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.     

The Concept of “The Will to Thrive” in Mental Health

Mental health nursing is focused on patients moving along the continuum between failing and thriving in terms of emotional functioning. This differs dramatically from a medical model of disease/cure. A variety of nursing theorists have both directly and indirectly identified the importance of patient's “will to thrive” although this term has never been used. Peplau spoke of self-efficacy and self-esteem. Barrett's model focuses on the patient's participation in their own recovery as a key component. This article explores the concept, akin to failure to thrive in infants, of the will to thrive in the chronically ill and its role in assessment and nursing intervention. A particular emphasis on the importance of patient responsibility is identified as vital to the process of true change.     

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.     

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.     

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.     

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.     

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 nursing knowledge.

On May 19, 1991, in Tokyo, Japan, four nurse theorists participated in a panel discussion at Discovery International, Inc.'s Biennial Nurse Theorist Conference. The participants were Imogene M. King, Hildegard E. Peplau, Rosemarie Rizzo Parse, and Martha E. Rogers. The goal of the conference was to present the latest views on nursing knowledge of these nurse leaders. The panel discussion provided the nurse theorists with an opportunity to engage in dialogue regarding issues of concern to the audience. The panel moderator was Hiroko Minami of St. Luke's College of Nursing in Tokyo.     

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.     

Statement on nursing: a personal perspective.

Contemporary nursing is based on a conglomerate of theoretical nursing models. These models each incorporate four central concepts: person, health, environment, and nursing. By defining these concepts, nurses develop an individual framework from which they base their nursing practice. As an aspiring nurse practitioner in the gastroenterology field, I have retrospectively assessed my personal definitions of person, health, environment, and nursing. From these definitions, I am able to incorporate specific theoretical frameworks into my personal belief system, thus formulating a basis for my nursing practice. This foundation is comprised of the influence of nursing theorists Jean Watson, Sister Callista Roy, Kolcaba, Florence Nightingale, and Ida J. Orlando; the Perioperative Patient-Focused Model; Watson's Theory of Human Caring; theories regarding transpersonal human caring and healing; and feminist theories. Therefore, this article describes self-examination of nursing care by defining central nursing concepts, acknowledging the influence of nursing theorists and theories, and developing a personal framework from which I base my nursing practice.     

Orlando's deliberative nursing process theory: a practice application in an extended care facility

Ida J. Orlando was one of the first nursing theorists to write about the nursing process based on her own research. Her Deliberative Nursing Process Theory focuses on the interaction between the nurse and patient, perception validation, and the use of the nursing process to produce positive outcomes or patient improvement. Orlando's key focus was to define the function of nursing. This author's purpose is to acquaint nurses with Orlando's theory and to encourage the use of the deliberative process to bring about patient improvement. This article provides an analysis of Orlando's theory and a demonstration of its successful use in clinical practice in an extended care setting.     

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.     

The therapeutic relationship: historical development and contemporary significance

The therapeutic relationship is a concept held by many to be fundamental to the identity of mental health nurses. While the therapeutic relationship was given formal expression in nursing theory in the middle of the last century, its origins can be traced to attendants' interpersonal practices in the asylum era. The dominance of medical understandings of mental distress, and the working-class status of asylum attendants, prevented the development of an account of mental health nursing based on attendants' relationships with asylum inmates. It was left to Peplau and other nursing theorists to describe mental health nursing as a therapeutic relationship in the 1940s and later. Some distinctive features of colonial life in New Zealand suggest that the ideal of the attendant as the embodiment of bourgeoisie values seems particularly unlikely to have been realized in the New Zealand context. However, New Zealand literature from the 20th century shows that the therapeutic relationship, as part of a general development of a therapeutic discourse, came to assume a central place in conceptualizations of mental health nursing. While the therapeutic relationship is not by itself a sufficient basis for professional continuity, it continues to play a fundamental role in mental health nurses' professional identity. The way in which the therapeutic relationship is articulated in the future will determine the meaning of the therapeutic relationship for future generations of mental health nurses.     

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.     

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。     

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。     

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.     

Psychiatric mental health nursing: challenge and change

. We invited Dr Peplau to provide a personal reflection on the recent history of psychiatric nursing and her thoughts on immediate challenges facing the profession. The paper is an individual scholar's commentary on the way that psychiatry has waxed and waned over the years, in relation to nursing. This historical review discovers and reports a challenge to current practice. Dr Peplau describes a professional shift that is pulling nurses toward the subordinate role observed earlier this century. The paper draws attention to how contemporary practice can be positively influenced, e.g., by giving a structure to the allocation and conduct of nurse–patient time.