Table 1 Explanations of the twelve theoretical domains used to generate Round 1 data
Domain label[12] | Domain content |
|---|---|
Beliefs about consequences | Often regarded as core to clinical reasoning, this domain covers the perceived benefits and harms of a clinical action. In some contexts it can also include consequences for the clinician such as workload, pay, career progression, or for the hospital or health service. |
Behavioural regulation | Includes the ‘how’ of changing clinical practice: what are the practical strategies that would facilitate or hinder uptake of a new practice. |
Beliefs about capabilities | How confident clinicians are that they could change their practice effectively. |
Emotion | Includes issues such as work stress, patient anxiety and other emotional factors that may help or hinder the uptake of new approaches to care. |
Environmental context/resources | Includes the physical (including financial) issues that may limit change, including staffing levels and time as well as equipment or space. |
Knowledge | Knowledge of the field (that is, whether there is adequate evidence) and individuals’ knowledge of the evidence or of a guideline. |
Memory, attention and decision processes | The level of attention that is needed to perform the key clinical action (that is, whether forgetting is likely to be a problem) and the processes by which clinical decisions are made by individuals and teams. |
Motivation and goals | The relative priority that is given to one clinical issue, compared with other demands. |
Social/professional role and identity | The clinical thinking and norms of a particular profession. |
Skills | Covers the possibility that new skills would be required by the staff that are required to implement a new procedure. |
Social influences | The influence of other individuals or groups on clinical practice; for example, patients, patients’ families, pressure groups. |
Nature of the behaviours | Some new practices are very similar to current practice and so are easier to implement than new practices that require a dramatic change in ways of working. |