A Guide to Hildegard Peplau’s Theory of Interpersonal Relations

The nurse-patient relationship is one of the essential factors in healthcare delivery. Nonetheless, the Hildegard Peplau interpersonal relationship theory can help you understand your different roles as a nurse working with patients.

While you are expected to provide patient care in your practice and after school, you must understand the nurse-patient relationship so that you can be better equipped to work with patients from different backgrounds. For this reason, we have compiled a comprehensive guide to help you understand this theory to achieve positive health outcomes.

Biography of Hildegard Peplau

Hildegard Elizabeth Peplau was born on September 1, 1909. Over her lifetime, she became an American nurse who is the only one to serve the American Nurse Association (ANA) as the executive director and later as president.

Additionally, she became the first nursing theorist published after Florence Nightingale. Peplau was well known for her theory of interpersonal relations, which played a significant role in revolutionizing scholarly nurse work. She passed on on March 17th, 1999, where she marked a 50-year career in nursing, including founding modern psychiatric nursing, advocating for mentally ill patients, being an innovative educator, a prolific author, and a proponent of advanced education for nurses.

Interpersonal RelationsTheory

Hildegard Peplau established the theory of international relations in 1952, influenced by Henry Stack Sullivan, Abraham Maslow, Neal Elgar Miller, and Percival Symonds. She believed nursing is a therapeutic career as it involves healing and assisting individuals with healthcare needs.

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This theory emphasizes the nurse-client relationship as the foundation of nursing practice. This relationship is a give-and-take approach, where nurses are on the giving side and the clients on the receiving side.

In this case, the interpersonal model is necessary for forming a partnership between the nurses and patients as opposed to a patient receiving treatment passively or the nurse acting out the doctor’s orders. 

Theory Description

The interpersonal theory defines nursing as an interpersonal process of therapeutic interaction between an individual who is sick and in need of health services and a nurse who is educated to recognize and respond to needed help. Additionally, Hildegard defines nursing as a therapeutic force that involves an interaction between two or more individuals with a common goal. In this case, the common goal is to provide an incentive for the process where nurses and patients respect each other as individuals and learn to grow during the interaction. 

Hildegard Peplau identified four components in theory: person, environment, health, and nursing. Ideally, a person is a developing organism that tries to reduce stress and anxiety caused by their needs.

On the other hand, the environment involves the external forces which affect the person. Nonetheless, health involves the forward movement of personality. At the same time, the nurse is a therapeutic interpersonal process that requires cooperation among human beings to achieve the health goals of individuals in the community.

Moreover, the nursing model involves four sequential phases of interpersonal relationships: orientation, identification, exploitation, and resolution. 

Hildegard also pointed out several roles, including the stranger role, resource role, teaching role, counseling role, surrogate role, active leadership, and technical expertise role.

Assumptions in the Hildegard Peplau Interpersonal Relations Theory

The theory assumes the following

  • The nurse and patient can interact.
  • Both the patient and nurse are mature as a result of this interaction.
  • Communication interviewing skills are fundamental tools in nursing.
  • Nurses have to understand themselves clearly to enhance patient growth and avoid limiting their choices to the ones that nurses value.
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Major Concepts of the Hildegard Peplau Interpersonal Relations Theory

  • Person- Peplau defines a person as an individual with a felt need.
  • Health- Health is the forward movement of personality and ongoing human processes in a constructive, creative, productive, and personal direction. Environment- Peplau insists that nurses should consider the patient’s culture while providing health care to increase cooperation and patient satisfaction.
  • Nursing- This concept is an effective therapeutic and interpersonal process between a sick individual and a nurse with the necessary education on recognizing and responding to these needs.

Phases of the Nurse-Patient Relationship

Orientation phase

This phase involves engaging the patient in treatment, providing information, and answering questions. Ideally, this phase starts when the patient meets the nurse as a stranger. The patient seeks assistance, asks questions, and shares expectations based on previous experiences. Nurses respond to the patients by explaining their roles and using the available resources.

Identification Phase

This phase begins when the patient works interdependently with a nurse after forming a bond in the orientation phase. In this case, the patient expresses their feelings and feels more comfortable in the nurse’s presence.

It also involves the selection of appropriate professional assistance, and the patients begin to have a sense of belonging and increase their belief in themselves to deal with the problem at hand, which decreases the feelings of helplessness.

Exploitation Phase

Patients use the nurse’s services to address the problem in this phase. Specifically, nurses use the available resources and knowledge to provide beneficial services to the patient.

As a result, patients feel like an integral part of the helping environment but may make minor requests or use techniques to gain the nurse’s attention. Additionally, the principles of interview techniques are explored, understood, and applied to help with the underlying problem.

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The patients may also fluctuate in independence, requiring the nurses to be aware of the different communication phases and provide the patient with the necessary aids to progress towards positive health outcomes.

Resolution Phase 

In this stage, the patient may no longer need professional services and is fully independent, which marks the end of the interpersonal relationship. The patient’s needs have already been met following their collaborative effort with the nurse, which leads to dissolving therapeutic relationship links. 

Roles in the Interpersonal Relations Theory

Peplau identifies the following roles of nurses in the therapeutic relationship.

  • Stranger role- The nurse offers the client the same acceptance and courtesy they would offer strangers.
  • Resource role- The nurse provides specific responses to the patient’s concerns within a larger context.
  • Teacher role- The nurse offers the patient information about their situation formally and informally.
  • Leader role- The nurse directs the patient on how they should achieve specific outcomes.
  • Surrogate role- The nurse is a substitute for the patient’s caregiver or family member.
  • Counselor role- The nurse promotes experiences that will help to achieve positive health outcomes, such as expressing feelings. 
  • Technical expert- In this role, the nurse provides physical care for the patient while operating equipment which can help to achieve their perceived outcomes.
Video Guide


What is the primary focus of Peplau’s theory of interpersonal relationships?

Peplau’s Theory focuses on interpersonal processes and the therapeutic relationship between a nurse and a patient.

In which ways can you foster nurse-patient relationships?

What are the main components of a therapeutic nurse-client relationship?

  • Professional intimacy
  • Power
  • Respect
  • Empathy
  • Trust

What are the main types of interpersonal communication?

  • Verbal communication
  • Active listening
  • Nonverbal communication
  • Written communication

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