GOVERNMENT COLLEGE OF NURSING,

JAGDALPUR

SUBJECT – ADVANCE NURSING PRACTICE

TOPIC PRESENTATION ON:

“INTERPERSONAL RELATIONSHIPS”

SUBMITTED TO: SUBMITTED BY:

MADAM MRS. PRERNA LUCAS NIDHI DWIVEDI
MSC DEMONSTRATOR MSC (N) IST YEAR
GCON JAGDALPUR GCON JAGDALPUR
Name of the student teacher : Ms. NIDHI DWIVEDI
Subject : ADVANCE NURSING PRACTICE
Unit :
Topic : INTERPERSONAL RELATIONSHIPS
Class :
Size of group :
Date and time :
Venue :
Method of teaching : LECTURE METHOD
[Link] :
Previous knowledge: Students have little knowledge about the topic
“ INTERPERSONAL RELATIONSHIPS ”.
[Link] TIME CONTRIBUTIVE CONTENT TEACHING/ A.V. AIDS EVALUATION
. OBJECTIVE LEARNING
ACTIVITIES

1. 1 min To introduce the topic INTRODUCTION Lecture and Introduce

interpersonal Interpersonal relationship are dynamic systems that change continuously discussion IPR?
relationship. during their existence. Like living organisms, relationships have a beginning, a
lifespan, and an end. They tend to grow and improve gradually, as people get
to know each other and become closer emotionally, or they gradually
deteriorate as people drift apart, move on with their lives and form new
relationships with others.

2. 2 min CONCEPT OF IPR Lecture Slide What is the

To explain the concept
An interpersonal relationship is a strong, deep or close association or concept of
of IPR.
acquaintance between two or more people that may range in duration from IPR?
brief to enduring. This association may be based on inference, love, solidarity,
regular business interactions, or some other type of social commitement.
Interpersonal relationships are formed in the context of social, cultural and
other influences. The context can vary from family or kinship relations,
friendship, marriage, relations with associates, work, clubs, neighborhoods,
and places of worship. They may be regulated by law, custom, or mutual
agreement, and are the basis of social groups and society as a whole.

3. 2 min To define DEFINITION Lecture Slide Define IPR?

interpersonal • “An interpersonal relationship is an association between two or more
relationship. people who are interdependent, who use some consistent patterns of
interaction, and who have interacted for an extended period of time.”

• “Interpersonal relationship is defined as a close association between

individuals who share common interests and goals.”

• “Interpersonal relationship means interaction or relations between

two or more individuals.”
4. 3 min To describe the CHARACTERISTICS OF IPR Lecture Slide Describe the
characteristics of IPR. • IPR includes 2 or more people. characteristic
• IPR include people who are interdependent. s of IPR?
• Individuals in IPR use some consistent pattern of interaction.
• Individuals in IPR generally interacted for some time.
• Individuals in an IPR must share common goals and objectives. They
should have more or less similar interests and think on the same lines.
It is always better if individuals come from similar backgrounds.
• Individuals in an IPR must respect each other’s views and opinions. A
sense of trust is important.
• Individuals must be attached to each other for a healthy IPR.
• It is important for an individual to be honest and transparent.

5. 3 min
To Enumerate the DYNAMICS OF IPR Lecture and Slide How you
dynamics of IPR. • Dyad discussion enumerate
 a dyad consists of two interacting people. the dynamics
 It is the simplest of the 3 interpersonal dynamics. of IPR?
 One person relays a message and the other listens.
 It is one of the most unstable interpersonal dynamic. The interaction
ends when one constituent of the dyad refuses to listen or share his or
her messages.
 It is also one of the most intimate interpersonal dynamic as the focus
of listening and communicating is centered on only one person.
• Triad
 A triad consists of 3 interacting people.
 The members engage in the relay and reception of thoughts and
ideas.
 It is more stable than the dyad as the third member may act as a
mediator when where is conflict between the other 2.
• Group
 A group consists of more than 3 members and is a collection of triads
and/ or dyads.
 It is the most stable form of interpersonal relationship.
  It is one of the least intimate relationships, as there is a diffusion of
attention and focus.
 The members engage in the relay and reception of thoughts and
ideas.
 It is more stable than the dyad and triad as many members may act as
a mediator when there is conflict between the other members.
 The triads and/ or dyads in a group share a certain association with
one another.
6. 5 min Lecture
To Explain the PURPOSES OF IPR What are the
purposes of IPR. different
 IPR for an individual purposes of
An IPR aids in personal growth and development, is a source of enjoyment, IPR?
provides a sense of security, boosts self-esteem, builds a context of
understanding, meets interpersonal needs and helps establish an identity for
an individual. These are discussed as:
 Personal growth and development: a good IPR actively and
continually facilitates personal growth and development of people by
sharing vivid experiences of life.
 Source of enjoyment : for some individuals, an IPR can be a source of
enjoyment as it helps them unwind, relax and maximize the fun.
 Sense of security : an IPR helps in boosting an individuals self esteem
and sense of security during relationship with others.
 Context of understanding : an IPR helps us better understand what
someone says in a given context. The words we use can mean
different things depending on how or in what context they are said. A
good IPR, however, helps in building a context of understanding.
 Interpersonal needs : an IPR helps individuals in expressing and
meeting interpersonal needs.
 Establishing personal identity : the main reason for developing IPRs is
to establish an identity. The roles we play in our relationships help us
in establishing an identity. So do the face and public self image we
present to others. Both roles and images are constructed based on
how we interact with others.
 IPR for nurses
Nursing personnel are the largest team members in a health care
organization. They interact with a variety of personnel such as
doctors, pharmacists, physiotherapists, respiratory therapists,
occupational therapists, social health workers and other paramedical
staff. Some of the important functions of IPRs for nurses are:

 Building a positive functional multidisciplinary team : a hospital is a

complex system where many people work together for a common
purpose, i.e, offer quality care. IPRs help nurses in building a positive
functional multidisciplinary team both personally and professionally.
 Improving intra- and/ or inter- team communication, coordination
and cooperation: IPRs help nurses establish intra-and/ or inter- team
communication, coordination and cooperation, which is very
important for functioning efficiently.
 Building mutual understanding and cooperation : IPRs help nurses
build mutual understanding and cooperation that helps them
accomplish their personal and professional tasks more efficiently.
 Understanding self: interpersonal relations not only help understand
others but also help in understanding oneself more effectively and
efficiently. IPRs help individuals introspect as well as receive positive
criticism from others. The use of effective IPR is a continuous process
that improves self awareness and insight. IPRs enable us become
interpersonally effective.
 Improved decision making and problem solving : interpersonal
relationships help nurses in taking right decisions and solve problems
effectively. It also acts as a tool in achieving common goals in
administration and management processes.

 IPR for patients

Patients are a core aspect in health care practices and each activity
evolves and revolves around them. IPR, therefore, certainly benefits
patients as well as their families and is discussed below in detail.
 Developing a sense of security and comfort : good IPRs help patients
and their families develop a sense of nonthreatening feelings in
 hospitals and also develop a sense of security and comfort during
their stay in hospital.
 Fostering trust and cooperation: trust is a key in personal, social and
professional functioning. IPR is an essential strategy to foster feelings
of trust between patients and the health care team. This plays an
important role in seeking the cooperation of patients and their
families in health care practices.
 Facilitating communication: IPRs are essential to foster
communication between patients, family and the health care team.
Good interpersonal relations also help patients express their distress
and disappointment, which ultimately helps in their recovery from the
present state of morbidity.
 Improving socialization: man is a social animal and each one of us
requires good socialization for effective personal and social
functioning. IPRs act as a tool for improving socialization between the
patients admitted in hospitals or health care facilities.
 Developing and maintaining positive feelings: IPRs are necessary to
develop and maintain positive feelings. Furthermore, positive feelings
between patients have multidimensional benefits.

7. 6 min To brief out the THEORIES OF IPR Lecture What are the
different theories of theories
IPR. SOCIAL EXCHANGE THEORY : This theory is proposed by George Casper related to
Homans in the year 1958. IPR?
According to Social Exchange Theory, “give and take” forms the basis of
almost all relationships though their proportions might vary as per the
intensity of the relationship.
In a relationship, every individual has expectations from his/her partner. A
relationship without expectations is meaningless.
According to Social Exchange Theory, feelings and emotions ought to be
reciprocated for a successful and long lasting relationship.
Relationships can never be one sided. An individual invests his time and
energy in relationships only when he gets something out of it.
There are relationships where an individual receives less than he gives. This
leads to situations where individual starts comparing his relationship with
others.
Comparisons sometimes can be really dangerous as it stops individuals from
putting their best in relationships. Don’t always think that you would have a
better relationship with someone else. Understand your partner and do as
much as you can for him/her. Don’t always expect the other person to do
things first. Take initiative on your own and value partner.

UNCERTAINTY REDUCTIONS THEORY : Both Charles R. Berger and Richard J.

Calabrese proposed uncertainty reductions. Theory explain the relationship
between individuals who donot know each other much or are complete
strangers.
According to Uncertainty Reductions Theory, two unknown individuals
meeting for the first time go through various stages to reduce the level of
uncertainty between them and come closer to each other. Strangers must
communicate well to know each other better and find out their compatibility
level.
Following are the stages individuals go through to reduce the level of
uncertainty in relationships.
I. Entry Stage
The entry stage is characterized by two individuals trying to know
each other better.
Each one tries to find out the other persons background, family
members, educational qualifications, interests, hobbies and so on.
Each one discloses his/her likes and dislikes to strengthen the bond
and take the relationship to the next level.
II. Personal Stage
In the second stage or the personal stage, individuals try to find out
more about their partners attitude and beliefs.
Individuals try to know more about the other persons ethics, values,
behavior and nature on the whole. Individuals who are no longer
strangers learn more about each others personality traits in the
personal stage.
III. The Exit Stage
The personal stage decides the fate of the relationship. Individuals
 comfortable in each others company decide to enter into long term
commitments i.e., either formally get married or stay together
forever.
Not all relationships flower into marriages. Individuals failing to
understand and adjust with each other decide to mutually end their
relationship for a better future.
The exit stage is characterized by individuals moving out of
relationships in search of a more compatible partner.

DIALECTICAL THEORY
There is a saying that goes, ‘ The only constant thing is change.’ This idea fits
dialectal theory perfectly. Under this theory, relationships are in a constant
state of flux, making their success determined by how those changes are
handled. Marriage partners have times of contradictory desires and goals, for
example, so for the relationship to last, they have to find a way to
communicate through their differences and reach compromises. Only by
working with the fluctuations that inevitably come with life events can
interpersonal relationships be maintained.

ATTACHMENT THEORY
The attachment theory attempts to explain the influence that family
dynamics have in creating one’s self and how an individual will behave in a
relationship. The attachment theory consists of many factors that influence
how an individual will behave in a relationship. Ones identity and psyche are
shaped by the relationship they have with their caregivers; such as their
parents. All individuals have had different parental treatment and
responsiveness from their parents as children. It is important for partners in a
relationship to be aware of how the other was brought up by their parents
because it will have a large impact on how they act in the relationship. Based
on the type of attachment that individuals had with their caregivers they are
likely going to be one of the four following attachment styles: secure,
preoccupied, Dissimissive-Avoidant, or Fearful-Avoidant. These attachment
styles begin to form at a very young age and carry into adulthood, influencing
behavior in interpersonal relationships. Attachment style mainly influences in
relationships partners selection, parenting behavior, and lastly
 communication behavior. It is true that similar styles attract each other, for
example, a secure will likely attract a secure. This is because they are the
most in common and are able to relate with one another. Problems arise in
communication behavior when individuals attract other attachment styles
then themselves because they are not similar. If individuals are not with the
same attachment style their relationship will not necessarily feature effective
communication.

8. 4 min To discuss about JOHARI WINDOW Lecture

Johari Window. What is
Johari
The Johari window is a technique that helps people better
window ?
understand their relationship with themselves and others. It was
created by psychologists Joseph Luft (1916-2014) and Harrington
Ingham (1916-1995) in 1955, and is used primarily in self help groups
and corporate settings as a heuristic exercise. Luft and Ingham called
their Johari Window model ‘Johari’ after combining their first names,
Joe and Harrington.
In the exercise, subjects pick a number of adjectives from a list,
choosing ones they feel describe their own personality. The subjects
peers then get the same list, and each picks an equal number of
adjectives that describe the subject. These adjectives are then
inserted into a two-by-two grid of four cells.
The philosopher Charles Handy calls this concept the Johari House
with four rooms. Room one is the part of ourselves that we and others
see. Room two contains aspects that others see but we are unaware
of. Room three is the private space we know but hide from others.
Room four is the unconscious part of us that neither ourselves nor
others see.
Open, or Arena
Adjectives that both the subject and peers select go in this cell (or
quadrant) of the grid. These are traits that subject and peers perceive.
Hidden, or Façade
Adjectives selected by the subject, but not by any of their peers, go in
this quadrant. These are things the peers are either unaware of, or
 that are untrue but for the subjects claim.
Blind spot
Adjectives not selected by subjects, but only by their peers go here.
These represent what others perceive but the subject does not.
Unknown
Adjectives that neither subject nor peers selected go here. They
represent subjects behaviors or motives that no one participating
recognizes either because they do not apply or because of collective
ignorance of these traits.
9. 5 min
To Enlist the different TYPES OF IPR What are the
Lecture
types of IPR. different
 Friendship : theories of friendship emphasize the concept as a freely types of IPR?
chosen association where individuals develop a common ground of
thinking and behaving when they enter into the relationship by
including mutual love, trust, respect and unconditional acceptance for
each other. This usually leads to the establishments of true friendship.
In other words, it is an unconditional IPR individuals enter into by their
own will and choice. Friendship is a relationship with no formalities
and the individuals enjoy each other’s presence. Friendship can be
between man and woman, man and man or woman an woman.
 Family and kinship
Individuals related by blood or by marriage are said to form a family.
Family communication patterns establish roles and identity and
enable personal and social growth of individuals.
 Professional relationship
Individuals working for the same organization are said to share a
professional relationship and are called colleagues may or may not
like each other.
 Love
A in formalized intimate relationship characterized by passion,
intimacy, trust and respect is called love. Individuals in a romantic
relationship are deeply attached to each other and share a special
bond.
 Marriage
Marriage is a formalized intimate relationship or a long term
relationship where two individuals decide to enter into wedlock and
stay together life long after knowing each other well.
 Platonic relationship
A relationship between two individuals without feelings of sexual
desire for each other is called a platonic relationship. In such a
relationship, a man and a woman are just friends and do not mix love
with friendship. Platonic, relationships might end in a romantic
relationship with both partners developing feelings of love for each
other.
 Casual relationships
In these relationships, the individuals usually develop a relationship
that exclusively lacks mutual love and consists of sexual behavior only
that does not extend beyond one night. These individuals may be
known as sexual partners in a wider sense or friends with benefits
who consider sexual intercourse only in their relationship.
 Brotherhood and sisterhood
Individuals united for a common cause or a common interest (may
involve formal memberships in clubs, organizations, associations,
societies, etc.) may be termed as a brotherhood or a sisterhood. In
this relationship, individuals are committed to doing good deeds for
fellow members and people. For example, India is expecting a
brotherhood relationship with neighboring countries including
Pakistan.

 Acquaintances
An acquaintance is a relationship where someone is simply known to
someone by introduction or by a few interactions. There is an absence
of close relationship and the individuals lack in depth personal
information about each other. This could also be a beginning of a
future close relationship.
10. 5 min To Explain the phases PHASES OF IPR Lecture Explain the
of IPR. Hildegard peplau (1952) gave the IPR model . Her model describes the phases of
phases in a nurse patient relationship in terms of the interpersonal IPR.
process used in psychodynamic nursing. Peplau’s model
comprehensively described the 4 major phases of a nurse patient
relationship i.e.,
Orientation phase
• The phase starts with an initial encounter between a nurse as a
stranger and the patient having problem.
• The pact formulation begins between the nurse and the patient. The
pact states the duration of the theraputic relationship, frequency of
sessions to be conducted by the nurse with the patients.
• The nurse clarifies his or her roles and responsibilities within the
therapeutic boundary to the patient with a view to avoid the
development of psychological bonding or dependence on each other.
• The nurse identifies the patients problems, defines the problems after
understanding them and settles on the type of nursing services
needed.
• After developing a trustworthy relationship, the patients starts
clarifying doubts, share preconceptions and convey their needs and
expectations to the nurse.
• There are several factors that may affect the orientation phase in
nurse patient relationship (values, cultural background, beliefs, past
experiences, expectations, and preconceived ideas of both the nurse
and the patient).
Identification phase
• In this phase, the nurse must approach the patient with empathic
understanding to accurately perceive the patients current feelings.
• While communicating with patients about their problems, the nurse
must avoid vagueness and ambiguity by using specific terminology
rather than abstractions. This will help foster understanding between
the nurse and the patients.
• The nurse helps the patient identify their problems in their own
 context and use the available resources to solve the problems.
• The nurse helps the patients select the best available professional
assistance to solve their problems.
• The patients self esteem will be boosted by having feelings of
belongingness and the ability to solve problems.
Exploitation phase
• The dictionary meaning of exploitation is the process of making use of
something to gain as much as possible from it. But during the
problematic phase, one feels that there are no resources available
which can help the person solve the problem.
• In this phase, the patients are made to understand the problems by
exploring all available avenues to solve the problems.
• The nurse can help the patient by extending minimal professional
assistance to learn how to explore and exploit the available avenues
that can help to solve the problems.
• The patient starts exploiting all the available resources in spite of
making requests to others to extend help.
Finally, the patient is able to deal adequately with his or her problem.
Resolution phase
• This is the termination of the professional relationship that begins
with convalesce and rehabilitation stage of hospitalization and ends
with discharge of the patient.
• As the pact has already formulated in the first phase, the patient is
well versed with termination phase of the therapeutic relationship.
• The patients needs have already been met by the collaborative efforts
of the patient and the nurse in previous phases, so this is the phase to
depart from each other therapeutically.
• If psychological dependence persists between both of them, it
becomes difficult to resolve the transference or counter transference.
A nurse must be aware of the techniques to resolve it.
• The relationship must be terminated by maintaining a healthier
emotional balance by both the parties involved and no one should
remain dependent on each other.
11. 8 min To classify the BARRIERS OF IPR Lecture and How you
different barriers of discussion classify the
IPR. different
1. Personal barriers – the major personal factors that can influence the
barriers of
development or maintenance of an IPR between two or more people
IPR?
are-
• Gender : it may influence an IPR. A strange man may establish a
prompt and intimate IPR with another man. However, the same may
not ensue between a man and a woman and vice versa.
• Lack of honesty and trust : absence of honesty and trust between two
or more individuals may affect their IPRs. Therefore the presence of
honesty and trust are essential factors in the development of IPRs. In
the absence of positive feeling of closeness may not be established
and trust cannot be built, which is one of the fundamental
prerequisites for building strong IPR.
• Lack of compatibility: reciprocal compatibility is essential for a strong
IPR. Two individuals with a contrasting personality, who are not at all
compatible, may face difficulties in getting along with each other and
may not be able to establish a good interpersonal relationship.
• Feelings of insecurity: when individuals lack security in a relationship,
they may fail to establish a good interpersonal relationship because of
feeling of threat and anxiety that may hinder a strong interpersonal
relationship.
• Ineffective communication: effective communication is a primary tool
for establishing good interpersonal relationships. Where active
listening, effective and helpful responding and open problem solving is
absent, a positive IPR cannot be established. Therefore, effective
communication is most essential for the establishment of good IPRs.
• Distorted self concept: self concept is a reflection of the past
experiences of an individual with others and includes characteristics
which differentiate him from others. Self concept, if developed in a
distorted way, tends to resist change in a person and acts as a barrier
in an IPR. To maintain interpersonal environment and to maximize the
congruence of harmony, a positive self concept or strong self esteem
 is needed.
• Lack of flexibility: rigidity in personality may become a cause of
concern in interpersonal relationships because rigidity blocks the
adaptability of an individual to desired situations. Individuals,
therefore, may not able to establish a congruent IPR.
• Lack of respect for the rights of others: an individuals conscious and
unconscious feelings of insecurity about his rights and freedom may
become a barrier in an IPR. Individual rights must, therefore, be
safeguarded by the people involved in an IPR.
• Fear of rejection: an individuals preoccupation with the fear of
rejection may block the development of strong IPR. People proceeding
to establish IPRs must ensure they are free from the fear of rejection.
• Pre-existing psychiatric / personality problems: individuals with pre
existing personality problems and other psychiatric problems may
have problems in developing maintaining IPRs. Therefore, people
dealing with these individuals must have special skills of therapeutic
communication so that a congruent IPR may be established.

2. Situational barriers

Some major situational factors that influence IPR are:

• Complex interactional settings: the depth of IPRs required by a
situation depends on how complex the task is, whether the people
involved possess expertise of different kinds, the frequency of
interaction in the setting and the degree of cetainty with which the
task outcomes can be predicted. For example, two workers A and B
working in a work situation that is very simple and familiar to both of
them, need minimal assistance from each other as both know their
tasks very well. That is why their interaction will also be less and the
situation will demand a less intimate relationship. If they have to work
in a different work situation that is complex in nature and demands
utilization of both of their knowledge. This situation will demand more
interaction duration and an intense relationship.
• Adverse environmental situations: environment is where the transition
takes place. It can be a problem to maintain an IPR if the environment
 is not cordial. Adverse environmental situations always play a crucial
role in blocking IPRs.
• Lack of territoriality: territoriality is the innate tendency to own space.
All individuals lay claim to certain areas as their own and feel safer in
their own area. Lack of territoriality leads to distortion in
interpersonal relationships.
• High density of individuals: density refers to the number of people
within a given environmental space. Prolonged exposure to high
density situations elicits certain behaviours, such as aggression, stress
and hostility. These behaviours can stop a person from building
effective IPRs.
• Lack of time: time plays an important role in relationships. Every
relationship needs time and an individuals effort to grow. Frustrations
arise when people do not have time to meet or interact with each
other. Even in organizations, individuals must spend quality time with
their co workers to strengthen the bond between them. Married
couples must take time out for each other for the magic to stay in the
relationship forever.

3. Sociocultural barriers

• Cultural diversity: culture plays an important role in the development

of IPR s as cultural mores, norms, ideas and customs provide the basis
for our way of thinking. For eg., a man and woman who hug each
other on the street give a different message in the indian culture than
they would in the american culture.
• Ethnic diversity: people with ethnic diversity have different values,
attitude and beliefs that can influence the development of an IPR. For
example, certain attitudes of prejudice are expressed through
negative stereotyping.
• Social diversity: people from a high status often convey their power
with gestures. For example, less eye contact, a more relaxed posture,
higher voice pitch, frequent use of hands on hips, power dressing,
greater height and more distance when communicating with
individuals are considered gestures of being from a lower social status
 in some societies.
• Language diversity: different languages are in use in different regions
of the world. Language plays a significant role in IPRs. For example,
individuals with different language abilities may fail to establish strong
IPRs.

12. 2 min To conclude the topic Lecture How you

CONCLUSION
IPR. conclude the
Interpersonal relationships are and have been the core of our social system. topic IPR?
Our ancestors formed associations and alliances to ensure survival in a hostile
environment and passed on this need for human companionship as an
integral part of our physical and emotional composition. Today friends,
lovers, companions and confidants make valuable contributions to our daily
lives.
Nurses must understand the dynamics of therapeutic relationships as
their professional responsibility to establish and maintain a relationship
within therapeutic boundaries by considering the patients cultural, spiritual,
emotional and biophysical needs. If a nurse is not able to understand the
difference between a therapeutic and a social or personal relationship, then it
will be difficult for a nurse and the patient to initiate or terminate the
relationship therapeutically.