Theory of Interpersonal Relations in Nursing
Summary
The aftereffect of order change within the discipline of nursing cultivated by Hildegard
Peplau in 1952 has had substantial impact on the nurse-client relationship (D’Antonio, Beeber,
Sills, & Naegle, 2013). Prior to Peplau, nursing was focused on what nurses did to their patients;
Peplau transformed this emphasis to what nurses did with their patients (Sitzman & Eichelberger,
2015). Peplau propositioned the core of nursing to emanate from achievement of mutualistic
relationships cognizant of individual traits of clients and self-awareness of nurses. Thus, implicit
in her model may have been the most primitive attempt to embrace cultural diversity and
encourage humility through construct of collaborative relationships in trade for authoritative.
Peplau’s theory is middle range descriptive with influences from Henry Stack Sullivan and
Abraham Maslow (McEwen & Wills, 2014).
Evaluation
Social Significance
Use of Hildegard Peplau’s theory for research in cultural humility is socially significant.
The multiculturalism of the general public continues to breed concomitant with advancements in
global mobility. Reduction in health disparities amongst the vulnerable necessitates supportive
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interpersonal relations inclusive of humble attitude, openness, and equitable belief in human
rights (Foronda et al., 2015).
Theoretical Significance
Peplau’s innovative insight into concentration on patient experiences and stories as
fundamental to nursing care provides theoretical significance (Hagerty, Samuels, Norcini-Pala,
& Gigliotti, 2017). Her philological of listening to the patient with reverence for dignity was
pioneering over 50 years ago and remains seminal today in theoretical developments and
researchability in nursing as well as other fields. Cultural sensitivity is offered as necessary to the
interpersonal relationship (Karnick, 2013).
Internal Consistency
Semantic clarity is present in this theory in a manner fairly divergent in that Peplau
identifies the major concepts and offers constitutive definitions; subconcepts are propositioned
with operational definitions (Sitzman & Eichelberger, 2015). Semantic consistency is peculiar in
this theory, yet, maintained as operational definitions are plural while upholding constitutive
measures (Fawcett & Garity, 2009). The propositions are reasonable in simplicity giving
generalizability with inductive reasoning, however, limited in precision and hypothetical testing
as deductive reasoning (Im, 2015).
Parsimony
Peplau’s theory is parsimonious. She offers a modest number of concepts and
propositions thereby capturing her essential features without loss of content (Fawcett & Garity,
2009). Her diagrams are supportive of said parsimony and the links within the nurse-patient
relationship (Hagerty et al., 2017).
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Testability
There has not been an abundant amount of formal testing of Peplau’s theory (Karnick,
2013). Nonetheless, it is considered to have capacity for empirical testing (Hagerty et al., 2017).
The structure of the model has been utilized in quantitative and qualitative research testing in
less than excessive amounts with good fit outcomes (Hagerty et al., 2017). Peplau’s interpersonal
theory has performed well in testing of pedagogical application in practice (Reid Searl et al.,
2014). Explicit hypothetical testing is limited due to inability to rule out chance difference versus
relational difference in patients who are not able to return communication.
Theoretical Selection
It is conceivable that either of the theories evaluated above may be suitable for the
investigation of cultural humility and its influence on nursing and healthcare. Both theories are
observed in their evaluations to be well-executed, have significance to the nurse and the patient,
and exhibit call for our discipline to transform from merely disease orientation to psychodynamic
nursing interventions (Foronda et al., 2015; Hagerty et al., 2017; Isaacson, 2014). Both theorists
incorporate the concept of individual culture of the patient as components in their philosophies.
Hildegard Peplau’s limelight on collaborating as one with the patient, devising care apropos to
the individuality of the patient, and nurse self-awareness does implicitly address culture. The
propositions of Madeline Leininger’s theory, inclusive of Peplau’s trinity above, are more easily
defined or explicit of cultural integration and its prominence on nurse-patient outcomes.
Leininger’s theory is not more correct than Peplau’s nor is the contrary accurate. Both
ladies’ theoretical contributions have revolutionized the practice of nursing with expansion of
concepts not considered prior, enhancement of research, and reflection-stimulated modifications
in patient care (Sitzman & Eichelberger, 2015). As a lifelong learner, it is this author’s
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responsibility to systematically evaluate which theory offers the most usefulness in fortifying
personal professional practice (Sitzman & Eichelberger, 2015).
The Theory of Culture Care: Diversity and Universality is deemed most appropriate for
exploration of the clinical practice problem of awareness, comprehension, and application of
cultural humility as opposed to the unbefitting and antiquated schooling of cultural competency.
As above, Leininger’s propositions are precise, thus, allowing for objectification of criteria and
hypotheses testing of the conceptual framework of cultural humility. The theory-testing research
encompassing of these propositions are anticipated to generate said hypotheses that are found
falsifiable in regards to the assertion of the duty of the nurse to provide cultural humility,
thereby, giving truism to the vision of the author (Fawcett & Garity, 2009). Peplau’s
propositions, although profound, have confines relative to testability apposite of culture leading
to reduction in generalizability. As a doctoral candidate, this author is attentive to the impending
capstone resulting in local practice generalizability that is correspondingly worthy of
contribution to the nursing profession (Walden University, 2015).
Refinement of Clinical Practice Question
At commencement of assignment, the intent of this author was to delineate the betterment
of cultural congruence with adoption of cultural humility as alternative to cultural competence.
The labors invested here in the scholarly evaluations of theory produced an opinion that is more
informed regarding progression of the approaching doctoral study. As such, the amended and
now well-formulated PICOT is as below. Noted is the adjustment is surmised compulsory
pertinent to deductive reasoning and generalizability (Fawcett & Garity, 2009; Im, 2015;
Karnick, 2013; McEwen & Wills, 2014; Sitzman & Eichelberger, 2015). Further noted is the
clinical inquiry to be formatted as an intervention PICOT (Melnyk & Fineout-Overholt, 2014).