Table 2 TDF domains
COM-B component—TDF domain | Theme name | Definition of the theme | Study type—no survey/interview/focus group/mixed methods/other | No. of data items |
|---|---|---|---|---|
Barriers/facilitators | ||||
Capability—knowledge | Alcohol-related knowledge | Doctors’ and nurses’ knowledge about specific concepts related to alcohol screening and brief interventions (e.g. drinking limits, definition of heavy drinking, guidelines, screening questionnaires, content of brief interventions) | 26/6/5/2/2 | 58/19 |
Disease model training | An approach to the patient in that health providers ask about alcohol only when the patient present with specific symptoms and/or signs | 2/2/1/0/0 | 5/0 | |
Patients’ receptiveness to alcohol interventions | The extent to which doctors and nurses think patients are open to be asked and advised about their drinking | 1/3/1/1/0 | 3/4 | |
Doctors and nurses own drinking habits | The use of doctors and nurses own drinking behaviour as a benchmark to define whether or not a patient drinks excessively | 0/2/1/0/0 | 3/0 | |
Alcohol being perceived as having health benefits | The extent to which doctors and nurses believe that drinking moderately improves health in general | 2/1/0/0/0 | 3/0 | |
Knowledge of support services | Doctors’ and nurses’ knowledge of alcohol services where they could refer the patient to | 2/0/0/0/0 | 2/0 | |
Capability—skills | Training | The extent to which doctors and nurses agree they have received/need training in screening and advising at-risk drinkers | 28/4/2/3/3 | 51/25 |
Role adequacy | The extent to which doctors and nurses believe they have sufficient knowledge and skills to manage drinkers | 16/4/2/3/4 | 45/0 | |
Demographical characteristics of the PHC professionals | Doctors’ and nurses’ demographical characteristics influencing their screening and advice performance | 2/0/0/0/0 | 3/0 | |
Capability—memory, attention and decision processes | Demographical characteristics of the patient | Patients’ demographical characteristics influencing doctors’ and nurses’ screening and advice performance | 1/3/1/0/0 | 6/0 |
Feedback on the results of delivering SBI | Information about doctors’ and nurses’ performance concerning screening, advice and/or effectiveness of their actions | 0/1/1/0/1 | 1/2 | |
Remembering | Doctors’ and nurses’ perception of how easy/difficult it is to remember to ask about alcohol | 0/1/1/0/0 | 2/0 | |
Capability—behaviour regulation | Organization for preventive counselling | Doctors’ and nurses’ perception of the presence or absence of organization/systematic strategies to implement alcohol screening and brief advice | 5/4/7/0/2 | 6/19 |
Motivation—beliefs about capabilities | Beliefs about the ability to deliver SBI and in helping patients to cut down | Doctors’ and nurses’ beliefs about, and/or confidence in, the effectiveness of their skills to screen and advise patients to reduce their alcohol intake | 23/5/4/2/6 | 60/6 |
Time | Time-related factors doctors and nurses believe to affect their capability to implement alcohol screening and brief interventions | 9/7/10/3/3 | 31/14 | |
Difficult task | Difficulties perceived by doctors and nurses when asking and advising patients about alcohol | 13/6/6/2/4 | 30/24 | |
Therapeutic commitment | Doctors’ and nurses’ predisposition to working therapeutically with people who have excessive alcohol consumption | 3/0/0/0/2 | 5/0 | |
Self-esteem when working with at-risk drinkers | Doctors’ and nurses’ perceived self-worth when working with at-risk drinkers | 4/0/1/0/0 | 4/3 | |
Disease model training | An approach to the patient in that health providers ask about alcohol only when the patient present with specific symptoms and/or signs | 0/1/0/0/0 | 1/0 | |
Patients’ beliefs about alcohol | Doctors’ and nurses’ perceptions of the conceptions patients have about the effects of alcohol, either beneficial or detrimental | 0/1/0/0/0 | 1/0 | |
Demographical characteristics of the patient | Patients’ demographical characteristics influencing doctors’ and nurses’ screening and advice performance | 0/1/0/0/0 | 2/0 | |
Motivation—beliefs about consequences | Effectiveness of SBI | Doctors’ and nurses’ beliefs about the effectiveness of asking and advising patients about their alcohol consumption | 13/3/4/1/4 | 24/14 |
Patients’ feelings when asked about their drinking | Doctors’ and nurses’ beliefs about how patients would feel if asked and advised about alcohol | 5/6/6/1/0 | 22/3 | |
Therapeutic relation with the patient | The therapeutic alliance that is established between a healthcare professional and a patient | 1/4/5/1/2 | 12/4 | |
Reliability of the answers of the patients when asked about alcohol | The degree to which doctors and nurses believe in the accuracy of the answers provided by patients concerning their alcohol consumption | 1/5/2/0/1 | 9/0 | |
Patients’ receptiveness to alcohol interventions | The extent to which doctors and nurses think patients are open to be asked and advised about their drinking | 4/3/2/1/0 | 7/4 | |
Patients’ reactions when asked about alcohol | Doctors’ and nurses’ beliefs about how patients would react if asked and advised about alcohol | 3/4/0/2/1 | 7/3 | |
Frustrating task | Doctors’ and nurses’ beliefs about how they would feel if they were to implement alcohol screening and brief interventions | 2/2/0/1/1 | 5/1 | |
Alcohol being perceived as having health benefits | The extent to which doctors and nurses believe that drinking moderately improves health in general | 2/1/0/0/0 | 3/0 | |
Incentives | Doctors’ and nurses’ beliefs about what they would gain by implementing alcohol screening and brief interventions | 4/1/2/1/1 | 2/22 | |
Time | Time-related factors doctors and nurses believe to affect their capability to implement alcohol screening and brief interventions | 1/4/4/0/1 | 2/14 | |
Delivering SBI can make other patients suffer | Doctors’ and nurses’ belief that implementing alcohol screening and brief interventions could harm other patients | 1/0/0/1/0 | 2/0 | |
Bad publicity | Doctors’ and nurses’ belief that dealing with at-risk drinkers could give the practice a bad name | 0/0/0/1/0 | 1/0 | |
Demographical characteristics of the patient | Patients’ demographical characteristics influencing doctors’ and nurses’ screening and advice performance | 0/1/0/0/0 | 1/0 | |
SBI delivery impedes caring for the patient | Doctors’ and nurses’belief that bringing alcohol into the discussion impedes the comprehensive care of the patient | 1/0/0/0/0 | 1/0 | |
Uncomfortable task | Doctors’ and nurses’ expectation of feeling unease or awkward when conducting alcohol screening and brief interventions | 0/0/1/0/1 | 1/1 | |
Patients with alcohol problems do not attend their appointments | Doctors’ and nurses’expectation that patients with alcohol problems would not attend appointments to address their drinking | 0/1/0/0/0 | 1/0 | |
Motivation—social/professional role and identity | Role legitimacy | The extent to which doctors and nursesbelieve they have a legitimate role in addressing alcohol issues in their patients | 15/4/4/1/2 | 41/0 |
Professional responsibility | The extent to which doctors and nurses find addressing alcohol in their patients to be their responsibility | 12/2/4/1/0 | 24/0 | |
Disease model training | An approach to the patient in that health providers ask about alcohol only when the patient present with specific symptoms and/or signs | 7/2/4/1/0 | 14/0 | |
Doctors and nurses own drinking habits | The use of doctors and nurses own drinking behaviour as a benchmark to define whether or not a patient drinks excessively | 4/2/3/0/0 | 9/0 | |
Doctors’ and nurses’ permissiveness towards alcohol | Doctors’ and nurses’ tolerance or acceptability towards their patients’ alcohol consumption | 3/3/0/0/0 | 7/0 | |
Role security | The extent to which doctors and nurses feel secure in their role when addressing alcohol issues in their patients | 3/0/0/0/2 | 5/0 | |
Doctors’ and nurses’ attitudes towards discussing alcohol with patients | The way doctors and nurses feel or think about asking and advising their patients about their drinking | 1/0/1/0/1 | 3/0 | |
Patients’ feelings when asked about their drinking | Doctors’ and nurses’ beliefs about how patients would feel if asked and advised about alcohol | 0/2/1/1/0 | 3/3 | |
Demographical characteristics of the PHC professionals | Doctors’ and nurses’ demographical characteristics influencing thier screening and advice performance | 0/0/1/0/0 | 1/0 | |
Demographical characteristics of the patient | Patients’ demographical characteristics influencing doctors’ and nurses’ screening and advice performance | 0/1/0/0/0 | 1/0 | |
Therapeutic relation with the patient | The therapeutic alliance that is established between a healthcare professional and a patient | 1/0/2/1/1 | 1/4 | |
Feedback on the results of delivering SBI | Information about doctors’ and nurses’ performance concerning screening, advice and/or effectiveness of their actions | 0/1/1/0/1 | 1/2 | |
Motivation—emotion | Satisfaction when working with at-risk drinkers | The extent to which doctors and nurses feel rewarded when working with at-risk drinkers | 13/0/1/0/0 | 19/0 |
Uncomfortable task | Doctors’ and nurses’ expectation of feeling unease or awkward when conducting alcohol screening and brief interventions | 5/6/3/0/3 | 16/1 | |
Patients’ feelings when asked about their drinking | Doctors’ and nurses’ beliefs about how patients would feel if asked and advised about alcohol | 0/2/5/1/0 | 7/3 | |
Frustrating task | Doctors’ and nurses’ beliefs about how they would feel if they were to implement alcohol screening and brief interventions | 2/2/0/1/1 | 5/1 | |
Therapeutic commitment | Doctors’ and nurses’ predisposition to working therapeutically with people who have excessive alcohol consumption | 3/0/0/0/2 | 5/0 | |
Self-esteem when working with at-risk drinkers | Doctors’ and nurses’ perceived self-worth when working with at-risk drinkers | 1/0/1/1/1 | 2/3 | |
Doctors and nurses own drinking habits | The use of doctors and nurses own drinking behaviour as a benchmark to define whether or not a patient drinks excessively | 0/2/0/0/0 | 3/0 | |
Motivation to work with at-risk drinkers | The extent to which doctors and nurses want to work with at-risk drinkers | 4/2/1/0/1 | 1/16 | |
Motivation—intentions | Motivation to work with at-risk drinkers | The extent to which doctors and nurses want to work with at-risk drinkers | 15/2/2/2/1 | 18/16 |
Therapeutic commitment | Doctors’ and nurses’ predisposition to working therapeutically with people who have excessive alcohol consumption | 3/0/0/0/2 | 5/0 | |
Motivation—reinforcement | Incentives | Doctors’ and nurses’ beliefs about what they would gain by implementing alcohol screening and brief interventions | 7/1/4/1/2 | 13/22 |
Motivation—optimism | Beliefs about the ability to deliver SBI and in helping patients to cut down | Doctors’ and nurses’ beliefs about, and/or confidence in, the effectiveness of their skills to screen and advise patients to reduce their alcohol intake | 3/2/1/1/1 | 4/6 |
Motivation—goals | Importance / Priority given to alcohol issues | Importance / priority given to alcohol issues by doctors and nurses when compared to other risk factors or tasks | 5/5/3/0/0 | 13/1 |
Time | Time-related factors doctors and nurses believe to affect their capability to implement alcohol screening and brief interventions | 5/4/3/0/2 | 7/14 | |
Opportunity—environmental context and resources | Time | Time-related factors doctors and nurses believe to affect their capability to implement alcohol screening and brief interventions | 16/7/11/3/5 | 45/14 |
Support | The extent to which doctors and nurses feel to be working in supporting environment to address alcohol problems | 24/3/5/2/4 | 30/57 | |
Resources | The availability of materials, tools or any other thing that doctors and nurses feel they need to screen and advise at-risk drinkers | 9/3/5/1/3 | 22/21 | |
Patients’ denial of the problem and resistance to accepting treatment | The extent to which doctors and nurses agree patient denial of the problem and resistance to treatment influence their decision to deliver screening and brief intervention | 6/3/1/1/0 | 14/0 | |
Patients’ feelings when asked about their drinking | Doctors’ and nurses’ beliefs about how patients would feel if asked and advised about alcohol | 5/3/3/1/0 | 12/3 | |
Organization for preventive counselling | Doctors’ and nurses’ perception of the presence or absence of organization/systematic strategies to implement alcohol screening and brief advice | 6/4/7/0/3 | 9/19 | |
Patients’ beliefs about alcohol | Doctors’ and nurses’ perceptions of the conceptions patients have about the effects of alcohol, either beneficial or detrimental | 1/3/1/0/0 | 8/1 | |
Incentives for patients | Something (e.g. reimbursement) doctors and nurses think would encourage patients to seek alcohol counselling | 5/1/1/0/0 | 7/0 | |
Patients with alcohol problems do not attend their appointments | Doctors’ and nurses’ perception that at-risk drinkers are not interested and frequently miss follow-up consultations | 0/2/0/1/1 | 4/0 | |
Patients’ receptiveness to alcohol interventions | The extent to which doctors and nurses think patients are open to be asked and advised about their drinking | 0/2/1/1/2 | 4/4 | |
Delivering SBI can make other patients suffer | Doctors’ and nurses’ belief that implementing alcohol screening and brief interventions could harm other patients | 1/0/0/1/0 | 2/0 | |
Familiarity with the patient | The level of acquaintance between the primary health care provider and the patient | 0/1/1/0/0 | 1/1 | |
Opportunity—social influences | Patients’ feelings when asked about their drinking | Doctors’ and nurses’ beliefs about how patients would feel if asked and advised about alcohol | 5/4/5/1/0 | 17/3 |
Patients’ reactions when asked about alcohol | Doctors’ and nurses’ beliefs about how patients would react if asked and advised about alcohol | 3/5/1/2/1 | 10/3 | |
Doctors’ and nurses’ permissiveness towards alcohol | Doctors’ and nurses’ tolerance or acceptability towards their patients’ alcohol consumption | 3/3/0/0/0 | 7/0 | |
Patients seeking help | Patients asking primary care doctors or nurses for help or advice about their drinking by their own initiative | 4/4/0/0/0 | 4/6 | |
Support | The extent to which doctors and nurses feel to be working in supporting environment to address alcohol problems | 11/3/5/2/2 | 3/57 | |
Patients’ receptiveness to alcohol interventions | The extent to which doctors and nurses think patients are open to be asked and advised about their drinking | 0/2/1/1/2 | 4/4 | |
Role legitimacy | The extent to which doctors and nurses believe they have a legitimate role in addressing alcohol issues in their patients | 0/1/1/0/0 | 2/0 | |
Presence of third parties in the consultation | Having relatives, friends or other persons attending the consultation with the patient | 0/1/0/0/0 | 1/0 |