PNUR124 Practical Nursing Theory 2

• Medication adherence refers to the extent to which all patients take appropriate medications, as and when prescribed by the physicians.
• This involves several factors such as, filling of prescriptions, remembering the medication, and understanding the direction and dosage of use.
• Healthcare professionals, especially nurses take initiatives to increase the effectiveness of medication adherence, which in turn will create great impacts on the overall health and wellbeing of all patients (Costa et al., 2015).

• Dr. Peplau published the ‘Theory of Interpersonal Relations’, in the year 1952, and 1968, where interpersonal techniques began to get recognized as the crux of nursing (Senn, 2013).
• The nursing model proposed by Peplau theory identifies four sequential phases that enhance in interpersonal relationship namely, orientation, identification, exploitation, and resolution (Deane & Fain, 2016).
• The theory emphasizes on the providing guidance to medications and improving the drug compliance.

• Anticoagulants are chemicals that prevent chances of blood coagulation by prolonging the time required for clotting (Kozek-Langenecker et al., 2013).
• Risks of bleeding are maximum among people who have been subjected to recent surgery or cerebral aneurysm (Dewilde et al., 2013).
• Major concerns are related to administration of safe surgical procedures, without increasing the risks of hemorrhage or venous and arterial thromboembolism

• The most essential concepts of this theory that can be applied in educating surgical patients about anticoagulants include self-esteem, hope, trust, value, empowerment, self-disclosure and openness.
• This theory would provide assistance to incorporate the prescribed medication regimen in their lifestyle, which will be facilitated by shared decision making (D’antonio, Beeber, Sills & Naegle, 2014).
• Understanding the lived experience of the patient will help them to develop new behavioural patterns regarding medication self-administration.

• Developing an interaction phenomena nurse-client relationship will have qualitative impacts on patient outcomes.
• The clients/patients will be involved in a collaboration of their own treatment.
• The theoretical framework will help in the establishment of a significant, therapeutic interpersonal process that will function cooperatively with other unit process for optimal patient health outcome (Sabater-Galindo, Fernandez-Llimos, Sabater-Hernández, Martínez-Martínez & Benrimoj, 2016).

• Displaying a readiness towards medication management is considered as a prerequisite for accepting the current health status.
• Application of persistent denial of medications will make the patients engage in shared participation in their treatment.
• This will also help in lowering chances of bleeding in peri-operative procedures and will also eliminate chances of recurrent hospitalization.
• The theory will utilise interpersonal skills and education to provide assistance to the surgical patients, thereby allowing them to function at their maximum potential and highest capability.
• Thus, the theory will promote optimal recovery and wellness of the patients.

Alligood, M. R. (2013). Introduction to nursing theory: its history, significance, and analysis. Nursing Theorists and Their Work-E-Book, 1-58. Retrieved from-   https://books.google.co.in/books?hl=en&lr=&id=97fwAwAAQBAJ&oi=fnd&pg=PA2&dq=Alligood,+M.+R.+(2013).+Introduction+to+nursing+theory:+its+history,+significance,+and+analysis.+Nursing+The  orists+and+Their+Work-E-Book,+1.&ots=F8RP7d1Aus&sig=NvYnJGKidYXHeW6WrpQMpLYduo4#v=onepage&q&f=false

Costa, E., Giardini, A., Savin, M., Menditto, E., Lehane, E., Laosa, O., … & Marengoni, A. (2015). Interventional tools to improve medication adherence: review of literature. Patient preference and adherence, 9, 1303.   doi:  10.2147/PPA.S87551

D’antonio, P., Beeber, L., Sills, G., & Naegle, M. (2014). The future in the past: Hildegard Peplau and interpersonal relations in nursing. Nursing inquiry, 21(4), 311-317. https://doi.org/10.1111/nin.12056

Deane, W. H., & Fain, J. A. (2016). Incorporating Peplau’s Theory of Interpersonal Relations to Promote Holistic Communication Between Older Adults and Nursing Students. Journal of Holistic Nursing, 34(1), 35-41.   https://doi.org/10.1177/0898010115577975

Dewilde, W. J., Oirbans, T., Verheugt, F. W., Kelder, J. C., De Smet, B. J., Herrman, J. P., … & Tijsen, J. G. (2013). Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing   percutaneous coronary intervention: an open-label, randomised, controlled trial. The Lancet, 381(9872), 1107-1115. https://doi.org/10.1016/S0140-6736(12)62177-1

Gordon, J. L., Fabian, T. C., Lee, M. D., & Dugdale, M. (2013). Anticoagulant and antiplatelet medications encountered in emergency surgery patients: a review of reversal strategies. Journal of Trauma and Acute Care   Surgery, 75(3), 475-486. doi: 10.1097/TA.0b013e3182a07391

Hochberger, J. M., & Lingham, B. (2017). Utilizing Peplau’s Interpersonal Approach to Facilitate Medication Self-Management for Psychiatric Patients. Archives of psychiatric nursing, 31(1), 122-124.   https://doi.org/10.1016/j.apnu.2016.08.006

Holmes, C. A. (2016). Some implications of postmodernism for nursing theory, research, and practice. Canadian Journal of Nursing Research Archive, 32(2), 89-101. Retrieved from-   http://cjnr.archive.mcgill.ca/article/view/1578

Kozek-Langenecker, S. A., Afshari, A., Albaladejo, P., Santullano, C. A. A., De Robertis, E., Filipescu, D. C., … & Jacob, M. (2013). Management of severe perioperative bleeding: guidelines from the European Society of   Anaesthesiology. European Journal of Anaesthesiology (EJA), 30(6), 270-382. doi: 10.1097/EJA.0b013e32835f4d5b

Sabater-Galindo, M., Fernandez-Llimos, F., Sabater-Hernández, D., Martínez-Martínez, F., & Benrimoj, S. I. (2016). Healthcare professional-patient relationships: systematic review of theoretical models from a community   pharmacy perspective. Patient education and counseling, 99(3), 339-347. https://doi.org/10.1016/j.pec.2015.09.010

Senn, J. F. (2013). Peplau’s theory of interpersonal relations: Application in emergency and rural nursing. Nursing science quarterly, 26(1), 31-35. https://doi.org/10.1177/0894318412466744

Washington, G. T. (2013). The theory of interpersonal relations applied to the preceptor–new graduate relationship. Journal for nurses in professional development, 29(1), 24-29. doi: 10.1097/NND.0b013e31827d0a8a

Zullig, L. L., Peterson, E. D., & Bosworth, H. B. (2013). Ingredients of successful interventions to improve medication adherence. Jama, 310(24), 2611-2612. doi:10.1001/jama.2013.282818