Dataset Information

Healthcare professionals' intentions to use clinical guidelines: a survey using the theory of planned behaviour.

ABSTRACT:

Background

Finnish clinical guidelines are evolving toward integration of knowledge modules into the electronic health record in the Evidence-Based Medicine electronic Decision Support project. It therefore became important to study which factors affect professionals' intention to use clinical guidelines generally in their decision-making on patient care. A theory-based approach is a possible solution to explore determinants of professionals' behaviour. The study's aim was to produce baseline information for developers and implementers by using the theory of planned behaviour.

Methods

A cross-sectional internet-based survey was carried out in Finnish healthcare organisations within three hospital districts. The target population (n = 2,252) included physicians, nurses, and other professionals, of whom 806 participated. Indicators of the intention to use clinical guidelines were observed by using a theory-based questionnaire. The main data analysis was done by means of multiple linear regressions.

Results

The results indicated that all theory-based variables--the attitude toward the behaviour, the subjective norm, and the perceived behaviour control--were important factors associated with the professionals' intention to use clinical practice guidelines for their area of specialisation in the decisions they would make on the care of patients in the next three months. In addition, both the nurse and the physician factors had positive (p < 0.01) effects on this intention in comparison to other professionals. In the similar models for all professions, the strongest factor for the physicians was the perceived behaviour control, while the key factor for the nurses and the other professionals was the subjective norm. This means that context- and guideline-based factors either facilitate or hinder the intention to use clinical guidelines among physicians and, correspondingly, normative beliefs related to social pressures do so for nurses and other healthcare professionals.

Conclusions

The results confirm suggestions that the theory of planned behaviour is a suitable theoretical basis for implementing clinical guidelines in healthcare practices. Our new finding was that, in general, profession had an effect on intention to use clinical guidelines in patient care. Therefore, the study reaffirms the general contention that different strategies need to be in place when clinical guidelines are targeted at different professional groups.

SUBMITTER: Kortteisto T

PROVIDER: S-EPMC2902417 | biostudies-literature | 2010 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Healthcare professionals' intentions to use clinical guidelines: a survey using the theory of planned behaviour.

Kortteisto Tiina T Kaila Minna M Komulainen Jorma J Mäntyranta Taina T Rissanen Pekka P

Implementation science : IS 20100629

<h4>Background</h4>Finnish clinical guidelines are evolving toward integration of knowledge modules into the electronic health record in the Evidence-Based Medicine electronic Decision Support project. It therefore became important to study which factors affect professionals' intention to use clinical guidelines generally in their decision-making on patient care. A theory-based approach is a possible solution to explore determinants of professionals' behaviour. The study's aim was to produce bas ...[more]

PMID: 20587021

Similar Datasets

Project description:BackgroundImplementing evidence-based healthcare (EBHC) to improve the quality of patient care is a key issue for physicians and nurses. One of the most effective activities for achieving this is the annual topic-oriented clinical application national competition in Taiwan. Hundreds of clinical issues have been presented in this competition. By using the decomposed theory of planned behaviour (DTPB), this study explored physicians' and nurses' behaviour and adherence to the clinical application of EBHC after participating in the competitions.MethodsWe conducted a 3-month cross-sectional online survey using a structured questionnaire adapted from the original study of the DTPB to collect behavioural and intention-related data. We also used a model of seven action stages (from aware of to adhered to) to assess target behaviours. We targeted contestants of the EBHC competitions between 1999 and 2017 as study participants. Of 631 teams, 321 teams completed the questionnaire, representing a 49.5% response rate. We applied structural equation modelling to test model fit. Moreover, we executed multivariate logistic regression to identify potential predictors.ResultsOf the respondents, 33.3% reportedly reached the final adhered to stage. The DTPB model exhibited a good fit to the observed data. All constructs (usefulness, compatibility, peer influence, superior influence, self-efficacy, resource facilitating conditions, attitude, subjective norms, behavioural control, and intentions) were positively associated with the target behaviours, except for ease of use and technology facilitating conditions. Furthermore, the study model explained the variance in the target behaviours (37.0%). Having managerial duties (odds ratio [OR] =2.03, 95% confidence interval [CI] =1.10-3.77), resource facilitating conditions (OR = 1.06, 95% CI = 1.01-1.11), behavioural control (OR = 2.21, 95% CI = 1.47-3.32), and intentions (OR = 1.96, 95% CI = 1.40-2.73) were significant predictors of the achievement of the adhered to stage.ConclusionsThe study demonstrated the association between determinants of behaviour and clinical applications and factors influencing adherence to EBHC among competition participants. The adherence rate was not high after the competitions, and this may be improved by promoting certain factors associated with the target behaviours.

Project description:BackgroundProducing graduates for a breadth of sectors is a priority for veterinary science programs. Undergraduate career intentions represent de-facto 'outcome' measures of admissions policy and curricula design, as intentions are strong predictors of eventual behaviour. Informed by Ajzen's Theory of Planned Behaviour, this study aimed to identify if contextually relevant attitudes and self-ratings affect student intentions for veterinary career sectors.ResultsSurvey responses from 844 students enrolled in five Australian veterinary programs in 2014 were analysed. Intention was measured for biomedical research/academia, industry, laboratory animal medicine, public health/government/diagnostic laboratory services, mixed practice, intensive animal production, companion animal practice, not work in the veterinary profession, and business/entrepreneurship. Hierarchical multiple linear regression analysis enabled comparison of explanation of variance in intent by demographics, animal handling experience, species preference, and attitudes to aspects of veterinary work. Career sector intentions were highest for mixed or companion animal clinical practice, then business/entrepreneurship, then non-clinical sectors. Overall, intent was explained to a greater extent by species preferences than by animal experience, attitudes to aspects of veterinary work and demographics (with the exception of mixed practice intent) with gender having no significant effect. Several variables exerted negative effects on career intent for less popular career sectors.ConclusionAjzen's Theory of Planned Behaviour (TPB) provides a framework to increase understanding of and predict career sector intentions. Incorporation of attitude and self-efficacy measures in our study revealed preference for species types contributes greatly to career sector intentions for veterinary students, particularly for the more popular practice based sectors. Importantly, specific species preferences and other attitudes can have a negative effect on intent for non-aligned veterinary sectors. Further research is required to identify additional attitudes and/or beliefs to better explain variance in intent for less popular career sectors. Veterinary admissions processes may benefit from utilising the TPB framework. Identified effects revealed by this study may stimulate innovation in marketing, recruitment, admissions and curricular design, such as timing and role modelling, to utilise positive effects and mitigate against negative effects identified for sectors requiring greater representation of career intent in the student body.

Project description:This study proposed an extended theory of planned behavior (TPB) to examine the factors that influence pre-service teachers’ intention to use technology-enabled learning, using constructivist pedagogical beliefs (CPB) and information and communication technologies (ICT) competencies as antecedent variables for attitudes, subjective norms (SNs), and perceived behavioral control. An online study was conducted with a random sample of pre-service teachers from 7 universities in China, and 811 validated questionnaires were obtained. The results showed that the extended TPB model explained 75% of the variance in intention; attitude, SNs, and perceived behavioral control had a positive and significant effect on intention. Furthermore, SNs had a positive and significant effect on attitude and perceived behavioral control. CPB were the antecedent variables for attitude, SNs, perceived behavioral control, and ICT competencies. ICT competencies were the antecedent variable for SNs and perceived behavioral control. Additionally, through multi-group analysis, this study found significant differences in path relationships between the lower and higher-grade groups. The effect of perceived behavioral control on intention diminished with increased grade level. The effect of SNs on perceived behavioral control reduced. The effect of CPB on attitude and perceived behavioral control on intention diminished. The effect of SNs on attitude increased. This study verified that adding the relationship between antecedent variables of theoretical factors and theoretical factors is an effective way to expand TPB and provided a reference for future studies to focus on the related intention of pre-service teachers. Furthermore, it recommends that Chinese universities should eliminate the hindering influence of CPB, ICT competencies, attitudes, SNs, and perceived behavioral control in the process of preparing pre-service teachers. They should also pay attention to the individual differences of students in different grades and the problems that arise in the existing training.

Project description:BackgroundSustainability of adherence to clinical practice guidelines (CPGs) represents an important indicator of the successful implementation in the primary care setting.AimTo explore the sustainability of primary care providers' adherence to CPGs after receiving planned guideline implementation strategies, activities, or programmes.MethodsCochrane Central Register of Controlled Trials (CENTRAL); Cumulative Index to Nursing and Allied Health Literature (CINAHL); EMBase; Joanna Briggs Institute; Journals@Ovid; Medline; PsycoINFO; PubMed, and Web of Science were searched from January 2000 through May 2021 to identify relevant studies. Studies evaluating the sustainability of primary care providers' (PCPs') adherence to CPGs in primary care after any planned guideline implementation strategies, activities, or programmes were included. Two reviewers extracted data from the included studies and assessed methodological quality independently. Narrative synthesis of the findings was conducted.ResultsEleven studies were included. These studies evaluated the sustainability of adherence to CPGs related to drug prescribing, disease management, cancer screening, and hand hygiene in primary care. Educational outreach visits, teaching sessions, reminders, audit and feedback, and printed materials were utilized in the included studies as guideline implementation strategies. None of the included studies utilized purpose-designed measurements to evaluate the extent of sustainability. Three studies showed positive sustainability results, three studies showed mixed sustainability results, and four studies reported no significant changes in the sustainability of adherence to CPGs. Overall, it was difficult to quantify the extent to which CPG-based healthcare behaviours were fully sustained based on the variety of results reported in the included studies.ConclusionCurrent guideline implementation strategies may potentially improve the sustainability of PCPs' adherence to CPGs. However, the literature reveals a limited body of evidence for any given guideline implementation strategy. Further research, including the development of a validated purpose-designed sustainability tool, is required to address this important clinical issue.Trial registrationThe study protocol has been registered at PROSPERO (No. CRD42021259748 ).

Project description:BackgroundWomen diagnosed with early breast cancer (stage I or II) can be offered the choice between mastectomy or breast conservation surgery with radiotherapy due to equivalence in survival rates. A wide variation in the surgical management of breast cancer and a lack of theoretically guided research on this issue highlight the need for further research into the factors influencing women's choices. An extended Theory of Planned Behaviour (TPB) could provide a basis to understand and predict women's surgery choices. The aims of this study were to understand and predict the surgery intentions and choices of women newly diagnosed with early breast cancer, examining the predictive utility of an extended TPB.MethodsSixty-two women recruited from three UK breast clinics participated in the study; 48 women, newly diagnosed with early breast cancer, completed online questionnaires both before their surgery and after accessing an online decision support intervention (BresDex). Questionnaires assessed views about breast cancer and the available treatment options using items designed to measure constructs of an extended TPB (i.e., attitudes, subjective norms, perceived behavioural control, and anticipated regret), and women's intentions to choose mastectomy or BCS. Objective data were collected on women's choice of surgery via the clinical breast teams. Multiple and logistic regression analyses examined predictors of surgery intentions and subsequent choice of surgery.ResultsThe extended TPB accounted for 69.9% of the variance in intentions (p <.001); attitudes and subjective norms were significant predictors. Including additional variables revealed anticipated regret to be a more important predictor than subjective norms. Surgery intentions significantly predicted surgery choices (p <.01).ConclusionsThese findings demonstrate the utility of an extended TPB in predicting and understanding women's surgery intentions and choices for early breast cancer. Understanding these factors should help to identify key components of interventions to support women while considering their surgery options.

Dataset Information

Healthcare professionals' intentions to use clinical guidelines: a survey using the theory of planned behaviour.

Background

Methods

Results

Conclusions

Publications

Healthcare professionals' intentions to use clinical guidelines: a survey using the theory of planned behaviour.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets