Inpatients With Bipolar Disorder: Their Quest to Understand

A dependence that empowers-the meaning of the conditions that enable a good life with bipolar disorder

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.

Extra dimensions in all aspects of life-the meaning of life with bipolar disorder

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.

Nursing processes used in the treatment of patients with bipolar disorder

Psychiatric nurses are increasingly being involved in the provision of care for outpatients with bipolar disorder. The establishment of a body of knowledge for the nursing of these patients is vital for the development of integrated evidence-based treatment. The literature for the period January 1980 to January 2006 is reviewed. A sensitive literature search included not only the nursing care based on research results but also nursing care based on experiences acquired by practising nurses. The results show that formal research on the nursing of patients with a bipolar disorder is remarkably limited. Three quantitative studies were identified in five articles and six qualitative studies addressing a broad range of topics. The remainder of articles meeting the inclusion criteria contained mostly descriptive reports. An overview is presented of the nursing processes used during the euthymic stage of a bipolar disorder and during an acute episode of (hypo)mania. No specific nursing processes for acute episodes of bipolar depression are described in the literature. The results show hardly any evidence for the described nursing processes.

Patient satisfaction with two models of group therapy for people hospitalized with bipolar disorder

The purpose of this study was to (a) compare participants' evaluations of two models of inpatient group therapy for people with bipolar disorder and (b) develop a taxonomy of patient satisfaction with such groups. The sample of 110 people included 59 participants in the self-management groups and 51 participants in the interactional groups. Results indicated that although neither of the models was clearly preferred by participants, the responses were useful in identifying needed changes, and the benefits of providing inpatient diagnostically homogeneous groups for this population were evident. A refined self-management model that incorporates agenda setting in the format, and a taxonomy for use in future research, are presented.