Understanding delays in chronic limb‐threatening ischaemia care: Application of the theoretical domains framework to identify factors affecting primary care clinicians' referral behaviours

• DOI: 10.1002/jfa2.12015
• Publication Date: 2024-05-04T19:20:00Z
• Authors: Eleanor Atkins; Panagiota Birmpili; Ian Kellar; Amundeep S. Johal; Qiuju Li; Sam Waton; Jonathan R. Boyle; Arun D. Pherwani; Ian Chetter; David A. Cromwell
• Keywords: Podiatrist; Relevance

Abstract Introduction Patients in the community with suspected Chronic limb‐threatening ischaemia (CLTI) should be urgently referred to vascular services for investigation and management. The Theoretical Domains Framework (TDF) allows identification of influences on health professional behaviour order inform future interventions. Here, TDF is used explore primary care clinicians' behaviours regards recognition referral CLTI. Methods Semi‐structured interviews were conducted 20 podiatrists, nurses general practitioners care. Directed content analysis was performed according framework method. Utterances coded domains, belief statements defined by grouping similar utterances. Relevance domains confirmed frequency, presence conflicting beliefs indicating relevance. Results Nine identified as relevant clinicians: Knowledge, Environmental context resources, Memory, Decision attention processes, Beliefs about capabilities, Skills, Emotions, Reinforcement Behavioural regulation. Relationships across identified, including how clinician confidence working a highly pressurized environment can affect behaviour. Conclusion We have key barriers enablers timely These identify targets theory‐driven change interventions reduce delays CLTI pathways.