Critiquing Interpersonal Relation Theory

Critique of Interpersonal Relations Theory

A critical review of theories and evidence provided by theories is what translates theories into successful nursing practice. Nurses specifically evaluate theories with a goal to apply them into practice to improve patient care and outcomes. These evaluations may be deliberate, systematic, criteria-based, and objective. They also may be subjective and completed in a quick manner. Both types are important in providing the best of patient care (Meleis, 2012).

Hildegard Peplau created interpersonal relations theory. Peplau dedicated her life to improving the lives on patient’s that suffered from acute mental illness. This theory has found success in all aspects of nursing care. Peplau’s work started

with a goal to provide precise care in a fragile moment in a patients’ lives. Hildegard Peplau had a true passion for improvement, change and innovation in patient care. Peplau was an advocate for patients and nurses. Hildegard Peplau created interpersonal relations theory to provide a framework and a guide for staff, providing the tools and skills needed to provide exceptional care. Interpersonal theory incorporates patient care, compassion, empathy and advocacy (Peplau, 1997).
The selection of this theory was chosen as it correlates with the specialized area of psychiatric nursing.

In researching, evaluating and critiquing this theory, it will allow for personal and professional growth. The metatheorists selected to follow, are Chinn & Kramer. Chinn & Kramer offer a set of questions that guide the critiquing process. They pose a series of why questions. Chinn & Kramer first guide the researcher to a group of questions that will allow for understanding a theory. Another group of questions, to guide the reviewer to critically reflect on the theory (Meleis, 2012). I believe their process is detailed, objective and accomplished in a systemic manner to promote a consistent, reliable

critique.
Peplau’s theory consists of four stages of patient interaction. Each stage is critically important and one stage cannot continue unless the previous task was completed fully. Prior to the orientation phase, the nurse must be self-aware and understand their own values and beliefs. Part of the orientation phase is defining a problem. The next phase is the identification phase. This level of interaction includes involvement from both communicating parties. The patient develops a sense of trust and interest in their care. In the next step, exploitation phase, the patient seeks and draws knowledge from the expert. The last step of the patient interaction process is the resolution phase, this phase leads to successful termination of the nurse-patient relationship (Current Nursing, 2012).
Purpose of Interpersonal Theory
The purpose of this theory is to provide a framework and guide for the nurse-patient communication and relationship process. The purpose of the interpersonal relations theory is to assist nurses in the work they must do in order for the patient to regain independence, health and well-being (Peplau, 1997). Hildegard Peplau articulated the importance of the nurse-patient relationship. The nurse-patient relationship is a therapeutic process that proceeds through specific steps of the interaction process. It is a therapeutic, interpersonal, goal-oriented process (Meleis, 2012).
Concepts of Interpersonal Theory
According to Peplau, nursing is a healing art, assisting a patient in a time of need.

Nursing is viewed as an interpersonal process that requires interaction between patient and nurse to acquire success. Respect and understanding are an integral part of interpersonal relations theory. Being self-aware and avoiding judgement are key components in this theories success. The interpersonal process focuses on a patient’s needs, feelings, problems and ideas. The concept of this theory consists of the four steps of patient and nurse interaction process. One step must be completed to the next for optimum success. In addition, there are 7 roles the nurse must fill in order to be a successful communicator. They consist of stranger, resource person, teacher, leader, surrogate, and counselor ("Hildegard Peplau Interpersonal," n.d.). The concepts applied in this theory are simple and apply across all aspects of nursing

care.
Definition of Interpersonal Theory
Peplau described interpersonal theory as a goal-oriented process that is a therapeutic, interpersonal process. It is a deliberate process of communication between individuals. It is a health-focused human relationship (Meleis, 2012). The process of interpersonal relationship theory consists of the development of problem-solving skills through the interpersonal process. It is a collaborative approach to patient interaction and care (Meleis, 2012). The relationships in interpersonal theory consists of links between structure and function. (Meleis, 2012). Assumptions
The structure of interpersonal relations is based on assumptions, concepts and propositions, describing the importance of the relationship between nurse and patient. This theory predicts the relationship and direction of the theory. (Meleis, 2012). In Peplau’s theory, it is noted that there are specific assumptions. One assumption is that the nurse and patient are willing and able to communication. It is not taking into effect a person that may be in a catatonic or withdrawn state. It is assumed by Peplau that both the patient and nurse gain maturity during the interaction process. Peplau believed and assumed nurses knew the importance of self-awareness and self-reflection. Peplau thought nurses needed to clearly understand themselves prior to the assessment process.
Clarity
Peplau’s Theory is easily understood with simple steps outlined in the nurse-patient interaction process. The is no excessive wordiness or complex steps. It is identified that each step must be completed prior to moving on to the next step. The concepts in Peplau’s theory are easily identifiable and understandable. Peplau’s concepts are consistent throughout her theory process. The steps are clear and precise and the steps have a concise flow. There are no gaps in the interpersonal process. Relationships between nurse, patient and health are clearly identified. There is a clear relationship between a nurse that is self-aware and understands their own values and beliefs and a positive patient outcome.
Simplicity
Peplau’s theory is simple in nature. There are four steps related to the nurse-patient relationship. Each step is clearly defined and each step needs to be completed in order. There is no excessive verbiage or excessive roles that need to be filled in the patient-nurse therapeutic process. It starts with the simple nurse-patient interaction. When looking at the seven roles of the nurse, this area may get more complex and add confusion to the theory. It may appear overwhelming to the nurse participant. The seven different roles that a nurse may play can possibly distract from the simple steps of the nurse-patient relationship.
Generalizability
Peplau’s Theory crosses boarders when it comes to application of this theory. Interpersonal theory can apply to nursing homes, community nursing, medical-surgical environments and most hospital units. This theory is general and can be applied in a multitude of nursing disciplines. This theory is broad in nature. Peplau offers concepts that are streamlined to offer the most success out of the nurse-patient relationship.
Accessibility
This theory is adaptable and accessible to a multitude of nursing disciplines. This theory has been used globally. This theory crosses the cultural divide. This theory is easily accessible by way of research and many studies have been completed and provide empirical evidence of theory success. Peplau’s theory has been published throughout the world. This theory provides a culturally diverse base for the nurse-patient relationship.
Importance
Peplau’s theory is linked to clinical nursing practice, nursing goals and research. There is a wealth of studies based on Peplau’s theory. This theory establishes the importance of the nurse-patient relationship. This theory has created the conceptual framework to further develop the nurse-patient relationship. The importance of this theory is noted in the established concepts based on patient advocacy, patient concern, empathy and the development of self to assist others. This theory provides the foundation to improve patient interactions in the future.
A critical review of a theory is necessary to offer growth to the nursing profession. Theory is an essential component of the art of nursing. There is a direct link between art and science in nursing (Peplau, 1997). In researching and reviewing this theory, it is noted that this theory provides the base for nursing care. In order for us to develop and improve the nation of nursing we need to further develop this theory and apply it to the current time. In critiquing this theory, there appears to be a missing component of the nurse-patient-family relationship. It would appear to be beneficial to further develop the relationship steps to include family member. This will assist in the patients’ integration back into the community.
Another important aspect to consider, is the implied fact that the patient and nurse are willing participants in the interaction process. The theory need to be further developed to include withdrawn or patients in a catatonic state. This theory could further be developed by adding a health promotion aspect to care. Treating the patient as a whole is going to provide the care needed for the patient to become an active and healthy member of society.
The journey of learning about theory and critiquing theory should never end. It is important to continue to ask questions as did Chinn & Kramer. It is crucial to ask questions about the disciplines focus and nursing goals. The journey of critiquing theory establishes the critical thinking skills that will be required for the future of nursing (Meleis, 2012).

References
Hildegard Peplau: Interpersonal relations theory. (n.d.). Retrieved from http://nursingtheories.weebly.com/hildegard-e-peplau.html
Meleis, A. I. (2012). Theoretical nursing, development and progress (5th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Peplau, H. E. (1997, Winter). Peplau’s theory of interpersonal relations. Nursing Science Quarterly, 10 (4), 162-167. Retrieved from http://nsq.sagepub.com.proxy.library.maryville.edu/content/10/4/162