الفهرس 
Overview about bipolar DisorderOnly 14 pages are availabe for public view
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Abstract
Bipolar disorder is a common, chronic and lifelong disorder characterized by recurrent episodes of mania or hypomania and depression which causes grave and debilitating consequences for its sufferers.
WHO ranks bipolar disorder collectively as the 6th most common moderately to severely disabling condition in the world for any age group. It has been associated with direct costs such as the cost of hospitalization, medications, and indirect cost such as productivity loss and burden on family caregivers.
Therefore, the burden among caregivers encompasses physical, psychological, emotional, social, and financial difficulties that family caregivers face because of taking care of responsibility for people with BD.
The nurse play significant role in improving quality of the family- patient relationship. As well as, a nurse can be a competent care provider for a bipolar patient, an instructor for the family caregiver, and counselor of the people about bipolar disorder.
Aim of the study:
This study aimed to assess burden and coping patterns among family caregivers of patients with bipolar disorder.
Research Question:-
This study is based on answering the following question:
1. What is the burden experienced by family caregivers of patients with bipolar disorder?
2. What are coping patterns adopted by family caregivers of patients with bipolar disorder?
3. What are the relationships between burden and coping patterns among caregivers of patients with bipolar disorder?
Subjects and Methods:
The study will be portrayed under four main designs as following:
Technical design:
The technical design includes research design, setting, subjects and tools of data collection.
A-Research design:
A descriptive relational design was used in this study to assess the burden and coping patterns among family caregivers of patients with bipolar disorder.
B-Setting:
This study was conducted in the outpatient clinic of the Institute of Psychiatry affiliated to Ain Shams University.
C-Subjects of the study:
The subjects of this study included 140 family caregivers of patients with bipolar disorder attending follow-up outpatient clinic of the Institute of Psychiatry at Ain Shams University in the previously mentioned setting and who were available at the time of study, fulfilled the following inclusion criteria:
Inclusion criteria for the patient:
• Age: 18 - 40 years old (adult age).
• Gender: males and females.
• Diagnosed case of bipolar disorder for at least one year.
• Without any co-morbid psychiatric disorder.
• Patient adhered to treatment plan for the last 6 months.
Inclusion criteria for the caregiver:
• Age: adult caregiver who are closely related and directly involved in the care of patients with bipolar disorder for at least one year.
• Patient who didn’t live independently, caregiver was the major person responsible for the patient well-being, bearers and stay within the same home.
• Gender: males and females.
• Educational level: all educational levels and different socioeconomic status.
• Free from any psychiatric illness.
• Not responsible for caregiving of other patient in the family.
Tools of data collection:
1. Interviewing questionnaire was designed by the researcher after reviewing related literature regarding bipolar disorder and included three parts as the following:
a. First part: Socio-demographic sheet for patient and caregiver: (Appendix I)
It was designed to assess socio demographic data of both family caregivers and patient with bipolar disorder and it divided into:-
-Patient’s socio-demographic data: included code Number, age, gender, marital status, residence, educational level, employment, commitment in employment, adequacy of monthly income, and living condition.
-Caregiver socio-demographic data: included code Number, age, gender, relation to patient, marital status, residence, educational level, employment, adequacy of monthly income and type of chronic diseases if present.
b. The second part: History of illness regarding BD: (Appendix II)
It included duration of illness, duration of treatment, type of treatment, degree in carry out the activity of daily living and things that help him\her in the care of the patient.
c. The third part: Knowledge about BD: (Appendix III)
Designed by the researcher to assess knowledge of caregiver about bipolar disorder, it include: definition, signs and symptoms, causes and methods of treatment.
2. Burden assessment schedule (BAS): (Appendix IV)
Burden assessment schedule is an instrument developed by Thara et al., 1998 to assess objective and subjective burden experienced by the caregivers of chronic mental ill patients using the process of stepwise ethnographic exploration. It has a total of 40 items scale measuring 9 different areas of objective and subjective caregiver burden such as spouse related, physical and mental health, external support, caregiver’s routines, support of patient, taking responsibility, socialization, patient’s behavior, and caregiver’s strategy.
3. Coping strategies inventory (CSI): (Appendix IIV)
This questionnaire was designed by David L. Tobin, (2001), and modified by the researcher; it designed to assess thought and behavior of the people used to handle the internal or external demands of a specific stressful event. The scale has 26 items self-report questionnaire, where each item is rated on a 3-point likert scale ”rare, sometimes and always”. The respondents indicated for each item the extent to which they performed that particular coping response in dealing with the previously described situation.
The findings of the study can be summarized in the followings:
1- There were more than two fifths of the studied caregivers’ age ranged from 36 ≤ 50 years. As regard to gender and marital status, more than three quarters and less than three quarters of them were female and married. In relation to the educational level of the caregivers under the study, less than two fifths of them were illiterate. Also, slightly more than two thirds of them were employed and the majority of them their monthly incomes were not enough respectively.
2- There were more than two thirds of the studied caregivers had satisfactory level of total knowledge about bipolar affective disorder. While, around one third of them had unsatisfactory level.
3- There were less than half of the studied caregivers had severe level of total burden. Also, about one third of them had moderate level of total burden. While, one quarter of them had mild level of total burden.
4- There was three fifths of the studied caregivers used low engagement coping. While, two fifths of them used high engagement coping. Also, more than half of them used high disengagement coping. While, more than two fifths of them had used low disengagement coping.
5- There were highly significant positive correlation between caregivers’ knowledge and their coping patterns. As well, there was a highly significant negative correlation between caregivers’ knowledge and their burden levels. Also, there were highly significant negative correlation between caregivers’ coping patterns and their burden levels.
Conclusion
The result of the present study concluded that, Less than half of the studied caregivers had severe level of burden; about one third of them had moderate level of burden, while, one quarter of them had mild level of burden. Regarding coping patterns, three fifths of the studied caregivers used low engagement coping and more than half of them used high disengagement coping. There were highly significant negative correlation between caregivers’ coping patterns and their burden levels.
Recommendations
Based on the findings of the study, the following recommendations are suggested:
For caregivers and patients:
• Development of psycho-educational supportive program for family caregivers of patients with BD to reduce their burden and improve coping patterns to deal with stress resulting in caring of their patients with bipolar disorder.
• Establishment of counseling program for patients with mental illness and their caregivers including BD to improve their psychological well-being.
For nurses:
• Development of psycho-educational program for psychiatric mental health nurse to provide psychosocial support throughout their routine work at health care setting.