health nurses participated in the study. Home visits were observed and audio-recorded beginning with the first prenatal home visit and ending in the early postpartum period. Audiotapes were transcribed and analyzed using a start list of codes based on Peplau's theory. Changes in the percentage of interaction assigned to the relationship phases along with a rating from the Relationship Form were compared over time to determine whether relationships progressed as predicted by Peplau. Findings of this study supported Peplau's theory. Implications for nursing practice and research are discussed.     

The interface of anthropology and nursing guiding culturally competent care in psychiatric nursing

Nurses and all health care providers are called on to involve patients and families in health care decision-making and to accommodate culturally diverse populations. This article describes the Interface of Anthropology and Nursing Model (IAN), which is derived from the works of Kleinman and Peplau, classical theorists from anthropology and nursing, respectively. This model provides a framework for nurses to uncover cultural information through the elicitation, analysis, transfer, restructure, and feedback of explanatory models within the interpersonal nurse-patient relationship. Such integration of theory enhances a holistic nursing practice incorporating good communication, mutual decision making, and fostering patient agency.