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Community Mental Health Journal

, Volume 53, Issue 8, pp 958–971 | Cite as

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
Original Paper

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 Treatment decision-making Qualitative Clinician attitudes Patient involvement Family involvement 

Notes

Acknowledgements

The authors wish to thank all the clinicians who willingly donated their time to participate in this research.

Funding

This research was partly funded by a Postgraduate Research Grant awarded to the first author by the University of Sydney.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Alana Fisher
    • 1
    • 2
  • Vijaya Manicavasagar
    • 3
    • 4
  • Louise Sharpe
    • 1
  • Rebekah Laidsaar-Powell
    • 1
    • 2
  • Ilona Juraskova
    • 1
    • 2
  1. 1.School of PsychologyUniversity of SydneyCamperdownAustralia
  2. 2.Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED)University of SydneyCamperdownAustralia
  3. 3.School of PsychiatryUniversity of New South WalesSydneyAustralia
  4. 4.Black Dog InstituteUniversity of New South WalesSydneyAustralia

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