Outcome Selection and Variance Analysis

      In order to care for a child with bipolar disorder, nurses must take into consideration the caregivers or family members affected by the mental illness. The caregivers may not be familiar with bipolar disorder and therefore must be educated on the disease process and treatments. Additionally, they may be concerned about who to turn to for emotional support and nurses can inform them of local support groups and counseling opportunities. Nurses must aid caregivers in assisting his or her loved one and help them stay “emotionally connected with the ill child, retaining a sense of self and hope, and finding a way through the elaborate systems of care and treatment regimes” (Doornbos, 2002; Nelson, 2002; Rose, Mallinson, & Gerson, 2006; Saunders, 2003, as cited in Wade, 2006, p.886-887). The nursing expected outcome for primary caregivers of children with bipolar disorder is that they will understand bipolar disorder and receive both education and support in caring for their child.

      There are variances that hinder a successful completion of the nursing expected outcome. The first variance is that primary caregivers are unable to provide appropriate care for their child with bipolar disorder due the burden that the extensive care of the child creates on the family and the caregiver as they struggle to manage their own personal lives. This variance is care related, for the family has to juggle care for their child and their own lives. Having a child with bipolar disorder can be difficult on a family due to financial expenses, limited outside activity involvement, and exhausted caregivers (Rose, Mallison, & Gerson, 2006). One caregiver in a study by Wade (2006) explains how erratic and time consuming the illness can be. The participant states “it seems like it’s a matter of adjusting all the time, every day, hour to hour, you know, minute to minute” (Wade, p.892). Caring for a child’s unpredictable behavior consumes the caregiver’s entire day and therefore affects his or her personal life. Being the primary caregiver is an overwhelming and taxing challenge that can cause caregivers to lose a part of themselves (Wade). It is a challenge to discover a way to provide the upmost care for their child, while maintaining a healthy and enriching environment for all family members.

      The second variance is that primary caregivers and families are often intimidated, afraid, and disturbed by bipolar disorder and the stigmas associated with it. This variance is care and client related. It is care related since it focuses on the appropriate care of the child. The variance is also client related since the disease the client suffers from is discussed in detail. Bipolar disorder often displays random irritable mood swings in which parents to feel like they are “walking on egg shells” trying to avoid a sudden outburst (Apps et al., 2008, p.85). Caregivers become concerned about their children’s future and typical phases of development. They often worry if they will ever do well in school, have relationships, or have their own identity (Morris, Miklowitz, & Waxmonsky, 2007). Wade (2006) concluded that fear was a common theme among caregivers. They are fearful for the protection of their child and others, afraid that professionals will neglect their child, and uneasy about what their child’s future entails (Wade). It is common for families, especially in small communities, to feel ashamed about having a child with a mental illness and believe that others think they should be able to handle this problem themselves (Rose et al., 2006). The media’s negative portrayal of mental illness displayed by stories involving violence and murder creates a harmful stigma of family members and patients themselves (Rose et al.). Caregivers deeply struggle with the reactions of others to their child as well as the fears associated with the disease itself, both feelings directly hinder their care.

<< Previous    1  [2]  3  4  5    Next >>