Objectives
The paper describes two healthcare theories: Hildegard Peplau’s interpersonal relations in nursing and Dorothea Orem’s self-care deficit theory. The first part describes Peplau’s phases of the nurse-patient relationship and aligns the presentation with a current nursing practice example. The second part describes Orem’s theory and its interrelated parts. In addition, it includes a current nursing practice example.
Peplau’s Theory
Peplau’s nursing theory entails a therapeutic and interpersonal process that occurs when nurses engage with clients in need of health services. The theory envisions nursing as an interactive and collaborative process between nurses and patients. The interpersonal process is a personality-maturing force. The nurse-client connection, communication, pattern integration, and the nurse’s roles are all examples of interpersonal processes. Health professionals can use their understanding of one’s own behavior to assist others in identifying their own struggles and to apply the fundamentals of human connections to issues that arise at all levels of experience according to psychodynamic nursing.
Orientation Phase
The orientation phase involves engaging the client in treatment, providing explanations and information, and answering clinical questions. This phase starts when the client meets the nurse as a stranger and establishes a foundation for a therapeutic relationship. The patient seeks help by providing critical information pertinent to one’s case. Data collection occurs in this stage when the nurse helps the patient provide pertinent information to identify health status and functioning. The nurse helps define the type of service the patient needs based on the information they provide. The nurse responds, explains roles to the client, identifies problems, and uses available resources and services.
Identification Phase
The nurse and patient work together to identify problems and set healthcare objectives. The identification phase generates a nursing care plan based on the patient’s circumstances and objectives. Appropriate interventions are developed in the nursing care plan derived from patient data. The goal-setting activity enables patients to participate in their care and help explore their feelings regarding the situation, such as hopelessness. The nurses identify strengths and resources capable of assisting patients in coping with their current health issues.
Exploitation Phase
Patients try to garner attention as they deem themselves essential to the supportive environment. When talking to patients, the nurse should employ interviewing techniques to determine prevalent issues. The nurse needs to be aware of changes in communication to adapt to the patient’s level of independence. The nursing plan is implemented during this phase, and steps are taken to achieve the objectives specified during the identification phase. The nursing care plan’s suitable interventions are reevaluated and reassessed to set new goals.
Resolution Phase
The patient-nurse relationship ends at this stage as the patient can now make individual decisions. The successful mitigation of issues reduces the dependence on nurse efforts leading to the termination of the relationship. The nurse and patient evaluate the achievement of their goals by assessing the progress of the interventions toward the nursing care plan goals. Psychological dependence presents a challenge as the patients break the nurse’s bond. The therapeutic relationship between the nurse and patient ends with satisfaction rewarding for both parties.
Theory Application
This theory primarily focuses on the psychiatric community but can also be applied to regular nursing. The nurse can develop a relationship with her patient and open up the communication necessary for treatment to begin. Nurses help others by forming relationships based on their knowledge, attitudes, and skills to communicate effectively. A health practitioner and the patient can discuss suitable nursing care interventions directed to improving the patient’s health. The health professional discharges the patient relative to the patient gaining independence over the healthcare issue. Nurses help others by forming relationships based on their knowledge, attitudes, and skills to communicate effectively.
Current Nursing Practice
Nurses working in PED are exposed to highly stressful and emotional situations. When a patient is brought to the PED, the triage nurse is identified as someone qualified to assist the patient and their family. The nurse assesses the child and recommends suitable interventions. The parents are comfortable dealing with the triage nurse as she takes care of their child. After treatment, the child is less dependent on the triage nurse and thus is discharged with medication.
Orem’s Self-Care Deficit Theory
Orem defines self-care as the execution of activities that people trigger to maintain optimal health and well-being. The circumstances that authenticate the existence of nursing care in adults is the absence of the power to engage in quality self-care continuously. The theory relates to the person in need of nursing and nurses and their actions. It focuses on each person’s ability to perform self-care.
Theory of Self Care
The self-care theory proposes that individuals engage in activities that influence their survival, wellness, and quality of life. Individuals who practice self-care take conscious measures to preserve their physical, social, and psychological well-being. Universal self-care entails maintaining human structure through processes such as maintaining a sufficient water intake. Developmental self-care requisites are derived from a condition or an event. These include adjustments to jobs or body changes. Health deviation requisites are vital in sickness situations and include seeking medical assistance.
Self Care Deficit Theory
Self-care deficiency happens when a person cannot undertake self-care because of age or other circumstances. The cause of this deficit in meeting self-care is related to limitations or barriers that prevent individuals from meeting their health, well-being, growth, and development requirements. Nursing is required when adults or parents of their children are incapable of providing continuous effective self-care. The interventions include guidance, support, and the provision of an environment that promotes personal development.
Theory of Nursing Systems
The theory describes how health professionals can satisfy the patient’s self-care needs. The wholly compensating system compensates for the patient’s lack of self-care and offers total care. The partially compensating system adjusts for the patient’s limitations in self-care and provides support as required. In the supportive-educative system, the nurse assists and leads the patient in exercising their self-care agency, and the patient is the one who takes care of themselves.
Major Components of Orem’s Theory
Nursing entails acts deliberately selected and performed by health professionals to help individuals or groups under their care to maintain or change conditions in themselves or their environments. The goal is to provide a better quality of life while helping the patient become more responsible and active in managing their health care at home. Humans are the subject of the environment nurses will act upon by providing direct care. Health is the absence of disease and full functioning in an optimal environment.
Strengths and Limitations
A significant strength of Orem’s theory is that it applies to nursing by the beginning practitioner and the advanced clinicians. It is useful for professional nursing in nursing practice, education, and administration. Orem’s self-care deficit theory allows the nurse to take a more active role in meeting the patient’s needs. The theory defines health as a single unit thus instead of including dynamism regarding community health. Nursing is a form of interaction between two or more people thus a person’s knowledge of potential health problems is needed to promote self-care behaviors. The major limitation includes its focus on individuals. This leads to the assumption that people should be reliant and responsible for their health and others.
Current Nursing Practice
When applying this theory to cyberbullying, nursing interventions should help adolescents meet their self-care needs and foster self-care independence in coping with cyberbullying. Orem’s theory seeks self-care independence; thus, the current practice of using adults to help adolescents cope with cyberbullying is incorrect. Self-care helps create action plans and provides professional referrals to assist students in developing self-care independence. Following Orem’s self-care deficit theory, psychiatrists can help mitigate cyberbullying through positive coping skills such as meditation and positive reframing.
References
Arabacı, L. B. (2019). Effect of using Peplau’s interpersonal relation nursing model in the care of a juvenile delinquent. Journal of Psychiatric Nursing, 10(3).
Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplau’s theory of interpersonal relations. Nursing Science Quarterly, 30(2), 160–167.
Isik, E., & Fredland, N. M. (2021). Orem’s self-care deficit nursing theory to improve children’s self-care: an integrative review. The Journal of School Nursing, 105984052110500.
Jesse Edward, F. (2019). Caring for adolescents experiencing cyberbullying. Nursing Made Incredibly Easy 17(3), 1.