Nursing Children and Adolescents With Bipolar Disorder: Assessment, Diagnosis, Treatment, and Management

Abstract

TOPIC: The role of the mental health nurse in the assessment, diagnosis, treatment, and management of children and adolescents with bipolar disorder in community and hospital settings. PURPOSE: In many areas of clinical practice, mental health nurses have more contact with service users than any other professional group. They are therefore well placed to support children and adolescents with bipolar disorder during first contact with primary care services, through engagement with specialist mental health services, and in accessing early intervention and crisis services. This paper summarizes the contribution that child and adolescent mental health nurses make to the care of children and adolescents with bipolar disorder. SOURCES: This paper is based on evidence from systematic reviews; meta‐analyses and best practice evidence from CINAHL; EMBASE; MEDLINE, PsychINFO; Cochrane Collaboration; National Institute for Health and Clinical Excellence; National Collaborating Centre for Mental Health; NHS Centre for Reviews and Dissemination; Oxford Centre for Evidence Based Medicine; United States Agency for Healthcare Research and Quality. CONCLUSIONS: Child and adolescent mental health nurses work with children and adolescents who have bipolar disorder in a range of settings. These include community mental health services, hospitals, and schools. Due to the multidisciplinary nature of the treatment and management of bipolar disorder during childhood and adolescence, nurses have a major role to play in providing frontline assessment services, monitoring treatment, and delivering psychosocial interventions.

The applicability of the nursing process in caring for psychiatric patients: an integrative review

“…Nurses play a fundamental role in planning care, one of the NP stages, as well as involving the family in drawing up care plans, this being a mode of intervention through educational and informative activities about the mental illness of their family member (19,30) , the changes in the mental health care model have a place for family participation in the recovery process of the mentally ill family member (30) . Still on the topic of developing the care plan, the studies show that when drawn up in participation with the patient, their needs and mental health problems are considered in an individualized and comprehensive way, as they are better drawn up by the nurse, these being the ones who spend the most time with the patient, as well as exchanging information on actions undertaken in the last 24 hours within the nursing team, this helps with planning and guiding nursing team activity (19,21,28) . Finally, the NP appears in the context of the new model of mental health care, so as to qualify the care delivered.…”

“…One of the literature reviews, in addition to demonstrating the development of the NP stages in nursing care for children and adolescents with bipolar disorder, emphasized the need for nurses to constantly evaluate these patients, due to occurrence of comorbidities and the fact that this disorder affects different aspects of their life, as well as including family members in the process of developing a care plan for these patients (19) . Nurses play a fundamental role in planning care, one of the NP stages, as well as involving the family in drawing up care plans, this being a mode of intervention through educational and informative activities about the mental illness of their family member (19,30) , the changes in the mental health care model have a place for family participation in the recovery process of the mentally ill family member (30) .…”

“…One of the literature reviews, in addition to demonstrating the development of the NP stages in nursing care for children and adolescents with bipolar disorder, emphasized the need for nurses to constantly evaluate these patients, due to occurrence of comorbidities and the fact that this disorder affects different aspects of their life, as well as including family members in the process of developing a care plan for these patients (19) . Nurses play a fundamental role in planning care, one of the NP stages, as well as involving the family in drawing up care plans, this being a mode of intervention through educational and informative activities about the mental illness of their family member (19,30) , the changes in the mental health care model have a place for family participation in the recovery process of the mentally ill family member (30) . Still on the topic of developing the care plan, the studies show that when drawn up in participation with the patient, their needs and mental health problems are considered in an individualized and comprehensive way, as they are better drawn up by the nurse, these being the ones who spend the most time with the patient, as well as exchanging information on actions undertaken in the last 24 hours within the nursing team, this helps with planning and guiding nursing team activity (19,21,28) .…”

“…Thus, one of the studies analyzed showed that the nurse in a care home, a communitybased service, used the NP in the treatment of one of the residents with a long-standing mental disorder, resulting in an improvement in the clinical status (14) , in this way, in the context of psychiatric nursing care, the focus of the NP is aimed a goals and based on a decision-making or problem resolving model that aims to improve patients' response to health problems and, in the patient in question, the goal was to better deal with their psychological suffering (5,14,28) . Another aspect to be considered in caring for patients with mental illness is adherence to treatment, defined as the degree to which patients adopt the health care professional's recommendations (6) , s two of the studies indicated that applying Irving's NP enabled two patients with mental disorders to adhere to treatment (15,19) , as it strengthened the treatment relationship between the nurse and the patient through developing the stages of the NP together, the linked between the subject and the nursing professional grew much closer (5) . At the same time, the NO contributes to constructing the treatment project as it enables the subjects' needs and responses to the health problems to be known, encouraging the drawing up of an individualized nursing care plan (5) .…”

“…Likewise, another of the studies, consisting of a systematic review, dealt with nursing care for children and adolescents with bipolar disorder, indicating that setting up a history of the patient's mood swings, evaluating and identifying signs and symptoms, developing a plan to deal with crisis and nursing interventions, showing the application of different stages of the NP in the context of psychiatric nursing care (19,28) . Moreover, the studies show that a formal record of applying the NP was made, summarizing the data collected about the patient and their family, as well as interaction with the collective, at a specific moment in the subject's health-illness process, which will serve to guide the patient's treatment as well as proving the NP has been carried out (6) .…”