Table 1 Overview of the categories/constructs in ORC, the subcategories/factors, and their explanations
Category in ORC/ Construct | Subcategory/Factor | Explanation |
|---|---|---|
Contextual factors | Preliminaries (E) | The preliminaries are described as an enabler and include meetings with various regional representatives, adjustments of the SICP into the Swedish context, and a pilot study. |
Broad Implementation (E/B) | Broad implementation is described both as an enabler and a barrier and is related to introducing the SICP in several units at the same time. Facilitators were unable to maintain omnipresence for every unit. | |
Leadership (E/B) | Leadership is described both as an enabler and a barrier. It was an important part in the implementation process and to create possibilities for the initiation of implementation. If the manager does not encourage the physicians, it is described as a barrier. | |
Time (E/B) | Time is described as both an enabler and barrier. It could be timesaving as well as time consuming. | |
Confidence (E/B) | Confidence and/or lack of confidence is also described as an enabler and a barrier for the physicians. Physicians seem to have more confidence to have these conversations after the training, A barrier was that the physicians sometimes seemed unconfident, uncomfortable, and afraid to take away the patients’ hope. | |
Change efficacy | Building foundation (E/B) | The building foundation is both an enabler and a barrier. This is done in several steps over time. Facilitators held several meetings with managers, but there was a lack of resources to support all units. |
Identification (E) | Identification of patients in need of SIC is described as an enabler for the implementation process. It is a key issue for implementation. | |
Motivation for work of change (E/B) | Motivation for work of change is described as both an enabler and a barrier. Motivation to implement the SICP. | |
Change commitment | Motivation for training in SIC (E/B) | Motivation to undergo education about SIC was described as both an enabler and a barrier. |
Attitudes (E/B) | Physicians’ attitudes and their own capabilities in SIC are described as both an enabler and a barrier. | |
Facilitator’s role (E) | Facilitator’s role is to support the units and was described as an important enabler to make the implementation possible. |