Can the collective intentions of individual professionals within healthcare teams predict the team's performance: developing methods and theory

<p>Abstract</p> <p>Background</p> <p>Within implementation research, using theory-based approaches to understanding the behaviours of healthcare professionals and the quality of care that they reflect and designing interventions to change them is being promoted. However...

Full description

Bibliographic Details
Main Authors: Bosch Marije, Steen Nick, Francis Jillian J, Hrisos Susan, Eccles Martin P, Johnston Marie
Format: Article
Language:English
Published: BMC 2009-05-01
Series:Implementation Science
Online Access:http://www.implementationscience.com/content/4/1/24
id doaj-1f8e5cc28cba4935877784439349cf67
record_format Article
spelling doaj-1f8e5cc28cba4935877784439349cf672020-11-25T00:57:19ZengBMCImplementation Science1748-59082009-05-01412410.1186/1748-5908-4-24Can the collective intentions of individual professionals within healthcare teams predict the team's performance: developing methods and theoryBosch MarijeSteen NickFrancis Jillian JHrisos SusanEccles Martin PJohnston Marie<p>Abstract</p> <p>Background</p> <p>Within implementation research, using theory-based approaches to understanding the behaviours of healthcare professionals and the quality of care that they reflect and designing interventions to change them is being promoted. However, such approaches lead to a new range of methodological and theoretical challenges pre-eminent among which are how to appropriately relate predictors of individual's behaviour to measures of the behaviour of healthcare professionals. The aim of this study was to explore the relationship between the theory of planned behaviour proximal predictors of behaviour (intention and perceived behavioural control, or PBC) and practice level behaviour. This was done in the context of two clinical behaviours – statin prescription and foot examination – in the management of patients with diabetes mellitus in primary care. Scores for the predictor variables were aggregated over healthcare professionals using four methods: simple mean of all primary care team members' intention scores; highest intention score combined with PBC of the highest intender in the team; highest intention score combined with the highest PBC score in the team; the scores (on both constructs) of the team member identified as having primary responsibility for the clinical behaviour.</p> <p>Methods</p> <p>Scores on theory-based cognitive variables were collected by postal questionnaire survey from a sample of primary care doctors and nurses from northeast England and the Netherlands. Data on two clinical behaviours were patient reported, and collected by postal questionnaire survey. Planned analyses explored the predictive value of various aggregations of intention and PBC in explaining variance in the behavioural data.</p> <p>Results</p> <p>Across the two countries and two behaviours, responses were received from 37 to 78% of healthcare professionals in 57 to 93% practices; 51% (UK) and 69% (Netherlands) of patients surveyed responded. None of the aggregations of cognitions predicted statin prescription. The highest intention in the team (irrespective of PBC) was a significant predictor of foot examination.</p> <p>Conclusion</p> <p>These approaches to aggregating individually-administered measures may be a methodological advance of theoretical importance. Using simple means of individual-level measures to explain team-level behaviours is neither theoretically plausible nor empirically supported; the highest intention was both predictive and plausible. In studies aiming to understand the behaviours of teams of healthcare professionals in managing chronic diseases, some sort of aggregation of measures from individuals is necessary. This is not simply a methodological point, but a necessary step in advancing the theoretical and practical understanding of the processes that lead to implementation of clinical behaviours within healthcare teams.</p> http://www.implementationscience.com/content/4/1/24
collection DOAJ
language English
format Article
sources DOAJ
author Bosch Marije
Steen Nick
Francis Jillian J
Hrisos Susan
Eccles Martin P
Johnston Marie
spellingShingle Bosch Marije
Steen Nick
Francis Jillian J
Hrisos Susan
Eccles Martin P
Johnston Marie
Can the collective intentions of individual professionals within healthcare teams predict the team's performance: developing methods and theory
Implementation Science
author_facet Bosch Marije
Steen Nick
Francis Jillian J
Hrisos Susan
Eccles Martin P
Johnston Marie
author_sort Bosch Marije
title Can the collective intentions of individual professionals within healthcare teams predict the team's performance: developing methods and theory
title_short Can the collective intentions of individual professionals within healthcare teams predict the team's performance: developing methods and theory
title_full Can the collective intentions of individual professionals within healthcare teams predict the team's performance: developing methods and theory
title_fullStr Can the collective intentions of individual professionals within healthcare teams predict the team's performance: developing methods and theory
title_full_unstemmed Can the collective intentions of individual professionals within healthcare teams predict the team's performance: developing methods and theory
title_sort can the collective intentions of individual professionals within healthcare teams predict the team's performance: developing methods and theory
publisher BMC
series Implementation Science
issn 1748-5908
publishDate 2009-05-01
description <p>Abstract</p> <p>Background</p> <p>Within implementation research, using theory-based approaches to understanding the behaviours of healthcare professionals and the quality of care that they reflect and designing interventions to change them is being promoted. However, such approaches lead to a new range of methodological and theoretical challenges pre-eminent among which are how to appropriately relate predictors of individual's behaviour to measures of the behaviour of healthcare professionals. The aim of this study was to explore the relationship between the theory of planned behaviour proximal predictors of behaviour (intention and perceived behavioural control, or PBC) and practice level behaviour. This was done in the context of two clinical behaviours – statin prescription and foot examination – in the management of patients with diabetes mellitus in primary care. Scores for the predictor variables were aggregated over healthcare professionals using four methods: simple mean of all primary care team members' intention scores; highest intention score combined with PBC of the highest intender in the team; highest intention score combined with the highest PBC score in the team; the scores (on both constructs) of the team member identified as having primary responsibility for the clinical behaviour.</p> <p>Methods</p> <p>Scores on theory-based cognitive variables were collected by postal questionnaire survey from a sample of primary care doctors and nurses from northeast England and the Netherlands. Data on two clinical behaviours were patient reported, and collected by postal questionnaire survey. Planned analyses explored the predictive value of various aggregations of intention and PBC in explaining variance in the behavioural data.</p> <p>Results</p> <p>Across the two countries and two behaviours, responses were received from 37 to 78% of healthcare professionals in 57 to 93% practices; 51% (UK) and 69% (Netherlands) of patients surveyed responded. None of the aggregations of cognitions predicted statin prescription. The highest intention in the team (irrespective of PBC) was a significant predictor of foot examination.</p> <p>Conclusion</p> <p>These approaches to aggregating individually-administered measures may be a methodological advance of theoretical importance. Using simple means of individual-level measures to explain team-level behaviours is neither theoretically plausible nor empirically supported; the highest intention was both predictive and plausible. In studies aiming to understand the behaviours of teams of healthcare professionals in managing chronic diseases, some sort of aggregation of measures from individuals is necessary. This is not simply a methodological point, but a necessary step in advancing the theoretical and practical understanding of the processes that lead to implementation of clinical behaviours within healthcare teams.</p>
url http://www.implementationscience.com/content/4/1/24
work_keys_str_mv AT boschmarije canthecollectiveintentionsofindividualprofessionalswithinhealthcareteamspredicttheteamsperformancedevelopingmethodsandtheory
AT steennick canthecollectiveintentionsofindividualprofessionalswithinhealthcareteamspredicttheteamsperformancedevelopingmethodsandtheory
AT francisjillianj canthecollectiveintentionsofindividualprofessionalswithinhealthcareteamspredicttheteamsperformancedevelopingmethodsandtheory
AT hrisossusan canthecollectiveintentionsofindividualprofessionalswithinhealthcareteamspredicttheteamsperformancedevelopingmethodsandtheory
AT ecclesmartinp canthecollectiveintentionsofindividualprofessionalswithinhealthcareteamspredicttheteamsperformancedevelopingmethodsandtheory
AT johnstonmarie canthecollectiveintentionsofindividualprofessionalswithinhealthcareteamspredicttheteamsperformancedevelopingmethodsandtheory
_version_ 1725224628195950592