Imhof, Lorenz

Schnepp, Wilfried

Suter-Riederer, Susanne

ZHAW digitalcollection

      Zürcher Fachhochschule www.zhaw.ch Reestablishing normal life. How patients with Multiple Sclerosis and Stroke  experience a nursing intervention to enhance mobility. Susanne Suter-Riederer, PhD cand., MScN, RN1,2, Wilfried Schnepp2, PhD, RN, Lorenz Imhof, PhD, RN.  1Zurich University of Applied Sciences, Institut of Nursing, Winterthur, Switzerland. 2Witten/Herdecke University, School of Nursing Science, Witten, Germany.  3Nursing Science & Care, Winterthur, Switzerland.Background A nursing intervention to enhance mobility (MENI) of MS and stroke patients, the so called «Bodenpflege», was tested in a randomised controlled trial (RCT). Functionality, quality of life and the risk of nursing care after discharge improved significantly. But the RCT design did not explain how the intervention influenced patient’s daily life. Therefore a qualitative study was realised to describe how patients experience MENI and how the intervention affect their daily life.   Mobility Enhancing Nursing Intervention (MENI) (Source: Kliniken Valens)                             Method • Open interviews with 61 participants of the intervention group. • Qualitative analysis based on the interpretive, phenomenological method (Benner and Heidegger).  Results The intervention MENI, with its unknown movement sequences from the ground floor to a wheelchair, and vice versa, increased uncertainty at the beginning. However, the close link to daily life activities to negotiate the learning process with nurses, and to become involved in decisions were building blocks of a new normality. Training was one of three practices patients used to build normality. The others were to develop new movement skills together with nurses, and to reconcile with a changing life. When these practices were successful, patients were talking about increased confidence, feelings of security, relaxation, and joy to move.  Discussion Patients experienced a learning process from losing daily routine to establishing a new normal life. The relationship to nurses, being actively involved, as well as shared skills and knowledge, were helpful elements of this process. Other studies found similar results. Restoration of functions does not guarantee an improved normal life. In addition the care environment has to enable patients to experience a sense of security, belonging, continuity, achievement, purpose and significance.  MENI offers such an environment in addition to the therapeutic exercises.  Implications for practice and research • Close relationship to patients and knowing their illness experience are key elements of patient centered care.  • Nurses are challenged to assess, understand, and integrate the patient’s lifeworld into their work.  • Nurses’ therapeutic work, including patient centeredness and negotiation process, should become more recognised in interdisciplinary practice and research. This could improve the interdisciplinary potential in rehabilitation.   References Benner, P. (1994). Interpretive Phenomenology. London: SAGE Publications. Imhof, L., Suter-Riederer, S. & Kesselring, J. (2015). Effects of Mobility-Enhancing Nursing Intervention in Patients with MS and Stroke: Randomised Controlled Trial. International Scholarly Research Notices, 2015, 6. doi: 10.1155/2015/785497  The authors would like to thank the Swiss Multiple Sclerosis Society and the Nursing Science Foundation Switzerland who funded this PhD project.   Contact: susanne.suter-riederer@zhaw.ch   

Reestablishing normal life. How patients with Multiple Sclerosis and Stroke experience a nursing intervention to enhance mobility

ZHAW Zürcher Hochschule für Angewandte Wissenschaften

    
  
Zürcher Fachhochschule www.zhaw.ch 
Reestablishing normal life. How patients with Multiple 
Sclerosis and Stroke  experience a nursing intervention 
to enhance mobility. 
Susanne Suter-Riederer, PhD cand., MScN, RN1,2, Wilfried Schnepp2, PhD, RN, Lorenz Imhof, 
PhD, RN. 
 
1Zurich University of Applied Sciences, Institut of Nursing, Winterthur, Switzerland. 
2Witten/Herdecke University, School of Nursing Science, Witten, Germany.  
3Nursing Science & Care, Winterthur, Switzerland.
Background 
A nursing intervention to enhance mobility (MENI) of MS and 
stroke patients, the so called «Bodenpflege», was tested in a 
randomised controlled trial (RCT). Functionality, quality of life 
and the risk of nursing care after discharge improved 
significantly. But the RCT design did not explain how the 
intervention influenced patient’s daily life. Therefore a 
qualitative study was realised to describe how patients 
experience MENI and how the intervention affect their daily life.  
 
Mobility Enhancing Nursing Intervention (MENI) (Source: Kliniken Valens) 
 
           
 
             
 
 
Method 
• Open interviews with 61 participants of the intervention 
group. 
• Qualitative analysis based on the interpretive, 
phenomenological method (Benner and Heidegger). 
 
Results 
The intervention MENI, with its unknown movement sequences 
from the ground floor to a wheelchair, and vice versa, 
increased uncertainty at the beginning. However, the close link 
to daily life activities to negotiate the learning process with 
nurses, and to become involved in decisions were building 
blocks of a new normality. Training was one of three practices 
patients used to build normality. The others were to develop 
new movement skills together with nurses, and to reconcile 
with a changing life. When these practices were successful, 
patients were talking about increased confidence, feelings of 
security, relaxation, and joy to move. 
 
Discussion 
Patients experienced a learning process from losing daily 
routine to establishing a new normal life. The relationship to 
nurses, being actively involved, as well as shared skills and 
knowledge, were helpful elements of this process. Other 
studies found similar results. Restoration of functions does not 
guarantee an improved normal life. In addition the care 
environment has to enable patients to experience a sense of 
security, belonging, continuity, achievement, purpose and 
significance.  MENI offers such an environment in addition to 
the therapeutic exercises. 
 
Implications for practice and research 
• Close relationship to patients and knowing their illness 
experience are key elements of patient centered care.  
• Nurses are challenged to assess, understand, and 
integrate the patient’s lifeworld into their work.  
• Nurses’ therapeutic work, including patient centeredness 
and negotiation process, should become more 
recognised in interdisciplinary practice and research. 
This could improve the interdisciplinary potential in 
rehabilitation.  
 
References 
Benner, P. (1994). Interpretive Phenomenology. London: SAGE Publications. 
Imhof, L., Suter-Riederer, S. & Kesselring, J. (2015). Effects of Mobility-Enhancing Nursing 
Intervention in Patients with MS and Stroke: Randomised Controlled Trial. 
International Scholarly Research Notices, 2015, 6. doi: 10.1155/2015/785497 
 
The authors would like to thank the Swiss Multiple Sclerosis Society and 
the Nursing Science Foundation Switzerland who funded this PhD project.  
 
Contact: susanne.suter-riederer@zhaw.ch  
 


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Reestablishing normal life. How patients with Multiple Sclerosis and Stroke experience a nursing intervention to enhance mobility

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