Abstract
Background. Bipolar disorder is a chronic condition that requires lifelong self-care. Many personal experiences are obtained in self-care. Therefore, gathering and utilizing these experiences is crucial for managing the condition effectively. This qualitative study explores the perspective of stakeholders on personal knowledge management in the context of bipolar disorder.
Methods. The current qualitative study was conducted in 2024 in Tabriz. First, semi-structured interviews were carried out with patients diagnosed with bipolar disorder, their families, and healthcare staff working in psychiatric departments to identify self-care experiences. The content analysis approach and MAXQDA software version 2020 were used for data analysis. Then, the Delphi technique was employed to assess the level of agreement among experts regarding the indicators of personal knowledge management for self-care among patients with bipolar disorder.
Results. By coding the interview transcripts, seven themes and 24 categories were identified. Two of these themes pertained to patients, including: 1) educational strategies for patients and their families, and 2) strategies for enhancing patients' engagement in the treatment process. Additionally, five themes related to healthcare providers were identifies: 1) attention to the privacy of service recipients, 2) barriers to self-care knowledge management, 3) essential input for self-care knowledge management, 4) processes for managing patients' personal experiences and 5) education in information technology. In the second stage, 41 out of 65 codes received an average score above 7.5 in the first round of Delphi process, while the remaining codes proceeded to the second round. According to the results of the second round, only seven codes achieved an agreement above 0.6. The remaining codes were removed due to having an agreement below 0.6.
Conclusion. According to the results, providing face-to-face training to patients with bipolar disorder and their families can enhance patients’ self-care practices. Also, sharing reliable experiences among patients via social media can enhance self-care behaviors. In addition to providing education, fostering the positive attitude among patients and their families toward the impact of sharing experiences can lead to effective behavioral changes.
Extended Abstract
Background
Bipolar disorder is a chronic condition that requires ongoing medication or other treatment approaches throughout a person’s life. Therefore, patients must be able to manage their self-care effectively. There are numerous personal experiences in self-care associated with self-care, and collecting and utilizing these personal experiences can play a crucial role in managing chronic diseases. Families of patients with bipolar disorder may face various challenges related to sleep management, stress, interpersonal relationships, and anger. These experiences are frequently overlooked or not explored. For the first time, this qualitative study presents the perspectives of stakeholders on personal knowledge management in the context of bipolar disorder.
Methods
The current research was a qualitative study conducted at Tabriz University of Medical Sciences in 2024. To achieve the study’s objectives, the research was carried out in two steps: 1) to identify the self-care experiences of patients with bipolar disorder, and 2) to assess the level of agreement among experts regarding the indicators of self-care and knowledge management of these patients.
In the first step, to determine the self-care experiences of patients with bipolar disorder, semi-structured interviews were conducted with patients, their families, and healthcare staff working in psychiatric departments who were involved in the care and treatment of these patients. The diagnosis of bipolar disorder in patients was made one year prior by a psychiatrist during hospitalization. The inclusion criteria were patients 1) who had at least one hospitalization, 2) diagnosed with bipolar disorder at least one year ago, 3) were clinically stable in terms of symptoms, and 4) had at least one caregiver at home. Exclusion criteria included unwillingness to continue participating in the study. The interview questions were based on a guide questionnaire and the process was directed according to the participants’ responses. The interviews were conducted to elicit the genuine and in-depth experiences of patients and their families in relation to the main research question. The interviews continued until the responses reached saturation. At the end of each interview, any ambiguous points noted during the conversation were clarified by asking the participant follow-up questions to ensure all aspects were clear. In addition to taking notes, the interviews were recorded to ensure that all responses were accurately documented. Finally, the recorded answers were classified and coded by the researcher. MAXQDA version 2020 software was used for data analysis in this study. In the second step of study, the Delphi technique was employed to assess the level of agreement among experts regarding the indicators of self-care and knowledge management for patients with bipolar disorder.
Results
The research participants included 12 patients and 13 healthcare staff working in psychiatric departments. Through coding the interview transcripts using content analysis approach, seven themes and 24 main categories were identified. Out of the seven themes identified, two emerged from interviews with patients: 1) strategies for educating patients and their families (three main categories), and 2) strategies for enhancing patients' agency in the treatment process (two main categories). Additionally, five themes emerged from interviews with healthcare providers: 1) attention to the privacy of service recipients (three main categories), 2) barriers to self-care knowledge management (four main categories), 3) essential input for self-care knowledge management (four main categories), 4) processes for managing patients' personal experiences (four main categories), and 5) education in information technology (four main categories). In the second stage, the first round Delphi questionnaire, consisting of 65 codes extracted from the previous stages, was distributed to the panel members in person. The panel members scored each code on a scale from 1 to 10 . According to the results of the first round of the Delphi process, 41 out of 65 codes received an average score above 7.5. The remaining codes which scored between 4 and 5.7, proceeded to the second round. In the second round, a questionnaire containing these 24 codes was distributed to the panel members, who then scored each code on a scale from 1 to 10. After collecting the responses, the agreement between the scores from the first and second round of Delphi results for each of the 24 codes was calculated using Cronbach's alpha. According to the results of the second round, only 7 codes achieved an agreement level above 0.6. The remaining codes were removed due to having an agreement level below 0.6.
Conclusion
According to the results, providing face-to-face training to patients with bipolar disorder and their families can enhance patients’ self-care. Additionally, sharing reliable experiences among patients via social media can further improve self-care behaviors. In addition to providing education, fostering a positive attitude among patients and their families toward the impact of sharing experiences can lead to effective behavioral changes in these patients. Considering strategies such as enhancing internal and external cooperation, along with facilitators such as strengthening internet and communication infrastructure within the healthcare system, can improve the self-care behaviors of bipolar patients and ultimately enhancing their quality of life.
Practical Implications
Applying experiences related to personal self-care knowledge management in people with bipolar disorder can be a step towards designing and presenting a model to show the stages of the knowledge management pattern among patients with bipolar disorder. It can also improve self-care behaviors in these patients and lead to an improvement in their quality of life.