Table 4.

Initial and final programme theories.

ID	Initial programme theory	Changes	Final programme theory
A	Patients in a specialist palliative care setting (Context) who have previously fallen are more likely to fall again (Outcome) because they have reduced functional status (Resource) as a result of the first fall (physical or physiological) (Reasoning).	None	Patients in a specialist palliative care setting (Context) who have previously fallen are more likely to fall again (Outcome) because they have reduced functional status (Resource) as a result of the first fall (physical or physiological) (Reasoning).
B	Patients in a specialist palliative care setting (Context) who are prescribed more than 5 medicines (Resource) are at increased risk of falling (Outcome) because of impaired mobility and/or cognition (Reasoning).	None	Patients in a specialist palliative care setting (Context) who are prescribed more than 5 medicines (Resource) are at increased risk of falling (Outcome) because of impaired mobility and/or cognition (Reasoning).
C	Patients in a specialist palliative care setting (Context) who are prescribed benzodiazepines (Resource) are at increased risk of falling (Outcome) because of impaired cognition (Reasoning).	Effect of medication and impact of other medicines	Patients in a specialist palliative care setting (Context) who are prescribed benzodiazepines and/or neuroleptic medications (Resource) are at increased risk of falling (Outcome) because of impaired cognition, sedation or other side effects (Reasoning).
D	Patients in a specialist palliative care setting (Context) who experience delirium (Resource) are at increased risk of falling (Outcome) because of cognitive impairment, inability to follow instructions or acute distress (Reasoning).	Effects of medicines used to treat delirium	Patients in a specialist palliative care setting (Context) who experience delirium (Resource) are at increased risk of falling (Outcome) because of cognitive impairment, inability to follow commands or acute distress all of which may be related to the delirium itself, the underlying cause of the delirium and/or the medicines used to treat delirium (Reasoning).
E	Patients in a specialist palliative care setting (Context) who are over the age of 65 (Resource) are at increased risk of falling (Outcome) because of impaired mobility and/or cognition (Reasoning).	Subsumed into ‘F’
F	Patients in a specialist palliative care setting (Context) who are over the age of 65 (Resource) are at increased risk of harm from a fall (Outcome) because of impaired mobility/weakness (Reasoning)	E and F combined	Patients in a specialist palliative care setting (Context) who are over the age of 65 (Resource) are at increased risk of falling and harm from falling (Outcome) because of impaired mobility/weakness and/or cognition (Reasoning).
G	Falls (Outcome) in a specialist palliative care setting (Context) can often be related to elimination or continence needs (Resource) because of urgency or inability to request help and therefore the patient independently mobilises to the bathroom (Reasoning).	Invalidated
H	Patients in a specialist palliative care setting (Context) who have a poor functional status (Resource) are more likely to fall (Outcome) due to weakness and impaired mobility (Reasoning).	None	Patients in a specialist palliative care setting (Context) who have a poor functional status (Resource) are more likely to fall (Outcome) due to weakness and impaired mobility (Reasoning).
		Additional PT added	Patients in a specialist palliative care setting (Context) who have an improving functional status (Resource) are more likely to fall (Outcome) due to increased likelihood of independent mobility and/or adaptation to increased levels of functionality.
I	Patients in a specialist palliative care setting (Context) who have a diagnosis of advanced/metastatic cancer (Resource) are at increased risk of falling (Outcome) because of fatigue/reduced functional status/polypharmacy (Reasoning).	Invalidated
J	In a specialist palliative care setting (Context) falls prevention is a priority (Resource) but patients continue to fall (Outcome) due to their wish to maintain their independence (Reasoning).	None	In a specialist palliative care setting (Context) falls prevention is a priority (Resource) but patients continue to fall (Outcome) due to their wish to maintain their independence (Reasoning).
K	Patients in a specialist palliative care setting (Context) who sustain a fall (Resource) will be adversely affected and at increased risk of mortality and morbidity from a the fall (Outcome) due to their complex disease processes, fear of deterioration in condition and existing reduced functional status (Reasoning)	None	Patients in a specialist palliative care setting (Context) who sustain a fall (Resource) will be adversely affected and at increased risk of mortality and morbidity from a the fall (Outcome) due to their complex disease processes, fear of deterioration in condition and existing reduced functional status (Reasoning)