Applying psychological theory to evidence-based clinical practice: Identifying factors predictive of taking intra-oral radiographs

被引:73
作者
Bonetti, Debbie [1 ]
Pitts, Nigel B.
Eccles, Martin
Grimshaw, Jeremy
Johnston, Marie
Steen, Nick
Glidewell, Liz
Thomas, Ruth
Maclennan, Graeme
Clarkson, Jan E.
Walker, Anne
机构
[1] Univ Dundee, Dent Hlth Serv Res Unit, Dundee DD1 4HN, Scotland
[2] Newcastle Univ, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England
[3] Univ Ottawa, Ottawa, ON K1N 6N5, Canada
[4] Univ Aberdeen, Aberdeen AB9 1FX, Scotland
关键词
evidence-based practice; social cognitive theory; intra-oral radiographs; psychological frameworks; theory of planned behaviour; self-regulation model; dentists; Scotland;
D O I
10.1016/j.socscimed.2006.04.005
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
This study applies psychological theory to the implementation of evidence-based clinical practice. The first objective was to see if variables from psychological frameworks (developed to understand, predict and influence behaviour) could predict an evidence-based clinical behaviour. The second objective was to develop a scientific rationale to design or choose an implementation intervention. Variables from the Theory of Planned Behaviour, Social Cognitive Theory, Self-Regulation Model, Operant Conditioning, Implementation Intentions and the Precaution Adoption Process were measured, with data collection by postal survey. The primary outcome was the number of intra-oral radiographs taken per course of treatment collected from a central fee claims database. Participants were 214 Scottish General Dental Practitioners. At the theory level, the Theory of Planned Behaviour explained 13% variance in the number of radiographs taken, Social Cognitive Theory explained 7%, Operant Conditioning explained 8 %, Implementation Intentions explained 11%. Self-Regulation and Stage Theory did not predict significant variance in radiographs taken. Perceived behavioural control, action planning and risk perception explained 16% of the variance in number of radiographs taken. Knowledge did not predict the number of radiographs taken. The results suggest an intervention targeting predictive psychological variables could increase the implementation of this evidence-based practice, while influencing knowledge is unlikely to do so. Measures which predicted number of radiographs taken also predicted intention to take radiographs, and intention accounted for significant variance in behaviour (adjusted R-2 = 5%: F(1, 166) = 10.28, p <.01), suggesting intention may be a possible proxy for behavioural data when testing an intervention prior to a service-level trial. Since psychological frameworks incorporate methodologies to measure and change component variables, taking a theory-based approach enabled the creation of a methodology that
引用
收藏
页码:1889 / 1899
页数:11
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