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Table 1 Explanations of the twelve theoretical domains used to generate Round 1 data

From: Clinical stakeholders’ opinions on the use of selective decontamination of the digestive tract in critically ill patients in intensive care units: an international Delphi study

Domain label[12] Domain content
Beliefs about consequences Often regarded as core to clinical reasoning, this domain covers the perceived benefits and harms of a clinical action. In some contexts it can also include consequences for the clinician such as workload, pay, career progression, or for the hospital or health service.
Behavioural regulation Includes the ‘how’ of changing clinical practice: what are the practical strategies that would facilitate or hinder uptake of a new practice.
Beliefs about capabilities How confident clinicians are that they could change their practice effectively.
Emotion Includes issues such as work stress, patient anxiety and other emotional factors that may help or hinder the uptake of new approaches to care.
Environmental context/resources Includes the physical (including financial) issues that may limit change, including staffing levels and time as well as equipment or space.
Knowledge Knowledge of the field (that is, whether there is adequate evidence) and individuals’ knowledge of the evidence or of a guideline.
Memory, attention and decision processes The level of attention that is needed to perform the key clinical action (that is, whether forgetting is likely to be a problem) and the processes by which clinical decisions are made by individuals and teams.
Motivation and goals The relative priority that is given to one clinical issue, compared with other demands.
Social/professional role and identity The clinical thinking and norms of a particular profession.
Skills Covers the possibility that new skills would be required by the staff that are required to implement a new procedure.
Social influences The influence of other individuals or groups on clinical practice; for example, patients, patients’ families, pressure groups.
Nature of the behaviours Some new practices are very similar to current practice and so are easier to implement than new practices that require a dramatic change in ways of working.