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The severe and recurrent symptoms of BD can considerably influence patients' significant others and alter their lives and thereby, influence family functioning (FF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed at exploring the influential factors on the FF of patients with BD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative study was undertaken in 2021\u20132022 with the conventional content analysis method, adhering to the COREQ checklist. Data were collected through semi\u2010structured interviews with 22 family members of BD patients and three healthcare providers, all purposefully selected from a psychiatric hospital in Hamadan, Iran. Data analysis was performed through Graneheim and Lundman's conventional content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants' experiences of the influential factors on their FF came into 20 categories and six main themes, namely family interaction, struggle for adaptation, role challenges, sexual behaviour challenges, financial problems and cultural backgrounds and conflicts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Different personal, financial and sociocultural factors influence the sociocultural, financial, relational, sexual and role\u2010related aspects of FF among the families of patients with BD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Practice<\/jats:title>\n                    <jats:p>Given the critical role of FF in the prevention, early diagnosis and effective treatment and rehabilitation of patients with BD, healthcare authorities and providers need to carefully consider these influential factors when planning care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance Statement<\/jats:title>\n                    <jats:p>This study offers valuable insight into the role of influential factors on the FF of patients with BD. The findings equip mental health nurses with a deeper understanding of these factors, enabling them to provide better support to relatives. Psychiatric nurses can adopt a participatory care approach that actively involves family members and provides stronger support for family caregivers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpm.70117","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:42:57Z","timestamp":1772998977000},"page":"397-408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influential Factors on the Family Functioning of Patients With Bipolar Disorder: A Qualitative Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8566-2713","authenticated-orcid":false,"given":"Safura","family":"Yaghmaei","sequence":"first","affiliation":[{"name":"Department of Nursing, Faculty of Nursing and Midwifery Hamadan University of Medical Sciences  Hamadan Iran"},{"name":"Student Research Committee Semnan University of Medical Sciences  Semnan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3786-7348","authenticated-orcid":false,"given":"Hassan","family":"Babamohamadi","sequence":"additional","affiliation":[{"name":"Nursing Care Research Center Semnan University of Medical Sciences  Semnan Iran"},{"name":"Department of Nursing, Faculty of Nursing and Midwifery Semnan University of Medical Sciences  Semnan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farshid","family":"Shamsaei","sequence":"additional","affiliation":[{"name":"Behavioral Disorders and Substance Abuse Research Center Hamadan University of Medical Sciences  Hamadan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali Asghar","family":"Ghods","sequence":"additional","affiliation":[{"name":"Nursing Care Research Center Semnan University of Medical Sciences  Semnan Iran"},{"name":"Department of Operating Room, Sorkheh School of Allied Medical Sciences Semnan University of Medical Sciences  Semnan Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57080771"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741\u20103729.2003.00137.x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2007.08.011"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.12.010"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEOR.S259338"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20105618.2005.00202.x"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165\u20100327(02)00347\u20106"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0060738"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10943\u2010014\u20109919\u2010y"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.4236\/jss.2015.312014"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00794947"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165\u20100327(01)00450\u20105"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.807546"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-008-9217-9"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20105618.2007.00339.x"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102022\u2010073591"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2003.10.001"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2014.05.047"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/ipj.ipj_15_16"},{"key":"e_1_2_13_21_1","unstructured":"Hall C. 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