Background
Interference and facilitation between healthcare delivery goal-directed behaviours
Physical activity and BP control in the diabetes consultation
Methods
Sampling and recruitment procedures
Data collection procedure
Analysis
Inter-rater reliability
Construct-specific coding
Control beliefs
Intention and past behaviour
Goal facilitation and goal interference
Results
Participants
Past behaviour
Intention
Control beliefs
Goal interference
Physical activity advice (N = 10 GPs) | Blood pressure prescribing (N = 7 GPs) | ||
---|---|---|---|
Theme | Goal-directed behaviours | Theme | Goal-directed behaviours |
Consultation (n = 8) | - fitting the patient agenda | Consultation (n = 4) | - capturing other GP contract information |
- focusing on GP contract-specific goals | - dealing with pressing issues | ||
- treating acute illness | - pursuing the contract BP targets | ||
- other clinical aspects (general) | - too much else going on in the consultation | ||
Diabetes (n = 4) | - addressing medication | - treating acute illness | |
- covering blood pressure and cholesterol | Diabetes (n = 2) | - addressing cholesterol | |
- giving instruction for diabetic control | - multiple drugs to prescribe | ||
- getting HbA1c down | - talking about glycemic control | ||
- looking at blood sugar | GP/patient relationship (n = 3) | - providing patient choice | |
GP factors (n = 2) | - not wanting to be a broken record | - respecting patient preference | |
- wanting to go home |
Goal facilitation
Physical activity advice (N = 11) | Blood pressure prescribing (N = 11) | ||
---|---|---|---|
Theme | Goal-directed behaviour | Theme | Goal-directed behaviour |
Consultation (n = 1) | - Taking a history | Consultation (n = 6) | - Clearly structuring the consultation |
Diabetes (n = 10) | - Addressing blood pressure | - Discussing diabetes as a whole | |
- Addressing cholesterol | - Engaging the patient | ||
- Addressing HbA1c | - Negotiating with the patient | ||
- Discussing cardiovascular risk | - Advise patient to return if side effects | ||
- Discussing sugar control | - Trying to reach GP contract targets | ||
- Discussing heart and kidney risks | Discussion about future health (n = 5) | - Addressing HbA1C | |
Lifestyle (n = 8) | - Addressing alcohol | - Addressing poor sugar control | |
- Addressing smoking | - Discussing cholesterol | ||
- Asking about work | - Discussing reducing risks | ||
- Checking BMI | - Showing CV risk | ||
- Checking general fitness | Lifestyle (n = 3) | - Exercise advice | |
- Talking about weight | - Taking a holistic approach | ||
- Talking about diet | - Giving weight advice | ||
- Weighing the patient | Educating patient (n = 4) | - Re: medication and side effects | |
Mental health (n = 2) | - Addressing well-being | - Re: high blood pressure | |
- Asking about low mood | - In general | ||
- Asking about stress | - Quoting guidelines | ||
- Showing results | |||
Prescribing (n = 3) | - Choosing drugs with good side effects | ||
- Explaining options | |||
- Following guidelines | |||
- Planning prescribing options |