A Qualitative Exploration of Clinician Views and Experiences of Treatment Decision-Making in Bipolar II Disorder

Alana Fisher; Vijaya Manicavasagar; Louise Sharpe; Rebekah Laidsaar-Powell; Ilona Juraskova

doi:10.1007/s10597-016-0077-4

A Qualitative Exploration of Clinician Views and Experiences of Treatment Decision-Making in Bipolar II Disorder

Community Ment Health J. 2017 Nov;53(8):958-971. doi: 10.1007/s10597-016-0077-4. Epub 2017 Jan 19.

Authors

Alana Fisher^{1

2}, Vijaya Manicavasagar^{3

4}, Louise Sharpe⁵, Rebekah Laidsaar-Powell^{5

6}, Ilona Juraskova^{5

6}

Affiliations

¹ School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia. a.fisher@sydney.edu.au.
² Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Camperdown, NSW, 2006, Australia. a.fisher@sydney.edu.au.
³ School of Psychiatry, University of New South Wales, Sydney, NSW, 2031, Australia.
⁴ Black Dog Institute, University of New South Wales, Sydney, NSW, 2031, Australia.
⁵ School of Psychology, University of Sydney, Brennan MacCallum (A18), Camperdown, NSW, 2006, Australia.
⁶ Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Camperdown, NSW, 2006, Australia.

PMID: 28102459
DOI: 10.1007/s10597-016-0077-4

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.

Keywords: Bipolar II disorder; Clinician attitudes; Family involvement; Patient involvement; Qualitative; Treatment decision-making.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Attitude of Health Personnel*
Bipolar Disorder / psychology
Bipolar Disorder / therapy*
Communication
Decision Making*
Family / psychology*
Female
Humans
Interviews as Topic
Male
Middle Aged
Patient Participation
Physician-Patient Relations*
Professional-Family Relations*
Qualitative Research
Referral and Consultation