T he o ret i ca l f ra m e w o r k s u n d erp i n n i n g pract i ce 27

someone who possessed self-awareness, basic honesty, Critique of the humanistic orientation
caring, and the ability to trust and be autonomous. One of the main criticisms of the humanistic

CHAPTER 2
Maslow described a range of other characteristics of orientation is the lack of scientific evidence for the
a self-actualising person, including the capacity to concept of free will, a core concept of the approach
welcome uncertainty in their lives, self-acceptance and (Burger, 2011). It is claimed that it is not possible to
acceptance of others not to live their lives according scientifically study free will. However, this argument
to the expectations of others, and possessing a sense of implies that there is only one valid approach to
humour (Corey, 2013). studying human behaviour. Cervone and Pervin
Maslow also proposed the concept of a hierarchy (2013) note that there are a variety of ways in which
of needs through which people are motivated to knowledge can be gained about human behaviour, of
fulfil basic needs before moving on to other needs. He which humanistic views such as Rogers’ is one. As you
believed that humans have an innate drive towards will read in Chapter 6, there are other ways in which
personal growth and strive for self-actualisation, to explore questions regarding human behaviour. A
which is the need to fulfil one’s potential. In Maslow’s second criticism of the humanistic orientation is that
view, this hierarchy of needs is systematic and higher because of its optimistic view of human nature, many
needs will not be aroused until lower-order needs of its ideas are over-simplistic and even naïve, and
are fulfilled. A person with a healthy personality such ideas do not address the reality of emotional ill
is self-actualised and pursues continuous personal health, illness and antisocial behaviour.
growth (Corey, 2013; Weiten, 2011). Maslow’s
hierarchy of needs is represented in Figure 2.8.
THE USE OF PSYCHOLOGICAL
AND SOCIOLOGICAL THEORIES OF
PERSONALITY IN MENTAL HEALTH
NURSING PRACTICE
In the preceding sections we have considered just
a few of the major theoretical perspectives within
psychology. Various nursing theorists have drawn
from both psychology and sociology in order to
understand human behaviour and how this influences
the role of the mental health nurse.
SOURCE: SHUTTERSTOCK.COM/MAYRUM

Hildegard Peplau
While Florence Nightingale was the first nurse to
document her ideas regarding health, illness and
the role of nurses in health care generally, Hildegard
Peplau (1909–99) was the first nurse to look specifically
FIGURE 2.8 at the discipline of mental health nursing and is
Maslow’s hierarchy of needs consequently viewed by many as the mother of mental
health nursing. She was also the first nurse to draw on
Relevance of the humanistic-orientation to theories from other disciplines such as psychology;
mental health nursing practice in particular, her work drew from the ideas of Harry
Rogers’ ideas about the importance of the therapeutic Stack Sullivan and Abraham Maslow. Viewing mental
relationship for successful counselling has resonated health nursing as an essential therapeutic and
within mental health nursing education, practice interpersonal process, Peplau (1962) believed that
Copyright © 2019. Cengage. All rights reserved.

and research for many years. Concepts such as the nurse–consumer relationship was the crux of
unconditional positive regard and empathy are central mental health nursing. Through this relationship, the
to a person-centred focus of practice. Debate ensues nurse uses him/herself as the therapeutic instrument;
regarding how mental health nurses should practise that is, the nurse engages with consumers through
and whether it is possible to attempt to connect with a variety of psychosocial interventions to facilitate
and understand another person’s world of which personal growth on the part of the consumer. This
they may have no experience. However, to deny the concept moved the idea of nursing practice from one
importance of seeing the humanness of all people fails of ‘doing things’ to them, to one of being with them.
to acknowledge the inherent capacity of people to This changes the focus of working with a consumer
move forward in positive and productive ways. from a passive relationship on their part to an active

Copyright 2020 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-202

Hercelinskyj, G., & Alexander, L. (2019). Mental health nursing. Cengage.

Created from acu on 2024-03-09 23:26:23.
 28 UND E R P INNINGS OF M E N TA L H E A LT H NU R SING

partnership and collaboration. Peplau (1962) also and resolution (Peplau, 1991). In order to maximise
proposed that the therapeutic relationship passed their work with consumers, Peplau (1962) proposed
SECTION 1

through a number of phases, which evolved from the that mental health nurses assume a variety of roles at
initial contact through to discharge. Peplau identified different times, in response to the emerging needs of
these phases as orientation, identification, exploitation the consumer. These roles are outlined in Table 2.5.

TABLE 2.5
Peplau’s nursing roles
PRIMARY ROLES FEATURES OF EACH ROLE
Stranger role Offering the consumer the same acceptance and courtesy that the nurse would to any stranger. The aim is
to establish a safe interpersonal climate and build trust.
The nurse must withhold any judgement, as when meeting as strangers both consumer and nurse are
unknown to each other. This holds true even when the nurse has worked with a consumer previously. In the
context of the current interpersonal context, they are again strangers
Resource role Providing specific information (usually health related) that assists the consumer in their understanding of a
particular issue.
Teacher role Imparting information and using strategies to facilitate a consumer’s learning.
This can be either a formal or informal process.

SOURCE: HTTP://NURSESLABS.COM/HILDEGARD-PEPLAUS-INTERPERSONAL-RELATIONS-THEORY/
Leader role The mental health nurse assists the consumer to take up maximum responsibility for meeting their
treatment goals in a mutually satisfying way.
Surrogate role Serving as a substitute for another such as a parent or a sibling.
Counsellor role The nurse uses the interpersonal process to facilitate the consumer’s understanding of their current life
circumstances and integrate this understanding into their world view. This can then facilitate the nurse in
helping the consumer to make positive health choices.
Other roles, including: These roles incorporate activities related to education, clinical skills and practice, advocacy, role modelling
• technical expert educative, clinical skills and practice, advocacy, milieu management to promote healing and use of
• consultant evidence to promote best practice.
• health teacher
• observer/recorder
• socialising agent
• manager of the environment
• mediator
• researcher.

EVIDENCE-BASED PRACTICE
Applying Peplau’s theory to mental health nursing Design
practice A critical literature review incorporating exploration of a
Title of study critique of the nurse’s role in promoting self-management
Utilising Peplau’s interpersonal approach to facilitate of medication utilising Peplau’s interpersonal theory with a
medication self-management for psychiatric patients recovery-oriented model of mental health nursing practice
was undertaken.
Authors
Judith M. Hochberger and Brenda Lingham Conclusions
Peplau’s interpersonal theory provides a way for mental
Background health nurses to integrate interpersonal communication
Copyright © 2019. Cengage. All rights reserved.

Mental health nurses have a key role in promoting
medication self-management as medication non-adherence
can have a major impact on consumer well-being, treatment
and outcomes. While many strategies have been identified
to promote consumers self-managing medications, there is a
lack of conceptual and evidence-based practice to support
this. This discussion paper explored utilising Peplau’s
interpersonal approach to promote consumer adherence
skills and education to promote best outcomes with
consumers in relation to medication self-management.
Implications
Mental health nurses must be encouraged to focus on
how an effective therapeutic relationship contributes to
consumer health outcomes.
SOURCE: HOCHBERGER, J.M. & LINGHAM, B. (2017). UTILIZING PEPLAU’S INTERPERSONAL APPROACH
TO FACILITATE MEDICATION SELF-MANAGEMENT FOR PSYCHIATRIC PATIENTS. ARCHIVES OF PSYCHIATRIC

and medication usage, including self-administration of NURSING, 31(1), 122–4. DOI:HTTPS://DOI.ORG/10.1016/J.APNU.2016.08.006

psychotropic medications.

Copyright 2020 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-202

Hercelinskyj, G., & Alexander, L. (2019). Mental health nursing. Cengage.

Created from acu on 2024-03-09 23:26:23.