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Background: Treatment decision-making in bipolar II disorder (BPII) is challenging, yet the decision support needs of patients and family remain unknown. Aim: To explore patient and family perspectives of treatment decision-making in BPII. Method: 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. Declaration of interest: 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. [ABSTRACT FROM AUTHOR]

Patients may not always be ready (i.e., well-equipped and enabled) to participate in shared decision making (SDM). The aim of this scoping review was to assess the qualitative evidence base for patient-related characteristics thought to influence patient readiness for SDM about treatment. We searched for literature in six databases from inception until September 2021. Two researchers independently performed title/abstract and full-text screening. We included qualitative studies that focused on associations between patient-related characteristics and SDM about treatment in adults. We coded the results sections of the included articles and analyzed the results inductively and in consensus. The search yielded 5818 hits, of which 62 articles were included. We identified 126 codes, which we categorized into four overarching themes. 1. Decision-related characteristics. Beneficial characteristics included: being able to defer or revise the decision, facing a non-urgent decision. Disadvantageous characteristics included: having a condition that requires a fast decision, uncertainty about the diagnosis or treatment, unreliable or conflicting information. 2. Person-related characteristics. Beneficial characteristics included: an open attitude towards SDM and the various options, being assertive, having confidence in communicating, feeling informed, wanting to participate, experiencing self-efficacy, and being aware of one's own interests and values. Disadvantageous characteristics included: feeling too anxious or overwhelmed, experiencing a limited sense of control. 3. Healthcare services-related characteristics. Beneficial characteristics included: being able to choose the clinician, continuity of healthcare provider, sufficient time during encounters. 4. Relationship-related characteristics. Beneficial characteristics included: having a good relationship with the clinician, trusting the clinician, not feeling judged, receiving support from family/friends. Disadvantageous characteristics included: trusting the clinician to make the right decision, experiencing pressure from family/friends. Many studies have reported a variety of patient-related characteristics that may influence how ready a patient is to participate in SDM. [ABSTRACT FROM AUTHOR]

Background: Family members (FMs) regularly attend oncology consultations. However, limited studies have assessed actual behaviours of oncologists, patients and FMs - particularly during decision-making. The current study aimed the following: (i) to rigorously develop a family (kin) interaction coding system (KINcode) capturing communication and decision-making behaviours of FMs and family-relevant behaviours of oncologists and patients and (ii) to apply KINcode to initial oncology consultations.Methods: The 80-item KINcode system was developed and applied to 72 transcripts of audiotaped medical/radiation oncology consultations including an FM, collected as part of two previous studies.Results: The role of the FM varied considerably within the one encounter, with 33% of FMs assuming three or more roles across the four consultation stages. Whilst most FMs asked treatment decision questions (71%), a minority engaged in other behaviours such as prompting patient questions (4%) or providing information relevant to the decision to the oncologist (18%). Although oncologists rarely initiated interaction with FMs such as in rapport building (18%) or asking FMs questions (25%), they were typically fully responsive to FM questions (90%). Many patients asked their FM a question (42%), but few elicited the FM's decision preferences (4%).Conclusions: This study provides novel insights into the complex nature of family involvement. The findings highlight potentially positive FM-focused consultation behaviours such as oncologist responsiveness to family questions and potential areas for improvement such as rapport building, invitation of questions and validation of the family's role. Family-specific communication skills training should be considered in medical student and professional education settings. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: While there is a clear need for psychosocial interventions that promote the well-being of carers of patients with cancer, the corresponding evidence base is disparate, complex, and difficult for end users to navigate and interpret. Carers remain undersupported with a lack of dedicated, effective, evidence-based programs. We will conduct a meta-review to synthesize this evidence and determine the state of science in this field., Objective: This study aims to address the question, "what psychosocial interventions are available to promote the well-being of carers for people with cancer?", Methods: A meta-review will synthesize the relevant reviews of psychosocial interventions that have been developed and evaluated with carers for people with cancer. A total of 4 electronic databases (PsycInfo, MEDLINE, CINAHL, and Cochrane Database of Systematic Reviews) will be searched for reviews published between January 2013 and December 2023. A team-based approach will be taken for screening and assessment of the returned records against the eligibility criteria to determine inclusion. Included reviews will be critically appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Relevant data on study characteristics, carer and patient populations, intervention details, and psychosocial outcomes will be extracted, synthesized, and the findings will be presented in a narrative format., Results: It is anticipated that the study will be completed by October 2024., Conclusions: Ensuring that carers have access to evidence-based programs that promote their well-being as they care for loved ones is critical. This meta-review will contribute to program development and translation efforts by providing a clear picture of the intervention evidence base of carers of patients with cancer and identifying notable strengths, weaknesses, and gaps across the literature. The findings are anticipated to offer future directions to advance research in the field., Trial Registration: PROSPERO (CRD42023403219); https://tinyurl.com/4tnzv49s., International Registered Report Identifier (irrid): DERR1-10.2196/56403., (©Brona Nic Giolla Easpaig, Bronwyn Newman, Judith Johnson, Rebekah Laidsaar-Powell, Ursula M Sansom-Daly, Lucy Jones, Lukas Hofstätter, Eden G Robertson, Stephen Mears, Kabir Sattarshetty, Reema Harrison. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 13.09.2024.)

Background: Carers often assume key roles in cancer care. However, many carers report feeling disempowered and ill-equipped to support patients. Our group published evidence-based guidelines (the Triadic Oncology [TRIO] Guidelines) to improve oncology clinician engagement with carers and the management of challenging situations involving carers., Objective: To facilitate implementation of the TRIO Guidelines in clinical practice, we aimed to develop, iteratively refine, and conduct user testing of a suite of evidence-based and interactive web-based education modules for oncology clinicians (e-Triadic Oncology [eTRIO]), patients with cancer, and carers (eTRIO for Patients and Carers [eTRIO-pc]). These were designed to improve carer involvement, communication, and shared decision-making in the cancer management setting., Methods: The eTRIO education modules were based on extensive research, including systematic reviews, qualitative interviews, and consultation analyses. Guided by the person-based approach, module content and design were reviewed by an expert advisory group comprising academic and clinical experts (n=13) and consumers (n=5); content and design were continuously and iteratively refined. User experience testing (including "think-aloud" interviews and administration of the System Usability Scale [SUS]) of the modules was completed by additional clinicians (n=5), patients (n=3), and carers (n=3)., Results: The final clinician module comprises 14 sections, requires approximately 1.5 to 2 hours to complete, and covers topics such as carer-inclusive communication and practices; supporting carer needs; and managing carer dominance, anger, and conflicting patient-carer wishes. The usability of the module was rated by 5 clinicians, with a mean SUS score of 75 (SD 5.3), which is interpreted as good. Clinicians often desired information in a concise format, divided into small "snackable" sections that could be easily recommenced if they were interrupted. The carer module features 11 sections; requires approximately 1.5 hours to complete; and includes topics such as the importance of carers, carer roles during consultations, and advocating for the patient. The patient module is an adaptation of the relevant carer module sections, comprising 7 sections and requiring 1 hour to complete. The average SUS score as rated by 6 patients and carers was 78 (SD 16.2), which is interpreted as good. Interactive activities, clinical vignette videos, and reflective learning exercises are incorporated into all modules. Patient and carer consumer advisers advocated for empathetic content and tone throughout their modules, with an easy-to-read and navigable module interface., Conclusions: The eTRIO suite of modules were rigorously developed using a person-based design methodology to meet the unique information needs and learning requirements of clinicians, patients, and carers, with the goal of improving effective and supportive carer involvement in cancer consultations and cancer care., (©Rebekah Laidsaar-Powell, Sarah Giunta, Phyllis Butow, Rachael Keast, Bogda Koczwara, Judy Kay, Michael Jefford, Sandra Turner, Christobel Saunders, Penelope Schofield, Frances Boyle, Patsy Yates, Kate White, Annie Miller, Zoe Butt, Melanie Bonnaudet, Ilona Juraskova. Originally published in JMIR Medical Education (https://mededu.jmir.org), 17.04.2024.)