member of their First Nursing Advisory Committee
and contributed to WHO’s first paper on psy-
chiatric nursing. She served as a consultant to the
Pan-American Health Association, and she served
two terms on the International Council of Nurses’
Board of Directors. Even after her retirement, she
continued to mentor nurses in many countries.
Hildegard Peplau died in March 1999 at her
home in Sherman Oaks, California.
Introducing the Theory
In 1969, at the first Nursing Theory Conference,
Hildegard Peplau proposed a research methodol-
ogy to guide “development of knowledge from
observations in nursing situations” (Peplau, 1989a,
p. 22). Peplau asserted that nursing was an applied
science and that nurses used established knowledge
for beneficial purposes. According to Peplau (1988,
p. 12), nurses not only “use the knowledge that
‘producing scientists’ publish,” but they, in practice,
create the context whereby this knowledge is trans-
formed into nursing knowledge, linking nursing
processes with nursing practice (Reed, 1996).
Peplau urged nurses to use nursing situa-
tions as a source of observations from
which unique nursing concepts could be
derived.Peplau urged nurses to use nursing situations as a
source of observations from which unique nursing
concepts could be derived. Practice provided the
context for initiating and testing nursing theory. To
direct nurses in the development of practice-based
theory, Peplau (1989a) proposed a three-step
process that would assist in this pursuit.
OBSERVATIONS
Theory development begins with observations
made in practice. In the first step, the nurse ob-
serves a phenomenon, which is then named, cate-
gorized, or classified. The nurse relies on an already
existing body of knowledge from which to derive
the name of the concept or phenomenon. By rely-
ing on existing literature to assist in naming the
concept, further information about the concept is
gained. Included in this step are the continuing
clinical observations of the nurse who seeks regu-
larities in the phenomenon.
Peplau (1952) identified several methods of ob-
servation, including participant observation, spec-
tator observation, and interviewer and random
observation. Participant observation, in which the
nurse observes while participating, yields the most
valuable clinical knowledge. This includes the
recording of observations of both self and the other
in order to analyze the interpersonal process.
Peplau identified the participant-observer as one of
the characteristic roles of the professional nurse
(Peplau, 1989b). Validation of the nurse’s observa-
tions, either with other professionals or with pa-
tients, is encouraged, in order to decrease observer
bias (Peplau, 1989c). A nurse enters clinical situa-
tions with “theoretical understanding, personal
bias, and previously acquired nursing knowledge”
(Reed, 1996, p. 31).SORTING AND CLASSIFICATION
In the second step of the process, the nurse sorts
and classifies information about the phenomenon.
Decoding, subdividing data, categorizing data,
identifying layers of meaning at different levels of
abstraction, and applying a conceptual framework
to explain the phenomenon may occur as a means
of interpreting observations (Peplau, 1989b). At
that time, a structure for obtaining more informa-
tion about the phenomenon emerges. Further ob-
servation or interviewing leads to a clearer, more
explicit description of the phenomenon or concept.
The nurse works to identify all of the behaviors as-
sociated with the concept. Included in this step is
the collection of information about patterns or
processes that accompany the phenomenon.
Using Peplau’s process, clinical data are collected
via observation and interview. Verbatim recordings
of interactions with patients are examined for reg-
ularities. The nurse, as the interviewer, assists the
patient in providing a thorough description of the
concept or process. Peplau (1989d) offered inter-
view techniques that encouraged description; for
example: “Describe one time that you were...”;
“Describe one example...”; “Say more about
that...”;and “Fill in the details about that experi-
ence” (Peplau, 1989d, pp. 221–222). Only by thor-
ough description of the concept or process can the
nurse assure that all of the behaviors associated
with the process are identified.CHAPTER 6 Hildegard E. Peplau’s Process of Practice-based Theory Development and Its Applications 61