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Aims and Objectives: This study examined the changes in patients' parental functioning and the associated factors, including manic, depressive symptoms and social support from before discharge to 6 months post‐discharge. Background: For parents with bipolar disorder and major depression, parenting is a recovery factor for patients, but little research examines the dynamic parental functioning from acute hospitalisation to a remission stage. Design: A longitudinal design was used. The STROBE Checklist were used in presenting this research. Methods: Participants were inpatients with bipolar disorder or major depression (n = 33) recruited within one week before discharge from the acute psychiatric ward in Taiwan. Data on parental functioning was collected four times: before discharge (T1), the 1st (T2), the 3rd (T3) and the 6th (T4) months of post‐discharge. Baseline parental functioning before admitting to the acute word was retrospectively assessed at T0. The questionnaires included positive and negative domains of parenting practice, hypomanic/manic symptoms, depressive symptoms and social support. Generalised estimating equations were applied for data analysis. Results: The negative parenting domains (poor monitoring, inconsistent discipline) decreased during hospitalisation but increased at one month post‐discharge, except corporal punishment at 3‐months discharge. The positive parenting domains (parental involvement and nurturance/responsiveness) did not recovery to baseline. While clinical symptoms remained stable during 6 months post‐discharge, social support decreased at 3 and 6 months post‐discharge. Higher depressive symptoms and low social support were associated with positive parenting domains but not related to negative parenting domains. Manic symptoms were not associated with positive or negative parenting domains. Conclusions: Positive parenting domains did not fully return to the usual situation during 6 months post‐discharge. Relevance to clinical practice: Parenting functioning recovery program targeting at the impacts of depressive symptoms on the parenting functioning and insufficient social support is needed from hospitalisation to post‐discharge. [ABSTRACT FROM AUTHOR]

This paper presents an enhanced direct adaptive scheme for radial basis function network (RBFN) based controller capable of online stably adjusting both of RBFN's output weights and variance parameters in the hidden nodes. The improved RBFN system is employed to online reconstruct the ideal control law adaptively and force the plant output to asymp-totically track the output of a reference model, which is predetermined to stabilize robustly the unstable internal dynamics of a nonlinear uncertain system with nonminimum phase. A case study is utilized for demonstrating the effectiveness of the proposed scheme. Simulation results indicate that the transient responses of balancing the inverted pendulum system are markedly improved by using the enhanced algorithm proposed herein. Index Terms--Enhanced RBFN controller, internal dynamics, nonlinear uncertain system, nonminimum phase.

Aims: This study explored how adult children perceived family resilience, barriers to develop family resilience and how cultural values influence their experience of parents with bipolar disorder in Chinese society. Design: A qualitative design with an interpretive phenomenological analysis of data was employed. Methods: Twenty adults who had lived with parents with bipolar disorder during childhood were recruited from the acute psychiatric ward when their parents were admitted to the hospital. They described their experiences of perceived family resilience and barriers to resilience (October 2013–September 2015). Semi‐structured interviews were conducted in the hospital meeting room or at a convenient location. Findings: Six themes were identified in family resilience: ill parents try to be good parents, parents' personal strengths, parents' positive attitudes towards mental illness, flexibility of family role, cohesive relationships between family members, and families' social connections. Three themes were identified in the barriers to develop family resilience: poor parenting/family function, conflict between parents and poor mental health literacy. Conclusion: Children's views of family resilience could transform their suffering from lived experiences with a mentally ill parent to a positive growth experience. Family resilience includes well and ill parents' efforts and social network's help to maintain family function. However, the conflicts between well and ill parents and poor family function result in a traumatic growth experience. Impact: To enhance a positive growth experience, family resilience programs for a parent with bipolar disorder aiming to cultivate both the ill and well parents' inner strength and their competence of parenting skills with connecting their social network to maintain family function is needed. Moreover, early stress‐reduction intervention needs to be developed for children who did not experience family resilience. [ABSTRACT FROM AUTHOR]

Introduction: Nurses can help children of parents with mental illness discover their resilience. However, previous studies have focused on their experience in Western settings and have limited understanding of a Chinese cultural context. This study aims to explore individual resilience emerging from adult children's experience of living with parents with bipolar disorder in Chinese society within the framework of character strengths and possible cultural components., Methodology: A content analysis with both inductive and deductive approaches. Twenty adults participated in this study. Interviews were conducted while the participants' parents were hospitalized in an acute psychiatric hospital ward., Results: The framework of character strengths confirmed five emergent themes of individual resilience in this study: courage, temperance, humanity, knowledge and wisdom, and transcendence., Discussion: Character strengths are an adequate framework for understanding of individual resilience. Chinese adult children develop resilience by regulating their emotions, respecting their parents, engaging in self-discipline, and positively interpreting adversity., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The purpose of this article was to describe the development and preliminary effectiveness of a digital case management education program. The e-learning program was built through the collaboration of a nurse educator and an informatics professor. The program was then developed according to the following steps: (1) building a visual interface, (2) scripting each unit, (3) preparing the course material and assessment tests, (4) using teaching software to record audio and video courses, (5) editing the audio recordings, (6) using instructional media or hyperlinks to finalize the interactions, (7) creating the assessment and obtaining feedback, and (8) testing the overall operation. The digital program consisted of five learning modules, self-assessment questions, learning cases, sharing experiences, and learning resources. Forty nurses participated in this study and fully completed the questionnaires both before and after the program. The knowledge and confidence levels in the experimental group were significantly higher over time than those of the comparison group. The results supported the use of educational technology to provide a more flexible and effective presentation method for continuing education programs.

This case analysis focuses on a male elderly inpatient with bipolar disorder during an acute manic episode. During the case's 3-week hospitalization, we used a participant observation approach to provide individualized nursing care. Our nursing assessment focused on linking this case's manic symptoms and psychosocial issues. Based on a content analysis of our nursing process record and the five psychosocial issues of elderly bipolar disorder reported by Reiser et al (2008), five major themes were presented. These themes included indulging the memory of youth-hood (cohort beliefs); presenting his old but still strong physical function (physical health); making an attempt to learn and showing the ability (socio-cultural context); providing working expert service and ability (transition in role investments); and playing a positive role as a warm-heartedness senior person (intergenerational relationship). This case's manic symptoms and psychosocial issues showed that he wished to perform as a young man to compensate for his ageing physical state and psychological loss, which revealed he want to maintain his social value. In view of the nursing intervention for this case during the acute manic state, we needed to pay attention to preventing the patient from physical overexertion and falls. We further needed to remind him to drink sufficient water, eat food, and take adequate rest. When the acute symptoms were in remission, we tried to empathize with and understand his psychosocial issues and self-concept and to help him integrate his illness and life experience to accomplish the elderly development task.

This paper addresses nursing procedures related to helping a manic patient promote emotional awareness and interpersonal adjustment. The caring period ran from September 20 through October 11, 2007. Using weekly records of interviewing process, care plans, team meetings, and medical charts, we found the case to suffer from a vicious cycle of emotional disturbance, low self esteem, and interpersonal problems. Using a therapeutic relationship and interviews that adopted a genuine, accepting, concerned and empathetic caring attitude, the author applied the principal focus of an interpersonal psychotherapy method to help the case become aware of her emotions, analyze key emotional influencers, and develop effective emotional adjustment strategies to improve interpersonal interaction.