Table 3.
Provider factors influencing uptake and use of pediatric hospital guidelines in Lao PDR
| Theme | Subtheme | Exemplar quotation |
|---|---|---|
| Behavioural regulation | “Usually paediatric doctors do not like to read” (Pediatric resident 1) | |
| “The attitude” (Pediatric resident 2) | ||
| “Some people don’t like to read, they just do in their same old way” (Pediatric resident 1) | ||
| Trust | “[Through the process of] translation into Lao many senior doctors read and have agreement already, what wouldn’t we trust it?” (Pediatric resident 9) | |
| Belief about capabilities | It makes staff and residents more confident...they have the same guidelines as the teachers have...They think they do the right thing for the patient.” (Pediatrician 20, central hospital 1) | |
| This book....is the same as a teacher who sits here with us. If I want to ask the teacher I open the book and look....If I want to check something about a symptom or treatment of a child I go to this book...I am more confident...(District hospital doctor 2) | ||
| Beliefs about consequences | Improved rational prescribing | “… it has changed a lot. Before we did this workshop to give medicines, the method, the patient comes and we give ceftriaxone. But after, we changed the medicine depending on severity and we changed the way we give amoxicillin...” (Pediatrician 12, central hospital 2) |
| Standardisation of care | “…before we did not have a book and some read this [book], and some read that, and there is no agreement...but now we have [information] in the book, we can tell them, use the book…Anywhere, anything is the same...” (Pediatrician 17, central hospital 3) | |
| Completeness of care | “At the beginning of seeing every patient we compare things we do with the information in the book. We must agree in the ways we take care of patients such as triage, drug doses…should be done step-by-step, as the book says.” (Provincial doctor 5) | |
| Attitude to reading | “[The Pocketbook]...encourages nurses, doctors and other people to read more...the people want to read more...because they understand.” (Pediatrician 4, central hospital 2) | |