Table 2.
TDF domains, description, questionnaire scale items and responses
| TDF domains | Description (24) | Statements in the survey (n) | Responses n(%) | Cronbach’s Alphaa | Scale mean | Scale variance | SD | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Strongly disagree | Disagree | Neither agree nor disagree | Agree | Strongly agree | |||||||
| Knowledge- self | An awareness of the existence of something | I know how homelessness affects patient health and wellbeing (315) | 13 (4.1) | 20 (6.3) | 32 (10.2) | 159 (50.5) | 91 (28.9) | 0.80 | 13.33 | 10.66 | 3.27 |
| I know how homelessness affects patient adherence to their medicines (315) | 11 (3.5) | 27 (8.6) | 39 (12.4) | 146 (46.3) | 92 (29.2) | ||||||
| I know how to advise homeless patients about minimising the impact of homelessness on their use of medicines (314) | 25 (8.0) | 125 (39.8) | 92 (29.3) | 56 (17.8) | 16 (5.1) | ||||||
| I know where to refer to if a homeless patient asks me about social support (314) | 40 (12.7) | 116 (36.9) | 56 (17.8) | 82 (26.1) | 19 (6.1) | ||||||
| Knowledge- patients | An awareness of the existence of something | Patients who are homeless know more than I do about coping with homelessness (314) | 5 (1.6) | 20 (6.4) | 71 (22.6) | 144 (45.9) | 74 (23.6) | 0.40 | 6.61 | 1.91 | 1.40 |
| Patients who are homeless know more than I do about general services available to them (315) | 9 (2.9) | 63 (20.0) | 124 (39.4) | 95 (30.2) | 24 (7.6) | ||||||
| Social/professional role and identity | A coherent set of behaviours and displayed personal qualities of an individual in a social or work setting | It is part of my role to ask homeless patients about their housing status (314) | 46 (14.6) | 112 (35.7) | 115 (36.6) | 36 (11.5) | 5 (1.6) | 0.60 | 14.79 | 9.46 | 3.08 |
| I should only initiate a conversation about homelessness if raised by the patient (314) | 14 (4.5) | 72 (22.9) | 90 (28.7) | 116 (36.9) | 22 (7.0) | ||||||
| Only GPs or social care professionals should initiate a conversation about homelessness (314) | 45 (14.3) | 137 (43.6) | 97 (30.9) | 26 (8.3) | 9 (2.9) | ||||||
| If I discuss aspects of homelessness with patients, I believe that I will be outside my own comfort zone (314) | 20 (6.4) | 71 (22.6) | 84 (26.8) | 119 (37.9) | 20 (6.4) | ||||||
| Managing a homeless patient is compatible with my daily practice (311) | 25 (8.0) | 60 (19.3) | 114 (36.7) | 95 (30.5) | 17 (5.5) | ||||||
| Skills/belief about capabilities | An ability or proficiency acquired through practice | I am confident in my ability to advise appropriate medicines management strategies for homeless patients (315) | 27 (8.6) | 114 (36.2) | 70 (22.2) | 86 (27.3) | 18 (5.7) | 0.80 | 11.7 | 11.07 | 3.32 |
| I am confident in approaching social care services on behalf of homeless patients (314) | 48 (15.3) | 105 (33.4) | 61 (19.4) | 83 (26.4) | 17 (5.4) | ||||||
| I am confident in my ability to advise homeless patients on aspects of self-care (314) | 20 (6.4) | 56 (17.8) | 60 (19.1) | 153 (48.7) | 25 (8.0) | ||||||
| I am confident in my ability to identify patients who do not have a fixed abode (313) | 30 (9.6) | 105 (33.5) | 85 (27.2) | 77 (24.6) | 16 (5.1) | ||||||
| Optimism/pessimism | The confidence that things will happen for the best, or that desired goals will be attained | The NHS can do little to alleviate homelessness (314) | 27 (8.6) | 83 (26.4) | 108 (34.4) | 77 (24.5) | 19 (6.1) | 0.70 | 14.1 | 9.40 | 3.07 |
| Pharmacists can do little to alleviate the effects of homelessness (315) | 16 (5.1) | 101 (32.1) | 97 (30.8) | 81 (25.7) | 20 (6.3) | ||||||
| Pharmacists can do little to alleviate the health impact of homelessness (314) | 33 (10.5) | 176 (56.1) | 58 (18.5) | 40 (12.7) | 7 (2.2) | ||||||
| Patients who are homeless may not want my advice about housing or social support (314) | 3 (1.0) | 41 (13.1) | 111 (35.4) | 141 (44.9) | 18 (5.7) | ||||||
| Managing homeless patients in pharmacy is pointless because they do not follow-up with their own care (315) | 36 (11.4) | 144 (45.7) | 99 (31.4) | 32 (10.2) | 4 (1.3) | ||||||
| Beliefs about consequences | Acceptance of the truth, reality, or validity about outcomes of a behaviour in a given situation | If I discuss aspects of homelessness with a patient, I believe that the patient may be reluctant to use my pharmacy again (313) | 27 (8.4) | 133 (42.5) | 106 (33.9) | 43 (13.7) | 4 (1.3) | 0.30 | 12.60 | 4.55 | 2.13 |
| Homeless patients will continue to have poor health outcomes regardless of pharmacy management (312) | 15 (4.8) | 129 (41.3) | 67 (21.5) | 86 (27.6) | 15 (4.8) | ||||||
| Goals | Mental representations of outcomes or end states that an individual wants to achieve | I would feel rewarded if I felt that a homeless patients’ health improved after I had provided advice to them (314) | 2 (0.6) | 3 (1.0) | 24 (7.6) | 156 (49.7) | 129 (41.1) | 0.43 | 7.98 | 1.90 | 1.38 |
| Pharmacy is not the right place to treat homeless patients (315) | 66 (21.0) | 133 (42.2) | 76 (24.1) | 31 (9.8) | 9 (2.9) | ||||||
| Intentions | A conscious decision to perform a behaviour or resolve to act or perform in a certain way | I would ask patients who are homeless whether they have access to food (314) | 9 (2.9) | 90 (28.7) | 87 (27.7) | 112 (35.7) | 16 (5.1) | 0.37 | 5.68 | 2.32 | 1.52 |
| Pharmacists should address medication needs and, not social circumstances of a patient (314) | 18 (5.7) | 119 (37.9) | 98 (31.2) | 65 (20.7) | 14 (4.5) | ||||||
| Environmental context and resources | Any circumstance of a person’s situation or environment that discourages or encourages the development of skills and abilities, independence, social competence, and adaptive behaviour | I have guidelines on advising homeless patients with no fixed abode (312) | 117 (37.5) | 135 (43.3) | 47 (15.1) | 11 (3.5) | 2 (0.6) | 0.70 | 16.7 | 15.71 | 3.96 |
| I have clear guidelines on how to advise homeless patients on their medicines use (313) | 97 (31.0) | 150 (47.9) | 48 (15.3) | 17 (5.4) | 1 (0.3) | ||||||
| I have clear guidelines on how to advise homeless patients on accessing housing information (313) | 121 (38.7) | 141 (45.0) | 39 (12.5) | 11 (3.5) | 1 (0.3) | ||||||
| Availability of guidelines on managing homeless patients in a community pharmacy will positively impact patient care (312) | 14 (4.5) | 20 (6.4) | 57 (18.3) | 163 (52.2) | 58 (18.6) | ||||||
| I have had homeless patients complaining to me of stolen medicines (309) | 80 (25.9) | 95 (30.7) | 60 (19.4) | 55 (17.8) | 19 (6.1) | ||||||
| I have had homeless patients complaining to me about lack of appropriate place to store their medicines (309) | 80 (25.9) | 109 (35.3) | 72 (23.3) | 37 (12.0) | 11 (3.6) | ||||||
| I have sufficient time to discuss aspects of homelessness with my patients (314) | 60 (19.1) | 107 (34.1) | 73 (23.2) | 67 (21.3) | 7 (2.2) | ||||||
| Social influences | Those interpersonal processes that can cause an individual to change their thoughts, feelings, or behaviours | I have sufficient support from my colleagues in my pharmacy in managing homeless patients (313) | 58 (18.5) | 97 (31.0) | 85 (27.2) | 62 (19.8) | 11 (3.5) | 0.52 | 13.50 | 8.93 | 3.0 |
| Homeless patients often experience stigma from pharmacy staff (315) | 26 (8.3) | 80 (25.4) | 105 (33.3) | 80 (25.4) | 24 (7.6) | ||||||
| Homeless patients often experience discrimination from pharmacy staff (314) | 44 (14.0) | 102 (32.5) | 105 (33.4) | 48 (15.3) | 15 (4.8) | ||||||
| My organisation discourages me from discussing homelessness with a patient (311) | 102 (32.8) | 96 (30.9) | 103 (33.1) | 10 (3.2) | 0 (0) | ||||||
| Individuals are responsible for their homelessness (313) | 69 (22.0) | 106 (33.9) | 103 (32.9) | 29 (9.3) | 6 (1.9) | ||||||
| Emotion | A complex reaction pattern, involving experiential, behavioural, and physiological elements, by which the individual attempts to deal with a personally significant matter or event | I become too emotional when I discuss aspects of homelessness with patients (315) | 54 (17.1) | 141 (44.8) | 94 (29.8) | 21 (6.7) | 5 (1.6) | N/A | N/A | N/A | N/A |
N/A not applicable
aNegative statements reversed scored for the analysis