The nursing profession comprises various aspects as it is a comprehensive profession dealing with varying patient needs within the control of different dimensions. Nursing theorists developed concepts incorporating theories to guide the profession and its practice. Nurses utilize theories in various categories, including behavioral, biological, and sociological sciences (McEwan & Wills, 2019). A grand nursing theory provides a broad focus to address sophisticated nursing issues and ideas relating to the different metaparadigm components, including person, nursing, environment, and health (McEwan & Wills, 2019). Hence, aligning metaparadigm concepts and an appropriate nursing theory will enhance nursing practice as an art and science.
Nursing Metaparadigm
The nursing metaparadigms encompass phenomena of interest to the nursing discipline, are globally recognized and provide a general perspective concerning a particular concept. The nursing paradigms include person, environment, health, and nursing and are interrelated in four propositions (McEwan & Wills, 2019). The person involves a holistic system composed of physical, biochemical, intellectual, and psychosocial needs, and the being is superior to all of its components (McEwan & Wills, 2019). A person has three dimensions: the mind, body, and soul, whose holistic nature deserves assistance, respect, and care (Nikfarid et al., 2018). The environment involves the internal and external factors impacting the person and includes an open system that offers individuals a platform to share energy, information, and matter (McEwan & Wills, 2019). The environment enables a person to realize their inner power of self-healing, and the atmosphere should be accompanied by empathy, love, and trust (Nikfarid et al., 2018). The environment is multifaceted and incorporates the person’s view, immediate context, and complex structures that influence reality (McEwan & Wills, 2019). Hence, the environment and person concepts are connected to understanding an individual’s wellbeing.
The nursing profession offers a scientific basis for its actions while performing activities that promote wellness. Hence, nursing is an art and science that involves caring for the well and sick while assisting in self-care activities and optimizing an individual’s potential (McEwan & Wills, 2019). Nursing also involves facilitating, supporting, and assisting people, communities, and societies in promoting and recovering their health and reverting the effects of illness (McEwan & Wills, 2019). Additionally, health is the harmonious interplay of the mind, body, and soul, offering heightened physical, mental, and social performance while acknowledging the absence or act of illness eradication (Nikfarid et al., 2018). Health involves adapting to life stressors while attaining optimal mind, body, and soul potential. Hence, health and nursing focus on holistic being while fulfilling individual needs.
Grand Nursing Theory
Nursing theories provide concepts that promote evidence-based practices that facilitate patient care. Hildegard Peplau’s interpersonal relations model stresses the patient’s experience and the nurse-patient relationship’s influence on their experiences (Yang et al., 2022). Peplau emphasized that scientific nursing research should focus on patients’ needs and the perceptions of care from the nurse (Yang et al., 2022). The dynamic nurse-patient relationship has four periods: recognition, determination, progress, and resolution. The nurse-patient relationship encompasses mutual participation and collaboration, clarifying problems, goal setting, service provision, and dissolving mutually-fulfilling relationships (Yang et al., 2022). The goals associated with Peplau’s interpersonal relations model focus on improving patients’ experience while receiving nursing care (Lee & Son, 2022). Additionally, the theory fosters effective communication behaviors, attitudes, and perceptions among nurses and patients while enhancing team efficacy (Lee & Son, 2022). Peplau aimed to enhance interpersonal relations among interdisciplinary members, including nurses and patients, to meet the latter’s health needs and preferences while enhancing their experience (Lee & Son, 2022). Hence, the theory focuses on improving patient experience and outcomes through effective interpersonal relationships.
Metaparadigm Concepts within Interpersonal Relations Model
The human-human relationship involved in interpersonal relations should influence health, nursing, the environment, and the person. In a nursing context, the nurse offers care to the individual, family, or society to prevent or cope with disease and suffering. Additionally, nursing establishes meaning from the experiences and explains to the patient what the disease process entails, cultivating Peplau’s interpersonal relations model (Parola et al., 2020). While offering nursing care, the nurse establishes rapport and gains insight into the patient’s needs. Effective interpersonal relationships offer a comprehensive assessment of an individual’s subjective and objective health, including their wellness state and physical, emotional, and psychological status (Parola et al., 2020). Interpersonal relations allow the nurse to assess the patient’s recovery process to necessitate discharge and termination of the relationship. Based on interpersonal relationships initiated by the nurse, the nursing interventions help the patient sustain their health while holding to hope.
Hence, the nurse should create a mutual relationship between the metaparadigms to meet set goals. In a person context, interpersonal relations help the nurse understand the patient as a unique being with different components that they can optimize through close trust relationships (Parola et al., 2020). Effective interpersonal relations help the nurse target the holistic being, including the mind, body, and soul, to ensure health while respecting and caring for the individual. Interpersonal relations occur at a convenient place where the patient is present to receive care services. Interpersonal relationships mold the nurses’ ability to provide care by acting on internal and external factors such as management, collaboration, and technology to realize patient needs (Parola et al., 2020). Hence, the model of the interpersonal relations covers the different metaparadigms while focusing on fulfilling the patient’s needs.
Application to Advance Nursing
The interpersonal relations model should be applied in various fields of nursing, including education, research, and clinical practice. In nursing education, the advanced practice nurse can appreciate the influence of interpersonal relations with physicians during their mandatory experience, which facilitates the development of clinical competencies (Rebeiro et al., 2021). Additionally, positive relationships enhance the advanced nursing practice student’s clinical learning and develop professional skills and critical thinking, facilitating education (Rebeiro et al., 2021). Additionally, interpersonal relations offer advanced practice nurses communication skills during data collection, while the theory itself is useful in the theoretical concept of the research to realize the study hypothesis. Positive interpersonal relations and their significant impact on research and education transcend the advanced practice nurse’s role and competence while attending to patients or their respective specializations. It facilitates optimizing their potential to ensure the translation of evidence-based practice from research and education to clinical practice. Hence, the advanced practice nurse ensures that Peplau’s interpersonal relations model facilitates enhanced education, research, and practice.
Conclusion
Therefore, the metapradigm concepts correlate with Peplau’s interpersonal relations in a mutually-benefiting aspect. The metaparadigm concepts involve nursing, person, health, and environment, with the latter associating with the internal and external factors associated with the individual’s wellness. The person incorporates the mind, body, and soul, ensuring that they deserve respect and care. Nursing facilitates the person, family, and community to realize health and recovery from illness, while health covers the emotional, physical, and mental wellbeing without disease or infirmity. Peplau’s interpersonal relations model focuses on the nurse-patient relationship to improve the patient’s experience. A nurse cultivates positive communication with the patient for a comprehensive assessment of holistic needs while offering nursing care to realize health and wellness. Hence, the advanced practice nurse should embrace interpersonal relations to ensure enhanced patient outcomes.
References
Nikfarid, L., Hekmat, N., Vedad, A., & Rajabi, A. (2018). The main nursing metaparadigm concepts in human caring theory and Persian mysticism: a comparative study. Journal of Medical Ethics and History of Medicine, 11. https://doi.org/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150916/
McEwan, M., & Wills, E. M. (2021). Theoretical basis for nursing (5th ed.). Wolters Kluwer
Lee, J., & Son, H. K. (2022). Effects of simulation problem-based learning based on Peplau’s Interpersonal Relationship Model for cesarean section maternity nursing on communication skills, communication attitudes and team efficacy. Nurse Education Today, 113, 105373. https://doi.org/10.1016/j.nedt.2022.105373
Yang, H., Wu, F., Yan, Y., Zhou, Y., & Liu, X. (2022). Peplau’s interpersonal relationship theory combined with bladder function training on patients with prostate cancer. World Journal of Clinical Cases, 10(9), 2792-2800. https://doi.org/10.12998/wjcc.v10.i9.2792
Rebeiro, G., Foster, K., Hercelinskyj, G., & Evans, A. (2021). Enablers of the interpersonal relationship between registered nurses and students on clinical placement: A phenomenological study. Nurse Education in Practice, 57, 103253. https://doi.org/10.1016/j.nepr.2021.103253
Parola, V., Coelho, A., Fernandes, O., & Apóstolo, J. (2020). Travelbee’s Theory: Human-to-Human Relationship Model-its suitability for palliative nursing care. Revista de Enfermagem Referência, (2). https://comum.rcaap.pt/bitstream/10400.26/37581/1/RERefer%c3%aancia2020-7.pdf
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