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Table 2 Thematic content analysis based on the TDF for physiotherapists

From: Professional barriers and facilitators to using stratified care approaches for managing non-specific low back pain: a qualitative study with Canadian physiotherapists and chiropractors

DomainQuestions (N)Utterances (N)Specific beliefs (N)Specific beliefs (number of utterances)Increasea N (%)Decreaseb N (%)No Influencec N (%)Themes
Knowledge4564I am aware of existing SCA (14)56 (100)00Awareness 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 consequences3443I 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)00Consequence 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 capabilities1141I am confident in assessing NSLBP patients using SCA & determining the targeted treatments. (14)14 (100)00Acceptance, capabilities
Behavioural Regulation3313I do (13)/ don't (1) have strategies to monitor changes in patients’ health status26 (84)05 (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)
Skills4534I have been trained to use SCA (14)41 (77)012 (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)
Intention1141I will manage all (10)/ most (4) of the next 10 patients using SCA14 (100)00Decision to manage patients using SCAs
Goals1161The goal of managing NSLBP patients with SCA is (12)/ not (4) incompatible with achieving other objectives.4 (25)12 (75)0Incompatibility with achieving other objectives
Memory, Attention & Decision2282Deciding if a patient should be managed using SCA is easy (11)/ not easy (1).27 (96)1 (4)0Ease 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).
Reinforcement1141I would manage NSLBP most of the time using the SCA because rewards are greater and patients are satisfied. (14)14 (100)00Better outcomes reinforce the use of SCAs
Environmental Context and Resources3525Barriers 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 Influences4584I 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.
Optimism1141I am generally optimistic (13)/ not sure (1) regarding the added value of using SCA, in my daily practice.13 (93)01 (7)Positive attitude
Social Professional identity2272I consider using SCA to be part of my work as a physiotherapist. (13)27 (100)00Professional role;
Professional agreement
I think it is appropriate that my role should include managing patients with non-specific LBP using the SCA. (14)
  1. aStatements perceived to increase use of stratified care approaches (facilitators). b Statements perceived to reduce use of stratified care approaches (barriers). c Statements perceived to neither increase/decrease the use of stratified care approaches. SCA stratified care approach, LBP low back pain.