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Jenabi Ghods M, Moghaddam LF, Hosseinabadi-Farahani MJ, Pourebrahimi M. The mediation role of self-esteem and hope on the relationship of quality of life and unmet needs of elderly with psychiatric disorders. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:89. [PMID: 37288421 PMCID: PMC10243421 DOI: 10.4103/jehp.jehp_163_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/11/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Self-esteem is one of the factors affecting the quality of life. On the other hand, quality of life decreases in people with psychiatric disorders. The aim of the present study was to evaluate the mediating role of self-esteem and hope on the relationship between unmet needs and quality of life of the elderly with psychiatric disorders. MATERIALS AND METHODS This descriptive-analytical study was performed on 112 chronic psychiatric patients hospitalized in the geriatric ward of (blinded) 2020. Based on the inclusion criteria, a total of 100 samples were entered into the study by census. The World Health Organization (WHO) quality of life questionnaire, Rosenberg Self-Esteem Scale, Snyder Hope Scale, and Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) were used to collect data. The research model was tested using the path analysis technique. Data was analyzed using Statistical Package for the Social Sciences (SPSS) Ver. 26 and LISREL Ver. 2/9. RESULTS Unmet needs were negatively related to the other three variables of the study, namely, self-esteem, hope, and quality of life. There was a significant relationship between unmet needs and quality of life with a mediating role of self-esteem and hope (P < 0.05). Quality of life was also negatively related to unmet needs and directly related to self-esteem and hope. CONCLUSION Based on the findings of this study, it is essential that health-care providers consider planning to provide programs to improve self-esteem and hope in order to reduce unmet needs and increase the quality of life.
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Affiliation(s)
- Mariye Jenabi Ghods
- Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- PhD Student, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ladan Fattah Moghaddam
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Başkaya E, Demir S. The problems and information needs of patients with bipolar disorder during the treatment process: A qualitative study in Turkey. Arch Psychiatr Nurs 2023; 42:45-54. [PMID: 36842827 DOI: 10.1016/j.apnu.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/22/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
The objective of the present study was to determine the problems and information needs of patients with bipolar disorder during the treatment process. The present research is in the type of descriptive and qualitative study. In-depth individual interviews were conducted with 11 volunteer patients with bipolar disorder. The data collected from the interviews were evaluated using the descriptive analysis method. In the study, four categories (disease onset/diagnosis stage, adherence to treatment, interpersonal relationships, information needs) and nine main themes (symptoms, family support, factors that positively affect treatment adherence, factors that negatively affect treatment adherence, positive effects of treatment, negative effects of treatment, stigmatization, treatment, disease) were determined. Patients with bipolar disorder can be helped to cope with the problems they experience by providing information about the disease, adherence to treatment, the treatment process, and the effects of drugs.
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Affiliation(s)
- Ebru Başkaya
- Uşak University, Vocational School of Health Services, Department of Health Care Services, Uşak, Turkey.
| | - Satı Demir
- Gazi University, Faculty of Health Sciences, Department of Psychiatric Nursing, Ankara, Turkey
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Geerling B, Kelders SM, Stevens AWMM, Kupka RW, Bohlmeijer ET. A Web-Based Positive Psychology App for Patients With Bipolar Disorder: Development Study. JMIR Form Res 2022; 6:e39476. [PMID: 35946327 PMCID: PMC9531003 DOI: 10.2196/39476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/04/2022] [Accepted: 08/09/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Patients with bipolar disorder (BD) report lower quality of life and lower levels of well-being than the general population. Despite the growing availability of psychotherapeutic and self-management interventions, important unmet needs remain. These unmet needs are closely linked to positive psychology domains. Although a growing number of studies have evaluated the impact of positive psychology interventions (PPIs) on patients with severe mental illness in general, only few have addressed the application of positive psychology for BD. OBJECTIVE This study aimed to gain insight into the opinions of patients with BD and health care professionals about (web-based) PPIs for BD and to develop and pilot-test an app containing PPIs specifically designed for patients with BD. METHODS The study was conducted in accordance with the Center for eHealth and Disease Management road map principles and incorporated cocreation and designing for implementation. Data were collected using focus group discussions, questionnaires, rapid prototyping, and web-based feedback on a prototype from the participants. In total, 3 focus groups were conducted with 62% (8/13) of patients with BD and 38% (5/13) of professionals. The collected data were used to develop a smartphone app containing short PPIs. The content was based on PPIs for which a solid base of evidence is available. Finally, a pilot test was conducted to test the app. RESULTS Focus groups revealed that PPIs as part of the current BD treatment can potentially meet the following needs: offering hope, increasing self-esteem, expressing feelings, acceptance, and preventing social isolation. Some patients expressed concern that PPIs may provoke a manic or hypomanic episode by increasing positive affect. The pilot of the app showed that the PPIs are moderately to highly valued by the participants. There were no adverse effects such as increase in manic or hypomanic symptoms. CONCLUSIONS With the systematic use of user involvement (patients and professionals) in all steps of the development process, we were able to create an app that can potentially fulfill some of the current unmet needs in the treatment of BD. We reached consensus among consumers and professionals about the potential benefits of PPIs to address the unmet needs of patients with BD. The use of PPI for BD is intriguing and can be usefully explored in further studies. We emphasize that more evaluation studies (quantitative and qualitative) that are focused on the effect of PPIs in the treatment of BD should be conducted. In addition, to establish the working mechanisms in BD, explorative, qualitative, designed studies are required to reveal whether PPIs can address unmet needs in BD.
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Affiliation(s)
- Bart Geerling
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
- Centre for Bipolar Disorder, Dimence Mental Health Institute, Deventer, Netherlands
| | - Saskia M Kelders
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
- Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
| | - Anja W M M Stevens
- Centre for Bipolar Disorder, Dimence Mental Health Institute, Deventer, Netherlands
| | - Ralph W Kupka
- Department of Psychiatry, Mental Health Program, Amsterdam Public Health, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ernst T Bohlmeijer
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
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Geerling B, Kraiss J, Kelders S, Stevens A, Kupka R, Bohlmeijer E. The effect of positive psychology interventions on well-being and psychopathology in patients with severe mental illness: A systematic review and meta-analysis. THE JOURNAL OF POSITIVE PSYCHOLOGY 2020. [DOI: 10.1080/17439760.2020.1789695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- B. Geerling
- Dimence, SCBS Centre for Bipolar Disorders, Deventer, The Netherlands
- Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - J.T. Kraiss
- Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - S.M. Kelders
- Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - A.W.M.M. Stevens
- Dimence, SCBS Centre for Bipolar Disorders, Deventer, The Netherlands
| | - R.W. Kupka
- VU Medisch Centrum, Public Health Research Institute, Afdeling Psychiatrie, GGZ inGeest, Amsterdam UMC, Amsterdam, The Netherlands
| | - E.T. Bohlmeijer
- Dimence, SCBS Centre for Bipolar Disorders, Deventer, The Netherlands
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van Lankeren JE, Testerink AE, Daggenvoorde TH, Poslawsky IE, Goossens PJJ. Patient experiences with nursing care during hospitalization on a closed ward due to a manic episode: A qualitative study. Perspect Psychiatr Care 2020; 56:37-45. [PMID: 30820964 DOI: 10.1111/ppc.12370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/30/2019] [Accepted: 02/17/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To describe the experiences of patients with nursing care they had received when hospitalized for mania. DESIGN AND METHODS Multicenter qualitative study using open interviews. Data were analyzed using the Stevick-Colaizzi-Keen method. FINDINGS Sense of security is vital for the recovery of these patients, nurses can support and hinder this. Feelings of security are related to clear and calm communication, respect, recognizability of nurses, and daily structure. PRACTICE IMPLICATIONS Nurses should make sure that the patient recognizes them as nurses. Nurses should spend as much time as possible in the living room. Clear communication about treatment goals is important.
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Affiliation(s)
| | - Annelies E Testerink
- Lecturer Health and Technology, Academic of Health Care, Saxion University of Applied Science, Enschede, The Netherlands
| | - Thea H Daggenvoorde
- Dimence Mental Health, Center for Bipolar Disorders, Deventer, The Netherlands.,Radboud University Medical Center, Radboud Institute for Health Sciences IQ Healthcare, Nijmegen, The Netherlands
| | - Irina E Poslawsky
- Lecturer Clinical Health Sciences, Faculty of Medicine, Utrecht University, Utrecht, The Netherlands.,Department Psychiatry, Division of Neuroscience, Policy Advisor Health Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Peter J J Goossens
- Advanced Nurse Practitioner and Senior Researcher, Dimence Mental Health, Center for Bipolar Disorders, Deventer, The Netherlands.,Department of Public Health and Primary Care, University Centre of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Maassen EF, Regeer BJ, Regeer EJ, Bunders JFG, Kupka RW. The challenges of living with bipolar disorder: a qualitative study of the implications for health care and research. Int J Bipolar Disord 2018; 6:23. [PMID: 30397833 PMCID: PMC6218397 DOI: 10.1186/s40345-018-0131-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/22/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In mental health care, clinical practice is often based on the best available research evidence. However, research findings are difficult to apply to clinical practice, resulting in an implementation gap. To bridge the gap between research and clinical practice, patients' perspectives should be used in health care and research. This study aimed to understand the challenges people with bipolar disorder (BD) experience and examine what these challenges imply for health care and research needs. METHODS Two qualitative studies were used, one to formulate research needs and another to formulate healthcare needs. In both studies focus group discussions were conducted with patients to explore their challenges in living with BD and associated needs, focusing on the themes diagnosis, treatment and recovery. RESULTS Patients' needs are clustered in 'disorder-specific' and 'generic' needs. Specific needs concern preventing late or incorrect diagnosis, support in search for individualized treatment and supporting clinical, functional, social and personal recovery. Generic needs concern health professionals, communication and the healthcare system. CONCLUSION Patients with BD address disorder-specific and generic healthcare and research needs. This indicates that disorder-specific treatment guidelines address only in part the needs of patients in everyday clinical practice.
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Affiliation(s)
- Eva F. Maassen
- Athena Institute, Faculty of Earth and Life Sciences, VU University Amsterdam, Boelelaan 1085, 1081HV Amsterdam, Netherlands
- Altrecht Institute for Mental Health Care, Nieuwe Houtenseweg 12, 3524 SH Utrecht, Netherlands
| | - Barbara J. Regeer
- Athena Institute, Faculty of Earth and Life Sciences, VU University Amsterdam, Boelelaan 1085, 1081HV Amsterdam, Netherlands
| | - Eline J. Regeer
- Altrecht Institute for Mental Health Care, Nieuwe Houtenseweg 12, 3524 SH Utrecht, Netherlands
| | - Joske F. G. Bunders
- Athena Institute, Faculty of Earth and Life Sciences, VU University Amsterdam, Boelelaan 1085, 1081HV Amsterdam, Netherlands
| | - Ralph W. Kupka
- Altrecht Institute for Mental Health Care, Nieuwe Houtenseweg 12, 3524 SH Utrecht, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, De Boelelaan 1117, Amsterdam, Netherlands
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Fountoulakis KN, Vieta E, Young A, Yatham L, Grunze H, Blier P, Moeller HJ, Kasper S. The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 4: Unmet Needs in the Treatment of Bipolar Disorder and Recommendations for Future Research. Int J Neuropsychopharmacol 2017; 20:196-205. [PMID: 27677983 PMCID: PMC5408978 DOI: 10.1093/ijnp/pyw072] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/09/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The current fourth paper on the International College of Neuropsychopharmacology guidelines for the treatment of bipolar disorder reports on the unmet needs that became apparent after an extensive review of the literature and also serves as a conclusion to the project of the International College of Neuropsychopharmacology workgroup. MATERIALS AND METHODS The systematic review of the literature that was performed to develop the International College of Neuropsychopharmacology guidelines for bipolar disorder identified and classified a number of potential shortcomings. RESULTS Problems identified concerned the reliability and validity of the diagnosis of bipolar disorder and especially of bipolar depression. This, in turn, has profound consequences for early detection and correct treatment of the disorder. Another area that needs improvement is the unsatisfactory efficacy and effectiveness of therapeutic options, especially in special populations such as those with mixed features and rapid cycling course. Gender issues and adherence problems constitute an additional challenge. The literature suggests that while treatment providers are concerned more with treatment-related issues, patients and their caregivers worry more about issues pertaining to the availability of services and care, quality of life, and various types of burden. The workgroup identified additional unmet needs related to the current standard of research in bipolar disorder. These include the fragmentation of bipolar disorder into phases that are handled as being almost absolutely independent from each other, and thus the development of an overall therapeutic strategy on the basis of the existing evidence is very difficult. Trials are not always designed in a way that outcomes cover the most important aspects of bipolar disorder, and often the reporting of the results is biased and unsatisfactory. The data on combination treatments and high dosages are sparse, whereas they are common in real world practice. CONCLUSIONS The workgroup endorses the full release of raw study data to the scientific community, and the development of uniform clinical trial standards (also including more realistic outcomes) and the reporting of results. The 2 large appendices summarize the results of this systematic review with regard to the areas of lack of knowledge where further focused research is necessary.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine Aristotle University of Thessaloniki Greece; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Eduard Vieta
- 3rd Department of Psychiatry, School of Medicine Aristotle University of Thessaloniki Greece; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Allan Young
- 3rd Department of Psychiatry, School of Medicine Aristotle University of Thessaloniki Greece; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Lakshmi Yatham
- 3rd Department of Psychiatry, School of Medicine Aristotle University of Thessaloniki Greece; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Heinz Grunze
- 3rd Department of Psychiatry, School of Medicine Aristotle University of Thessaloniki Greece; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Pierre Blier
- 3rd Department of Psychiatry, School of Medicine Aristotle University of Thessaloniki Greece; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Hans Jurgen Moeller
- 3rd Department of Psychiatry, School of Medicine Aristotle University of Thessaloniki Greece; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Siegfried Kasper
- 3rd Department of Psychiatry, School of Medicine Aristotle University of Thessaloniki Greece; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Vancouver, Canada; Paracelsus Medical University, Salzburg, Austria; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Psychiatric Department Ludwig Maximilians University, Munich, Germany; Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
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Neogi R, Chakrabarti S, Grover S. Health-care needs of remitted patients with bipolar disorder: A comparison with schizophrenia. World J Psychiatry 2016; 6:431-441. [PMID: 28078207 PMCID: PMC5183995 DOI: 10.5498/wjp.v6.i4.431] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 09/18/2016] [Accepted: 10/18/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To investigate health-care needs and their correlates among patients with remitted bipolar disorder (BD) compared to patients with remitted schizophrenia.
METHODS Outpatients with BD (n = 150) and schizophrenia (n = 75) meeting clearly defined remission criteria were included in the study along with their relatives. Diagnostic ascertainment was carried out using the Mini International Neuropsychiatric Interview. Demographic and clinical details were recorded using structured formats. Residual symptoms were assessed using standardized scales. Health-care needs were assessed on two separate scales. The principal instrument employed to assess health-care needs was the Camberwell Assessment of Need-Research version (CAN-R). To further evaluate health-care needs we felt that an additional instrument, which was more relevant for Indian patients and treatment-settings and designed to cover those areas of needs not specifically covered by the CAN-R was required. This instrument with a structure and scoring pattern similar to the CAN-R was used for additional evaluation of needs. Patients’ level of functioning was assessed using the Global Assessment of Functioning Scale and their quality of life (QOL) using the World Health Organization Quality Of Life-BREF version in Hindi.
RESULTS An average of 6-7 needs was reported by patients with BD as well as their relatives. Commonly reported needs were in the areas of economic and welfare needs, informational needs, social needs and the need for treatment. According to the CAN-R, both patients and relatives reported that more than 60% of the total needs were being met. However, over 90% of the needs covered by the additional evaluation were unmet according to patients and relatives. Needs in the areas of economic and welfare-benefits, information, company, daytime activities and physical health-care were largely unmet according to patients and relatives. Total, met and unmet needs were significantly higher for schizophrenia, but the most common types of needs were quite similar to BD. Relatives reported more needs than patients with certain differences in the types of needs reported. Level of patients’ functioning was the principal correlate of greater total and unmet needs in both groups. Significant associations were also obtained with residual symptoms and QOL.
CONCLUSION The presence of unmet needs in remitted patients with BD was an additional marker of the enduring psychosocial impairment characteristic of the remitted phase of BD.
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Dautzenberg G, Lans L, Meesters PD, Kupka R, Beekman A, Stek ML, Dols A. The care needs of older patients with bipolar disorder. Aging Ment Health 2016; 20:899-907. [PMID: 26046823 DOI: 10.1080/13607863.2015.1047321] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES With aging, bipolar disorder evolves into a more complex illness, with increasing cognitive impairment, somatic comorbidity, and polypharmacy. To tailor treatment of these patients, it is important to study their needs, as having more unmet needs is a strong predictor of a lower quality of life. METHOD Seventy-eight Dutch patients with bipolar I or II disorder aged 60 years and older in contact with mental health services were interviewed using the Camberwell Assessment of Need in the Elderly (CANE) to assess met and unmet needs, both from a patient and a staff perspective. RESULTS Patients (mean age 68 years, range 61-98) reported a mean of 4.3 needs compared to 4.4 reported by staff, of which 0.8 were unmet according to patients and 0.5 according to staff. Patients frequently rated company and daytime activities as unmet needs. More current mood symptoms were associated with a higher total number of needs. Less social participation was associated with a higher total number of needs and more unmet needs. CONCLUSION Older bipolar patients report fewer needs and unmet needs compared to older patients with depression, schizophrenia, and dementia. A plausible explanation is that older bipolar patients had higher Global Assessment of Functioning scores, were better socially integrated, and had fewer actual mood symptoms, all of which correlated with the number of needs in this study. The results emphasize the necessity to assess the needs of bipolar patients with special attention to social functioning, as it is suggested that staff fail to recognize or anticipate these needs.
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Affiliation(s)
| | - Luuk Lans
- b Department of Psychiatry , GGZ inGeest/VUmc , Amsterdam , The Netherlands
| | - Paul D Meesters
- b Department of Psychiatry , GGZ inGeest/VUmc , Amsterdam , The Netherlands
| | - Ralph Kupka
- a Altrecht Institute for Mental Health Care , Utrecht , The Netherlands.,b Department of Psychiatry , GGZ inGeest/VUmc , Amsterdam , The Netherlands
| | - Aartjan Beekman
- b Department of Psychiatry , GGZ inGeest/VUmc , Amsterdam , The Netherlands
| | - Max L Stek
- b Department of Psychiatry , GGZ inGeest/VUmc , Amsterdam , The Netherlands
| | - Annemiek Dols
- b Department of Psychiatry , GGZ inGeest/VUmc , Amsterdam , The Netherlands
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10
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Beentjes TAA, Goossens PJJ, Jongerden IP. Nurses' Experience of Maintaining Their Therapeutic Relationship With Outpatients With Bipolar Disorder and Their Caregivers During Different Stages of a Manic Episode: A Qualitative Study. Perspect Psychiatr Care 2016; 52:131-8. [PMID: 25772270 DOI: 10.1111/ppc.12109] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 01/19/2015] [Accepted: 02/11/2015] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Caregivers often consult community mental health (CMH) nurses when they recognize prodromes of mania in the outpatient. The purpose of this study was to determine nurses' experiences of their therapeutic relationship and nursing interventions to outpatients and caregivers during different stages of mania. DESIGN AND METHODS A qualitative study was conducted. Nine nurses were interviewed. FINDINGS CMH nurses experienced dual loyalty when facing conflicting interests. They strived to stay connected to patients and caregivers with an open and nonjudgmental attitude. In euthymic episodes, nurses anticipated by developing good relationships with both and by making relapse prevention plan. PRACTICE IMPLICATIONS Early involvement of caregivers in the treatment is recommended.
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Affiliation(s)
- Titus A A Beentjes
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, the Netherlands.,Saxion University of Applied Science, Faculty of Health, Deventer, the Netherlands.,Dimence Group Mental Health Care Center, Bipolar Specialists Center, Deventer, the Netherlands.,Nursing Science Program, Clinical Health Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Peter J J Goossens
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, the Netherlands.,Dimence Mental Health Care Centre, Bipolar Specialists Center, Deventer, the Netherlands.,Ghent University, Department of Nursing Sciences, Ghent, Belgium.,GGZ-VS, Institute for Education of Clinical Nurse Specialist in Mental Health, Utrecht, the Netherlands
| | - Irene P Jongerden
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.,Clinical Health Sciences Program, University Medical Center Utrecht, Utrecht, the Netherlands
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Grover S, Avasthi A, Shah S, Lakdawala B, Chakraborty K, Nebhinani N, Kallivayalil RA, Dalal PK, Sinha V, Khairkar P, Mukerjee DG, Thara R, Behere P, Chauhan N, Thirunavukarasu M, Malhotra S. Indian Psychiatric Society multicentric study on assessment of health-care needs of patients with severe mental illnesses as perceived by their family caregivers and health-care providers. Indian J Psychiatry 2015; 57:181-9. [PMID: 26124525 PMCID: PMC4462788 DOI: 10.4103/0019-5545.158185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
AIM To study the health-care needs of the patients with severe mental disorders as perceived by their family caregivers and the treating psychiatrists. MATERIALS AND METHODS Caregivers of patients with severe mental disorders and their treating psychiatrists were assessed using Camberwell Assessment of Need-Research Version (CAN-R) scale and indigenously designed Supplementary Assessment of Needs Scale (SNAS). RESULTS The study included 1494 patients recruited from 15 centers. The mean needs as per the CAN-R, perceived by the caregivers were 7.8 and treating psychiatrists were 8.1. About one-third of needs were unmet. On SNAS, both caregivers and treating psychiatrists reported a mean of 7.9 needs, of which more than half were unmet as per the caregivers. As per the treating psychiatrists, 45.5% of the needs as assessed on SNAS were unmet. There was a high level of correlation between needs perceived by the patients, caregivers and the treating psychiatrists. On CAN-R, main domains of needs as reported by the caregivers were those of money, relief of psychological distress, information about the illness and treatment, welfare benefits, transport, company and food. As per the treating psychiatrists, the most common total needs identified were those of relief of psychological distress, welfare benefits, information about the illness and treatment, money, transport, company self-care and physical health. The most common domains of needs as assessed on SNAS as per the caregivers were those of free treatment, medical reimbursement, psychoeducation, financial help, social support, insurance, more time from the clinicians and travel concession. The treating psychiatrists identified dealing with caregiver's stress as the most common need. CONCLUSIONS According to the family caregivers and treating psychiatrists, about one-third of the needs of the patients as assessed using CAN-R and about half of the needs as assessed using SNAS are unmet.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandip Shah
- Department of Psychiatry, SBKS MI and RC, Sumandeep Vidyapeeth, Pipaira, Vadodara, Gujarat, India
| | - Bhavesh Lakdawala
- Department of Psychiatry, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Kaustav Chakraborty
- Department of Psychiatry, College of Medicine and J.N.M. Hospital, Kalyani, India
| | | | - Roy A Kallivayalil
- Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Tiruvalla, Kerala, India
| | - Pranob K Dalal
- Department of Psychiatry, KGMU, Lucknow, Uttar Pradesh, India
| | - Vishal Sinha
- Department of Psychiatry, S. N. Medical College, Agra, Uttar Pradesh, India
| | - Praveen Khairkar
- Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India
| | - Divya G Mukerjee
- Department of Psychiatry, R. G. Kar Medical College, Kolkata, West Bengal, India
| | - R Thara
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | - Prakash Behere
- Department of Psychiatry, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | | | - M Thirunavukarasu
- Department of Psychiatry, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India
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Grover S, Avasthi A, Shah S, Lakdawala B, Chakraborty K, Nebhinani N, Kallivayalil RA, Dalal PK, Sinha V, Khairkar P, Mukerjee DG, Thara R, Behere P, Chauhan N, Thirunavukarasu M, Malhotra S. Indian Psychiatric Society multicentric study on assessment of health-care needs of patients with severe mental illnesses. Indian J Psychiatry 2015; 57:43-50. [PMID: 25657456 PMCID: PMC4314916 DOI: 10.4103/0019-5545.148520] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
AIM To assess the health-care needs of the patients with severe mental disorders. MATERIALS AND METHODS Patients with the diagnosis of a severe mental disorder (schizophrenia and related psychotic disorders, bipolar disorder, recurrent depressive disorder, major depressive disorder and obsessive compulsive disorder) were assessed using Camberwell Assessment of Need-Research version (CAN-R) Scale and indigenously designed Supplementary Needs Assessment Scale (SNAS). RESULTS The study included 1494 patients recruited from 15 centers. The most common diagnostic group was that of affective disorders (55.3%), followed by psychotic disorders (37.6%). The mean number of total needs as perceived by the patients was 7.6 on the CAN-R. About two-third of the needs as assessed on CAN-R were met, and one-third were unmet. On CAN-R, main domains of needs as reported by patients were those of money, welfare benefits, transport, information about the illness and treatment, relief of psychological distress, company, household skills and intimate relationships. On SNAS, the mean number of total needs as perceived by the patients was 7.6 of which 4.1 were met needs. The most common domains of needs as assessed on SNAS were those of financial help, medical reimbursement, psychoeducation, free treatment, certification of mental illness, flexible work/job timings, addressing the caregiver stress and legal aid. CONCLUSION About two-third of the needs, of the patients with severe mental disorders are met as assessed using CAN-R. However, higher percentages of unmet needs are identified on SNAS. In view of the commonly reported needs, a change in the orientation of services offered to people with mental disorders is very much called for. At the government level, desired policies must be formulated to support the patients with mental disorders.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandip Shah
- Department of Psychiatry, SBKS MI and RC, Sumandeep Vidyapeeth, Pipaira, Vadodara, Gujarat, India
| | - Bhavesh Lakdawala
- Department of Psychiatry, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Kaustav Chakraborty
- Department of Psychiatry, College of Medicine and J.N.M. Hospital, Kalyani, India
| | | | | | - Pranob K Dalal
- Department of Psychiatry, KGMU, Lucknow, Uttar Pradesh, India
| | - Vishal Sinha
- Department of Psychiatry, S. N. Medical College, Agra, Uttar Pradesh, India
| | - Praveen Khairkar
- Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India
| | - Divya G Mukerjee
- Department of Psychiatry, R. G. Kar Medical College, Kolkata, West Bengal, India
| | - R Thara
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | - Prakash Behere
- Department of Psychiatry, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
| | | | - M Thirunavukarasu
- Department of Psychiatry, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India
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Grover S, Chakrabarti S, Ghormode D, Dutt A. A comparative study of caregivers' perceptions of health-care needs and burden of patients with bipolar affective disorder and schizophrenia. Nord J Psychiatry 2015; 69:629-36. [PMID: 25928091 DOI: 10.3109/08039488.2015.1033010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Although many studies in schizophrenia have evaluated health-care needs, there is a lack of data on the needs of patients with bipolar affective disorder (BPAD), with only occasional studies evaluating them, and no study has evaluated the relationship of health-care needs of patients with caregiver's burden. AIM To study the relationship of caregiver's burden and needs of patients as perceived by caregivers of patients with BPAD and schizophrenia. METHOD Caregivers of patients with BPAD and schizophrenia were assessed using the Camberwell Assessment of Needs - Research version (CAN-R) and Supplementary Needs Assessment Scale (SNAS), the Family Burden Interview schedule (FBI) and the Involvement Evaluation Questionnaire (IEQ). RESULTS Mean total needs of patients on CAN-R were 7.54 (SD 3.59) and 7.58 (SD 4.24) for BPAD and schizophrenia respectively. Mean total needs for SNAS were 7.24 (SD 3.67) and 7.68 (SD 5.02) for BPAD and schizophrenia groups, respectively. Total objective and subjective burden as assessed on FBI was significantly more for the schizophrenia group. Caregivers of patients with BPAD perceived significantly less disruption of routine family activities and lower impact on the mental health of others. On IEQ, the mean score on the domain of supervision was significantly higher for the BPAD group. In the schizophrenia group, positive correlations were seen between the total number of unmet and total (met and unmet) needs and certain aspects of burden, but no such correlations emerged in the BPAD group. CONCLUSION There is no correlation between number of needs and burden in the BPAD group; however, in the schizophrenia group the number of needs correlated with the perceived burden. Accordingly, orienting services to address needs of patients with schizophrenia can lead to reduction in burden among caregivers.
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Affiliation(s)
- Sandeep Grover
- a Sandeep Grover, Department of Psychiatry , Post Graduate Institute of Medical Education and Research , Chandigarh , India
| | - Subho Chakrabarti
- b Subho Chakrabarti, Department of Psychiatry , Post Graduate Institute of Medical Education and Research , Chandigarh , India
| | - Deepak Ghormode
- c Deepak Ghormode, Department of Psychiatry , Post Graduate Institute of Medical Education and Research , Chandigarh , India
| | - Alakananda Dutt
- d Alakananda Dutt, Department of Psychiatry , Post Graduate Institute of Medical Education and Research , Chandigarh , India
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Fradgley EA, Paul CL, Bryant J, Roos IA, Henskens FA, Paul DJ. Consumer participation in quality improvements for chronic disease care: development and evaluation of an interactive patient-centered survey to identify preferred service initiatives. J Med Internet Res 2014; 16:e292. [PMID: 25532217 PMCID: PMC4285719 DOI: 10.2196/jmir.3545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 09/02/2014] [Accepted: 11/06/2014] [Indexed: 11/16/2022] Open
Abstract
Background With increasing attention given to the quality of chronic disease care, a measurement approach that empowers consumers to participate in improving quality of care and enables health services to systematically introduce patient-centered initiatives is needed. A Web-based survey with complex adaptive questioning and interactive survey items would allow consumers to easily identify and prioritize detailed service initiatives. Objective The aim was to develop and test a Web-based survey capable of identifying and prioritizing patient-centered initiatives in chronic disease outpatient services. Testing included (1) test-retest reliability, (2) patient-perceived acceptability of the survey content and delivery mode, and (3) average completion time, completion rates, and Flesch-Kincaid reading score. Methods In Phase I, the Web-based Consumer Preferences Survey was developed based on a structured literature review and iterative feedback from expert groups of service providers and consumers. The touchscreen survey contained 23 general initiatives, 110 specific initiatives available through adaptive questioning, and a relative prioritization exercise. In Phase II, a pilot study was conducted within 4 outpatient clinics to evaluate the reliability properties, patient-perceived acceptability, and feasibility of the survey. Eligible participants were approached to complete the survey while waiting for an appointment or receiving intravenous therapy. The age and gender of nonconsenters was estimated to ascertain consent bias. Participants with a subsequent appointment within 14 days were asked to complete the survey for a second time. Results A total of 741 of 1042 individuals consented to participate (71.11% consent), 529 of 741 completed all survey content (78.9% completion), and 39 of 68 completed the test-retest component. Substantial or moderate reliability (Cohen’s kappa>0.4) was reported for 16 of 20 general initiatives with observed percentage agreement ranging from 82.1%-100.0%. The majority of participants indicated the Web-based survey was easy to complete (97.9%, 531/543) and comprehensive (93.1%, 505/543). Participants also reported the interactive relative prioritization exercise was easy to complete (97.0%, 189/195) and helped them to decide which initiatives were of most importance (84.6%, 165/195). Average completion time was 8.54 minutes (SD 3.91) and the Flesch-Kincaid reading level was 6.8. Overall, 84.6% (447/529) of participants indicated a willingness to complete a similar survey again. Conclusions The Web-based Consumer Preferences Survey is sufficiently reliable and highly acceptable to patients. Based on completion times and reading level, this tool could be integrated in routine clinical practice and allows consumers to easily participate in quality evaluation. Results provide a comprehensive list of patient-prioritized initiatives for patients with major chronic conditions and delivers practice-ready evidence to guide improvements in patient-centered care.
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Affiliation(s)
- Elizabeth A Fradgley
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health & Hunter Medical Research Institute, University of Newcastle, Callaghan, Australia.
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Kurdal E, Tanrıverdi D, Savaş HA. The Effect of Psychoeducation on the Functioning Level of Patients With Bipolar Disorder. West J Nurs Res 2013; 36:312-28. [DOI: 10.1177/0193945913504038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bipolar disorder has adverse effects on the lives of the individuals and the people around them and causes disability due to impaired social and occupational functioning, risk of suicide, and frequent relapses. This study was conducted as a two-group pretest–posttest design to determine the effect of psychoeducation on the functioning levels of patients with bipolar disorder. A total of 80 patients were assigned to either the experimental ( n = 40) or the control group ( n = 40). The data were collected using a questionnaire form, and the Bipolar Disorder Functioning Questionnaire. The experimental group scored significantly higher on the functioning levels (emotional functioning, intellectual functioning, feelings of stigmatization, social withdrawal, household relations, relations with friends, participating in social activities, daily activities and recreational activities, taking initiative and self-sufficiency, and occupation) ( p < .05) compared with the control group after psychoeducation. Psychoeducation has become considerably effective in increasing the functioning levels of patients with bipolar disorder.
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Houtjes W, Van Meijel B, Deeg DJH, Beekman ATF. Late-life depression: systematic assessment of care needs as a basis for treatment. J Psychiatr Ment Health Nurs 2012; 19:274-80. [PMID: 22070502 DOI: 10.1111/j.1365-2850.2011.01823.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Research shows that most of the variance in depression severity levels in late life can be explained by the unmet psychological needs of patients, more in particular the care needs of patients related with psychological distress. This case report describes the treatment of an 84-year-old patient suffering from depression. Her complaints faded upon the use of nursing interventions that were defined on the basis of a systematic assessment of her care needs with the Camberwell Assessment of Needs for the Elderly. The methodical attention to her needs for care and the interventions carried out led to the patient feeling acknowledged and to a diminished need for care and a better quality of life. Although there is no scientific evidence to date, a systematic assessment of care needs may well be a meaningful addition to the nursing diagnostic process. Moreover, alleviating distress in patients by fulfilling unmet care needs through tailored interventions can be seen as an essential element of an effective multidisciplinary depression treatment process.
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Affiliation(s)
- W Houtjes
- EMGO Institute on Health, VU University Medical Center, Amsterdam, The Netherlands.
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Unmet needs of outpatients with late-life depression; a comparison of patient, staff and carer perceptions. J Affect Disord 2011; 134:242-8. [PMID: 21684611 DOI: 10.1016/j.jad.2011.05.052] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 05/26/2011] [Accepted: 05/27/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is evidence that late life depression is associated with high levels of unmet needs. Only a minority of the depressed patients appears to be adequately treated. METHODS Ninety-nine older patients (58-92 years), 96 informal carers and 85 health-care professionals were recruited from six outpatient facilities for old age psychiatry in the Netherlands and interviewed to identify met and unmet needs, using the Camberwell Assessment of Needs for the Elderly (CANE). The severity of depression was measured with the Montgomery Åsberg Depression Rating Scale (MADRS). RESULTS On average patients scored more unmet needs than staff and carers. On item level, patients and staff showed the highest agreement in the psychological needs category. Patient and carers showed the highest agreement on physical health needs. Logistic regression showed that severe depression is a significant predictor of low concordance between stakeholders on a substantial number of CANE items. LIMITATIONS Kappa coefficients were computed to determine agreement between parties involved. However, Kappa coefficients should be interpreted with caution, especially when obvious disparity in unmet needs scores between groups of interest can be observed. CONCLUSION Home dwelling older patients with major depressive disorder, their practitioners and their informal carers have different perceptions of the older patients unmet needs.Practitioners should be aware of the negative impact of depression severity on reaching agreement regarding unmet needs and its possible consequences for mutual goal setting and compliance.
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Recognising prodromes of manic or depressive recurrence in outpatients with bipolar disorder: A cross-sectional study. Int J Nurs Stud 2010; 47:1201-7. [DOI: 10.1016/j.ijnurstu.2010.01.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 01/20/2010] [Accepted: 01/31/2010] [Indexed: 11/23/2022]
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Rusner M, Carlsson G, Brunt D, Nyström M. A dependence that empowers-the meaning of the conditions that enable a good life with bipolar disorder. Int J Qual Stud Health Well-being 2010; 5. [PMID: 20640025 PMCID: PMC2879869 DOI: 10.3402/qhw.v5i1.4653] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2009] [Indexed: 01/18/2023] Open
Abstract
The extensive suffering related to a complex life situation with bipolar disorder (BD) and the reported difference between care needs and the needs that are actually met implicates that there are still questions about management of life with BD that need to be answered. The present study therefore aims to describe the meaning of the conditions that enable a good life with BD. Ten persons, six women and four men (aged 30–61), diagnosed with BD were interviewed. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings present the essential meaning of the conditions that enable a good life with BD as a dependence that empowers, which is further described by its constituents: “turning the course of life,” “protecting oneself from running out of energy,” “being needed,” “being oneself through reliable others,” “personal landmarks for navigating through life.” A voluntary chosen dependence, as described in the present study, is a new approach of care that enables a good life with BD, while enhancing own power, freedom, and control. The conditions that enable a good life with BD are more than separate supporting measures. Therefore a holistic perspective is preferable while providing care for individuals with BD.
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Affiliation(s)
- Marie Rusner
- Correspondence: M. Rusner, School of Health Sciences, University of Borås, SE-501 90 Borås, Sweden. Tel: +46 (70) 265 03 74. Fax: +46 (33) 435 40 10.
| | | | - David Brunt
- School of Health Sciences and Social Work, Växjö University, Växjö, Sweden
| | - Maria Nyström
- School of Health Sciences, University of Borås, Borås, Sweden
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Rusner M, Carlsson G, Brunt D, Nyström M. Extra dimensions in all aspects of life-the meaning of life with bipolar disorder. Int J Qual Stud Health Well-being 2009; 4:159-69. [PMID: 20523885 PMCID: PMC2879964 DOI: 10.1080/17482620902864194] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2009] [Indexed: 11/12/2022] Open
Abstract
Living with Bipolar Disorder (BD) greatly affects the whole life; still the meaning of it is poorly explored from the perspective of the individuals actually living with it. The aim of this study is thus to explore the existential meaning of life with BD. Ten persons, six women and four men, (aged 30–61), diagnosed with BD were interviewed. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings show that living with BD entails experiencing extra dimensions in all aspects of life, expressed in terms of a magnitude and complexity beyond that which is perceived as pertaining to normal life. The essential meaning of the phenomenon is further described by its constituents: “a specific intensity”, “a struggle to understand”, “an illness that is intertwined with one's whole being”. Living with BD means more for the individual than having episodes of depression and mania and must therefore be understood from a holistic perspective. Adequate care for persons with BD, therefore, includes places for safe and profound reflecting about existential issues, such as identity, trust and self-confidence. The present study recommends the caring services to change their ways to explain and talk about the BD illness.
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Affiliation(s)
- Marie Rusner
- School of Health Sciences, University of Borås, Sweden
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