Constructs (number of questions) | Example Question(s) |
---|---|
Theory of Planned Behaviour [23] | Â |
Behavioural intention (3) | I intend to prescribe antibiotics for patients who present with an URTI as part of their management |
Attitude: Direct (3); Indirect (8 behavioural beliefs (bb) multiplied by 8 outcome evaluations (oe). The score was the mean of the summed multiplicatives.) | Direct: In general: The possible harms of antibiotics to patients with an URTI outweighs their benefits; Indirect: In general, prescribing an antibiotic for a patient with an URTI would reassure them (bb) × reassuring the patient is (oe: un/important) |
Subjective Norm: Indirect (5 normative beliefs (nb) multiplied by 5 motivation to comply (mtc) questions. The score was the mean of the summed multiplicatives). | When managing URTIs, I feel under pressure not to prescribe an antibiotic: from published literature (nb) × How motivated are you to do what the published literature states that you should (mtc: very much/not at all) |
Perceived Behavioural Control: Direct (4); Indirect/power (7)c | Direct: Whether I manage an URTI without prescribing an antibiotic is entirely up to me Indirect: I find it difficult to manage patients presenting with an URTI without prescribing an antibiotic who: Expect me to prescribe an antibiotic |
Social Cognitive Theory [26] | Â |
Risk Perception (3) | It is highly likely that patients with an URTI will be worse off if I do not prescribe an antibiotic. |
Outcome Expectancies Self (2 × 2), Behaviour (8 × 8). The score was the mean of the summed multiplicatives. | Self: If I do not prescribe an antibiotic for a patient with an URTI, then I will think of myself as a competent GP × Thinking of myself as a competent GP is (Un/Important) Behaviour: See Attitude (Theory of Planned Behaviour) |
Self-Efficacy: General: Generalized Self-Efficacy Scale [43] (10: 4 point scale, not at all true/exactly true); Specific (7) | General: I can always manage to solve difficult problems if I try hard enough Specific: How confident are you in your ability to manage patients with URTIs symptomatically |
Implementation Intention [29] | Â |
Action planning (1) | Currently, my standard method of managing patients with an URTI does not include prescribing an antibiotic |
Operant Learning Theory [28]; BF Skinner Foundation [44] | Â |
Anticipated consequences (3) | If I do not routinely prescribe antibiotics for URTIs then, on balance, my life as a GP will be easier in the long run |
Evidence of habit (2) | When I see patients with URTIs, I automatically consider managing them without an antibiotic |
Experienced (rewarding and punishing) consequences (4: more likely to prescribe (score = 1); less likely (score = -1); unchanged/not sure/never occurred (score = 0)). Scores were summed. | Think about the last time you prescribed an antibiotic for a patient with an URTI and felt pleased/sorry: Think about the last time you decided not to prescribe an antibiotic for a patient with an URTI and felt pleased/sorry that you had not done so': |
Common Sense Self-Regulation Model [30] | Â |
Perceived identity (3) | URTIs as seen in general practice generally have symptoms of an intense nature |
Perceived cause (5) | Getting a URTI is determined by stress |
Perceived controllability (patient, doctor, treatment) (6) | What the patient does can determine whether an URTI gets better or worse |
Perceived duration (acute/chronic; cyclical) (3) | URTIs as seen in general practice are very unpredictable |
Perceived consequences (3) | An URTI does not have much effect on a patient's life |
Coherence (2) | I have a clear picture or understanding of URTIs |
Emotional response (4) | Seeing patients with an URTI does not worry me |
Stage Model [31,32] | Â |
Current stage of change. A single statement is ticked to indicate the behavioural stage | Unmotivated (2): I have not/it has been a while since I have thought about changing my management of URTIs to try to avoid the use of antibiotics. Motivated (2): I have decided that I will/will not change my management of URTIs to try to avoid the use of antibiotics. Action (1): I have already changed my management of URTIs to try to avoid the use of antibiotics. |
Other Measures | Â |
Knowledge (5) (True/False/Not Sure) Demographics | The presence of pus on the tonsils suggests a bacterial infection post code, gender, time qualified, number of other doctors in practice, trainer status, hours per week, list size |