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Potential determinants of health-care professionals’ use of survivorship care plans: a qualitative study using the theoretical domains framework

机译：卫生保健专业人员使用生存护理计划的潜在决定因素：使用理论领域框架进行的定性研究

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Background Survivorship care plans are intended to improve coordination of care for the nearly 14 million cancer survivors in the United States. Evidence suggests that survivorship care plans (SCPs) have positive outcomes for survivors, health-care professionals, and cancer programs, and several high-profile organizations now recommend SCP use. Nevertheless, SCP use remains limited among health-care professionals in United States cancer programs. Knowledge of barriers to SCP use is limited in part because extant studies have used anecdotal evidence to identify determinants. This study uses the theoretical domains framework to identify relevant constructs that are potential determinants of SCP use among United States health-care professionals. Methods We conducted semi-structured interviews to assess the relevance of 12 theoretical domains in predicting SCP use among 13 health-care professionals in 7 cancer programs throughout the United States with diverse characteristics. Relevant theoretical domains were identified through thematic coding of interview transcripts, identification of specific beliefs within coded text units, and mapping of specific beliefs onto theoretical constructs. Results We found the following theoretical domains (based on specific beliefs) to be potential determinants of SCP use: health-care professionals? beliefs about the consequences of SCP use (benefit to survivors, health-care professionals, and the system as a whole); motivation and goals regarding SCP use (advocating SCP use; extent to which using SCPs competed for health-care professionals? time); environmental context and resources (whether SCPs were delivered at a dedicated visit and whether a system, information technology, and funding facilitated SCP use); and social influences (whether using SCPs is an organizational priority, influential people support SCP use, and people who could assist with SCP use buy into using SCPs). Specific beliefs mapped onto the following psychological constructs: outcome expectancies, intrinsic motivation, goal priority, resources, leadership, and team working. Conclusions Previous studies have explored a limited range of determinants of SCP use. Our findings suggest a more comprehensive list of potential determinants that could be leveraged to promote SCP use. These results are particularly timely as cancer programs face impending SCP use requirements. Future work should develop instruments to measure the potential determinants and assess their relative influence on SCP use.
机译：背景技术幸存者护理计划旨在改善美国近1400万癌症幸存者的护理协调性。有证据表明，幸存者护理计划（SCP）对幸存者，医疗保健专业人员和癌症计划产生了积极的结果，一些知名组织现在建议使用SCP。尽管如此，在美国癌症计划中，SCP的使用仍然受到医疗保健专业人员的限制。关于使用SCP的障碍的知识是有限的，部分原因是现有的研究已经使用轶事证据来确定决定因素。这项研究使用理论领域框架来确定相关构架，这些构架可能是美国卫生保健专业人员使用SCP的潜在决定因素。方法我们进行了半结构化访谈，以评估12个理论领域在预测美国7个癌症项目中具有不同特征的13位医疗保健专业人员中使用SCP方面的​​相关性。通过采访记录的主题编码，在编码文本单元内识别特定信念，以及将特定信念映射到理论构造上，可以确定相关的理论领域。结果我们发现以下理论领域（基于特定的信念）是使用SCP的潜在决定因素：卫生保健专业人员？对使用SCP的后果的信念（对幸存者，医疗保健专业人员以及整个系统的好处）;有关使用SCP的动机和目标（提倡使用SCP;使用SCP竞争医疗专业人员的程度？时间）;环境背景和资源（是否在一次专门访问中交付了SCP，以及是否有系统，信息技术和资金促进了SCP的使用）;和社会影响力（是否使用SCP是组织的优先事项，有影响力的人支持SCP的使用，以及可以协助SCP使用的人都赞成使用SCP）。具体的信念映射到以下心理结构上：结果期望，内在动机，目标优先级，资源，领导能力和团队合作精神。结论先前的研究已经探索了有限的SCP使用决定因素。我们的研究结果提出了可以用来促进SCP使用的潜在决定因素的更全面列表。当癌症计划面临即将使用SCP的要求时，这些结果特别及时。未来的工作应该开发工具来测量潜在的决定因素并评估其对SCP使用的相对影响。

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