Introduction

Psychiatric problems can be defined as those conditions that affect mood, thinking, and behavior of an individual. To address these conditions, there is a need to incorporate theories that would help appropriately approach the problems. One of the theories is that of middle range theory which can be used to approach the practical problem of communicating with psychiatric patients. The middle range theory to approach this problem will be that of Hildegard Peplau’s Interpersonal Relations Theory. The problem can also be tackled using a borrowed theory too and find a solution to it. Examples of conditions that psychiatric patients include clinical depression, anxiety disorder, bipolar disorder, dementia, autism among others(Kurtz, Draper, & Silverman, 2016). To best approach the problem these theories can be used because patients with these conditions must be handled in the best way possible to try and come up with the best diagnostic approach.

Summary of the problem and the potential middle-range theory

Psychiatric patients experience some disorders that need to be handled by professionals, and their interactions should be with people who understand what they are suffering from. One of the problems that nurses face in their daily activities is whereby they find it hard to communicate with the patients with the different disorders in the right and healthy way. The said disorders are clinical depression, anxiety disorder, bipolar disorder, dementia, autism among others. These disorders are psychiatric illnesses that cause an individual to feel significant emotions of anxiety and fear. They are serious problems among children because they put a child at risk of social, educational, and family impairment during toddlerhood, youth, and adulthood. Currently, it is estimated that the number of adults who have psychiatric problems is as large as the number of children. Hence, there is a need to develop an evidence-based treatment to prevent more children from suffering from the condition.  While there are many attempts in research to formulate effective treatment approaches for these disorders among children, it has been hard to understand the causes, prevalence, and dealing mechanisms of psychiatric disorders(Peplau, Travelbee, & Orlando, 2015).

One of the middle range theories to be used on the clinical problem of communicating with psychiatric patients is the Hildegard Peplau’s Interpersonal Relations Theory. This is a middle range theory that involves the creation of an interpersonal relationship between nurses and patients with special needs as part of a therapeutic process. It involves the engagement between the patients and the caregivers where they create a bond between each other through the sharing information. This helps in creating a better understanding of the patient and contributes massively to the recovery process of the patient.Hildegard Peplau’s Interpersonal Relations Theory is the most appropriate theory to the problem of communication with patients suffering from psychiatric disorders. This is because it aims to develop a mutual relationship between the caregiver and the patient to help understand their problem better.

A borrowed theory that could be applied to the problem

A borrowed theory is a theory with information that is assembled from different disciplines and incorporated into nursing practice to assist the caregivers in their hospital settings. The problem in our case study is that of communicating with psychiatric patients, and one of the most effective borrowed theories is that of the Lazarus’ theory. The Lazarus theory is a theory that provides a framework on the different types of stress and how individuals respond to the different stressful situation(Biggs, Brough, & Drummond, 2017). Individuals suffering from psychiatric diseases like depression suffer from stressful situations which can be addressed through the Lazarus theory. This theory is one of the borrowed theories that are used to solve problems that affect patients with different conditions by nurses.

This theory is the most appropriate to tackle the identified problem of communicating with psychiatric patients. To better understand the problem the said patients are suffering the nurses should go down to their level and talk with them. After listening to what they fears and stress are then the incorporation of the Lazarus theory is administered. Here the nurses develop a way of knowing how the different psychiatric patients respond to their respective conditions. With this knowledge, the nurses also develop a way to communicate with the patients and counter the challenges encountered during the process.

A brief history of the Lazarus theory

This borrowed theory was invented by Lazarus himself with the help of Folkman in 1984, and it explained the mental process which influences the stressors or the stress factor. Lazarus used the example of a woman who is in labor pain to try and explain how stress occurs and how individuals can handle the situations.  Richard Lazarus was highly educated and had finished his Ph.D. at the university. He was also an award-winning book writer who won several awards for his mastery.In his career, he was a professor of psychology in different universities. His topics of research were mostly on, “emotion theory and research, health psychology or behavioral medicine, personality and social psychology, clinical research psychology, stress, and coping theory”(Delaney, Shattell, & Johnson, (2017).

The theory was created to try and understand the different situations that a person has to go through during a stressful period. One might even end up suffering from disorders like those odepression, post-traumatic stress disorders among others due to the accumulation of the stressful conditions in their mind. With the implementation of the theory, its sole aim was to try and help the individuals suffering from stress to overcome and manage the situation in the best way possible. It also aimed to develop and if possible identify the various resources that are useful, and that might be used to eradicate the different stress factors that are responsible for the creation of stressful situations. This theory with the said explanation also gave birth to the theory of cognitive appraisal which assists the mind to understand and overcome a psychiatric condition.

How the Lazarus theory has been previously applied

The theory since 1984 when Lazarus created it has been used to tackle different situations and its application bore some excellent results. One of the scenarios where it has been applied before is that of an organizational setting. People daily get stuck in their offices and places of work where they are required to solve problems and also make hard decisions which require critical thinking. These people always fear to fail, and these kinds of situations give them a lot of stress to deal with. With the introduction of Lazarus theory, it aimed to help them to develop a calm approach to the different situations that they face. In the organizational setting, the Lazarus theory helped a lot because many employees even considered the option of quitting from their jobs due to the pressure that they used to face(Hagerty et al., 2017). The theory worked by inventing methods on how to understand these cases of mental depression and how to solve and go through them in a comfortable and resourceful way. These kind of scenarios are the ones that led tothe introduction of the cognitive appraisal theory. This was a theory that involved the individual in the problem-solving process by first understanding the background and the sources of the psychiatric problem. It also involved the individuals in the assembling of information of information to approach the problem in a resourceful way.

Application of the Lazarus theory to the problem of communicating with psychiatric patients

Lazarus believed that a more natural way to provide an understanding of emotional regulation among psychiatric patients is to view how different patients in the past with similar conditions regulated their emotions being that research evidence shows that there is a connection between emotional regulations among different patients. Nurses during the application of the theory should use a healthy control group and a control group that has mixed psychiatric problems(Kurtz, Draper, & Silverman, 2016).  The findings should show that patients with psychiatric problems have great maladaptive emotional regulation strategies and low adaptive emotional regulations strategies. The findings confirm the idea that emotional regulations deficit exists in various patients as long as the Lazarus theory is incorporated in the diagnostic process.

However, there are minimal differences in self-reported cases of habitual emotional regulation strategies among patients with the problems. The incorporation of the theory would change the practice whereby the nurses would not struggle to identify the conditions that patients with psychiatric problems suffer. This is a clear indication that the Lazarus theory can work to provide a solution to the proper of maintaining communication with patients suffering from psychiatric problems. This because the theory will first involve a test with the patients to understand the different stress conditions that they are going through. After these identifications, the nurses then come up with ways to solve the issue and ones a solution is found proper communication between the patients and the caregivers is achieved.

Application of both the borrowed theory and the middle-range theory

The incorporation of the Lazarus theory and the Hildegard Peplau’s interpersonal relations theory can work well together to come up with the solution to the identified psychiatric problem in different ways. Peplau’s interpersonal relations theory works to make sure that there is a good relationship between the nurse and the patient through the provision of a therapeutic process. With the relationship strengthened the nurses are then able to obtain the relevant information from the patients, and this helps in the improvement in communication between the caregivers and the psychiatric patients(Peplau, Travelbee, & Orlando, 2015). On the other hand, the Lazarus theory involves first the identification of the different conditions of psychiatric conditions and then coming up with the of different ways of eradicating the problem. The two can work appropriately whereby the nurses get to use thePeplau’s interpersonal relations theory to gain attention and build a relationship with the patient. After this is achieved, the nurses would then embark on the use of the Lazarus theory where they talk to the patients and get to know the conditions on a personal basis. On knowing and understanding the conditions, the nurses can use the Lazarus theory again to come up with different solutions to solve and eradicate the sources of the depression or psychiatric conditions that the patients suffer.

Conclusion

Many people understand psychiatric problems as minor mental health illness which impairs learning, development of skills, peer interactions during youth, adulthood and even at old age. However, few people understand the significance of using different theories and emotional regulations in solving the different conditions. Apart from the Lazarus theory and Hildegard Peplau’s interpersonal relations theory, other theories can be applied by nurses to solve different situations. However, it is also important to note that the two theories are the most appropriate theory to solve this particular problem of communicating with psychiatric patients.

References

Kurtz, S., Draper, J., & Silverman, J. (2016). Skills for communicating with patients.CRC Press.

Peplau, H., Travelbee, J., & Orlando, I. J. (2015).Nurse-Patient Relationship Theories. Nursing Theories and Nursing Practice, 67.

Hagerty, T. A., Samuels, W., Norcini-Pala, A., &Gigliotti, E. (2017). Peplau’s Theory of Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data?. Nursing science quarterly, 30(2), 160-167.

Delaney, K. R., Shattell, M., & Johnson, M. E. (2017).Capturing the interpersonal process of psychiatric nurses: A model for engagement. Archives of Psychiatric Nursing, 31(6), 634-640.

Biggs, A., Brough, P., & Drummond, S. (2017). Lazarus and Folkman’s psychological stress and coping theory (pp. 349-364). Chichester, UK: John Wiley & Sons, Ltd.