Implementing Peplau's Interpersonal Theory in Emergency Nursing: A Qualitative Action Research Study
DOI:
https://doi.org/10.51143/jksi.v11i1.944Keywords:
Emergency Nursing Therapeutic Communication Peplau’s Theory Quality of Nursing ServicesAbstract
Nursing services in the Emergency Department (ED) require fast and accurate actions, demanding effective communication amid high work pressure. This study aimed to explore nurses’ experiences, identify ideas, challenges, and suggestions in implementing a therapeutic communication model based on Hildegard E. Peplau’s theory, and examine its impact on the quality of nursing services in the ED of RSUD dr. Loekmonohadi Kudus. This qualitative study employed an Action Research design and involved eight ED nurses selected through purposive sampling. Data were collected using a Focus Group Discussion (FGD) module and were analyzed through thematic analysis, following workshops and expert consultations. The results indicated that nurses maintained effective communication despite high mobility demands by strategically tailoring their approach to patient conditions, fostering trust, and integrating holistic nursing care principles. Communication effectiveness was further strengthened through soft skills training and leadership support. The study recommends ongoing training, the development of standardized communication modules, and systemic support to reinforce therapeutic communication practices. These findings contribute to advancing humanistic and patient-centered nursing practices in high-acuity emergency care settings.
References
Alabdullah, F. M., Alqahtani, S. H. S., Almalki, R. A., Albalawi, A. S., Alsallami, O. A., & Alqahtani, R. M. (2024). Quality of EMS to Emergency Department Handoffs and Communication Barriers And Challenges; Systematic Review. World Journal of Advanced Research and Reviews, 24(3), 3311–3315. https://doi.org/10.30574/wjarr.2024.24.3.3670
Alharbi, H. F., Alzahrani, N. S., Almarwani, A. M., Asiri, S. A., & Alhowaymel, F. M. (2023). Patients’ Satisfaction with Nursing Care Quality and Associated Factors: A Cross-Section Study. Nursing Open, 10(5), 3253–3262. https://doi.org/10.1002/nop2.1577
Alhussin, E. M., Mohamed, S. A., Hassan, A. A., Al-Qudimat, A. R., Doaib, A. M., Al Jonidy, R. M., Al Harbi, L. I., & Alhawsawy, E. D. (2024). Patients’ Satisfaction With the Quality of Nursing Care: A Cross-Section Study. International Journal of Africa Nursing Sciences, 20(2), 100690. https://doi.org/https://doi.org/10.1016/j.ijans.2024.100690
Alsabri, M., Boudi, Z., Lauque, D., Dias, R. D., Whelan, J. S., Östlundh, L., Alinier, G., Onyeji, C., Michel, P., Liu, S. W., Jr Camargo, C. A., Lindner, T., Slagman, A., Bates, D. W., Tazarourte, K., Singer, S. J., Toussi, A., Grossman, S., & Bellou, A. (2022). Impact of Teamwork and Communication Training Interventions on Safety Culture and Patient Safety in Emergency Departments: A Systematic Review. Journal of Patient Safety, 18(1), e351–e361. https://doi.org/10.1097/PTS.0000000000000782
Babaii, A., Mohammadi, E., & Sadooghiasl, A. (2021). The Meaning of the Empathetic Nurse-Patient Communication: A Qualitative Study. Journal of Patient Experience, 26(8), 2374. https://doi.org/10.1177/23743735211056432
Bahari, Z., Vosoghi, N., Ramazanzadeh, N., Moshfeghi, S., & Aghamohammadi, M. (2024). Patient Trust in Nurses: Exploring the Relationship With Care Quality and Communication Skills in Emergency Departments. BMC Nursing, 23(1), 595. https://doi.org/10.1186/s12912-024-02241-z
Bhattad, P. B., & Pacifico, L. (2022). Empowering Patients: Promoting Patient Education and Health Literacy. Cureus, 14(7), e27336. https://doi.org/10.7759/cureus.27336
Birnbaum, S. (2021). Therapeutic Communication in Mental Health Nursing; Aesthetic and Metaphoric Processes in the Engagement with Challenging Patients. Imprint Routledge.
Bowlby, R. (2018). Fifty years of attachment theory. Routledge.
Bradbury, H. (2020). Action Research in Practice: Participatory Inquiry for Social Change. SAGE Publications.
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589–597. https://doi.org/10.1080/2159676X.2019.1628806
Creswell, J. (2021). Research Design, Pendekatan Metode Kualitatif, Kuantitatif dan Campuran. Pustaka Pelajar.
Damschroder, L. J., Reardon, C. M., Opra Widerquist, M. A., & Lowery, J. (2022). Conceptualizing Outcomes for Use with the Consolidated Framework for Implementation Research (CFIR): the CFIR Outcomes Addendum. Implementation Science (IS), 17(1), 7. https://doi.org/10.1186/s13012-021-01181-5
DeVito, J. A. (2021). The Interpersonal Communication Book. Pearson. https://books.google.co.id/books?id=hutPXwAACAAJ
Forchuk, C. (2024). Peplau and Therapeutic Relationships. Springer link.
Foronda, C., MacWilliams, B., & McArthur, E. (2021). Interprofessional Communication In Healthcare: An Integrative Review. Nurse Education in Practice, 19(3), 36–40. https://doi.org/10.1016/j.nepr.2016.04.005
Gabay, G., Gere, A., Zemel, G., & Moskowitz, H. (2022). Personalized Communication with Patients at the Emergency Department-An Experimental Design Study. Journal of Personalized Medicine, 12(10), 1542. https://doi.org/10.3390/jpm12101542
Ghosh, S., Ramamoorthy, L., & pottakat, B. (2021). Impact of Structured Clinical Handover Protocol on Communication and Patient Satisfaction. Journal of Patient Experience, 8, 1–6. https://doi.org/10.1177/2374373521997733
Hennink, M., & Kaiser, B. N. (2022). Sample Sizes for Saturation in Qualitative Research: A Systematic Review of Empirical Tests. Social Science & Medicine, 292(3), 114523. https://doi.org/https://doi.org/10.1016/j.socscimed.2021.114523
Iraizoz-Iraizoz, A., García-García, R., Navarrete-Muro, A., Blasco-Zafra, A., Rodríguez-Beperet, A., & Vázquez-Calatayud, M. (2023). Nurses’ Clinical Leadership in The Intensive Care Unit: A Scoping Review. Intensive and Critical Care Nursing, 75(2), 103368. https://doi.org/https://doi.org/10.1016/j.iccn.2022.103368
Johari, S., Razak Zakaria, A., Kalsum, U., & Salleh, M. (2024). The Application of Peplau’s Theory Approach to Improve Interpersonal Relationship and Communication Skills between the Nursing Students’ and the Patients’. Journal of Chemical Health Risks, 14(1), 2180–2185. www.jchr.org
Kim, S., Chang, H., Kim, T., & Cha, W. C. (2023). Patient Anxiety and Communication Experience in the Emergency Department: A Mobile, Web-Based, Mixed-Methods Study on Patient Isolation During the COVID-19 Pandemic. Journal of Korean Medical Science, 38(39), e303. https://doi.org/10.3346/jkms.2023.38.e303
Marshall, S., & Hurtig, R. R. (2020). Developing a Culture of Successful Communication in Acute Care Settings: Part I. Solving Patient-Specific Issues. Perspectives of the ASHA Special Interest Groups, 4(5), 1028–1036. https://doi.org/10.1044/2019_pers-sig12-2019-0015
McNiff, J. (2021). Action Research: All You Need to Know. SAGE Publications.
Milton, J., David Åberg, N., Erichsen Andersson, A., Gillespie, B. M., & Oxelmark, L. (2023). Patients’ Perspectives on Care, Communication, and Teamwork in The Emergency Department. International Emergency Nursing, 66, 101238. https://doi.org/https://doi.org/10.1016/j.ienj.2022.101238
Mulfiyanti, D., & Satriana, A. (2022). The Correlation between the use of the SBAR Effective Communication Method and the Handover Implementation of Nurses on Patient Safety. International Journal of Public Health Excellence (IJPHE), 2(1), 376–380. https://doi.org/10.55299/ijphe.v2i1.275
Murphy, M., Engel, J. R., McGugan, L., McKenzie, R., Thompson, J. A., & Turner, K. M. (2022). Implementing a Standardized Communication Tool in an Intensive Care Unit. Critical Care Nurse, 42(3), 56–64. https://doi.org/10.4037/ccn2022154
Oliveira, D. M. (2024). Effective Communication in Healthcare Settings: Building Trust and Improving Patient Outcomes. Media and Communication Agency, April. https://doi.org/10.5281/zenodo.10946653
Orem, D. (2021). Nursing concept of Practice. C.V. Mosby Company.
Peplau. (2024). Theory of Interpersonal Relations. Springer link.
Polit, D. F., & Beck, C. T. (2021). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Lippincott Williams & Wilkins.
Roy, C. (2021). The Roy Adaptation Model: The definitive statement. McGraw- Hill/Appleton & Lange.
Shin, S., & Yoo, H. J. (2023). Emergency Nurses’ Communication Experiences With Patients and Their Families During The COVID-19 Pandemic: A Qualitative Study. International Emergency Nursing, 66(3), 101240. https://doi.org/10.1016/j.ienj.2022.101240
Siswanto, A., Monalisa, M., Triany, N. A., Rai, N. G. M., Syarweny, N., Supriyanto, E., Kusumawati, B., & Suspahariati. (2022). Buku Ajar MSDM. PT. Sonpedia Publishing Indonesia.
Suraya, C., Bin Sansuwito, T., Dioso, R. I., & Citra Wisuda, A. (2024). Effective Communication in Nursing: a Comprehensive Systematic Review of Best Practices. Journal of Nursing Science Research, 1(1), 34–48. https://doi.org/https://doi.org/10.33862/jnsr.v1i1.450
Takashima, M. D., Horton, A., Day, K., Parsons, A., Tummon, G., Hare, D., & Henderson, A. (2022). Nurses’ And Patients’ Perceptions on Interruptions on Admission Processes At an Acute Public Hospital Using Cross-Sectional Survey. Collegian, 29(5), 701–707. https://doi.org/10.1016/j.colegn.2022.02.003
Tam, H. L., Wong, E. M. L., & Cheung, K. (2020). Effectiveness of Educational Interventions on Adherence to Lifestyle Modifications Among Hypertensive Patients: An Integrative Review. International Journal of Environmental Research and Public Health, 17(7). https://doi.org/10.3390/ijerph17072513
Tamufor, A. M. (2024). The Application of Therapeutic Communication Between Staff and Patients. ScholarWorks.
Tappen, R. M. (2022). Advanced Nursing Research: From Theory to Practice. Jones & Bartlett Learning.
Tran, T. V., Tran, T. D., Nguyen, A. Q., Dinh, T. T., Le, A. T. K., Tran, H. B., Vu, P. T., Nguyen, H. T., & Dang, L. V. P. (2021). Nurse-Patient Communication: A Quality Assessment in Public Hospital. International Journal of Healthcare Management, 14(4), 1127–1133. https://doi.org/10.1080/20479700.2020.1752987
Tuohy, D., & Wallace, E. (2024). Maximising Nurse-Patient Communication in The Emergency Department. Emergency Nurse?: The Journal of the RCN Accident and Emergency Nursing Association, 32(2), 15–18. https://doi.org/10.7748/en.2023.e2179
Watson. (2021). Assessing And Measuring Caring In Nursing And Health Science. Springer Publishing Company Inc.
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References
Alabdullah, F. M., Alqahtani, S. H. S., Almalki, R. A., Albalawi, A. S., Alsallami, O. A., & Alqahtani, R. M. (2024). Quality of EMS to Emergency Department Handoffs and Communication Barriers And Challenges; Systematic Review. World Journal of Advanced Research and Reviews, 24(3), 3311–3315. https://doi.org/10.30574/wjarr.2024.24.3.3670
Alharbi, H. F., Alzahrani, N. S., Almarwani, A. M., Asiri, S. A., & Alhowaymel, F. M. (2023). Patients’ Satisfaction with Nursing Care Quality and Associated Factors: A Cross-Section Study. Nursing Open, 10(5), 3253–3262. https://doi.org/10.1002/nop2.1577
Alhussin, E. M., Mohamed, S. A., Hassan, A. A., Al-Qudimat, A. R., Doaib, A. M., Al Jonidy, R. M., Al Harbi, L. I., & Alhawsawy, E. D. (2024). Patients’ Satisfaction With the Quality of Nursing Care: A Cross-Section Study. International Journal of Africa Nursing Sciences, 20(2), 100690. https://doi.org/https://doi.org/10.1016/j.ijans.2024.100690
Alsabri, M., Boudi, Z., Lauque, D., Dias, R. D., Whelan, J. S., Östlundh, L., Alinier, G., Onyeji, C., Michel, P., Liu, S. W., Jr Camargo, C. A., Lindner, T., Slagman, A., Bates, D. W., Tazarourte, K., Singer, S. J., Toussi, A., Grossman, S., & Bellou, A. (2022). Impact of Teamwork and Communication Training Interventions on Safety Culture and Patient Safety in Emergency Departments: A Systematic Review. Journal of Patient Safety, 18(1), e351–e361. https://doi.org/10.1097/PTS.0000000000000782
Babaii, A., Mohammadi, E., & Sadooghiasl, A. (2021). The Meaning of the Empathetic Nurse-Patient Communication: A Qualitative Study. Journal of Patient Experience, 26(8), 2374. https://doi.org/10.1177/23743735211056432
Bahari, Z., Vosoghi, N., Ramazanzadeh, N., Moshfeghi, S., & Aghamohammadi, M. (2024). Patient Trust in Nurses: Exploring the Relationship With Care Quality and Communication Skills in Emergency Departments. BMC Nursing, 23(1), 595. https://doi.org/10.1186/s12912-024-02241-z
Bhattad, P. B., & Pacifico, L. (2022). Empowering Patients: Promoting Patient Education and Health Literacy. Cureus, 14(7), e27336. https://doi.org/10.7759/cureus.27336
Birnbaum, S. (2021). Therapeutic Communication in Mental Health Nursing; Aesthetic and Metaphoric Processes in the Engagement with Challenging Patients. Imprint Routledge.
Bowlby, R. (2018). Fifty years of attachment theory. Routledge.
Bradbury, H. (2020). Action Research in Practice: Participatory Inquiry for Social Change. SAGE Publications.
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589–597. https://doi.org/10.1080/2159676X.2019.1628806
Creswell, J. (2021). Research Design, Pendekatan Metode Kualitatif, Kuantitatif dan Campuran. Pustaka Pelajar.
Damschroder, L. J., Reardon, C. M., Opra Widerquist, M. A., & Lowery, J. (2022). Conceptualizing Outcomes for Use with the Consolidated Framework for Implementation Research (CFIR): the CFIR Outcomes Addendum. Implementation Science (IS), 17(1), 7. https://doi.org/10.1186/s13012-021-01181-5
DeVito, J. A. (2021). The Interpersonal Communication Book. Pearson. https://books.google.co.id/books?id=hutPXwAACAAJ
Forchuk, C. (2024). Peplau and Therapeutic Relationships. Springer link.
Foronda, C., MacWilliams, B., & McArthur, E. (2021). Interprofessional Communication In Healthcare: An Integrative Review. Nurse Education in Practice, 19(3), 36–40. https://doi.org/10.1016/j.nepr.2016.04.005
Gabay, G., Gere, A., Zemel, G., & Moskowitz, H. (2022). Personalized Communication with Patients at the Emergency Department-An Experimental Design Study. Journal of Personalized Medicine, 12(10), 1542. https://doi.org/10.3390/jpm12101542
Ghosh, S., Ramamoorthy, L., & pottakat, B. (2021). Impact of Structured Clinical Handover Protocol on Communication and Patient Satisfaction. Journal of Patient Experience, 8, 1–6. https://doi.org/10.1177/2374373521997733
Hennink, M., & Kaiser, B. N. (2022). Sample Sizes for Saturation in Qualitative Research: A Systematic Review of Empirical Tests. Social Science & Medicine, 292(3), 114523. https://doi.org/https://doi.org/10.1016/j.socscimed.2021.114523
Iraizoz-Iraizoz, A., García-García, R., Navarrete-Muro, A., Blasco-Zafra, A., Rodríguez-Beperet, A., & Vázquez-Calatayud, M. (2023). Nurses’ Clinical Leadership in The Intensive Care Unit: A Scoping Review. Intensive and Critical Care Nursing, 75(2), 103368. https://doi.org/https://doi.org/10.1016/j.iccn.2022.103368
Johari, S., Razak Zakaria, A., Kalsum, U., & Salleh, M. (2024). The Application of Peplau’s Theory Approach to Improve Interpersonal Relationship and Communication Skills between the Nursing Students’ and the Patients’. Journal of Chemical Health Risks, 14(1), 2180–2185. www.jchr.org
Kim, S., Chang, H., Kim, T., & Cha, W. C. (2023). Patient Anxiety and Communication Experience in the Emergency Department: A Mobile, Web-Based, Mixed-Methods Study on Patient Isolation During the COVID-19 Pandemic. Journal of Korean Medical Science, 38(39), e303. https://doi.org/10.3346/jkms.2023.38.e303
Marshall, S., & Hurtig, R. R. (2020). Developing a Culture of Successful Communication in Acute Care Settings: Part I. Solving Patient-Specific Issues. Perspectives of the ASHA Special Interest Groups, 4(5), 1028–1036. https://doi.org/10.1044/2019_pers-sig12-2019-0015
McNiff, J. (2021). Action Research: All You Need to Know. SAGE Publications.
Milton, J., David Åberg, N., Erichsen Andersson, A., Gillespie, B. M., & Oxelmark, L. (2023). Patients’ Perspectives on Care, Communication, and Teamwork in The Emergency Department. International Emergency Nursing, 66, 101238. https://doi.org/https://doi.org/10.1016/j.ienj.2022.101238
Mulfiyanti, D., & Satriana, A. (2022). The Correlation between the use of the SBAR Effective Communication Method and the Handover Implementation of Nurses on Patient Safety. International Journal of Public Health Excellence (IJPHE), 2(1), 376–380. https://doi.org/10.55299/ijphe.v2i1.275
Murphy, M., Engel, J. R., McGugan, L., McKenzie, R., Thompson, J. A., & Turner, K. M. (2022). Implementing a Standardized Communication Tool in an Intensive Care Unit. Critical Care Nurse, 42(3), 56–64. https://doi.org/10.4037/ccn2022154
Oliveira, D. M. (2024). Effective Communication in Healthcare Settings: Building Trust and Improving Patient Outcomes. Media and Communication Agency, April. https://doi.org/10.5281/zenodo.10946653
Orem, D. (2021). Nursing concept of Practice. C.V. Mosby Company.
Peplau. (2024). Theory of Interpersonal Relations. Springer link.
Polit, D. F., & Beck, C. T. (2021). Nursing Research: Generating and Assessing Evidence for Nursing Practice. Lippincott Williams & Wilkins.
Roy, C. (2021). The Roy Adaptation Model: The definitive statement. McGraw- Hill/Appleton & Lange.
Shin, S., & Yoo, H. J. (2023). Emergency Nurses’ Communication Experiences With Patients and Their Families During The COVID-19 Pandemic: A Qualitative Study. International Emergency Nursing, 66(3), 101240. https://doi.org/10.1016/j.ienj.2022.101240
Siswanto, A., Monalisa, M., Triany, N. A., Rai, N. G. M., Syarweny, N., Supriyanto, E., Kusumawati, B., & Suspahariati. (2022). Buku Ajar MSDM. PT. Sonpedia Publishing Indonesia.
Suraya, C., Bin Sansuwito, T., Dioso, R. I., & Citra Wisuda, A. (2024). Effective Communication in Nursing: a Comprehensive Systematic Review of Best Practices. Journal of Nursing Science Research, 1(1), 34–48. https://doi.org/https://doi.org/10.33862/jnsr.v1i1.450
Takashima, M. D., Horton, A., Day, K., Parsons, A., Tummon, G., Hare, D., & Henderson, A. (2022). Nurses’ And Patients’ Perceptions on Interruptions on Admission Processes At an Acute Public Hospital Using Cross-Sectional Survey. Collegian, 29(5), 701–707. https://doi.org/10.1016/j.colegn.2022.02.003
Tam, H. L., Wong, E. M. L., & Cheung, K. (2020). Effectiveness of Educational Interventions on Adherence to Lifestyle Modifications Among Hypertensive Patients: An Integrative Review. International Journal of Environmental Research and Public Health, 17(7). https://doi.org/10.3390/ijerph17072513
Tamufor, A. M. (2024). The Application of Therapeutic Communication Between Staff and Patients. ScholarWorks.
Tappen, R. M. (2022). Advanced Nursing Research: From Theory to Practice. Jones & Bartlett Learning.
Tran, T. V., Tran, T. D., Nguyen, A. Q., Dinh, T. T., Le, A. T. K., Tran, H. B., Vu, P. T., Nguyen, H. T., & Dang, L. V. P. (2021). Nurse-Patient Communication: A Quality Assessment in Public Hospital. International Journal of Healthcare Management, 14(4), 1127–1133. https://doi.org/10.1080/20479700.2020.1752987
Tuohy, D., & Wallace, E. (2024). Maximising Nurse-Patient Communication in The Emergency Department. Emergency Nurse?: The Journal of the RCN Accident and Emergency Nursing Association, 32(2), 15–18. https://doi.org/10.7748/en.2023.e2179
Watson. (2021). Assessing And Measuring Caring In Nursing And Health Science. Springer Publishing Company Inc.
