Table 2 Thematic content analysis based on the TDF for physiotherapists

Knowledge

4

56

4

I am aware of existing SCA (14)

56 (100)

0

0

Awareness of SCAs; Knowledge of evidence

My understanding about the use of SCA is to classify patients into groups to provide effective treatment for each group. (14)

I agree with the recommended use of SCA for LBP patients. (14)

I know how to use SCA to target the management of non-specific LBP patients. (14)

Belief about consequences

3

44

3

I believe the benefits of using SCA include empowering patients to self-manage, more accurate assessment, better matching of treatment, minimizing visits and costs, increasing self-efficacy, less passive treatment. (16)

44 (100)

0

0

Consequence of managing patients with/without

SCAs

I believe the disadvantages of not using SCA include slower recovery, lower patient satisfaction, less self-management and autonomy, longer treatment time, higher costs, poorer standard of care. (14)

Outcomes I expect to see are less pain, better function, faster recovery, adherence to protocols, self-management, higher satisfaction, faster return to work, fewer visits, less medication. (14)

Belief about capabilities

1

14

1

I am confident in assessing NSLBP patients using SCA & determining the targeted treatments. (14)

14 (100)

0

0

Acceptance, capabilities

Behavioural Regulation

3

31

3

I do (13)/ don't (1) have strategies to monitor changes in patients’ health status

26 (84)

0

5 (16)

Assessing readiness for change; Intentional planning behaviour

It would be helpful to have: more subjective and objective exams (2), team work (1), and awareness from other stakeholders (1).

I have a clear plan under what circumstances I will use SCA in my practice. (13)

Skills

4

53

4

I have been trained to use SCA (14)

41 (77)

0

12 (23)

Clinical training; Clinician-Patient and clinician –clinician communication skill

I have the necessary skills to use SCA (13)

Skills required to treat patients with high risk of disability are: ability to screen, good communication, psychosocial training, teamwork. (12)

Communication skills are extremely important for the management of LBP patients using SCA. (14)

Intention

1

14

1

I will manage all (10)/ most (4) of the next 10 patients using SCA

14 (100)

0

0

Decision to manage patients using SCAs

Goals

1

16

1

The goal of managing NSLBP patients with SCA is (12)/ not (4) incompatible with achieving other objectives.

4 (25)

12 (75)

0

Incompatibility with achieving other objectives

Memory, Attention & Decision

2

28

2

Deciding if a patient should be managed using SCA is easy (11)/ not easy (1).

27 (96)

1 (4)

0

Ease of decision

The rule of thumb I use to guide my decision making for the patient care is: the SCA itself (11), research and effectiveness (1), the mechanical component in the history (2), or patient compliance (2).

Reinforcement

1

14

1

I would manage NSLBP most of the time using the SCA because rewards are greater and patients are satisfied. (14)

14 (100)

0

0

Better outcomes reinforce the use of SCAs

Environmental Context and Resources

3

52

5

Barriers to using SCA include lack of time, cost, other colleagues who do not use SCA, lack of expertise, patient preference, language, and unmotivated patients. (16)

34 (65)

17 (33)

1 (2)

Environmental resources

No barriers to using SCA. (1)

Facilitators to using SCA include: need for fewer sessions, having private room, autonomy, team work, and support from management. (6)

No (13)/ some (1) onsite rehabilitation equipment is required.

There are resources available that help me manage patients using the SCA. (15)

Social Influences

4

58

4

I would (9)/ not (4) consider consulting more experienced practitioners if I need help.

41 (71)

10 (17)

7 (12)

Influence of colleagues and researchers; psychological cases influence

decision

The views of other colleagues (9)/ researchers (7) influence my decision to manage patients using SCA.

Having an acute patient in apparent distress would (1)/ would not (13) influence my decision to manage such patients using the SCA.

Having a chronic patient with important psychological overlay would (5)/ would not (10) influence my decision to manage with SCA.

Optimism

1

14

1

I am generally optimistic (13)/ not sure (1) regarding the added value of using SCA, in my daily practice.

13 (93)

0

1 (7)

Positive attitude

Social Professional identity

2

27

2

I consider using SCA to be part of my work as a physiotherapist. (13)

27 (100)

0

0

Professional role;

Professional agreement

I think it is appropriate that my role should include managing patients with non-specific LBP using the SCA. (14)