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。     

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.     

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。     

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.     

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.     

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.     

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.     

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.     

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.     

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     

Meaningful nursing research

Dr. Fawcett's editorial (Western Journal of Nursing Research, August 2000), staunchly criticizes research journals and researchers for their lack of attentiveness to nursing discipline-specific knowledge. She suggests that this lack of attentiveness posits nursing for extinction; in doing so, she raises fundamental questions about the relationship between nursing and nursing science. Despite a plethora of nursing literature, professional nursing remains an intangible concept for many nurses. The author addresses this issue from the perspective of her sense of self as a nurse.     

Getting Comfortable With the Uncomfortable: Nurse Leader as Advocate—One Leader’s Story

Nursing advocacy serves as the bedrock for supporting problems affecting nursing practice, the nursing profession as a whole, and health care issues. Every nurse has a professional mandate to advocate for the profession and answer the call to action to be the voice in all issues affecting nursing and patient care. Dr. Nicolette Fiore-Lopez shares her personal insights by providing examples of political advocacy in the nursing arena and how one may overcome the fears of conversing with congressional leaders. She addresses the why, the how, and the interface between advocacy and nursing practice. Grounded in the advocacy mission of the American Organization for Nursing Leadership, Dr. Fiore-Lopez reminds us that advocacy is our responsibility as nurses, and we should be able to speak about our profession and the legislative issues that affect it.     

Nursing praxis within Margaret Newman's theory of health as expanding consciousness

Nursing praxis was explored from the perspective of one Newman scholar. She shared her evolving perspectives on research as a doctoral candidate and as a member of a hospital-based praxis team she went on to develop with colleagues focusing on women with cancer. Using Newman's research method, the team interviewed families regarding meaningful persons and events in their lives. They then conducted another study in the form of action research. The praxis team found that Newman's theory resonated throughout nursing practice. Newman nursing praxis integrates theory, practice, and research.     

护士长兼任糖尿病专科护士工作的实践与成效

随着医学的发展，专科护士已成为近年来护理专科迅速发展起来的新角色。某院于2005年起，由内分泌科护士长兼任糖尿病专科护士，其为了兼顾好病房管理和专科护士两方面的工作，通过科学管理好时间，有计划地安排工作；优化护理工作模式，实施“层级全责一体化护理模式”；以成立“糖尿病联络护士工作小组”的形式，培训和指导非内分泌科护士的糖尿病专科知识和技能等。经过两年多的工作实践，在护理管理、专科护理质量、糖尿病患者教育等方面均获得很好成效，科室没有投诉和纠纷，没有发生任何差错事故；提高了患者的糖尿病知识知晓率；患者的综合满意度达到95％以上；并能开展一些糖尿病护理研究。因此，在目前没有条件设立全职糖尿病专科护士岗位的情况下，由护理骨干兼任糖尿病专科护士，履行其职责及发挥其功能，对为患者提供高水平、高质量的临床护理同样起到很好的作用。     

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.     

Hildahood: Taking the interpersonal theory of nursing to the neighborhood

This article examines the use of problematic patterns of interpersonal interactions as an intervention focus that is based on the interpersonal theory of nursing developed by Hildegard Peplau. In previous articles, interpersonal change strategies have been suggested that focus on the patterns that emerge between the client and the nurse. This article proposes an elaboration of the technique by shifting the focus from the “virtual” interactions that occur in the laboratory of the therapeutic nurse-client relationship to the “real” relations between the clients and their significant others. Measurement of the effect of the intervention by the appearance, intensity, and persistence of changes in outcomes along the lines predicted by the theory are illustrated.     

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.     

A Role Model of Leadership in and Advocacy for Nursing

Surely most nurses have heard her name. While in undergraduate nursing programs students dutifully study nursing leaders, trying to differentiate their theories and memorize their accomplishments. At the least, they recognize the names. But does the new generation of nurses understand the impact that one nursing leader can have on the profession? Unless one has been privileged to attend NYU, for example, I wonder if today's young nurse realizes what Martha Rogers has accomplished in her career. Does today's nurse know what her advocacy for nursing has meant to our profession? This paper addresses those issues and attempts to explain the leadership and advocacy roles that Martha Rogers has assumed in the practice of professional nursing.     

In Opposition to Nursing Diagnosis: A Minority Opinion

Does nursing diagnosis further nursing practice? This article examines the premises underlying nurses diagnoses and their impact on clinicians and the health care delivery system. The authors argue that nursing diagnoses in their current form limit nursing practice, create obstacles to clear communication, and constrain inference and intuition.
Once upon a hot summer day, a community health nursing student returned from a home visit to do her charting. Unbeknown to her instructor, this student was an aficionado of nursing diagnosis. She completed her note and gave it to the instructor to read:
S: "My feet hurt."'7 waked three miles today.(in 97o weather.)
O: Ankles edematous bilaterally; dorsum of feet warm to touch; 1 cm. vesicle on plantar aspect, right foot.
A. Alternation in comfort as a result of restless legs.
P. Bathe feet in tepid water; dry well; do not rupture vesicle; elevate legs.