Peplau

Hildegard E. Peplau (1909–1999) was an American nurse theorist and one of the foundational figures in psychiatric-mental health nursing. Her work helped position nursing as a profession grounded in interpersonal processes and therapeutic relationships, rather than solely in procedures.

Peplau’s most influential contribution is her theory of interpersonal relations in nursing, first articulated in the book Interpersonal Relations in Nursing (1952). The theory frames the nurse-patient relationship as a dynamic, therapeutic process that can influence patient outcomes. It emphasizes communication, collaboration, and the active role of the nurse in guiding patients through their health experiences.

A central element of Peplau’s theory is the four-phase model of the nurse-patient relationship: orientation, identification, exploitation, and resolution. In the orientation phase, the patient seeks help and the nurse begins to establish trust. During identification, the patient and nurse explore problems and establish a collaborative plan. In the exploitation phase, the patient makes use of available resources and interventions. In the resolution phase, the relationship concludes as goals are met or the patient moves forward.

Peplau also introduced the concept of the therapeutic use of self, stressing that a nurse’s attitudes, perceptions, and behavior can facilitate healing. She outlined the nurse’s roles within the relationship, including stranger, resource person, teacher, leader, surrogate, and technical expert, as integral to care.

Her theory has shaped nursing education, practice, and research, particularly in mental health settings, and remains influential in how nurses conceptualize patient care and professional roles.