الفهرس | Only 14 pages are availabe for public view |
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. Bipolar disorder can be challenging to diagnose and manage. It is often assumed to be recurrent major depression, until an episode of mania/hypomania occurs and the diagnosis of bipolar disorder is confirmed. Bipolar disorder is characterized by extreme mood swings – from hopeless depression to euphoric or irritable mania – with each episode usually bookended by symptom free periods referred to as euthymia. 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 costs of hospitalization and medications, and indirect costs such as productivity loss, and burden on family and care givers. The disease produces a range of unpleasant and debilitating symptoms, which can have a profound impact including disrupting activities of daily living, employment, income, relationships, social and leisure activities, and life goals, which are known to influence quality of life. BD patients have markedly lower quality of life than the general population.Thus, adjusting to the illness is therefore particularly challenging, given the evidence that psychoeducation (psychosocial nursing intervention) is a structured intervention focused on achieving improvement in mental health and psychosocial aspects of chronic health conditions. Aim of the study: The aim of this study was to assess the effect of quality of life among patients with bipolar disorder. Subject and setting: The study was conducted in the outpatient clinic of the Institute of Psychiatry at Ain Shams University. A descriptive explorative study design was used to accomplish the aim of the study. The subjects were 100 cases of BD who met the following criteria during the study period: age between 18 and 50 years old, from both sexes, all education levels, had a definite diagnosis of BD ”of any type” , agreed to participate in the study, free from any psychiatric disorders except bipolar disorder, and had no medical disorders. Data collection tools: Data were collected using interviewing questionnaire containing the following parts: socio-demographic sheet, detailed history of illness, and drug attitude inventory (DAI- 30). As well as, using World Health Organization Quality of Life – BREF questionnaire (WHOQOL- BREF, 26 items), it provides a quality of life measure to BD.Fieldwork: A pilot study was carried out on 10 cases. The fieldwork lasted from the beginning of November 2015 to the mid of April 2016. The main findings of this study showed that: 1- There were more than half of the sample fell at age group between 25-31oyears old; and nearly half of the sample was divorced. Regarding residence, three fifths of the sample lived in urban areas, as well as more than two thirds of the sample had finished secondary education, but only (5%) of the sample was illiterate. In addition, three quarters of the studied sample were unemployed, as well three fifths of the sample had not enough monthly income, and the highest percentage of the sample suffered from the high cost of the treatment & transportation. 2- There were less than three quarters of the sample had gradual onset of the symptoms; and less than three fifths had weekly duration of these symptoms. Less than three fifths of the sample had predisposing factors during the episode, while the majority of the sample had increase in the intensity of symptoms. Regards the psychiatric illness in their family, the highest percentage of the sample was without psychiatric illness in family members but only (10%) had psychiatric illness in family members. 3- The highest percentage of the sample had poor quality of life regarding the overall QOL and general health domain, and less than three quarters of them had adequate level as regards the physical health domain, and nearly half of them had poor scores regarding psychological the psychological domain. As regards the social relationship domain, half of them had average scores, and the majority of them had average scores in the environment domain. 4- Less than three quarters of the study sample had positive attitude towards drugs, while more than one quarter of the subject had a negative attitude towards it. 5- There was a highly statistically significant relation between the educational level, marital status, age, and gender as regards the overall QOL & general health domain, and physical health domain among patients with bipolar disorder. 6- There was a highly statistically relation between age, gender, educational level, and monthly income as regard psychological domain and social relationship domain among patients with BD. 7- There was a highly statistically significant relation between age, gender and educational level with the environment domain among patients with BD. 8- There was a highly statistically significant relation between gender, age, adequacy of monthly income, and suffering from the cost of treatment as regards the drug attitude inventory.It is concluded that the QOL of bipolar patients is poor in the overall QOL and psychological domain regarding bipolar disorder. |