TABLE 4.
COM‐B: Results, mean and standard deviation of individual COM‐B items
| COM‐B | Questions | Results (summarized) | Mean | SD | |
|---|---|---|---|---|---|
| Capability refers to individuals' physical and psychological capability (skills, strength or stamina) to engage in a behaviour | |||||
| Physical | No questions addressed this aspect | ||||
| Psychological | 1 | I have received adequate training in how to start pACP discussions |
69% SA/A 16% D |
2.19 | 1.123 |
| 2 | I have developed my own approach to pACP initiation through experience | 89% SA/A | 1.56 | .847 | |
| Opportunity refers to environmental factors that influence behaviour and may be physical or social. | |||||
| Physical | 3 | My work environment facilitates pACP discussions adequately | 73% SA/A | 2.03 | 1.075 |
| 4 | I have enough time to engage in pACP discussions. | 75% SA/A | 2.05 | 1.158 | |
| 5 | We have a nominated team member responsible for initiating pACP discussions | No ‐ 89% | 1.89 | .310 | |
| 6 | There are protocols in place to help me find the words to start pACP discussions | No – 74% | 1.74 | .438 | |
| Social | 7 | I have had opportunities to observe experienced colleagues planning and initiating pACPs | 80% SA/A | 1.85 | 1.090 |
| 8 | My colleagues are supportive of pACP discussions with families | 85% as/Mt | 1.71 | .913 | |
| 9 | My ability to begin pACP discussions is impacted by families' cultural beliefs | 61% SA/A | 3.60 | 1.169 | |
| 10 | My ability to begin pACP discussions is impacted by families' religious beliefs | 56% SA/A | 3.47 | 1.206 | |
| 11 | My ability to begin pACP discussions is impacted by families' spiritual beliefs | 55% SA/A | 3.47 | 1.180 | |
| 12 | I delay starting pACP discussions because I am worried about the family's emotional reaction. |
34% SA/A 41% SD/D |
2.81 | 1.166 | |
| 13 | I delay starting pACP discussions because I expect disagreement with families |
11% SA/A 90% SD/D |
2.33 | 1.010 | |
| 14 | I fear parents may lose confidence in me if I start talking about pACP |
8% SA/A 78% SD/D |
1.83 | .985 | |
| 15 | I worry about families losing hope when I start a pACP discussion |
19% SA/A 61% SD/D |
2.27 | 1.164 | |
| Motivation includes all brain processes that guide behaviour and includes reflective and automatic processes. | |||||
| Reflective motivation includes individuals' evaluations and plans to engage in behaviour | 16 | I am confident in how to start pACP conversations. | 88% SA/A | 1.68 | .838 |
| 17 | I believe that I know when to start a pACP conversation | 90% SA/A | 1.72 | .684 | |
| 18 | I believe pACP are unnecessary | 93% SD/D | 1.22 | .586 | |
| 19 | pACP is useful for health care professionals | 96% SA/A | 1.22 | .572 | |
| 20 | pACP is useful for families | 96% SA/A | 1.25 | .573 | |
| 21 | pACP can have an adverse effect on the relationship the family have with me |
12% SA/A 62% SD/D |
2.16 | 1.064 | |
| 22 | pACP fits well with my usual manner of working | 87% SA/A | 1.50 | .708 | |
| 23 | I believe professionals are responsible for starting pACP conversation not the family | 73% SA/A | 2.22 | .687 | |
| 24 | I believe I am responsible for starting pACP conversation | 52% A/MT n = 73 | 2.64 | .967 | |
| 25 | I believe the initiation of pACP is another professionals' responsibility | 83% SD/D | 2.12 | .740 | |
| 26 | I plan how I start pACP (no‐one reported not planning them) |
87% SA/A |
1.57 | .726 | |
| Automatic motivation refers to emotions, impulses and habits. | 27 | I am very motivated to start pACP discussions with families | 88% SA/A | 1.58 | .681 |
| 28 | I feel that starting pACP is part of my existing work process | 87% SA/A | 1.36 | .647 | |
| 29 | I am very uncomfortable discussing death, even with friends. |
25% SA/A 71% SD/D |
2.04 | 1.543 | |
| 30 | I am emotionally prepared to start pACP discussions with families | 93% SA/A | 1.59 | .915 | |
Abbreviations: A, agree; As, always; D, disagree; Mt, most of the time; pACP, paediatric advance care planning; SA, strongly agree; SD, strongly disagree.