The Effect of Telenursing on Functionality and Treatment Adherence in Bipolar Disorder

The Effect of Telenursing Counseling on Functioning and Treatment Adherence Levels in Individuals With Bipolar Disorder

This research is a randomized controlled experimental study with a pretest-posttest design, conducted to determine the effect of telenursing counseling on functionality and treatment adherence levels in patients with bipolar disorder.

First, patients followed up with a diagnosis of bipolar disorder at the Community Mental Health Center (CMHC) were evaluated by the researcher through face-to-face interviews in terms of the inclusion criteria. Patients who met the criteria and voluntarily agreed to participate in the study were informed about the research, and their written informed consent was obtained. Subsequently, the participants were assigned to the experimental and control groups by an independent faculty member using a stratified block randomization method. Following the randomization process, a nurse working at the Community Mental Health Center administered the Descriptive Information Form, the Short Functioning Assessment Scale, and the Morisky Medication Adherence Scale to both groups face-to-face as a pretest.

After the baseline measurements, an eight-week telenursing counseling intervention was implemented with the patients in the experimental group. No intervention was provided to the control group; they only received standard treatment and care services. At the end of the eight-week period, the same nurse working at the CMHC administered the SFAS and MMAS scales again, and the posttest measurements were obtained.

Inclusion Criteria:

• Having received a diagnosis of bipolar disorder (Type I/II) at least one year ago according to the diagnostic criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR),
• Being followed up at the Community Mental Health Center (CMHC) for at least one year,
• Having a Morisky Medication Adherence Scale score of ≥ 1,
• Having at least a primary school education,
• Owning a mobile phone and having no visual and/or hearing impairment related to calling/messaging use,
• Voluntarily agreeing to participate in the research.

Exclusion Criteria:

• Presence of an acute mood episode,
• Presence of a comorbid mental disorder (e.g., severe personality disorder, substance use disorder),
• Being unable to continue tele-intervention due to a serious physical illness (e.g., cancer, heart failure) and/or cognitive impairment (e.g., loss of intellectual capacity, neurocognitive disorder),
• Presence of conditions that make tele-access impossible,
• Concurrent participation in another psychoeducation or tele-intervention program with similar content.