Nursing Intervention in Patients with Bipolar Disorders

Main Article Content

Karen Alejandra Sanchez-Gomez
Cecilia Raquel Ferrer-Sorroza
Antonio Marques-Firmino

Abstract

The establishment of a body of knowledge for nursing about patients with bipolar disorder is vital for the development of an integrated, evidence-based treatment. The research aims to explore nursing interventions in the treatment of bipolar I and II disorder, covering all phases of the disorder. Barriers and facilitators to treatment compliance were identified. The study was conducted following the PRISMA guidelines for systematic reviews. A search was carried out in databases such as Google Scholar, Scopus and PubMed, for articles in English and Spanish published in the last ten years. Data extraction was guided by the Cochrane Template, to ensure reliability. A mixed approach was applied, initially quantifying publications by year, country and type, and subsequently performing a qualitative extraction to answer specific research questions. The findings indicate that nursing interventions should be tailored to each phase of the disorder. In the manic phase, the priority is mood stabilization and patient safety, in the depressive phase, the goal is to improve mood and prevent social isolation. During the euthymic phase, education and long-term stability strategies are emphasized, promoting treatment adherence and relapse prevention. The importance of a strong therapeutic relationship between nurses and patients is also stressed, as it significantly influences treatment outcomes and recovery.

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How to Cite
Sanchez-Gomez , K., Ferrer-Sorroza , C. ., & Marques-Firmino , A. (2024). Nursing Intervention in Patients with Bipolar Disorders. 593 Digital Publisher CEIT, 9(6), 941-966. https://doi.org/10.33386/593dp.2024.6.2840
Section
Artículos de revisión
Author Biographies

Karen Alejandra Sanchez-Gomez , Instituto Tecnológico Euroamericano - Ecuador

https://orcid.org/009-00080552-6737

Graduate in Nursing at the Santiago de Guayaquil Catholic University 

Guayaquil-Ecuador 

Diploma in Research Culture 

International University of La Rioja 

Professor at the Euro-American University Technological Institute 

Coordinator of the first Nursing Congress of the Euro-American University Technological Institute 

Cecilia Raquel Ferrer-Sorroza , Instituto Tecnológico Euroamericano - Ecuador

https://orcid.org/0009-0009-7703-945X

Graduate of Nursing from the Universidad Católica Santiago de Guayaquil.

Master in Management in Health Services from the Universidad Católica Santiago de Guayaquil.

Penitentiary Nurse at the La Roca Detention Center

Maternal and child nurse at the Francisco Jácome Center.

Nurse at IESS Ceibos hospital, Internal Medicine area.

Co-leader of the Dialysis Area

Direct care of the Emergency Area, ICU Area, Hemodynamics Area.

Leader of the sterilization center until now Hospital Teodoro Maldonado Carbo

Antonio Marques-Firmino , Instituto Superior Tecnológico EuroAmericano - Ecuador

Rector of EuroAmericano Technological Institute, a higher education entity, holds a Master’s Degree in Education Management. With more than 40 years of experience, since its humble beginnings in 1980, Mr. Marques has worked as head of leading education centers such as National Cash Register (NCR) Programming Institute, Educativo Micro EDC, EuroAmericano Center for Studies and Culture and EuroAmericano Technological Institute.

References

Akbaş, E. (2019). Nursing care for a patient with bipolar disorder (Mixed Attack) according to neuman systems model: Case report. Journal of Psychiatric Nursing. https://doi.org/10.14744/phd.2019.80774

Ameel, M., Leino, H., Kontio, R., Van Achterberg, T., & Junttila, K. (2020). Using the Nursing Interventions Classification to identify nursing interventions in free‐text nursing documentation in adult psychiatric outpatient care setting. Journal of Clinical Nursing, 29(17–18), 3435–3444. https://doi.org/10.1111/jocn.15382

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596

Armijo, J. E. (2023). Bipolar spectrum disorders among American registered nurses: A narrative literature review. Discover Psychology, 3(1), 11. https://doi.org/10.1007/s44202-023-00072-8

Ata, E. E., Bahadir‐Yilmaz, E., & Bayrak, N. G. (2020). The impact of side effects on schizophrenia and bipolar disorder patients’ adherence to prescribed medical therapy. Perspectives in Psychiatric Care, ppc.12483. https://doi.org/10.1111/ppc.12483

Beaudin, J., Chouinard, M.-C., Hudon, É., & Hudon, C. (2024). Integrated self-management support provided by primary care nurses to persons with chronic diseases and common mental disorders: A qualitative study. BMC Primary Care, 25(1), 212. https://doi.org/10.1186/s12875-024-02464-8

Beentjes, T. A. A., Goossens, P. J. J., & Jongerden, I. P. (2016). 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: Nursing and Manic Stages. Perspectives in Psychiatric Care, 52(2), 131–138. https://doi.org/10.1111/ppc.12109

Bereda, G. (2022). Stage and symptoms of bipolar disorders. Insights on the Depression and Anxiety, 6(1), 007–010. https://doi.org/10.29328/journal.ida.1001030

Brickman, H. M., Young, A. S., & Fristad, M. A. (2023). Bipolar and related disorders. En Encyclopedia of Mental Health (pp. 232–239). Elsevier. https://doi.org/10.1016/B978-0-323-91497-0.00195-8

Carey-Hock, E. (2024). Experiences of self-recovery among adults with bipolar disorder: A narrative review. Mental Health Practice, 27(4), 22–27. https://doi.org/10.7748/mhp.2024.e1691

Casey, S. (2024). Preparing nursing students to communicate with mental health patients: A scoping review. Nurse Education in Practice, 80, 104099. https://doi.org/10.1016/j.nepr.2024.104099

Chen, J., & Dhillon, D. (2022). Bipolar Disorder. The Meducator, 1(42). https://doi.org/10.15173/m.v1i42.3271

Chiang, K.-J., Tsai, J.-C., Liu, D., Lin, C.-H., Chiu, H.-L., & Chou, K.-R. (2017). Efficacy of cognitive-behavioral therapy in patients with bipolar disorder: A meta-analysis of randomized controlled trials. PLOS ONE, 12(5), e0176849. https://doi.org/10.1371/journal.pone.0176849

Chou, P.-H., Liu, W.-C., Lin, W.-H., Hsu, C.-W., Wang, S.-C., & Su, K.-P. (2023). NIRS-aided differential diagnosis among patients with major depressive disorder, bipolar disorder, and schizophrenia. Journal of Affective Disorders, 341, 366–373. https://doi.org/10.1016/j.jad.2023.08.101

Coelho, J., Moreno Poyato, A., Roldán Merino, J., Sequeira, C., & Sampaio, F. (2024). Perspectives of adult patients with mental health disorders on the relationship with nurses: A focus group study. BMC Nursing, 23(1), 9. https://doi.org/10.1186/s12912-023-01663-5

Copara, O., Cumbicus, E., Morales, J., Caibe, M., & Ríos, L. (2021). Reflexiones sobre la intervención de enfermería en adultos con episodio depresivo. Revista Eugenio Espejo, 15(2), 88–97. https://doi.org/10.37135/ee.04.11.12

Crowe, M., Beaglehole, B., & Inder, M. (2016). Social rhythm interventions for bipolar disorder: A systematic review and rationale for practice. Journal of Psychiatric and Mental Health Nursing, 23(1), 3–11. https://doi.org/10.1111/jpm.12271

Darwish, D. (2024). Chatbots vs. AI Chatbots vs. Virtual Assistants. En Design and Development of Emerging Chatbot Technology (pp. 26–50). IGI Global. https://doi.org/10.4018/979-8-3693-1830-0.ch002

Durgu, N., & Dulgerler, S. (2021). The Meaning of Recovery: The Lived Experience of Patients with Bipolar Disorder in Turkey. Issues in Mental Health Nursing, 42(6), 573–580. https://doi.org/10.1080/01612840.2020.1818015

Elowe, J., Vallat, J., Castelao, E., Strippoli, M.-P. F., Gholam, M., Ranjbar, S., Glaus, J., Merikangas, K., Lavigne, B., Marquet, P., Preisig, M., & Vandeleur, C. L. (2022). Psychotic features, particularly mood incongruence, as a hallmark of severity of bipolar I disorder. International Journal of Bipolar Disorders, 10(1), 31. https://doi.org/10.1186/s40345-022-00280-6

García de la Orden, L., & García Carretero, R. (2015). Cuidados enfermeros en un paciente con trastorno bipolar y diabetes insípida nefrogénica por litio. Enfermería Clínica, 25(2), 92–97. https://doi.org/10.1016/j.enfcli.2014.12.002

Geerling, B., Lolkema, E. C., Kelders, S. M., Stevens, A. W. M. M., Kupka, R. W., & Bohlmeijer, E. T. (2023). Why patients diagnosed with bipolar disorder start, continue or discontinue health‐related apps supporting their self‐management. Journal of Psychiatric and Mental Health Nursing, 30(3), 537–546. https://doi.org/10.1111/jpm.12894

Gümüş, F., & Buzlu, S. (2018). Psychoeducation in Bipolar Disorder. Florence Nightingale Hemşirelik Dergisi, 131–139. https://doi.org/10.26650/FNJN427814

Guo, Q., Jia, J., Sun, X. L., Yang, H., & Ren, Y. (2024). Comparing the metabolic pathways of different clinical phases of bipolar disorder through metabolomics studies. Frontiers in Psychiatry, 14, 1319870. https://doi.org/10.3389/fpsyt.2023.1319870

Harmancı, P., & Yıldız, E. (2023). The effects of psychoeducation and motivational interviewing on treatment adherence and functionality in individuals with bipolar disorder. Archives of Psychiatric Nursing, 45, 89–100. https://doi.org/10.1016/j.apnu.2023.04.026

Hermans, A. P. C., Schutter, D. J. L. G., & Bethlehem, R. A. I. (2024). Functional network characteristics in anxiety- and mania-based subgroups of bipolar I disorder. Psychiatry Research: Neuroimaging, 344, 111868. https://doi.org/10.1016/j.pscychresns.2024.111868

Hormazábal‐Salgado, R., & Poblete‐Troncoso, M. (2020). Living with bipolar disorder in Chile: A qualitative study. International Journal of Mental Health Nursing, 29(3), 488–497. https://doi.org/10.1111/inm.12686

Johansen, E. R., Nielsen, H. S., & Verner, M. (2020). Long-Term Consequences of Early Parenthood. Journal of Marriage and Family, 82(4), 1286–1303. https://doi.org/10.1111/jomf.12634

Johansen, K. K., Hounsgaard, L., Frandsen, T. F., Fluttert, F. A. J., & Hansen, J. P. (2021). Relapse prevention in ambulant mental health care tailored to patients with schizophrenia or bipolar disorder. Journal of Psychiatric and Mental Health Nursing, 28(4), 549–577. https://doi.org/10.1111/jpm.12716

Johansen, K. K., Marcussen, J., Hansen, J. P., Hounsgaard, L., & Fluttert, F. (2022). Early recognition method for patients with schizophrenia or bipolar disorder in community mental health care: Illness insight, self‐management and control. Journal of Clinical Nursing, 31(23–24), 3535–3549. https://doi.org/10.1111/jocn.16181

Kadar, K. S., Andriani, A., & Tandi, D. N. (2019). Exploring mental health nursing practice in Indonesian rural area. Journal of Public Mental Health, 19(2), 119–126. https://doi.org/10.1108/JPMH-11-2018-0078

Kaplan, S. N., & Gençarslan, D. Ö. (2024). The effects of mindfulness-based psycoeducation program on the perceived stress levels and emotion regulation strategies of patients diagnosed with bipolar disorder1. Archives of Psychiatric Nursing, 52, 167–174. https://doi.org/10.1016/j.apnu.2024.07.020

Kavitha, R. R., Kamalam, S., & Rajkumar, R. P. (2022). Effectiveness of Family-Focused Nurse-led Intervention on Functional Improvement of Patients with Bipolar Disorder at a Tertiary Hospital in South India: A Randomized Controlled Trial. Indian Journal of Psychological Medicine, 44(2), 152–159. https://doi.org/10.1177/02537176211060557

Keshavarzpir, Z., Seyedfatemi, N., Mardani-Hamooleh, M., Esmaeeli, N., & Boyd, J. E. (2021). The Effect of Psychoeducation on Internalized Stigma of the Hospitalized Patients with Bipolar Disorder: A Quasi-Experimental Study. Issues in Mental Health Nursing, 42(1), 79–86. https://doi.org/10.1080/01612840.2020.1779881

Khedr, M. A., El-Ashry, A. M., El-Sayed, M. M., Elkot, M. A., & Hussein, R. M. (2024). The effect of physical exercises program on social functioning, alexithymia, and sense of coherence among patients with bipolar disorders: A randomized control trial. Archives of Psychiatric Nursing, 49, 83–92. https://doi.org/10.1016/j.apnu.2024.02.002

Kragh, M., Dyrberg, H., Speed, M., Pedersen, P., Kristiansen, S. T., & Martiny, K. (2024). The efficacy of a transdiagnostic sleep intervention for outpatients with sleep problems and depression, bipolar disorder, or attention deficit disorder: Study protocol for a randomized controlled trial. Trials, 25(1), 57. https://doi.org/10.1186/s13063-024-07903-6

Lázaro, P. G., Torres López, J., Jimenez Zamudio, M. J., & Hernández Martínez, A. (2024). Atención de Enfermería a una Persona con trastorno Afectivo Bipolar, Episodio Maniaco con Síntomas Psicóticos Basada en el Modelo de Adaptación de Callista Roy. Ciencia Latina Revista Científica Multidisciplinar, 8(3), 11042–11058. https://doi.org/10.37811/cl_rcm.v8i3.12264

Liu, J. (2024). The Transition Between Depressive Episode and Manic Episode During the Treatment of Bipolar Disorder. Lecture Notes in Education Psychology and Public Media, 59(1), None-None. https://doi.org/10.54254/2753-7048/59/20241702

Ljubic, N., Ueberberg, B., Grunze, H., & Assion, H.-J. (2023). Treatment of Bipolar Disorders in Older Adults: A Review. Focus, 21(4), 434–443. https://doi.org/10.1176/appi.focus.23021024

Loots, E., Dilles, T., Hadouchi, S., Van Rompaey, B., & Morrens, M. (2023). The attitude of healthcare providers towards medication self‐management in hospitalized patients diagnosed with schizophrenia or bipolar disorders. Journal of Psychiatric and Mental Health Nursing, 30(4), 761–772. https://doi.org/10.1111/jpm.12903

Loots, E., Goossens, E., Vanwesemael, T., Morrens, M., Van Rompaey, B., & Dilles, T. (2021). Interventions to Improve Medication Adherence in Patients with Schizophrenia or Bipolar Disorders: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 18(19), 10213. https://doi.org/10.3390/ijerph181910213

Maget, A., Platzer, M., Bengesser, S. A., Fellendorf, F. T., Birner, A., Queissner, R., Hamm, C., Reininghaus, B., Hecker, A., Tomberger, L., Pilz, R., Dalkner, N., Moll, N., Schütze, G., Schwarz, M., Kapfhammer, H. P., & Reininghaus, E. Z. (2020). Differences in Kynurenine Metabolism During Depressive, Manic, and Euthymic Phases of Bipolar Affective Disorder. Current Topics in Medicinal Chemistry, 20(15), 1344–1352. https://doi.org/10.2174/1568026619666190802145128

Massa, L., Abelli, M., Forfori, F., Di Luca, P., Benvenuti, A., Palagini, L., Pacciardi, B., Raia, A., Caruso, V., & Pini, S. (2023). Binge eating disorder, impulsivity and bipolar spectrum features in a sample of obese candidates for bariatric surgery. Rivista di Psichiatria, 58(2), 76–83.

McCombe, G., Fogarty, F., Swan, D., Hannigan, A., Fealy, G. M., Kyne, L., Meagher, D., & Cullen, W. (2018). Identified mental disorders in older adults in primary care: A cross-sectional database study. European Journal of General Practice, 24(1), 84–91. https://doi.org/10.1080/13814788.2017.1402884

McCormick, U., Murray, B., & McNew, B. (2015). Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses. Journal of the American Association of Nurse Practitioners, 27(9), 530–542. https://doi.org/10.1002/2327-6924.12275

Miola, A., Tondo, L., Pinna, M., Contu, M., & Baldessarini, R. J. (2023). Comparison of bipolar disorder type II and major depressive disorder. Journal of Affective Disorders, 323, 204–212. https://doi.org/10.1016/j.jad.2022.11.039

Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1. https://doi.org/10.1186/2046-4053-4-1

Öksüz, E., Mersin, S., Uçgun, T., & Sarikoc, G. (2024). Experiences of nurses providing care to hospitalized patients with acute mania in Türkiye: A phenomenological study. Archives of Psychiatric Nursing, 50, 33–39. https://doi.org/10.1016/j.apnu.2024.03.005

Ortega, T. I. (2016). Trastorno bipolar: Garantías explícitas de salud e implicancias para enfermería. Horizonte de Enfermería, 27(1), Article 1.

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, n71. https://doi.org/10.1136/bmj.n71

Palagini, L., Miniati, M., Marazziti, D., Franceschini, C., Zerbinati, L., Grassi, L., Sharma, V., & Riemann, D. (2022). Insomnia symptoms are associated with impaired resilience in bipolar disorder: Potential links with early life stressors may affect mood features and suicidal risk. Journal of Affective Disorders, 299, 596–603. https://doi.org/10.1016/j.jad.2021.12.042

Permana, G. G. S. (2024). Providing Psychological Nursing Care at Mental Rehabilitation Clinic, Addressing Self-Concept Challenges: Low Self-Worth Alongside a Bipolar Diagnosis. Nursing Case Insight Journal, 2(1), Article 1.

Simjanoski, M., Patel, S., Boni, R. D., Balanzá-Martínez, V., Frey, B. N., Minuzzi, L., Kapczinski, F., & Cardoso, T. D. A. (2023). Lifestyle interventions for bipolar disorders: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 152, 105257. https://doi.org/10.1016/j.neubiorev.2023.105257

Tahghighi, H., Mortazavi, H., Manteghi, A. A., & Armat, M. R. (2023). The effect of comprehensive individual motivational-educational program on medication adherence in elderly patients with bipolar disorders: An experimental study. Journal of Education and Health Promotion, 12(1). https://doi.org/10.4103/jehp.jehp_1109_22

Tondo, L., Miola, A., Pinna, M., Contu, M., & Baldessarini, R. J. (2022). Differences between bipolar disorder types 1 and 2 support the DSM two-syndrome concept. International Journal of Bipolar Disorders, 10(1), 21. https://doi.org/10.1186/s40345-022-00268-2

Uçgun, T., & Öksüz, E. (2024). The relationship between biological rhythm and perceived social support, coping styles and medication adherence in patients with bipolar disorder in Türkiye. Archives of Psychiatric Nursing, 48, 68–73. https://doi.org/10.1016/j.apnu.2024.01.013

Van Den Heuvel, S. C. G. H., Goossens, P. J. J., Terlouw, C., Schoonhoven, L., & Van Achterberg, T. (2019). Self-Management Education for Bipolar Disorders: A Hermeneutic-Phenomenological Study on the Tacit Knowledge of Mental Health Nurses. Issues in Mental Health Nursing, 40(11), 942–950. https://doi.org/10.1080/01612840.2019.1636166

Van Der Voort, T. Y. G., Van Meijel, B., Hoogendoorn, A. W., Goossens, P. J. J., Beekman, A. T. F., & Kupka, R. W. (2015). Collaborative care for patients with bipolar disorder: Effects on functioning and quality of life. Journal of Affective Disorders, 179, 14–22. https://doi.org/10.1016/j.jad.2015.03.005

vanLankeren, J. E., Testerink, A. E., Daggenvoorde, T. H., Poslawsky, I. E., & Goossens, P. J. J. (2020). Patient experiences with nursing care during hospitalization on a closed ward due to a manic episode: A qualitative study. Perspectives in Psychiatric Care, 56(1), 37–45. https://doi.org/10.1111/ppc.12370

Wakelin, R., & Oakes, P. (2019). Clinicians’ perceptions of the Bipolar Disorder diagnosis: A Q-study. The Journal of Mental Health Training, Education and Practice, 15(1), 1–12. https://doi.org/10.1108/JMHTEP-08-2018-0045

Wang, X., & Yu, Y. (2021). Application of systematic nursing in patients with maniac access of bipolar disorder and its impact on treatment compliance and quality of life. American Journal of Translational Research, 13(6), 6929–6936.

Yu, H., Li, M.-L., Meng, Y., Li, X.-J., Wei, W., Li, Y.-F., Li, L., Guo, W., Wang, Q., Deng, W., Ma, X., Coid, J., & Li, T. (2021). Inferior frontal gyrus seed-based resting-state functional connectivity and sustained attention across manic/hypomanic, euthymic and depressive phases of bipolar disorder. Journal of Affective Disorders, 282, 930–938. https://doi.org/10.1016/j.jad.2020.12.199

Zeighami, R., Raeisolhagh, A., & Ranjbaran, M. (2021). Effect of Home Nursing Care on the Severity of Symptoms in Patients With Bipolar I Disorder: A Randomized Clinical Trial. Home Health Care Management & Practice, 33(2), 81–87. https://doi.org/10.1177/1084822320969122

Zeighami, R., Raeisolhagh, A., & Ranjbaran, M. (2023). Follow-up of Symptoms of Patients with Type 1 Bipolar Disorder After Home Nursing Care: A Randomized Controlled Trial. Jundishapur Journal of Chronic Disease Care, 13(1). https://doi.org/10.5812/jjcdc-138664

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