Theoretical and scientific foundations of nursing

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Application of Middle Range Theories to the Care of Individuals with Bipolar

Bipolar disorder, initially referred to as manic depression, is a mental health illness whereby individuals exhibit extreme mood swings, including emotional highs (mania or hypomania) and lows (depression). The condition can severely impact an individual’s daily life; however, the effects vary between individuals. The Nation Alliance of Mental Illness reported that over 10 million Americans have bipolar, accounting for 2.8% of the population (McIntyre et al., 2020).

Middle range theories play an instrumental role in nursing, improving practice and quality of life. Several middle range nursing theories can be applied to the care of individuals with bipola. The theories offer nurses a framework for understanding and addressing the complex needs of these individuals. The self-regulation model, developed by Pender, Murdaugh, And Parsons, is an effective theory. Also known as the health promotion model, the theory describes health as a state characterized by positive dynamics instead only the absence of illness (Younas & Quennell, 2019). The health promotion model aims to enhance the overall well-being of individuals, which is why it is effective in helping individuals manage bipolar. The model notes the multifaceted character of individuals as they interact with their environments to achieve health.

Pender’s model is categorized into three factors: individual features and experiences, cognitions and behavior-related feelings, and behavioral consequences (Gorbani et al., 2020). According to the theory, every individual has different personal features and experiences that impact later behaviors. The set of behavior-specific knowledge and affect factors holds significant motivational value. Nursing activities can be employed to alter the variables. This model’s end-point is to promote healthy behavior (Gorbani et al., 2020).

The self-regulation model stresses the significance of promoting and maintaining health. Following the model, nurses can develop strategies significant in helping individuals with bipolar manage mood swings, follow recommended medications, and adopt a healthy lifestyle supporting mood stability. According to the self-regulation model, people are more likely to embrace health-promoting behaviors when significant others direct their behavior and offer the necessary assistance and support to facilitate the behavior (Younas & Quennell, 2019). Nurses are considered significant in health care provision and can effectively promote positive and health-promoting behavior among people with bipolar disorder. Besides, another theoretical statement deduced from the self-regulation model, which provides a foundation for investigative work on health behaviors, is that families, friends, and healthcare providers are significant interpersonal influences that can either enhance or limit engagement in behaviors that promote health (Younas & Quennell, 2019). The statement implies that through proper interventions, nurses can help promote healthy behaviors among these individuals. Nurses can work closely with family members of bipolar individuals to enhance the achievement of positive outcomes.

The self-regulation model highlights the roles of self-efficacy in promoting health behaviors. Nurses can improve bipolar individuals’ self-efficacy in managing the condition by closely working with them. Enhancing self-efficacy can involve teaching the individuals how to cope with the condition, providing education about the condition, and helping individuals set realistic goals necessary in managing their mental health.

Another model that nurses can apply to bipolar care is the Chronic Care Model. The theory emphasizes the significance of individual-centered care, self-management support, and healthcare team collaboration in managing chronic conditions like bipolar (Ortiz, 2021). The model was developed by a group of researchers led by Ed Wagner. Self-management support, a component of the model, posits that nurses should empower and prepare individuals to manage their health. According to self-management support, nurses should recognize that individuals play a central role in managing their health. While treating bipolar individuals, nurses need to involve individuals in the care and tailor treatment plans to their preferences. It implies considering individual goals of individuals in managing the condition.

Besides, nurses need to employ effective self-management support approaches, including goal-setting, action planning, and follow-up. Through self-management support, nurses can provide bipolar individuals with the resources and support necessary to manage their conditions. It includes educating individuals on mood monitoring, medication management, and coping strategies. Another critical component of the Chronic Care Model is using scientific evidence to support decisions (Ortiz, 2021). While developing appropriate interventions for individuals with bipolar, nurses base their decisions on evidence-based guidelines.


Gorbani, F., Mahmoodi, H., Sarbakhsh, P., & Shaghaghi, A. (2020). Predictive performance of pender’s health promotion model for hypertension control in iranian individuals. 
Vascular health and risk management, 299-305.

McIntyre, R. S., Berk, M., Brietzke, E., Goldstein, B. I., López-Jaramillo, C., Kessing, L. V., … & Mansur, R. B. (2020). Bipolar disorders. 
The Lancet
396(10265), 1841-1856.

Ortiz, M. R. (2021). Best Practices in Individual-Centered Care: Nursing Theory Reflections. 
Nursing Science Quarterly
34(3), 322-327.

Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: An integrative review. 
Scandinavian journal of caring sciences
33(3), 540-555.

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