Table 3 Comparison of determinant mapping across theoretical frameworks
Determinant themes from AMDE study | TDF domains selected | TICD domains:determinants selected | Apparent match in underlying meaning | ||
|---|---|---|---|---|---|
Both mappers | One mapper | Both mappers | One mapper | ||
PHYSICIAN BELIEFS | |||||
AMDEs considered expected or unavoidable and not adverse unless outcomes catastrophic; viewed as more severe in other specialties | Beliefs about consequences | Social-professional role and identity | Health professional cognitions: expected outcome | Health professional cognitions: agreement with the recommendation | Yes (expected outcome) |
AMDEs within 2 years of use were considered unusual | Beliefs about consequences | – | Health professional cognitions: expected outcome | Health professional cognitions: agreement with the recommendation | Yes (expected outcome) |
Views about cause of AMDEs confounded by multiple factors | – | Beliefs about consequences, Knowledge | – | Health professional cognitions: agreement with the recommendation, Health professional knowledge and skills: domain knowledge | Yes (knowledge) |
Incidence of AMDEs has decreased, thus devices were thought to be improved | – | Beliefs about consequences, optimism | Health professional cognitions: expected outcome | Health professional cognitions: agreement with the recommendation | Yes (expected outcome) |
POLICIES, PROCESSES OR SYSTEMS | |||||
Follow-up of device-related outcomes beyond short-term results done elsewhere | Environmental context and resources | Social-professional role and identity | Recommended behaviour: observability | Health professional cognitions: intention and motivation, Health professional behaviour: nature of the behaviour, Health professional knowledge and skills: knowledge about own practice, Health professional behaviour: self-monitoring or feedback, Professional interactions: referral processes | Yes (professional role or behaviour, observability or knowledge of own behaviour) |
Devices implanted not recorded in patient records | Environmental context and resources | – | Incentives and resources: information system | Health professional knowledge and skills: knowledge about own practice, Health professional behaviour: self-monitoring or feedback, Health professional behaviour: capacity to plan change | Yes (resources or information system) |
No hospital, national or international systems for AMDE reporting | Environmental context and resources | Knowledge, Reinforcement, Behavioural regulation | Incentives and resources: information system, Incentives and resources: availability of necessary resources, Capacity for organizational change: regulations, rules and policies | Health professional knowledge and skills: domain knowledge, Health professional cognitions: intention and motivation, Health professional behaviour: self-monitoring or feedback, Incentives and resources: non-financial incentives and disincentives, Incentives and resources: quality assurance and patient safety systems, Capacity for organizational change: monitoring and feedback | Yes (resources or information system, knowledge, reinforcement or non-financial incentives or disincentives, regulation or self- or organizational monitoring) |
DEVICE MARKET | |||||
Use of specific devices often determined by purchase group contract obligations | Environmental context and resources | – | Health professional behaviour: capacity to plan change | Capacity for organizational change: regulations, rules and policies, Incentives and resources: financial incentives and disincentives, Capacity for organizational change: mandate, authority and accountability, Social, political and legal factors: economic constraints on the health care budget, Social, political and legal factors: contracts | Yes (context and resources or policies, financial incentives and disincentive, authority, budget, contracts) |
Lack of responsiveness to AMDEs from industry | Reinforcement | Knowledge, Optimism, Beliefs about consequences, Environmental context and resources | – | Health professional cognitions: expected outcome, Health professional cognitions: intention and motivation, Health professional behaviour: self-monitoring or feedback, Social, political and legal factors: influential people | Yes (reinforcement or feedback or influential people, expected outcome, optimism or motivation) |