Peplau’s Middle-Range Theory in Mental Health Nursing

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Table of Contents

Introduction
Article Summary and Theory Identification
The Value of Theory for Nursing Research
Personal Practice and Nursing Theory
Conclusion
Refrerences

Introduction

Nursing theory, or the structuring of ideas pertaining to the philosophy and practice of care, fulfills a variety of tasks. Its roles range from the provision of guidance to explaining nursing as a phenomenon. This paper addresses the topic of nursing theory by reviewing current research pertaining to hypothetico-deductive reasoning, suggesting the model’s potential value in the research of nurse education techniques and barriers to decision-making, and discussing the uses of Peplau’s middle-range theory in mental health nursing.

Article Summary and Theory Identification

In her scholarly article on the pitfalls of managing clients that may have life-threatening conditions, Watkins (2020) delves into the real-life applications of decision-making theories and provides a substantial analysis of the scenario of an elderly female client with chest pain. In the analysis section, the researcher reviews the nurse student’s use of the ABCDE assessment and the cardiology team’s efforts to make the diagnosis of ST-elevated myocardial infarction (Watkins, 2020). In general, using the case scenario, the researcher provides insight into the uses of decision-making theories, including the hypothetico-deductive reasoning model, inpatient evaluation, and care escalation decisions.

The hypothetico-deductive model of reasoning refers to a series of thinking interventions that support effective clinical decision-making in emergency situations. Being among the most popular and rational approaches to decision-making, the model can be described as prescriptive in nature since it prescribes the desired sequence of actions based on descriptive observations of real-life approaches to clinical decisions and the normative principles of logic and rational thinking. As the model suggests, the process of making a decision is comprised of a series of stages, including the acquisition of pre-counter cues, for instance, the information regarding warning signs, and hypothesis generation, during which one applies previous knowledge to new situations and creates at least one hypothesis, sometimes demonstrating the principle of pattern recognition (Watkins, 2020). Finally, in the hypothesis evaluation stage, one determines and implements the most relevant diagnostic tools to gain further clinical evidence and conclude on the validity of the initial proposition.

The Value of Theory for Nursing Research

Theoretical assumptions and models support research by generating the phenomena of interest and allowing for comparisons between several approaches to care and decision-making. Nursing theory can promote the expansion of the knowledge base on the most promising approaches to nurse education. For instance, the abovementioned theory, the hypothetico-deductive model of reasoning, may find application in experimental scholarly research focusing on approaches to teaching clinical reasoning skills to future healthcare professionals. In particular, the hypothetico-deductive model can be used as an experimental condition and compared to alternative reasoning models, such as intuitive or non-analytical reasoning, in terms of how these approaches to managing patient cases affect care outcomes and diagnostic accuracy. Experimental studies that test the model against some alternatives, such as dual-process diagnostic reasoning models, integrative models, and pattern recognition, are not extremely common, but they could shed light on the effective approaches to the development of diagnostic competence in healthcare students.

The hypothetico-deductive reasoning model might be useful in researching novice nurses’ barriers to effective decision-making and producing recommendations on the uses of approaches to reasoning depending on the experience level. The model in question suggests the use of cues for the generation of hypotheses. However, modern researchers agree that novice and student nurses’ understanding of health conditions and their symptoms is not always profound enough to lead to the creation of one or more hypotheses and consider differential diagnoses, which is a barrier to be studied (Watkins, 2020). Additionally, as per critical assertions, the hypothetico-deductive model wrongly implies a “simple rational approach to decision-making” without considering other factors, such as the context and decision-makers’ emotions (Krishnan, 2018, p. 75). Thus, the scholarly discussions of this model might suggest the need for studies that would explore the merits of the various decision-making models for diverse nurse populations and cause improvements in practical recommendations.

Personal Practice and Nursing Theory

As a nurse in an inpatient mental health setting that serves adult and geriatric populations, I make use of Peplau’s theory of interpersonal relations to guide my collaboration with patients. This mid-range theory introduces the benefits of interpersonal techniques and describes effective nurse-patient collaboration as the sequence of four phases, such as orientation, problem identification, exploitation, and resolution (Pehlivan & Güner, 2016). Establishing personal rapport with patients to promote effective care is among my core responsibilities, and my interactions with new and actual patients basically follow the four-stage approach introduced above. Thus, my interaction with new patients starts with problem definition and needs assessments, during which I apply nursing ethical principles to avoid overly personal and irrelevant questions, and then proceeds to the identification phase that involves personalized care plan development. Next, the exploitation and resolution stages involve plan implementation, the use of interviews and teaching techniques to ensure patients’ proper understanding of treatment goals, and communication to review the patient’s progress. Leading mental health patients through these stages of therapeutic relationships is often challenging and may require family involvement, but the theory is still valuable to my practice.

Conclusion

To sum up, nursing theory plays a critical part in the promotion of effective care, positive and trust-based nurse-patient communication, and nurse education. The hypothetico-deductive model supports decision-making and might shed light on the effectiveness of strategies used to teach clinical reasoning skills. Theories of interpersonal relationships enable mental health nurses to promote the best possible patient outcomes by taking a structured approach to therapeutic interpersonal relationships.

Refrerences

Krishnan, P. (2018). A philosophical analysis of clinical decision making in nursing. Journal of Nursing Education, 57(2), 73-78. Web.

Pehlivan, T., & Güner, P. (2016). The use of theories in psychiatric nursing-II. Journal of Psychiatric Nursing, 7(2), 100-104.

Watkins, S. (2020). Effective decision-making: Applying the theories to nursing practice. British Journal of Nursing, 29(2), 98-101.

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Peplau’s Middle-Range Theory in Mental Health Nursing

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