NURSING THEORISTS OF

HISTORICAL
SIGNIFICANCE
Part 1
 HILDEGARD E. PEPLAU
THEORY OF INTERPERSONAL
RELATONS
• “Nursing has made great progress from being an occupation to
becoming a professional in the 20th Century. As the 21st Century
approaches, further progress will be reported and recorded in
Cyberspace – The Internet being one conduit for that. Linking nurses
and their information and knowledge across borders – around the
world – will surely advance the profession of nursing much more
rapidly in the next century.”
• – Hildegard Peplau
 HILDEGARD E. PEPLAU
THEORY OF INTERPERSONAL
RELATONS
• She was an American nurse who is the only one to serve the American
Nurses Association (ANA) as Executive Director and later as President.
• Described as the mother of psychiatric nursing because her theoretical
and clinical work led to the development of the distinct specialty field of
psychiatric nursing.
• According to Peplau (1952/1988), nursing is therapeutic because it is a
healing art, assisting an individual who is sick or in need of health care.
 HILDEGARD E. PEPLAU
THEORY OF INTERPERSONAL
RELATONS
• She discussed four psychobiological experiences that compel destructive
or constructive patient responses, as follows:
- Needs,
- Frustrations,
- Conflicts, and
- Anxieties.
 FOUR PHASES/STAGES OF THE
NURSE-PATIENT RELATIONSHIP
 HILDEGARD E. PEPLAU
THEORY OF INTERPERSONAL
RELATONS
NURSING ROLES:
1. Stranger
2. Resource person
3. Teacher
4. Leader
5. Surrogate and
6. Counselor
 HILDEGARD E. PEPLAU
THEORY OF INTERPERSONAL
RELATONS
• Her work on nurse-patient relationships is known well internationally
and continues to influence nursing practice and research.
• Peplau’s work is specific to the nurse-patient relationship and is a theory
for the practice of nursing.
 VIRGINIA HENDERSON’S
NEED THEORY
• As a patient receives treatment and is on the road to recovery, it’s
important that the patient is able to take care of him or herself after being
released from medical care.
• To that end, nurses should be caring for the patient while, at the same
time, be helping the patient become more independent and reach goals
and milestones on the road to health.
 VIRGINIA HENDERSON’S
NEED THEORY
• Henderson is well known for her definition of nursing, which says,
“The unique function of the nurse is to assist the individual, sick or well,
in the performance of those activities contributing to health or its recovery
(or to peaceful death) that he would perform unaided if he had the
necessary strength, will or knowledge; and to do this in such a way to help
him gain independence as rapidly as possible. ”
 VIRGINIA HENDERSON’S
NEED THEORY
• Henderson identified three levels of nurse-patient relationships in which
the nurse acts as:
1) A substitute for the patient.
2) A helper to the patient.
3) A partner with the patient.
- Through the interpersonal process, the nurse must get “inside the skin”
of each of her or his patients to know what help is needed.
 FAYE GLENN ABDELLAH
TWENTY-ONE NURSING
PROBLEMS
• Faye Glenn Abdellah is recognized as a leader in the development of
nursing research and nursing as a profession within the U.S. Public
Health Services (PHS) and as an international expert on health problems.
• Abdellah (2004) considers her greatest accomplishment being able to
“play a role in establishing a foundation for nursing research as a
science”
 FAYE GLENN ABDELLAH
TWENTY-ONE NURSING
PROBLEMS
• Her book, Patient-Centered Approaches to Nursing, emphasizes the
science of nursing and has elicited changes throughout nursing curricula.
• Her work, which is based on the problem-solving method, serves as a
vehicle for delineating nursing (patient) problems as the patient moves
toward a healthy outcome.
 FAYE GLENN ABDELLAH
TWENTY-ONE NURSING
PROBLEMS
• She used Henderson’s 14 basic human needs and nursing research to
establish the classification of nursing problems. Abdellah’s 21 Nursing
Problems are the following:
1. To maintain good hygiene and physical comfort.
2. To promote optimal activity: exercise, rest, sleep
3. To promote safety by preventing accidents, injuries, or other trauma
and preventing the spread of infection.
4. To maintain good body mechanics and prevent and correct the
deformity.
 FAYE GLENN ABDELLAH
TWENTY-ONE NURSING
PROBLEMS
5. To facilitate the maintenance of a supply of oxygen to all body cells.
6. To facilitate the maintenance of nutrition for all body cells.
7. To facilitate the maintenance of elimination.
8. To facilitate the maintenance of fluid and electrolyte balance.
9. To recognize the physiologic responses of the body to disease
conditions—pathologic, physiologic, and compensatory.
 FAYE GLENN ABDELLAH
TWENTY-ONE NURSING
PROBLEMS
10. To facilitate the maintenance of regulatory mechanisms and functions.
11. To facilitate the maintenance of sensory function.
12. To identify and accept positive and negative expressions, feelings, and
reactions.
13. To identify and accept interrelatedness of emotions and organic
illness.
 FAYE GLENN ABDELLAH
TWENTY-ONE NURSING
PROBLEMS
14. To facilitate the maintenance of effective verbal and nonverbal
communication.
15. To promote the development of productive interpersonal relationships.
16. To facilitate progress toward achievement and personal spiritual goals.
17. To create or maintain a therapeutic environment.
18. To facilitate awareness of self as an individual with varying physical,
emotional, and developmental needs.
 FAYE GLENN ABDELLAH
TWENTY-ONE NURSING
PROBLEMS
19. To accept the optimum possible goals in the light of limitations,
physical and emotional.
20. To use community resources as an aid in resolving problems that arise
from an illness.
21. To understand the role of social problems as influencing factors in the
cause of illness.
 ERNESTINE WIEDENBACH
THE HELPING ART OF CLINICAL
NURSING
• She is known for her work in theory development and maternal infant
nursing developed while teaching maternity nursing.
• Her definition of nursing reflects her nurse-midwife background as
follows:
“People differ in their concept of nursing, but few would disagree that
nursing is nurturing or caring for someone in a motherly
fashion”(Wiedenbach,1964)
 ERNESTINE WIEDENBACH
THE HELPING ART OF CLINICAL
NURSING
• She specified four elements of clinical nursing:
1) Philosophy,
2) Purpose,
3) Practice and
4) Art
• She postulated that clinical nursing is directed toward meeting the
patient’s perceived need for help in a vision of nursing that reflects
considerable emphasis on the art of nursing.
 ERNESTINE WIEDENBACH
THE HELPING ART OF CLINICAL
NURSING
• She proposes that nurses identify patients’ need for help in the following
ways:
1) Observing behaviors consistent with their comfort.
2) Exploring the meaning of their behavior.
3) Determining the cause(s) of their discomfort or incapability.
4) Determining whether they can resolve their problems or have a need
for help.
The-need-for-help
 LYDIA HALL
CORE, CARE, AND CURE MODEL
• She was a rehabilitative nurse who used her philosophy of nursing to
establish the Loeb Center for Nursing and Rehabilitation at the
Montefiore Hospital in New York.
• Hall argued for the provision of hospital beds grouped into units that
focus on the delivery of therapeutic nursing. The Loeb plan has been
considered to be similar to what later emerged as “primary nursing”
(Wiggins, 1980).
 LYDIA HALL
CORE, CARE, AND CURE MODEL
 LYDIA HALL
CORE, CARE, AND CURE MODEL
• Hall believed that professional nursing care hastened recovery, and as
less medical care was needed, more professional nursing care and
teaching were necessary.
• She stressed the autonomous function of nurses.
• She recognized professional nurses and encouraged them to contribute to
patient outcomes.