Paper
Saturday, November 3, 2007
64
Self-Reported Needs for Care of Outpatients with a Bipolar Disorder in the Netherlands
P. J. J. Goossens, RN, MSN, Expertise Centre for Bipolar Disorders, Adhesie GGZ Midden-Overijssel, Deventer, Netherlands, Elise A. M. Knoppert van der Klein, MD, PhD, GGZ Rijnstreek, Rivierduinen Mental Health Leiden, Alphen aan den Rijn, Netherlands, and Theo Van Achterberg, PhD, RN, Centre for Quality of Care Research, Nursing Science Section, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.
| Learning Objective #1: understand the importance of needs assesment in the nursing processes |
| Learning Objective #2: gather information about needs assesment methodologies |
Bipolar disorder is a chronic psychiatric condition characterized by the alternating occurrence of (hypo)manic and depressive episodes. Bipolar disorder has a considerable degree of illness related morbidity and imposes a significant impact on patients’ social, occupational, and general functioning and wellbeing. The illness impacts quality of life (QoL). QoL impairments are comparable to or greater than those with other chronic nonmental disorders. Among the psychiatric disorders, ratings of QoL are similar to those with depression but higher than those with schizophrenia. Impairments continue in bipolar patients even when they are in a stable euthymic mood state. A strong predictor of lower QoL is the existence of unmet needs for care. No studies have examined the needs for care (NfC) of patients with a bipolar disorder. This study describes received care, NfC and unmet needs in a population of outpatients with a bipolar disorder recruited in five outpatient clinics in the Netherlands. Participants (n=157) completed a questionnaire regarding demographical and clinical characteristics and the Needs for Care Questionnaire (NCQ). Results indicate that NfC are mainly found in the domains of psychological help, psychiatric help and within the domain of social needs. Unmet needs in all domains are reported frequently. It is possible that NfC remain unmet because little attention is given to the assement of NfC. A point for improvement is to incorporate the assessment of NfC into the treatment processes. Identification of NfC using standardized questionnaires can be of great value. According to the results of this assessment, the involvement of the Community Psychiatric Nurse (CPN) can be more suited to the NfC of the patient. CPN’s should regularly evaluate the status of these NfC. The results of repeated measures during the treatment process with the aforementioned questionnaires can be used as an outcome indicator for the quality of care.