title: A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder.
abstract: BACKGROUND
  Treatment decision-making in bipolar II disorder (BPII) is challenging, yet the decision support needs of patients and family remain unknown.
  
  
  OBJECTIVE
  To explore patient and family perspectives of treatment decision-making in BPII.
  
  
  METHODS
  Semistructured, qualitative interviews were conducted with 28 patients with BPII-diagnosis and 13 family members with experience in treatment decision-making in the outpatient setting. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics and preferences for patient decision-making involvement were assessed.
  
  
  RESULTS
  Four inter-related themes emerged: (1) Attitudes and response to diagnosis and treatment; (2) Influences on decision-making; (3) The nature and flow of decision-making; (4) Decision support and challenges. Views differed according to patient involvement preferences, time since diagnosis and patients' current mood symptoms.
  
  
  CONCLUSIONS
  This is the first known study to provide in-depth patient and family insights into the key factors influencing BPII treatment decision-making, and potential improvements and challenges to this process. Findings will inform the development of BPII treatment decision-making resources that better meet the informational and decision-support priorities of end users.
  
  
  BACKGROUND
  This research was partly funded by a Postgraduate Research Grant awarded to the first author by the University of Sydney. No conflicts of interest declared.
authors.affiliation: a School of Psychology.|b Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney , New South Wales , Australia.
authors.forename: Alana
authors.initials: A
authors.lastname: Fisher
authors.affiliation: c School of Psychiatry , and.|d Black Dog Institute, University of New South Wales , New South Wales , Australia.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Manicavasagar
authors.affiliation: a School of Psychology.
authors.forename: Louise
authors.initials: L
authors.lastname: Sharpe
authors.affiliation: a School of Psychology.|b Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney , New South Wales , Australia.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Laidsaar-Powell
authors.affiliation: a School of Psychology.|b Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney , New South Wales , Australia.
authors.forename: Ilona
authors.initials: I
authors.lastname: Juraskova
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy*; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D036301:Qualitative Research
keywords: Bipolar II disorder; barriers; facilitators; patient involvement; qualitative; treatment decision-making