Applying psychological theory to evidence-based clinical practice: Identifying factors predictive of taking intra-oral radiographs
Applying psychological theory to evidence-based clinical practice: Identifying factors predictive of taking intra-oral radiographs
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DOI：
10.1016/j.socscimed.2006.04.005
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发表时间：
2006-10-01
影响因子：
5.4
通讯作者：
Walker, Anne
中科院分区：
文献类型：
--
作者：
Bonetti, Debbie;Pitts, Nigel B.;Walker, Anne
本研究将心理学理论应用于循证临床实践的实施。第一个目标是看看来自心理学框架(开发来理解、预测和影响行为)的变量是否可以预测基于证据的临床行为。第二个目标是为设计或选择实施干预措施提供科学依据。通过邮寄调查收集数据，测量了计划行为理论、社会认知理论、自我调节模型、操作条件、实施意图和预防采用过程中的变量。主要结果是每个疗程的口腔内X光照片的数量，这些照片是从中央费用索赔数据库收集的。参与者是214名苏格兰全科牙科医生。在理论层面上，计划行为理论解释了X光照片数量差异的13%，社会认知理论解释了7%，操作条件反射理论解释了8%，实施意图解释了11%。自我调节和阶段性理论并不能预测X光片的显著差异。感知到的行为控制、行动计划和风险感知解释了拍摄X光照片数量差异的16%。结果表明，针对预测性心理变量的干预可以增加这一循证实践的实施，而影响知识不太可能做到这一点。预测拍摄X光照片数量的测量也预测了拍摄X光照片的意向，意图解释了行为的显著差异(调整后的R-2=5%：F(1,166)=10.28，p
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