living successfully with bipolar disorder - webinar with dr. erin michalak
DESCRIPTION
On March 31st 2014 - following the inaugural World Bipolar Day - Dr. Erin Michalak, Associate Professor of Psychiatry, hosted a live webinar to explore findings from CREST.BD's current Delphi Self-Management study. During the webinar Dr. Michalak discussed the study's participatory methods, shared some of the demographic data and research findings from Phase 1 of the study, as well as discussed the team's experiences with using Delphi Consensus methods. We've recently launched Round 2 of our Delphi study to our 150 survey panel members. In this 30 minute webinar you'll learn more about the findings of this unique international study, how the findings will be used to improve wellness in bipolar disorder, and how to get involved in CREST.BD's community-engaged research. Don't forget to check out the Storify from our World Bipolar Day #bipolarchat on March 30th 2014! http://sfy.co/tSZUTRANSCRIPT
Welcome to our 2014 Webinar SeriesLiving Successfully with Bipolar Disorder:
Tips from the Experts
The broadcast will begin at 11am PDT March 31st 2014. Thank you for your patience
Featuring Sara Lapsley and Dr. Erin Michalak In Collaboration with
2014 Webinar SeriesInstructions for
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Living Successfully with Bipolar Disorder:
Tips from the Experts
Erin MichalakAssociate Professor,
Department of Psychiatry, UBCLeader, CREST.BD
Sara LapsleyCounsellor and Group Clinician,
Forensic Psychiatric HospitalPeer Researcher, CREST.BD
Objectives:
Introduction to CREST.BD
Self-management in BD
Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach
What we’ve learned so far
Q&A
Objectives:
Introduction to CREST.BD
Self-management in BD
Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach
What we’ve learned so far
Q&A
Strategic Vision for Research and Knowledge Exchange
Effective psychosocial research and knowledge exchange in BD is critical.
CREST.BD advances BD psychosocial research and application of research in Canada and internationally. In doing so, we optimise health and QoL and diminish stigma for people with BD across the lifespan.
CREST.BD
StaffClinician
Leads
Core Members
Trainees
StaffClinician
Leads
Core Members
Trainees
Methods•Membership: academic researchers, people with
BD, family members, healthcare providers
•Multidisciplinary: psychology, psychiatry, criminology, nursing, gerontology, genetic counselling, social work, OT
•Expertise: wide range of BD specialisation
•Focus: integrated knowledge exchange
•Emphasis: community-based participatory research framework
Community Advisory Group
Staff and volunteers
Peer Researchers
National Advisory Group
Community Consultation
Group
Organizational Structure
Partner Organizations
(Canada)
Objectives:
Introduction to CREST.BD
Self-management in BD
Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach
What we’ve learned so far
Q&A
Previous research
• First study of wellness strategies used by people with BD
• Strategies to stay well:
- acceptance of diagnosis
- mindfulness education
- identifying triggers/warning signs
- sleep/stress management
- lifestyle changes
- treatment access
- stay well plans
Russell and Browne (2005) Staying well with bipolar disorder. Aust N Z J Psychiatry; 39(3):187-93.
Russell and Browne (2005) Staying well with BD. Aust N Z J Psychiatry; 39(3):187-93.
Wellness in BD study
Study Aim – To identify self-management strategies used by people living well with BD
Methods - Purposeful sampling used to identify:
~ People with BD Type I/II (N = 32)~ Median Age: 41±13 yrs~ 63% female ~ 78% BD I~ Functioning well
Individual interviews or focus groups, thematic analysis.
Suto et al. (2010) JAD, 124 (1-2):76-84; Murray et al (2011) Clinical Psychology and Psychotherapy, 18:95-109.
Clinical Psychology and Psychotherapy, 18:95-109.
Sleep, rest, diet and exercise
Regular monitoring and adjustment
Reflective, meditative, spiritual practices
Understanding BD, educating others
Connecting with others
Enacting a plan
Results: Categories of self-management
Sleep, rest, diet and exercise
Regular monitoring and adjustment
Reflective, meditative, spiritual practices
Understanding BD, educating others
Connecting with others
Enacting a plan
- acceptance of diagnosis- mindfulness education- identifying triggers/warning signs- sleep/stress management- lifestyle changes- treatment access- stay well plans
Gaps and limitations
• Methodological limitations
• Where are we getting our evidence?
• Little known about strategies for hypo/mania
Objectives:
Introduction to CREST.BD
Self-management in BD
Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach
What we’ve learned so far
Q&A
Study objective:
To generate knowledge on what self-management strategies work best for:
- Keeping balance in mood - Stopping progression in hypomania
and mania
CREST.BD definition of ‘self-management’
• Plans and/or routines that a person with BD uses to promote health and QoL
• Healthcare providers can provide information about self-management strategies
• Friends, family or caregivers can be involved in developing strategies and supporting their use
• Outside of hospital settings, it is typically the person with BD who chooses, enacts their approach to self-management and tailors their self-management strategies
• Encompass a wide range of plans, activities or routines, e.g., optimising sleep or eating habits, pursuing leisure activities, engaging in relaxation practices
Peer-reviewed literature
Re-analysis of Wellness
Study
Phase 1
Phase 1Grey
LiteratureSearch
Materials NOT published in academic journals
VideosConference Proceedings
BlogsWebsites
Government DocumentsBooks
Phase 1Grey
LiteratureSearch
Materials NOT published in academic journals
Phase 1Grey
LiteratureSearch
Materials NOT published in academic journals
VideosConference Proceedings
BlogsWebsites
Government DocumentsBooks
Organisation
493
ThousandsPhase 2
PanelRecruitment
Phase 3
> 19 years
Panel 2 Healthcare providers regularly working with people with BD (e.g. psychiatrists, counsellors, occupational therapists, nurses)
Panel 1 People with BD(type I or II), self-identified as living well
Survey
Phase 3a Consent Form
Sample Question
Participants were asked to rate each strategy twice
Survey
Phase 3a
Demographics Form
The Phase 1 survey took approx. 1 hour
to complete
All information was confidential and kept highly secured
RecruitmentTechniques
Social Media
RecruitmentTechniques
Videos
Stigma - One Minute Medical School and
CREST.BD
Objectives:
Introduction to CREST.BD
Self-management in BD
Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach
What we’ve learned so far
Q&A
Round 1 ResultsGender & Age
Fe-male70%
Male30%
Female78%
Male22%
Healthcare Providers: Community Members:
• 79 female • 22 male, mean age 43 (range 19-68)• 101 total
• 35 female • 15 male, mean age 47 (range 24-81)• 51 total
Round 1 Results Community members, diagnosis
• Type I: 49 respondents• Type II: 48 respondents• Other: 9 respondents
“Other” included: Unknown (2), NOS (5), Forgot (2)
Type I46%
Type II45%
Other8%
Round 1 Results Healthcare providers, discipline
22%
2%
26%
50%
Psychiatrist (11)Nurse Practitioner (1)Psychologist (13) Family physician (0)Other (25)
“Other” included: Occupational Therapist (5), Social Worker (4), Psychotherapist (2), Mental Health Worker (2), Did not specify (2), Researcher (2), Peer Support Worker, Nurse, Genetic Counsellor, Nurse Educator, Family Counsellor, CBT & EMDR Therapist.
Respondents by geography
“Other” included: Australia, France, Hong Kong, Italy, New Zealand, Spain, Sweden, Turkey, United Kingdom, Yemen.
Canada United States Other*0
10
20
30
40
50
60
70
80
90
Number of respondents
Looking at “Other” Geographies
• 3% of CMs (n=6) from other geographies • These were Australia, France, Italy & UK
Healthcare provider respondents were more diverse than community member respondents
• 20% of healthcare providers (n=10) from geographies other than US/Canada
• These were Australia, HK, NZ, Spain, Sweden, Turkey, UK & Yemen
Round 1 Results SMS ratings
There was a very high level of consensus between both panels on the ratings
Strategies about early warning signs were prominent for Stopping Progression
Strategies about relationships and emotions were prominent for Maintaining Balance
Strategies for Maintaining Balance were rated higher than those for Stopping Progression
Round 1 ResultsAnd while there was consensus…
…there were also interesting, though slight, differences between the opinions of the panels.
HCPs had more strategies for Stopping Progression in their top quartile than CMs did
CMs rated strategies about social supports lower than HCPs for both MB and SP
Round 1 ResultsWhat about low-rated strategies?
The lowest-rated strategy for both panels was “Take St. John’s Wort”
Strategies that referenced spirituality received low ratings from panels
Strategies about regulating diet generally did not rate highly in either panel
No strategies on parenting and only one on sex in the highest quartile for either panel
Choosing which SMSs to include in Round 2
• Strategies for Maintaining Balance received higher ratings than those for Stopping Progression
• We decided to choose an equal number of both types of strategy
Top Strategies
• We chose the strategies in the top quartile (highest 25%) for both Maintaining Balance and Stopping Progression• This gave us an equal number of both types of
strategy
Choosing which SMSs to include in Round 2
• Round 1: 436 strategies
• Round 2: 154 strategies• 70 strategies for both Maintaining Balance and
Stopping Progression• 42 each for only MB or SP• Approximately 15 to 20 minutes to complete
Delphi Survey Round 2: Live Today!
SharingResearchFindings
Blogs
www.crestbd.ca
Phase 4
Delphi research blogs
Phase 4Sharing
ResearchFindings
With thanks to… Our 152 Delphi participants – you rock!
Objectives:
Introduction to CREST.BD
Self-management in BD
Discussion of how CREST.BD has applied Delphi methods in the context of a 'community-based participatory research' approach
What we’ve learned so far
Q&A
Twitter.com/CREST_BD
Facebook.com/CRESTBDBipolarResearch
Youtube.com/CRESTBD
Flickr.com/photos/CRESTBD
Slideshare.net/CRESTBD
www.crestbd.ca/get-involved
Next up in our 2014 Webinar Series
That’s Just Crazy Talk: Using theatre to address bipolar stigmaApril 30th 2014
Registration will open soon!
Featuring Victoria Maxwell and Dr. Erin Michalak
2014 Webinar SeriesInstructions for
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