The diagnosis of multiple sclerosis: Peplau's Interpersonal Relations Model in practice

Multiple sclerosis (MS) is a chronic, frequently progressive neurological disease of unknown etiology and uncertain trajectory. Physicians and nurses have historically been uncomfortable broaching the topic of a possible MS diagnosis with patients and have tended instead to talk about it in euphemistic terms. However, with the development of therapeutic agents that may be more effective early in the disease course, the early communication of diagnostic and treatment information has become increasingly important. In our MS clinic, individual with MS symptoms are rapidly referred and assessed by a team of experienced physicians and nurses. Our experience with this referral process has led to our adoption of Peplau's Interpersonal Relations Model as a guide to nursing practice. The central element of Peplau's model is the development of a therapeutic relationship between patient and nurse. This relationship develops through four overlapping stages: orientation, identification, exploitation, and resolution. The collaborative relationship that develops between nurse and patient enhances problem solving and creates a strong bond that is essential across the long trajectory of the illness.