A Qualitative Study of Nursing Care for Hospitalized Patients with Acute Mania

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Abstract

Patients with a bipolar disorder and currently experiencing acute mania often require hospitalization. We explored patient problems, desired patient outcomes, and nursing interventions by individually interviewing 22 nurses. Qualitative content analysis gave a top five of patients problems, desired patient outcomes and nursing interventions, identified as most important in the interviews. We then conducted three focus group meetings to gain greater insight into these results. Intensive nursing care is needed, fine-tuning on the patient as a unique person is essential, taking into account the nature and severity of the manic symptoms of the patient.

Section snippets

Methods

A qualitative research methodology was selected to map the experiences of the nurses in our study (Holloway & Wheeler, 2002). Semi-structured interviews were first conducted with the individual nurses. Focus group meetings were then held to deepen our understanding of the interview results. According to Dutch legislation, formal approval of the ethics of the study was not needed from the Netherlands Central Committee on Research Involving Human Subjects (www.ccmo.nl). However, the Scientific

Results

The individual interviews were held with a total of 22 nurses: twelve female and ten male. The nurses ranged in age from 24 to 53 years with a mean of six and a half years (SD: 4.2) of nursing experience on the ward where they currently worked. The nurses had all been trained to care for patients with different types of psychiatric disorders and were thus generalists.

Three focus group meetings were organized in different parts of the Netherlands. All of the nurses were invited to attend the

Discussion

The lists of identified patient problems and relevant nursing interventions are relatively long compared to the list of desired patient outcomes (see Table 2). The most frequently mentioned patient problems were disturbed day–night rhythm, agitation, no insight in the disease, verbal aggression, and too much physical activity. The top five identified nursing interventions correspond to these patient problems: limit setting, motivation to take medication, adequate administration of medication,

Conclusion

According to nurses, hospitalized patients in an acute manic mood state require intensive nursing care and, as a core part of this, the setting of limits in order to reduce ongoing restlessness and agitation, which are also reflected in the communication with other people (family, professionals and other patients). Motivating the patient to take medication as prescribed, helping the patient establish an adequate day–night rhythm, and supportive communication are also important nursing

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