student profile: Ms Alana Fisher


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Thesis work

Thesis title: Enhancing treatment decision-making in bipolar II disorder: Development and evaluation of a treatment decision-aid for patients and their families

Supervisors: Louise SHARPE , Vijaya MANICAVASAGAR, Josephine ANDERSON, Ilona JURASKOVA

Thesis abstract:

Bipolar II disorder (BPII), a chronic, relapsing and understudied mental health disorder that is associated with significant disability and illness burden. A diagnosis of BPII is commonly accompanied by a need to make complex treatment decisions about medications and adjunctive psychological therapies, often for lifetime prophylactic use. As most research on treatment efficacy relates to bipolar I disorder, treatment decisions in BPII have less evidence to support available treatment options and are more finely balanced in terms of their benefit/side-effect profiles. Research shows that many people with mental health disorders, including bipolar disorders, prefer a more active and informed role in their treatment decisions than they currently have. Yet, there is currently no resource that might facilitate this involvement. Patient decision-aids (DAs) are one way of better involving patients to make decisions based on up-to-date clinical evidence, patients’ values and life situation. This thesis project aims to develop and evaluate the potential usefulness of the first known DA for patients considering BPII treatment options. The thesis comprises four primary phases: i) systematic review of the literature on communication and decision-making about treatment in mental health, with a focus on bipolar disorders; ii) qualitative interviews with key stakeholders in the treatment decision-making process (patients with BPII, their family, and experienced psychiatrists, psychologists, and GPs); iii) development of a DA based on iterative review with an expert working party of experienced treating clinicians, research academics, patients with BPII and their family; iv) Pilot of the DA to obtain evidence on its acceptability, feasibility, and safety within a sample of potential end-users (30 patients with BPII and 10 family members).

Selected grants

2017

  • Enhancing treatment decision-making in bipolar II disorder: Evaluation of a decision-aid for young adults; Juraskova I, Manicavasagar V, Sharpe L, Fisher A, Anderson J; Australian Rotary Health/Mental Health Research Grants.

Selected publications

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Journals

  • Fisher, A., Manicavasagar, V., Sharpe, L., Laidsaar-Powell, R., Juraskova, I. (2017). A Qualitative Exploration of Clinician Views and Experiences of Treatment Decision-Making in Bipolar II Disorder. Community Mental Health Journal, 53, 958-971. [More Information]
  • Fisher, A., Manicavasagar, V., Sharpe, L., Laidsaar-Powell, R., Juraskova, I. (2017). A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder. Journal of Mental Health, in press. [More Information]
  • Fisher, A., Manicavasagar, V., Sharpe, L., Laidsaar-Powell, R., Juraskova, I. (2017). Identifying and Addressing Barriers to Treatment Decision-making in Bipolar II Disorder: Clinicians' Perspective. Australian Psychologist, in press. [More Information]
  • Laidsaar-Powell, R., Butow, P., Bu, S., Fisher, A., Juraskova, I. (2017). Oncologists' and oncology nurses' attitudes and practices towards family involvement in cancer consultations. European Journal of Cancer Care, 26(1), 1-14. [More Information]
  • Honan, C., Allen, S., Fisher, A., Osborne-Crowley, K., McDonald, S. (2017). Social Disinhibition: Piloting a New Clinical Measure in Individuals with Traumatic Brain Injury. Brain Impairment, 18(1), 74-87. [More Information]
  • Laidsaar-Powell, R., Butow, P., Bu, S., Fisher, A., Juraskova, I. (2016). Attitudes and experiences of family involvement in cancer consultations: a qualitative exploration of patient and family member perspectives. Supportive Care in Cancer, 24(10), 4131-4140. [More Information]
  • Fisher, A., Manicavasagar, V., Kiln, F., Juraskova, I. (2016). Communication and decision-making in mental health: A systematic review focusing on Bipolar disorder. Patient Education and Counseling, 99(7), 1106-1120. [More Information]
  • Laidsaar-Powell, R., Butow, P., Bu, S., Dear, R., Fisher, A., Coll, J., Juraskova, I. (2016). Exploring the communication of oncologists, patients and family members in cancer consultations: development and application of a coding system capturing family-relevant behaviours (KINcode). Psycho-Oncology, 25(7), 787-794. [More Information]
  • Laidsaar-Powell, R., Butow, P., Bu, S., Charles, C., Gafni, A., Fisher, A., Juraskova, I. (2016). Family involvement in cancer treatment decision-making: A qualitative study of patient, family, and clinician attitudes and experiences. Patient Education and Counseling, 99(7), 1146-1155. [More Information]
  • Connors, E., Jeremy, R., Fisher, A., Sharpe, L., Juraskova, I. (2015). Adjustment and Coping Mechanisms for Individuals with Genetic Aortic Disorders. Heart, Lung and Circulation, 24(12), 1193-1202. [More Information]
  • Honan, C., McDonald, S., Gowland, A., Fisher, A., Randall, R. (2015). Deficits in comprehension of speech acts after TBI: The role of theory of mind and executive function. Brain and Language, 150, 69-79. [More Information]
  • Juraskova, I., Butow, P., Fisher, A., Bonner, C., Anderson, C., Bu, S., Scarlet, J., Stockler, M., Wetzig, N., Ung, O., et al (2015). Development and piloting of a decision aid for women considering participation in the Sentinel Node Biopsy versus Axillary Clearance 2 breast cancer trial. Clinical Trials, 12(4), 409-417. [More Information]
  • Kiln, F., Fisher, A., Juraskova, I. (2014). Which disease and individual-based factors predict intentions to undergo whole genome sequencing? International Journal of Clinical Medicine, 5, 1248-1260. [More Information]
  • Fisher, A., Bonner, C., Biankin, A., Juraskova, I. (2012). Factors influencing intention to undergo whole genome screening in future healthcare: A single-blind parallel-group randomised trial. Preventive Medicine, 55, 514-520. [More Information]

2017

  • Fisher, A., Manicavasagar, V., Sharpe, L., Laidsaar-Powell, R., Juraskova, I. (2017). A Qualitative Exploration of Clinician Views and Experiences of Treatment Decision-Making in Bipolar II Disorder. Community Mental Health Journal, 53, 958-971. [More Information]
  • Fisher, A., Manicavasagar, V., Sharpe, L., Laidsaar-Powell, R., Juraskova, I. (2017). A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder. Journal of Mental Health, in press. [More Information]
  • Fisher, A., Manicavasagar, V., Sharpe, L., Laidsaar-Powell, R., Juraskova, I. (2017). Identifying and Addressing Barriers to Treatment Decision-making in Bipolar II Disorder: Clinicians' Perspective. Australian Psychologist, in press. [More Information]
  • Laidsaar-Powell, R., Butow, P., Bu, S., Fisher, A., Juraskova, I. (2017). Oncologists' and oncology nurses' attitudes and practices towards family involvement in cancer consultations. European Journal of Cancer Care, 26(1), 1-14. [More Information]
  • Honan, C., Allen, S., Fisher, A., Osborne-Crowley, K., McDonald, S. (2017). Social Disinhibition: Piloting a New Clinical Measure in Individuals with Traumatic Brain Injury. Brain Impairment, 18(1), 74-87. [More Information]

2016

  • Laidsaar-Powell, R., Butow, P., Bu, S., Fisher, A., Juraskova, I. (2016). Attitudes and experiences of family involvement in cancer consultations: a qualitative exploration of patient and family member perspectives. Supportive Care in Cancer, 24(10), 4131-4140. [More Information]
  • Fisher, A., Manicavasagar, V., Kiln, F., Juraskova, I. (2016). Communication and decision-making in mental health: A systematic review focusing on Bipolar disorder. Patient Education and Counseling, 99(7), 1106-1120. [More Information]
  • Laidsaar-Powell, R., Butow, P., Bu, S., Dear, R., Fisher, A., Coll, J., Juraskova, I. (2016). Exploring the communication of oncologists, patients and family members in cancer consultations: development and application of a coding system capturing family-relevant behaviours (KINcode). Psycho-Oncology, 25(7), 787-794. [More Information]
  • Laidsaar-Powell, R., Butow, P., Bu, S., Charles, C., Gafni, A., Fisher, A., Juraskova, I. (2016). Family involvement in cancer treatment decision-making: A qualitative study of patient, family, and clinician attitudes and experiences. Patient Education and Counseling, 99(7), 1146-1155. [More Information]

2015

  • Connors, E., Jeremy, R., Fisher, A., Sharpe, L., Juraskova, I. (2015). Adjustment and Coping Mechanisms for Individuals with Genetic Aortic Disorders. Heart, Lung and Circulation, 24(12), 1193-1202. [More Information]
  • Honan, C., McDonald, S., Gowland, A., Fisher, A., Randall, R. (2015). Deficits in comprehension of speech acts after TBI: The role of theory of mind and executive function. Brain and Language, 150, 69-79. [More Information]
  • Juraskova, I., Butow, P., Fisher, A., Bonner, C., Anderson, C., Bu, S., Scarlet, J., Stockler, M., Wetzig, N., Ung, O., et al (2015). Development and piloting of a decision aid for women considering participation in the Sentinel Node Biopsy versus Axillary Clearance 2 breast cancer trial. Clinical Trials, 12(4), 409-417. [More Information]

2014

  • Kiln, F., Fisher, A., Juraskova, I. (2014). Which disease and individual-based factors predict intentions to undergo whole genome sequencing? International Journal of Clinical Medicine, 5, 1248-1260. [More Information]

2012

  • Fisher, A., Bonner, C., Biankin, A., Juraskova, I. (2012). Factors influencing intention to undergo whole genome screening in future healthcare: A single-blind parallel-group randomised trial. Preventive Medicine, 55, 514-520. [More Information]

Note: This profile is for a student at the University of Sydney. Views presented here are not necessarily those of the University.