Peplau’s theory of interpersonal relations

Ken Jenkins is a seventeen-year-old male, overweight but active. He is currently on his high school football team. Both his grandfather and his aunt have type II diabetes. Recently, Ken complained of frequent urination, excessive thirst, fatigue, weight loss, and blurred vision which he first attributed to strenuous football practices in the heat (“Symptoms,” 2014). However, a subsequent visit to his pediatrician revealed Ken to be pre-diabetic. As an athlete who had always viewed making weight to be a good thing and who had never restricted his calories, Ken was surprised. He is concerned about how the diabetes will affect his ability to play as well as how the prescribed weight loss will affect his football career, given the increased emphasis on larger players even at the high school and college levels.

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Peplau identifies four phases in the nursing process: orientation, identification, exploitation, and resolution (“Peplau’s theory,” 2014). In the orientation phase, the problem is defined — in this case, the fact that Ken’s predisposition to develop diabetes has been identified. The nurse meets the client “as a stranger” and defines the problem, namely Ken’s need for assistance with his diet and exercise to support his life goals and overall health (“Peplau’s theory,” 2014). Ken’s state of health should also be defined during this phase, its strengths as well as weaknesses. Nursing involves a mutual exchange of information between nurse and patient (“Peplau’s theory,” 2014).

In the identification phase, the appropriateness of specific professional assistance is offered (“Peplau’s theory,” 2014). There is a strong stress on the patient being given empowering tools over their health. For a patient such as Ken who has always seen himself as strong and in control, this is particularly important, so he can continue to feel that sense of empowerment as he negotiates adolescence along with his diabetes. The exploitation phase is a professional phase in which specific nursing techniques are communicated to the patient in a language he can understand. The resolution phase involves a termination of the professional relationship after the patient’s needs have been met (“Peplau’s theory,” 2014). Three questions posed by this four-step process include: how to convince the patient of the need to change his diet and of his state of health? How to work with an adolescent client to create a feasible plan of management of a potentially lifelong chronic illness? How to communicate with the client to achieve his specific athletic health goals?

Peplau’s model is extremely useful in this instance because diabetes is a self-managed illness to a great degree. It is chronic but the client must be cooperative in making dietary changes. Also, during every life stage and for every individual client, the definition of what constitutes health and wellness will vary. The Peplau model allows for considerable flexibility, which was needed for this particular client. The only stage which did not fit was the resolution phase, given that the relationship between providers and patients never really ends in the management of the diabetic or pre-diabetic condition.

The Peplau perspective rendered the client into an active participant in his care. For adolescents who can be potentially resistant to dictatorial demands of a provider, this type of approach could be very persuasive in motivating change, in a manner that other models cannot. It also was useful as a way of acknowledging individual client differences.

References

Peplau’s theory of interpersonal relations. (2013). Nursing Theories. Retrieved from:

http://currentnursing.com/nursing_theory/interpersonal_theory.html

Symptoms. (2014). Diabetes. Mayo Clinic. Retrieved from:

http://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-symptoms/art-20044248?pg=2