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A nursing theory is a body of knowledge or a pedagogic model that is used to explain and access every process related to the nursing profession and practice. Nursing theory is an organized and structured set of statements and models to follow that set the direction for nursing. Nursing theories are the elements of nursing profession that give scientific grounds to it, and therefore make it a discipline. Nursing theories are meant to generate further knowledge in the sphere of nursing enhancement and set the principles underpinning the practical implementations. Nursing theories serve as guidelines and show the direction of nursing development in research, education and professional nursing practice. It would be difficult to evaluate the quality of nursing service if there were no criteria that are provided by the nursing theories. Decision-making based upon the current health condition of a patient is also possible due to the nursing care quality measurements. At the end of the day, nursing theories shape nursing practices and determine its independent functions. There are several types of nursing theories, and the researcher has chosen the Peplau’s theory of interpersonal relationship between the nurse and the patient as it appealed to the ideas and views that the researcher had before in terms of nursing practice. This paper will include three sections dedicated to the importance of Peplau’s theory.
- The first section will include general comments on the nursing theory importance, its analysis and practical implementation in nursing profession.
- The second section will include the summary of the key concepts in the theory and their relationships.
- The third section will include comments on how Peplau’s nursing theory views nursing leadership, nursing education, informatics, and health policy, and support the arguments with real-life examples from nursing practice.
- The fourth section is a conclusion describing what has been learned in the result of investigation, and the researcher’s further ideas are shared.
Nursing theory gives guidance to the nurses while they take controls and try to influence different phenomena that they face in their profession. In spite of the settings, nursing theories serve as scientific grounds for nursing practice meant to improve the patient care outcomes. In multidisciplinary institutions (such as usual hospitals) nursing theories determine the boundaries of nursing practice and make it an individual discipline. A useful nursing theory assumes on the matter of health problem, behavior, environment or target population, and it has to stay logical, supported by former scientific investigations in this area, similar to the methods used in former successful experiments and consistent with what contemporary development of medicine has to offer. A nurse that takes care of a patient requires a certain perspective of his problems to be developed, and in case the theory can’t give a clear explanation, nursing explanation and research (that are also integral elements of the existence of the nursing theories) can be used as instruments on the way to acquire new essential knowledge about the issue. Although it may seem at first glance that the gap between theoretical assumptions and practical implementations in nursing is quite significant, several successful examples prove that some theories do have a right to live in real-life settings of a hospital or any other institution that involves nursing practice.
Therefore, a nursing theory:
- Is aimed to explain, describe and predict the process of nursing;
- Provides the grounds for nursing practice and helps to develop new ideas determining the direction of enhancement that should be taken in the future;
- Describes nursing, and therefore makes it an independent discipline with its principles and peculiarities;
- Tries to provide theoretical measurements and evaluation criteria for nursing care;
- Preserves the uniqueness of nursing as a discipline;
- Helps nursing practice to preserve its professional boundaries.
Summary of the Key Concepts
The nursing theory of Peplau concentrates mainly on the interpersonal relationships between the nurse and the patient, and the role that nurse plays in the patient’s life, especially during the medication course. Peplau’s theory was selected because it bases on the principles of psychological comfort for the patient, and this is one of the major tasks of the nurse. It corresponds with modern theories about the quality of service and its evaluation criteria. The purpose of the theory is to fulfill the expectations and needs while addressing the problems of the patient in the most comfortable manner. This nursing theory gives detailed explanations to interpersonal relationships and provides correlative connections with other disciplines such as psychology that originated in the field of nursing. Peplau’s theory established an entirely new range of standards and new ways of their examination and assessment making nursing a profession rather than a skill. This theory is essential to nursing practice because positive interaction directed at the well-being of the patient defines the quality of service and the outcome of the provided care to a significant degree.
The interpersonal relationship between the nurse and the patient includes emotions, thoughts, feelings, and actions of each interaction participant. Peplau makes an attempt to prove that a patient has a better experience of health care if his or her individual needs and expectations are fulfilled on each stage of the caring process. There are four major elements included in Peplau’s theory (1952):
- Boundaries: the roles of interaction and meetings are determined. The nurse represents the professional approach and mainly concentrates on the problems and needs of the patient.
- Contract: it is clear when, where and why the meetings for interaction are arranged. All other conditions are also stated.
- Nurse behavior patterns: the nurse has to be friendly, warm, respectful and genuine; she needs to remain self-aware and demonstrate empathy for the patient; she shows cultural sensitivity considering the patient’s background; she sets objectives for each meeting and tries to fulfill them; she is responsible and ethical to the patient.
- Privacy: The nurse is responsible for keeping the private information of the client in secret except for other professionals in the healthcare team. Each time the information is requested for sharing a written agreement of the patient should be provided.
The additional elements that were introduced as important elements of interpersonal relationships between the patient and the nurse included humor, building trust, and emotional support but they were added later by other academicians that followed the study of Peplau. All the key elements are not mutually exclusive which makes the theory balanced. The main connection between the key principles is the benefit and comfort of the patient as each of the principles listed supports this central idea. Setting boundaries and an agreement lets both patient and nurse get a clearer picture of how their interaction will go on, and the privacy principles and the standardized nurse behavioral patterns make this interaction positive and beneficial for the patient. Clarity, emotional comfort, guarding private information and professional support define what Peplau views as a perfect nursing practice based on trustful interpersonal relationship between the nurse and the patient. This theory addresses the nursing metaparadigm by recommending empathy, care and emotional support in an individual way that suits the preferences of the patient as a unique human being; clarifying the environment for the patient and making it as comfortable as possible; stressing out emotional health; emphasizing the role of nursing as an ethical practice.
Views of Nursing Specializations in Peplau’s Theory
The peculiarities of Peplau’s nursing theory and its view of nursing specializations is described in the following list (1952):
- Nursing Leadership: the nurse is viewed as a central figure in healthcare that has to be active and make the decisions basing on the observations, interaction with the patient, interpretations, descriptions, interventions and validations. Active leadership in nursing is defined as one of the essential nursing roles in professional practice. Nurse is always an active participant of healthcare provision.
- Nursing Education: the nurse is encouraged to use his or her individual interpretations to gain experience and form knowledge for the future. One of the nursing roles is the role of a teacher who actively involves the patient in choosing the right care strategy (not being a passive recipient).
- Nursing Research: the nurse is encouraged to be a resource person who can provide the necessary information at all times. If it is not possible to provide all the details, the nurse is encouraged to conduct further research. The additional roles requiring research in nursing include the role of the researcher, technical expert, and consultant.
- Nursing Informatics: the nurse is recommended to implement multiple technologies that are available if it is necessary for the benefit of the patient.
One of the real-life examples supporting these views is a study by McNaughton that revealed the correctness of Peplau’s nursing theory. It gave statistical support for the arguments in favor of the leadership importance of the nurse and the growing relationship and interaction between the nurse and the patient (2006).
Another interview-based study by Forchuk, Ward-Griffin and Coatsworth-Puspoky proved that the relationship depends largely on the personality of the nurse and her attitude. If she wasn’t impersonal but demonstrated ethic approach providing emotional support the relationship was positive and helped the patient to come through his experiences (2006).
Therefore, Peplau’s nursing theory is essential in nursing practice and it majorly concentrates on the interpersonal relationships between the nurse and the patient. The theory assumes that it sufficiently influences the outcome of care in general, and it has been proven by several real-life experiments. This theory puts the client in the center of all processes connected with healthcare service, and it also implies constant enhancement of the existing patterns in nursing. Empowering both the nurse and the patient, this theory urges for the best outcomes of the process. However, these studies have not revealed all the principles and key concepts of this theory, so further research should be completed in the sphere of practical implementation of Peplau’s theory.
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