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/tSZU
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Living Successfully with Bipolar Disorder - Webinar with Dr. Erin Michalak
1. Welcome to our 2014 Webinar Series
Living 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
3. Living Successfully with
Bipolar Disorder:
Tips from the Experts
Erin Michalak
Associate Professor,
Department of Psychiatry, UBC
Leader, CREST.BD
Sara Lapsley
Counsellor and Group Clinician,
Forensic Psychiatric Hospital
Peer Researcher, CREST.BD
4.
5.
6. 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
7. 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
8. 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.
10. 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
13. 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
14. 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.
15. 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.
16. 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
17. 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
18.
19. Gaps and limitations
• Methodological limitations
• Where are we getting our
evidence?
• Little known about
strategies for hypo/mania
20. 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
21. Study objective:
To generate knowledge on what self-
management strategies work best for:
- Keeping balance in mood
- Stopping progression in hypomania
and mania
22. 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
33. 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
34. Round 1 Results
Gender & Age
Female
70%
Male
30%
Female
78%
Male
22%
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
35. 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 I
46%
Type II
45%
Other
9%
0%
36. Round 1 Results
Healthcare providers, discipline
22%
2%
26%
0%
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.
37. Respondents by geography
“Other” included: Australia, France, Hong Kong, Italy, New
Zealand, Spain, Sweden, Turkey, United Kingdom, Yemen.
0
10
20
30
40
50
60
70
80
90
Canada United States Other*
Number of respondents
38. 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, Swed
en, Turkey, UK & Yemen
39. 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
40. Round 1 Results
And 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
41. Round 1 Results
What 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
42. 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
43. 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
44. 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
52. 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
54. Next up in our 2014 Webinar Series
That’s Just Crazy Talk: Using theatre to address bipolar stigma
April 30th 2014
Registration will open soon!
Featuring Victoria Maxwell and Dr. Erin Michalak