title: A Qualitative Exploration of Clinician Views and Experiences of Treatment Decision-Making in Bipolar II Disorder.
abstract: This study qualitatively explored clinicians' views and experiences of treatment decision-making in BPII. Semi-structured interviews were conducted with 20 practising clinicians (n = 10 clinical psychologists, n = 6 GPs, n = 4 psychiatrists) with experience in treating adult outpatients with BPII. Interviews were audiotaped, transcribed verbatim and thematically analysed using framework methods. Professional experience, and preferences for patient involvement in decision-making were also assessed. Qualitative analyses yielded four inter-related themes: (1) (non-)acceptance of diagnosis and treatment; (2) types of decisions; (3) treatment uncertainty and balancing act; and (4) decision-making in consultations. Clinician preferences for treatment, professional experience, and self-reported preferences for patient/family involvement seemed to influence decision-making. This study is the first to explore clinician views and experiences of treatment decision-making in BPII. Findings demonstrate how clinician-related factors may shape treatment decision-making, and suggest potential problems such as patient perceptions of lower-than-preferred involvement.
authors.affiliation: School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia. a.fisher@sydney.edu.au.|Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Camperdown, NSW, 2006, Australia. a.fisher@sydney.edu.au.
authors.forename: Alana
authors.initials: A
authors.lastname: Fisher
authors.affiliation: School of Psychiatry, University of New South Wales, Sydney, NSW, 2031, Australia.|Black Dog Institute, University of New South Wales, Sydney, NSW, 2031, Australia.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Manicavasagar
authors.affiliation: School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Sharpe
authors.affiliation: School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia.|Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Camperdown, NSW, 2006, Australia.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Laidsaar-Powell
authors.affiliation: School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia.|Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Camperdown, NSW, 2006, Australia.
authors.forename: Ilona
authors.initials: I
authors.lastname: Juraskova
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy*; D003142:Communication; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D036301:Qualitative Research; D012017:Referral and Consultation
keywords: Bipolar II disorder; Clinician attitudes; Family involvement; Patient involvement; Qualitative; Treatment decision-making