Hildegard E. Peplau's Interpersonal Relations Theory

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Questions and Answers

What is the main focus of Hildegard Peplau's Interpersonal Relations Theory?

The nurse-client relationship as the foundation of nursing practice.

Who were the main influences on Hildegard Peplau's development of her Interpersonal Relations Theory?

  • Abraham Maslow and Sigmund Freud
  • Carl Rogers and B.F. Skinner
  • Henry Stack Sullivan, Percival Symonds, Abraham Maslow, and Neal Elgar Miller (correct)
  • Jean Piaget and Erik Erikson

Peplau's theory emphasizes a passive approach to nursing, where the nurse follows the doctor's orders and the client passively receives treatment.

False (B)

What are the four phases of the therapeutic nurse-patient relationship according to Peplau's model?

<p>Orientation, identification, exploitation, and resolution</p> Signup and view all the answers

In what phase of the nurse-client relationship is the nursing care plan developed?

<p>Identification (C)</p> Signup and view all the answers

According to Peplau, what is the ultimate goal of psychodynamic nursing?

<p>To help understand one's own behavior, help others identify felt difficulties, and apply principles of human relations to the problems that come up at all experience levels.</p> Signup and view all the answers

What is the role of the nurse as a 'surrogate' in Peplau's theory?

<p>To help the client clarify their dependence, interdependence, and independence. (C)</p> Signup and view all the answers

What are the four levels of anxiety according to Peplau's model?

<p>Mild, Moderate, Severe, and Panic</p> Signup and view all the answers

Mild anxiety is characterized by a ______ perceptual field, allowing the person to learn new behaviors and solve problems.

<p>heightened</p> Signup and view all the answers

Which level of anxiety involves feelings of dread and terror, making it difficult for the person to focus on tasks?

<p>Severe (A)</p> Signup and view all the answers

Panic anxiety is characterized by a loss of rational thought and potential hallucinations.

<p>True (A)</p> Signup and view all the answers

What is the primary focus of the orientation phase in Peplau's model?

<p>Defining the problem and identifying the type of service needed by the patient.</p> Signup and view all the answers

What is the key characteristic of the identification phase according to Peplau?

<p>The patient begins to feel a sense of belonging and capability, reducing feelings of helplessness and hopelessness.</p> Signup and view all the answers

Match the following terms with their corresponding levels of anxiety in Peplau's model:

<p>Mild anxiety = Positive state of heightened awareness and sharpened senses. Moderate anxiety = Decreased perceptual field, can only solve problems with assistance. Severe anxiety = Feelings of dread and terror, focusing only on scattered details. Panic anxiety = Loss of rational thought, delusions, hallucinations, and complete physical immobility.</p> Signup and view all the answers

What is the primary goal of the resolution phase in Peplau's model?

<p>The termination of the professional relationship, ensuring that the client's needs have been met.</p> Signup and view all the answers

What does Peplau identify as the foundation of nursing practice?

<p>The nurse-client relationship (D)</p> Signup and view all the answers

Hildegard Peplau's Interpersonal Relations Theory was mainly influenced by which of the following?

<p>Henry Stack Sullivan (D)</p> Signup and view all the answers

In Peplau's model, what is the nurse's role in the therapeutic process?

<p>To create a partnership with the client (D)</p> Signup and view all the answers

Which of the following best describes Peplau's view on client engagement in the therapeutic process?

<p>Clients actively engage and learn (A)</p> Signup and view all the answers

What significant event in Peplau's early life influenced her understanding of illness?

<p>The flu epidemic in 1918 (B)</p> Signup and view all the answers

What degree did Peplau earn in 1943 that contributed to her theoretical framework?

<p>Bachelor’s in Interpersonal Psychology (A)</p> Signup and view all the answers

What was revolutionary about Peplau's emphasis on nurse-client relationships?

<p>It focused on partnership rather than passive treatment (D)</p> Signup and view all the answers

Peplau's Interpersonal Relations Theory primarily helped to develop what in clinical settings?

<p>Therapeutic interventions (C)</p> Signup and view all the answers

What is the primary assumption underlying Travelbee's Human-to-Human Relationship Model?

<p>The nurse-patient relationship is the objective of nursing. (C)</p> Signup and view all the answers

Which phase involves the initial impressions formed by the nurse and patient?

<p>Original Encounter (B)</p> Signup and view all the answers

How does Travelbee define 'health' in her model?

<p>Subjective and objective wellbeing. (B)</p> Signup and view all the answers

What does 'logo therapy' primarily focus on according to Viktor Frankl's philosophy?

<p>Fulfillment and finding meaning. (D)</p> Signup and view all the answers

What is essential for nurses in understanding their relationship with patients?

<p>Understanding the concept of being human. (C)</p> Signup and view all the answers

In which phase do the nurse and patient start to perceive each other's uniqueness?

<p>Emerging Identities (D)</p> Signup and view all the answers

What is characterized by a desire from the nurse to alleviate the patient's suffering?

<p>Sympathy (A)</p> Signup and view all the answers

What might hinder the establishment of understanding between a nurse and a patient?

<p>Using stereotypes about patients. (D)</p> Signup and view all the answers

According to Travelbee, what are individuals seeking through their experiences?

<p>Meaning in their experiences. (A)</p> Signup and view all the answers

In the Human-to-Human Relationship Model, what role does communication play?

<p>It is essential for effective nursing care. (B)</p> Signup and view all the answers

What is the implication of patients being seen as unique individuals according to Travelbee?

<p>Their care must be individualized. (A)</p> Signup and view all the answers

What does the rapport phase focus on in the nurse-patient relationship?

<p>Lessening the patient’s suffering. (D)</p> Signup and view all the answers

What is implied by the statement 'there are only individual human beings' in Travelbee's perspective?

<p>Care is required for diverse individuals. (B)</p> Signup and view all the answers

What does Travelbee urge nurses to avoid in their practice?

<p>Evoking stereotypes about patients. (C)</p> Signup and view all the answers

Which role of the nurse involves creating an environment of trust when first meeting a patient?

<p>Stranger (B)</p> Signup and view all the answers

What is highlighted by Ida Jean Orlando's Deliberative Nursing Process Theory?

<p>The collaborative relationship between nurse and patient (D)</p> Signup and view all the answers

What is the primary task of the nurse acting as a resource person?

<p>To offer information needed by the patient (B)</p> Signup and view all the answers

Which level of anxiety is characterized by the inability to focus and feelings of terror?

<p>Severe anxiety (C)</p> Signup and view all the answers

What is the goal of the nurse in the role of counselor according to Peplau's theory?

<p>To guide the patient in understanding life situations (C)</p> Signup and view all the answers

Which factor describes the nature of mild anxiety?

<p>Heightened awareness and perception (C)</p> Signup and view all the answers

In Orlando’s Deliberative Nursing Process, how should nurses respond to unexpected complications during care?

<p>By adapting the care plan as necessary (D)</p> Signup and view all the answers

Which of the following roles does the nurse take on when advocating for the patient?

<p>Surrogate (A)</p> Signup and view all the answers

Which level of anxiety involves learning new behaviors with some assistance?

<p>Moderate anxiety (A)</p> Signup and view all the answers

What did Ida Jean Orlando perceive as fundamental to the nursing profession?

<p>Incorporation of mental health into nursing (B)</p> Signup and view all the answers

Which aspect of nursing does Peplau's model mainly emphasize?

<p>The importance of a therapeutic relationship (B)</p> Signup and view all the answers

In what context did Ida Jean Orlando develop her nursing theory?

<p>During a practical nursing course at Yale University (A)</p> Signup and view all the answers

How is the nurse as a leader supposed to function in nursing practice?

<p>By empowering the patient to take responsibility (B)</p> Signup and view all the answers

What was a significant aspect of Ida Jean Orlando's background that contributed to her nursing philosophy?

<p>Her diverse nursing experiences in multiple specializations (D)</p> Signup and view all the answers

What is Ida Jean Orlando's primary goal in her nursing theory?

<p>To develop a theory of effective nursing practice (C)</p> Signup and view all the answers

According to Orlando, what typically causes patient distress?

<p>Inability to cope with their own needs (D)</p> Signup and view all the answers

Which concept is not included in Orlando's nursing metaparadigm?

<p>Environment (C)</p> Signup and view all the answers

What does Orlando classify 'presenting behavior' as?

<p>The patient's problematic situation (A)</p> Signup and view all the answers

In Orlando's theory, how is nursing characterized?

<p>As a unique and independent practice (B)</p> Signup and view all the answers

What is identified as an automatic internal response in a patient according to Orlando?

<p>Immediate reaction to their perceptions (D)</p> Signup and view all the answers

Why do patients need help communicating their needs, according to Orlando?

<p>They feel uncomfortable and ambivalent about dependency (B)</p> Signup and view all the answers

Which statement best describes the function of professional nursing in Orlando's theory?

<p>Organizing and meeting immediate patient needs for help (D)</p> Signup and view all the answers

In the context of Orlando's model, how do actions and reactions between the nurse and patient manifest?

<p>They are dynamic and interdependent (D)</p> Signup and view all the answers

What distinguishes deliberative nursing actions from automatic nursing actions?

<p>Deliberative actions are decided upon after ascertaining a need. (B)</p> Signup and view all the answers

What element does Orlando explicitly emphasize as crucial in nurse-patient interactions?

<p>The individual patient's need for help (D)</p> Signup and view all the answers

Which of the following is a critical assumption in Orlando's nursing model?

<p>Nursing can add to a patient's distress (A)</p> Signup and view all the answers

Which stage of the Deliberative Nursing Process involves making clinical judgments about health problems?

<p>Diagnosis (A)</p> Signup and view all the answers

Orlando's theory suggests that observation shared with the patient has what benefit?

<p>It helps ascertain and meet the patient's needs (B)</p> Signup and view all the answers

In the nursing process, when does the nurse evaluate the effectiveness of their actions?

<p>After implementation (A)</p> Signup and view all the answers

What is the main goal of the nursing process discipline?

<p>To validate the nurse's reactions to patient behavior. (C)</p> Signup and view all the answers

What does Orlando disregard in her theory concerning patient needs?

<p>The patient's support system (D)</p> Signup and view all the answers

What happens if the patient's behavior does not improve after a nursing action is implemented?

<p>The nursing process starts over for specific problems. (C)</p> Signup and view all the answers

What does Orlando classify as the response of the nurse following a patient's presenting behavior?

<p>An automatic internal response (C)</p> Signup and view all the answers

Joyce Travelbee emphasized the importance of which aspect in the nurse-patient relationship?

<p>Facilitating an interpersonal connection. (A)</p> Signup and view all the answers

Which factor is NOT taken into account during the assessment stage of the nursing process?

<p>Immediate reason for encounter (A)</p> Signup and view all the answers

How did Travelbee view the role of the nurse in relation to the patient?

<p>As a facilitator in the patient's journey. (A)</p> Signup and view all the answers

What is the ultimate goal of nursing according to Travelbee's model?

<p>To help patients find meaning in their experiences. (D)</p> Signup and view all the answers

What best describes the 'Improvement' stage in the nursing process?

<p>Resolving the patient's situation through intervention. (D)</p> Signup and view all the answers

Which of the following actions represents a characteristic of automatic nursing actions?

<p>Responding based on learned protocols without patient input. (C)</p> Signup and view all the answers

Which nursing process stage directly involves creating interventions to achieve patient goals?

<p>Planning (C)</p> Signup and view all the answers

What is a key component of the implementation stage in the nursing process?

<p>Executing the nursing care plan. (D)</p> Signup and view all the answers

In what way does the nursing process begin its cycle again?

<p>If new problems are identified during evaluation. (D)</p> Signup and view all the answers

What defines the concept of 'health' in Hildegard Peplau's theory?

<p>A forward movement of personality and human processes. (C)</p> Signup and view all the answers

In which phase of the therapeutic nurse-patient relationship do patients begin to feel they belong and can cope with their problems?

<p>Identification phase. (C)</p> Signup and view all the answers

What is emphasized as crucial for nurses in Peplau's Interpersonal Relations Theory?

<p>Clear self-understanding to avoid limiting client choices. (A)</p> Signup and view all the answers

What does Peplau define as essential skills for effective nursing practice?

<p>Communication and interviewing skills. (C)</p> Signup and view all the answers

Which of the following best describes the resolution phase in Peplau's model?

<p>Dissolving the nurse-client relationship after needs are met. (C)</p> Signup and view all the answers

What role does the nurse play in the exploitation phase of the therapeutic nurse-client relationship?

<p>Using professional assistance for problem-solving alternatives. (D)</p> Signup and view all the answers

How does Peplau define 'man' in her theory?

<p>A developing organism aiming to reduce tension caused by needs. (A)</p> Signup and view all the answers

What does the environment encompass in Peplau's theory?

<p>Cultural and societal influences on the patient. (B)</p> Signup and view all the answers

What aspect of nursing does Peplau consider significant in her theoretical assertions?

<p>Therapeutic interpersonal relationships. (C)</p> Signup and view all the answers

In the identification phase, what does the nurse focus on primarily?

<p>Developing a nursing care plan based on the patient’s needs. (A)</p> Signup and view all the answers

What was a notable achievement of Hildegard Peplau?

<p>First published nursing theorist after Florence Nightingale. (B)</p> Signup and view all the answers

Peplau's theory encourages nurses to take into account which of the following?

<p>The patient's culture and mores. (A)</p> Signup and view all the answers

Which of the following statements about Peplau's nursing theory is incorrect?

<p>Nurses should avoid understanding their own feelings. (B)</p> Signup and view all the answers

What is a key outcome expected from the therapeutic nurse-client relationship?

<p>Both nurse and patient maturing through interaction. (A)</p> Signup and view all the answers

Flashcards

Peplau's Interpersonal Relations Theory

A nursing theory emphasizing the nurse-client relationship as the foundation of practice, focusing on a collaborative partnership instead of passive treatment.

Therapeutic nurse-client relationship

A professional and planned relationship between nurse and client focused on the client's needs, feelings, and problems.

Orientation phase

The initial phase of the therapeutic relationship where nurse and patient meet as strangers, defining the problem and needs of the patient.

Identification phase

Phase where the patient feels a sense of belonging and starts to feel capable of managing the problem.

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Exploitation phase

Phase where professional help is utilized to solve problems and address the client's needs, supporting independence.

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Resolution phase

Final phase where the relationship ends as the patient's needs are met; achieving health, independence, and growth.

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Nurse's role as a stranger

Creating trust by approaching the patient as they would meet a stranger in any other situation.

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Nurse's role as a teacher

Providing knowledge relevant to the patient's needs and interests.

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Nurse's role as a resource person

Providing specific information/resources to aid the patient.

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Nurse's role as a counselor

Supporting the patient in understanding current situations and encouraging change through guidance.

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Nurse's role as a surrogate

Helping the patient understand dependence, interdependence, and independence; advocating for the patient.

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Nurse's role as a leader

Supporting the patient to take responsibility for their treatment goals.

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Mild anxiety

A heightened awareness, allowing learning and problem-solving.

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Moderate anxiety

Decreased perceptual capabilities, requiring external direction for problem-solving.

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Severe anxiety

Dread and terror, preventing focus on tasks.

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Panic anxiety

Loss of rational thought, leading to severe physiological responses and potential for harm.

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Psychodynamic nursing

Understanding one's behavior and assisting others with felt difficulties using human relations.

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Health (Peplau)

Forward movement of personality toward creative and constructive living.

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Man (Peplau)

An organism reducing tension from needs.

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Nursing (Peplau)

A therapeutic, interpersonal process of a nurse helping someone in need of health care.

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Interpersonal Relations Theory

Hildegard Peplau's theory focusing on the nurse-client relationship as the foundation of nursing practice, emphasizing a collaborative partnership rather than passive treatment.

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Therapeutic Process

A process involving interaction between nurse and patient with a shared goal of improving the patient's health, involving mutual respect and learning.

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Nurse's Role

According to Peplau, the nurse plays various roles in the nurse-client relationship, depending on the patient's needs. These roles range from being a teacher to counselor and even a leader.

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Influences on Peplau's Theory

Peplau's theory was influenced by thinkers like Henry Stack Sullivan, Percival Symonds, Abraham Maslow, and Neal Elgar Miller, drawing inspiration from their work on interpersonal relationships and human behavior.

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Peplau's Nursing Theory

A theory that emphasizes the therapeutic relationship between the nurse and patient, focusing on the interpersonal process of care.

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Orlando's Deliberative Nursing Process Theory

A theory that emphasizes the importance of a nurse's ability to adapt to a patient's changing needs and unexpected problems.

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Reciprocal Relationship

The nurse-patient interaction is a two-way process, where both individuals influence each other.

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Patient Participation

Orlando's theory stresses the importance of the patient actively participating in the creation and implementation of their nursing care plan.

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Nursing as a Distinct Profession

Orlando viewed nursing as separate from medicine, emphasizing nurses' autonomy in determining their actions.

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What is the purpose of nursing according to Peplau?

To help individuals identify and manage difficulties, using human relations principles at all experience levels.

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What is Peplau's definition of man?

An organism that strives to reduce tension caused by needs.

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What is Peplau's definition of health?

Forward movement of personality in the direction of creative, constructive, productive, personal, and community living.

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What is the key to Peplau's theory?

The therapeutic nurse-client relationship, which is professional and planned, focusing on the client's needs, feelings, and problems.

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What are the four phases of the therapeutic relationship?

Orientation, identification, exploitation, and resolution.

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What happens in the orientation phase?

Nurse and client meet as strangers, defining the problem and needs of the client.

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What happens in the identification phase?

The client starts to feel a sense of belonging and becomes capable of managing the problem.

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What happens in the exploitation phase?

Professional services are used to solve problems and address client needs, fostering independence.

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What happens in the resolution phase?

The relationship ends as client needs are met, resulting in improved health, independence, and growth.

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How does Peplau view the nurse's role?

A significant, therapeutic, interpersonal process that involves a nurse helping someone in need of health care.

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Why is understanding the nurse's own self important in Peplau's theory?

To promote client's growth, reduce subjective biases, and avoid limiting the client's choices to those valued by the nurse.

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What are the assumptions of Peplau's theory?

(1) Nurse and patient can interact. (2) Both mature through the therapeutic interaction. (3) Communication is crucial. (4) Nurses must understand themselves to promote client growth.

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What is the role of communication in Peplau's theory?

Communication and interviewing skills are fundamental nursing tools, both in the therapeutic relationship and for understanding the client's needs and challenges.

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Orlando's Nursing Process

A nursing approach focusing on identifying and meeting immediate needs for help in the nurse-patient relationship.

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Presenting Behavior

The patient's actions or words that signal a potential need for help or distress.

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What is the role of a nurse, according to Orlando?

To find out and address the patient's immediate needs for help.

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What does Orlando's theory emphasize?

The dynamic, individual nature of the nurse-patient relationship and how it shapes immediate needs.

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What is 'Immediate Reaction' in Orlando's theory?

The nurse's internal response to the patient's presenting behavior, including thoughts and feelings.

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What is 'Nurse's Action' in Orlando's process?

The nurse's deliberate actions based on their assessment of the patient's presenting behavior and internal reaction.

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What does Orlando's theory say about patients?

Patients are helpless and need help to communicate their needs; they are uncomfortable and ambivalent about dependency.

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What is the goal of Orlando's theory?

To develop a theory of effective nursing practice, focusing on meeting the patient's immediate need for help.

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How does Orlando's theory view nursing?

Nursing is a unique and independent discipline concerned with the patient's immediate needs.

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What is the role of the environment in Orlando's theory?

It is disregarded, focusing solely on the 'here and now' needs of the patient in relation to the nurse.

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How is helplessness treated in Orlando's theory?

Helplessness is the trigger for seeking nursing care, and the nurse's job is to help the patient regain a sense of control.

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What is the 'Nursing Process Discipline' in Orlando's theory?

A structured process involving the nurse's reaction, action, and evaluation to help patients meet their immediate needs.

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What is the 'function of professional nursing' in Orlando's theory?

To discover and address the patient's immediate needs for help in a responsive, caring manner.

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What is the central concept of Orlando's theory?

The patient's immediate need for help, which is a response to a sense of helplessness.

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How is 'health' defined in Orlando's theory?

Health is replaced by a sense of helplessness, which is the primary reason patients seek nursing care.

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Nursing Process

A systematic approach used by nurses to provide patient care, involving five stages: assessment, diagnosis, planning, implementation, and evaluation.

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Deliberative Nursing Actions

Nursing actions that are thoughtfully planned and implemented after carefully assessing the patient's needs.

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Automatic Nursing Actions

Nursing actions performed without deliberate consideration of the patient's needs, often based on routine or habit.

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What is the main goal of the nursing process?

To provide individualized and effective care by addressing the patient's specific needs and ensuring the best possible outcomes.

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What are the five stages of the Deliberative Nursing Process?

Assessment, diagnosis, planning, implementation, and evaluation.

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Assessment (Nursing Process)

The initial stage where the nurse gathers information about the patient's needs, including both subjective and objective data.

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Diagnosis (Nursing Process)

The stage where the nurse analyzes the collected assessment data to identify the patient's health problems and formulate nursing diagnoses.

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Planning (Nursing Process)

The stage where the nurse establishes goals for the patient's care and develops a plan to achieve these goals through nursing interventions.

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Implementation (Nursing Process)

The active stage where the nurse puts the care plan into action, carrying out nursing interventions to address the patient's needs.

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Evaluation (Nursing Process)

The final stage where the nurse assesses the effectiveness of the care plan by evaluating progress toward goals and making adjustments as needed.

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Joyce Travelbee's Human to Human Relationship Model

A nursing theory emphasizing the importance of human-to-human relationships in nursing practice, recognizing the nurse and patient as individuals with unique experiences and emotions.

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How does Travelbee's theory differ from traditional nursing models?

It emphasizes the emotional and interpersonal aspects of nursing, recognizing that nursing care goes beyond simply providing medical treatments.

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What is the purpose of nursing according to Travelbee?

To help and support individuals, families or communities to prevent or cope with illnesses and suffering, ultimately aiming for hope and finding meaning in experiences.

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What are the stages in Travelbee's human-to-human relationship model?

The model progresses through stages of original encounters, emerging identities, developing empathy, and ultimately reaching sympathy.

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What is Travelbee's contribution to nursing theory?

She expanded on existing interpersonal relationship theory, emphasizing the significance of the nurse-patient relationship as a key component of effective nursing care.

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Human-to-Human Relationship Model

Travelbee's model emphasizes the importance of the nurse-patient relationship as a human-to-human interaction, focusing on the individual uniqueness of each person rather than stereotypes.

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Existentialism

A philosophical perspective emphasizing individual responsibility for choices and meaning in life. Travelbee used this to explain the importance of patient choices in their healthcare journey.

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Logo therapy

A type of psychotherapy focusing on finding meaning in life as a way to promote mental well-being. Travelbee applied this to understand how patients seek purpose within their illness.

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Patient as a stereotype

Travelbee argues that seeing patients as just a category is problematic. Instead, we should understand each person's unique needs and experiences.

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Illness as a classification

Travelbee emphasizes that illness is not just a category, but something experienced by each person based on their individual context.

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Hope in illness

Travelbee sees hope as vital for navigating suffering. It provides direction for lessening pain and finding meaning in the situation.

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Communication in nursing

For Travelbee, communication is essential for good nursing practice. It allows nurses to understand the patient's needs and provide effective care.

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Original Encounter

The initial meeting between the nurse and patient, often filled with stereotyped roles and first impressions.

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Emerging Identities

The phase where the nurse and patient begin to recognize each other's uniqueness and develop a more individualised relationship.

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Empathy

The ability to understand and share in the patient's experience, feeling their emotions without being overwhelmed.

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Sympathy

Going beyond empathy to actively wanting to lessen the patient's suffering, taking action to help.

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Rapport

The strong connection built through effective nursing interventions, fostering trust and a respectful human-to-human relationship with the patient.

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Nursing's objective

According to Travelbee, the ultimate aim of nursing is the nurse-patient relationship, built upon mutual understanding and respect.

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Uniqueness in the nurse-patient relationship

Travelbee emphasizes that the nurse-patient relationship can only be successful when both parties acknowledge and appreciate their individuality.

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Subjective vs. Objective Health

Travelbee defines health from both personal and objective perspectives, emphasizing the importance of both perspectives.

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Environment's influence

Travelbee acknowledges the influence of the environment on the patient's experience and emphasizes observing the patient within their context.

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Study Notes

Hildegard E. Peplau's Interpersonal Relations Theory

  • Peplau's theory emphasizes the therapeutic nurse-client relationship as the foundation of nursing practice.
  • The theory views nursing as a significant, therapeutic, interpersonal process involving interaction between a sick/needy individual and a specially-trained nurse.
  • The goal is for both nurse and client to mature and grow through the interaction.

Key Concepts

  • Man: Viewed as an organism striving to reduce tension from unmet needs.
  • Health: Implies forward movement towards creative & productive living.
  • Society/Environment: Acknowledged as a factor influencing interaction, with a strong emphasis on cultural sensitivity.

Key Concepts of Peplau's Interpersonal Relations Theory:

  • Nursing: Defined as a therapeutic interpersonal process between a sick or needy individual and a specially educated nurse.
  • Therapeutic Nurse-Client Relationship: A planned professional relationship focusing on the client's needs, feelings, problems, and ideas.

Four Phases of the Therapeutic Relationship

  • Orientation: Defining the problem, assessing the patient's health and situation, identifying needed services, and exploring expectations. (Nurse assesses patient's health and situation)
  • Identification: Selecting appropriate help, reducing helplessness and hopelessness, developing a nursing care plan based on the patient's situation and goals. (Developing a nursing plan based on needs and goals)
  • Exploitation: Utilizing professional assistance for problem-solving; implementation of the nursing plan. The nurse helps the patient utilize all avenues of support (Implementing the nursing plan)
  • Resolution: Termination of the professional relationship; the evaluation of if the goals were met (Evaluation of nursing process)

Nurse Roles

  • Stranger: Creates an environment of trust by acting neutral, as a stranger would.
  • Teacher: Sharing knowledge relating to patient needs/interests.
  • Resource Person: Providing specific information needed by the patient.
  • Counselor: Guiding patient to understand life situations and encourage change.
  • Surrogate: Clarifying dependency levels and advocating for the patient.
  • Leader: Encouraging the patient to take responsibility for treatment.

Levels of Anxiety

  • Mild: Heightened awareness, sharpened senses; learning and problem-solving are possible.
  • Moderate: Decreased perceptual field, learning/problem-solving only with assistance.
  • Severe: Feelings of dread and terror, focus on scattered details, physiological symptoms (e.g., tachycardia, diaphoresis).
  • Panic: Loss of rational thought, possible delusions/hallucinations, complete physical immobility or agitation.

Assumptions of Peplau's Theory

  • Nurse-patient interaction is possible and valuable.
  • Both nurse and patient mature through interaction.
  • Communication and interview skills are fundamental nursing tools.
  • Nurses need self-awareness to support client growth without imposing their values.

Goals of Psychodynamic Nursing

  • Understanding one's own behavior.
  • Helping others identify and address their difficulties.
  • Applying human relations principles to challenges at various experience levels.

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