Nursing Research

Nursing Research

Mood disorders as a management problem for a therapeutic nursing situation

Mood disorders are common psychiatric disorders presented by a number of patients. These disorders are associated with conditions such as depression, irritability and intense excitement that have considerable effect on therapeutic disease management strategies.  Individuals with a depression disorder are often sad, unmotivated, feel worthless, suicidal, may be unable to eat and sleep and have no interest in typical delightful activities. Some patients suffer from a bipolar disorder a condition that occurs when a person with depression experiences mania. Depression is mainly concurrent with other psychiatric diagnoses. Primarily, virtually all patients diagnosed with major depression disorders record histories of non-mood psychiatric disorders. The disorder is most prevalent in persons with chronic diseases or in prolonged hospitalization. Mood disorder challenges therapeutic interventions by interfering with the interaction of the patient and the nurse because it makes patient develop negative attitudes towards the caregiver. A therapeutic nurse-patient relationship is based on concepts of mutual trust, promoting faith and hope and helping the patient overcome physical, spiritual and emotional challenges. However, mood disorders create an environment that does not foster any of these principles. Consequently, studies have affirmed establishing knowledge about mood disorder is essential in building successful therapeutic strategies. A number of scholars have explored this problem and this paper examines various proposals towards the management of the mood disorder.

Annotated bibliography

Barry, J. J. (2003). The Recognition and Management of Mood Disorders as a Comorbidity of Epilepsy. Epilepsia (Series 4), 4430-40. doi:10.1046/j.1528-1157.44.s4.4.x

The authors of this article noted that mood disorders have a co-morbid manifestation in people with medical disorders and it presents severe health concerns to those with epilepsy. However, physicians have not identified affective disorders and appropriate treatment is rare. Consequently, the study reviewed assessment issues related with the management of mood disorders. This included examining the beneficial and destructive effects of antiepileptic drugs. Furthermore, the article discusses the treatment strategies by focusing on antidepressants in people with epilepsy in the aspect of safety and drugs interactions. The article proposes a strategy of utilizing electroconvulsive therapy in management of depressive disorders. However, the authors observe that although electroconvulsive provide an effective detection and treatment strategy, application of this knowledge in the management of mood disorders is still challenging.

Bajaj, P., & Tyrer, P., (2005). Managing mood disorders and comorbid personality disorders. Medscape; 18(1): 27-31

The article was aimed at evaluating the effect of personality disorder co-morbidity on common procedures of managing mood disorders. The examination identified that personality disorders affect management of mood disorders negatively. The article argues that accounting for personality features has the potential of reducing the negative outcome. Consequently, article supports the unique role of psychological and educational therapies in the management of various co-morbid disorders.

Baldwin, D. (2007). Instant wisdom: Mood and anxiety disorders. Hospital Doctor. Retrieved from http://search.proquest.com/docview/225255419?accountid=45049

Baldman argues that individuals can easily experience emotions, but few have adequate skills for assessing mood and anxiety disorders. The article gathered relevant secondary information in order to develop strategic practices that would improve physician’s skills for managing mood disorders. The article’s main recommendation emphasizes the significance of correct diagnosis in the management of these disorders. The scholar guides that physicians must be cautious when examining conditions that present mood disorder symptoms because various patients with bipolar disorder are often misdiagnosed.

Bowles, B., Coleman, N. & Jansen, L. (2012). Postpartum mood disorders:  The Nurses’ role in identification and intervention. World Psychiatry Association. Retrieved from http://faculty.mwsu.edu/nursing/laren.jansen/ppmdpaper.pdf.

The study focuses on the postpartum mood disorders. The scholars utilized a qualitative approach of research where they reviewed various scholarly articles, relevant publications and reports. The study suggests early screening and education as ultimate strategies for managing mood disorders. The study encourages the use of screening tools such as Zung Scale and Postpartum Depression Scale (PDS) in managing the problem. The article concludes that the objectives of these interventions can be accomplished through a communal effort where all stakeholders, families, physicians and communities participate activity in managing the problem of mood disorder.

Hede, A. (2010). The dynamics of mindfulness in managing emotions and stress. The Journal of Management Development, 29(1), 94-110. doi: http://dx.doi.org/10.1108/02621711011009090

The article had an aim of examining the concept of mindfulness in order to explain the how it may be extended from psychology into the management of mood disorders. Furthermore, the study targeted developing a new model for managing mood disorders by utilizing two types of mindfulness. The scholar believed that a model that utilizes concepts of “meta-mindfulness” and “supra-mindfulness” could improve strategies for managing emotional reactivity and in minimizing stress. The study approach assumed that “meta-self” plays a vital role in emotions management by utilizing meta-mindfulness to monitor one’s sub-selves that react with external world. The article describes strategies for testing the proposed schemes of psyche and dynamic mindfulness in stress management in future. The article recommends that therapeutics should utilize mindfulness strategies in avoiding emotional reactivity and managing stress.

Kims, G., & Linda, F., (2000). Management of bipolar disorder. American Family of Physician 15, 62(6):1343-1353.

The article indicates that bipolar disorder is a serious condition with high potential of interfering with the management of diseases. Consequently, the authors of this article conducted extensive literature review with the intention of developing strategic recommendation that could aid management of mood disorders. The article directs that individuals with acute mania should be examined urgently. The scholars argue that medication offers a strategic intervention of stabilizing bipolar disorder. This should include an initial package of treating mania using lithium or Depakene. Furthermore, the article highlights that care providers should use brupropion in depressed bipolar disorder patients.  The article emphasize that physicians should utilize a universal management plan that includes collaboration between patient’s family and psychiatrist in managing bipolar disorder.

Lepine, J., (2012). Mood disorders: management and treatment strategies for the 21st century. Medscape Education. Retrieved from http://www.medscape.org/viewarticle/549528

The article focuses on the relationship between somatic and psychic symptoms. The author argues that earlier clinical experience has focused on identification of psychic symptoms. However, the article notes that psychic symptoms are not primarily the main target when of the typical therapeutic strategy. The scholar reviewed various studies in order to develop succinct conclusions regarding management of the mood disorders. The scholar concluded that somatic symptoms present a trait of increased chances of measured depression. Furthermore, the article notes that somatic symptoms and depression manifest a common pharmacology that involves both noradrenergic and serotonergic transmission. Interestingly, the article proposes that care providers can use antidepressants in managing both depression and somatic symptoms successfully.

Markowitz, J. & Weissman, M. (2004). Interpersonal psychotherapy: principles and applications. World Psychiatry Association. 3(3): 136–139.

The article’s major aim included describing essential strategies and some operation principles of interpersonal psychotherapy (IPT). Examining IPT was essential because this model provides a time-limited and empirically approved treatment procedure for managing mood disorders. The study relied on secondary information. The scholars approve cognitive behavioral therapy (CBT) and IPT as the two major psychotherapeutic interventions for managing mood disorders. The article concludes that IPT is an effective psychotherapy diagnosis strategy that is well defined and has high efficiency. However, the scholar proposes that further studies should examine aspects such as the indication of the IPT strategy under diverse conditions, the optimal dosing and the possibility of combining the model with the pharmacotherapy strategies.

Pettinati, H. M., O’Brien, C. P., & Dundon, W. D. (2013). Current Status of Co-Occurring Mood and Substance Use Disorders: A New Therapeutic Target. American Journal Of Psychiatry, 170(1), 23-30.

The articles argue that although mood and substance use disorders co-occur, studies have not identified effective pharmacologic management for these disorders. The study reviewed accessible empirical findings including the modern clinical pharmacotherapy procedures for treating co-occurring disorders. The study identified that pharmacotherapy for managing mood attributes may be effective in clients with substance dependence. The scholars also described that the medication for managing mood signs did not have a significance effect on the substance use disorder. The article highlights that combination of treatment procedures is very effective in the management of depressive symptoms. However, the study proposes for the need of utilizing the newly available data in examining modern procedures in management of mood and substance use disorders.

Yonkers,K., & Vigod, S., & Ross, L. (2011) Diagnosis, pathophysiology, and management of mood disorders in pregnant and postpartum women. National Center of Biotechnology, l117(4):961-77. doi: 10.1097/AOG.0b013e31821187a7.

The article highlights that mood disorders have considerable effects on patients. This is because mood disorders particularly one that appear during pregnancy lead to complications such obstetric, maternal suicide, neonatal problems and infanticide. The study had the prime aim of examining important information on depressive diseases by concentrating in the prenatal period. The scholars focused on main depressive disorder and bipolar condition. The study utilized qualitative research approach in examining its variables. The research concluded that precise diagnosis of unipolar main depressive condition from bipolar disorder could enhance the selection of the most appropriate treatment alternatives. The scholars pointed out that counseling may be adequate for patients who have mild depression; however, patients with severe depression should receive antidepressants. The study warns that women with bipolar disorder have high chances of presenting deteriorated states in situations where mood stabilizer medication is withdrawn. Furthermore, the scholars guide that co-management of the care of these patients with psychiatrists has the potential of reducing a recurrence of illness.

Discuss whether the researchers present a case for the efficacy of a specified therapeutic approach.

The review of various studies indicates that researchers tend to present a case for the efficacy of a therapeutic approach that prioritizes the concepts of accurate diagnosis and a communal effort in managing the condition. Various studies have argued that the major problem associated with the management of mood disorders include poor or misinformed diagnosis that leads to adoption of wrong interventions. A strong observation made by various researchers indicates correct diagnosis that includes earlier detection of the condition would provide nurses with the opportunity of adopting appropriate interventions. Furthermore, most researchers emphasize that joint interventions that incorporate various stakeholders and diverse procedures provide the ultimate therapeutic approach of managing mood disorders. This is because mood disorders present diverse implications and conditions that can hardly be managed using a single set or strategy. For example, researchers identify that at some stages of depression would better be managed using medications while other levels need different interventions. Moreover, combined effort becomes essential because of the sophisticated nature of moods disorders.

Identify whether the researchers chose tools that were similar or different

The researchers selected different tools in exploring the subject. Researchers chose tools that they believed would enable them attain the best results. Consequently, each study presents a unique design and strategy for examining its variables and making deductions. The selection of the tools to be utilized on the study is influenced by consideration of factors such as the type of study, the information that needs to be accessed, analysis to be conducted on the accessible data and the available resources among others. Utilizing studies that are based on various tools provides the learner with the opportunity of examining the subject from diverse perspectives.

Discuss whether you believe the tools the researchers chose could have affected their results

I strongly believe that the tools selected by the researchers have high potential of affecting their results. Research tools delineate the boundaries of the study because the evaluating must fall within the capacity of the available tools. Consequently, research tools will define attributes such as the type and the amount of data to be evaluated, the procedure of developing conclusions and the precision of the research. All these aspects are capable of affecting the study’s results. For example, examination of small amount of data may lead to partial examination of essential variables that may limit findings. In contrast, utilization of effective tools or the tool with high capability may have a constructive effect on the results. This affirms the need of reviewing research tools when evaluating the feasibility of a particular study.

An evidence summary of the articles

The articles examined in this paper assume various research approaches in evaluating the subject. Most of the articles have utilized qualitative methodologies in collecting and evaluating the topic. Primarily, the articles are organized in scientific manner and have utilized standard and reliable tools in conducting analysis. The researchers have great knowledge of drafting and presenting research work as exemplified in their professional way of organizing their findings and arguments. Furthermore, the authors of these articles have knowledge about major concerns in the management of mood disorders. The articles present diverse conclusions and recommendations for effective strategies of managing the condition. These include the proposal for the use of medication, education, special practices like understanding patient’s personality and utilizing unique concepts such as “mindfulness” in managing the problem. The major criteria used in developing articles include designing them according to the study’s aim. Furthermore, most scholars have established their studies by identifying gaps that were left by earlier scholars.

Recommendation of a specific nursing strategy

Emphasizing correct diagnosis and educational strategies would provide an effective nursing strategy for addressing the problem of mood disorders. Appropriate diagnosis includes the concept of utilizing effective screening tools that would enhance early detection. Strategic tools that would improve physician’s knowledge of diagnosing the condition appropriately should accompany this procedure. Consequently, education interventions should target all relevant stakeholders and explore diverse concerns experienced in the management of mood disorders. Considering the significance of combined approach in the management of these disorders, educational interventions should empowers stakeholders such as the health care providers and the patient’s family. This becomes essential because stakeholders who have knowledge of the condition and the available therapeutic strategies are capable of managing the disorder accordingly.

Importance of using a theoretical model for nursing research

Utilizing a theoretical mode for nursing research is important because the strategy provides principles that underline practice and help in creating further nursing knowledge. However, disagreements in the professional literature on nursing theory bring confusion.  Theoretical mode can enable patient managers identify unique role of nurses in the healthcare procedures. Furthermore, health professionals utilize theoretical mode in organizing their care procedures and in developing informed disease management strategies that are feasible. This happens when professional puts theoretical knowledge into practice. Theoretical mode for nursing ensures that researchers are utilizing appropriate approach when designing their studies. Moreover, the mode ensures that healthcare professionals are using the best available strategies in managing health challenges.

References

Bajaj, P., & Tyrer, P. (2005). Managing mood disorders and comorbid personality disorders. Medscape; 18(1): 27-31

Baldwin, D. (2007). Instant wisdom: Mood and anxiety disorders. Hospital Doctor. Retrieved from http://search.proquest.com/docview/225255419?accountid=45049

Barry, J. J. (2003). The Recognition and Management of Mood Disorders as a Comorbidity ofEpilepsy. Epilepsia (Series 4), 4430-40. doi:10.1046/j.1528-1157.44.s4.4.x

Bowles, B., Coleman, N. & Jansen, L. (2012). Postpartum mood disorders:  The Nurses’ role in identification and intervention. World Psychiatry Association. Retrieved from http://faculty.mwsu.edu/nursing/laren.jansen/ppmdpaper.pdf.

Hede, A. (2010). The dynamics of mindfulness in managing emotions and stress. The Journal of Management Development, 29(1), 94-110. doi: http://dx.doi.org/10.1108/02621711011009090

Kims, G., & Linda, F., (2000). Management of bipolar disorder. American Family of Physician 15, 62(6):1343-1353.

Lepine, J., (2012). Mood disorders: management and treatment strategies for the 21st century. Medscape Education. Retrieved from http://www.medscape.org/viewarticle/549528

Markowitz, J. & Weissman, M. (2004). Interpersonal psychotherapy: principles and applications. World Psychiatry Association. 3(3): 136–139.

Pettinati, H. M., O’Brien, C. P., & Dundon, W. D. (2013). Current Status of Co-Occurring Mood and Substance Use Disorders: A New Therapeutic Target. American Journal Of Psychiatry, 170(1), 23-30.

Yonkers,K., & Vigod, S., & Ross, L. (2011). Diagnosis, Pathophysiology, and management of mood disorders in pregnant and postpartum women. National Center of Biotechnology, l117(4):961-77. doi: 10.1097/AOG.0b013e31821187a7.