Mental Health: Peplau

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BN 606 Person-centred care: The mental health context
Portfolio Option 2: Exploring mental health theories
In this portfolio I was allowed the opportunity to explore an in depth discussion with nursing theorist Hildegarde Peplau. Peplau explains and justifies her approach to mental health nursing, from this discussion I will summarise the key points she gave details on. I will demonstrate an understanding of her ideas that I received through this summary. Peplau’s model applied interpersonal theory to nursing practice and had a great focus on nurse-client relationship development (Townsend, 2009). This portfolio will explain Peplau’s belief of interpersonal relationships in mental and psychiatric health being critical, the roles that the nurse assumes to provide an interpersonal involvement with a patient and the phases the nurse-client relationship progresses through in order to implement the interpersonal relationship. Peplau’s theory of interpersonal relations has been used extensively through nursing history, it is used today as a basis for understanding, and providing care within, psychiatric nursing. Hildegarde Peplau developed her theory for the purpose of assisting nurses to understand interpersonal relationship, to guide nursing practice and so the nurse can care for their patients in an understanding way. Peplau was the first theorist to describe interpersonal relations as the foundation of nursing practice (Townsend, 2009), her theory was described as the “mother of mental health” nursing (Arnold & Boggs, 2007). Peplau believes that interpersonal relationships are the key to mental health nursing, but more in particular developing specific interpersonal connections between a nurse and client (McQuiston & Webb, 1995). The belief is that the nurse-client relationships should be built interpersonally through person-to-person communication (Craven & Hirnle, 2009). Peplau believed that the interpersonal relationship should be developed in a “doing with” the patient approach opposed to “doing for” the patient (Elder, Evans & Nizette, 2009). Peplau’s nursing model uses the skill of interaction with the patient, as its main theme (Simpson, 1991). Peplau believes the development of skills needed to maintain and nurture the nurse-client relationship to be the most important factor in the process of care for mental health (Simpson, 1991). Without this, the nurse could not truly be helpful or therapeutic. In the mental health context, a therapeutic relationship allows for a meaningful journey to recovery for the patient, through a shared experience between the nurse and client. Mental health care should not have a focus on medical treatment, but rather on the interpersonal model of nursing, which uses oneself as a therapeutic agent working together with the client (Feely, 1997). Peplau believed the development of trusting relationships to be the basis of successful outcomes (Simpson, 1991). Peplau designed her model in the belief that the nurse will work in the company of the patient with a focus on the patient’s independent decision making and problem solving, promoting autonomy (Varcarolis & Halter, 2009). Peplau views nursing as a developmental educational instrument, with which the nurse would help individuals, families and communities achieve changes in wellbeing, illness and health care status to improved function (Craven & Hirnle, 2009). The nurse has a need to develop skills in the way of therapeutic and interpersonal communication to be successful in psychiatric nursing. Communication is a key skill that underpins mental health nursing interventions (Elder, Evans & Nizette, 2009). Therapeutic skills such as listening, observing and talking as a participant, allows the nurse to actively engage with their clients. This communication can help increase the knowledge and awareness of health issues, problems and outcomes (Craven & Hirnle, 2009). Peplau believes therapeutic skills are essential to the nurse client...
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