Assessment of factors influencing physicians’ intention to prescribe transfusion using the theory of planned behavior

Abstract

Background: Blood shortage is a persistent problem affecting Taiwan’s health-care system. The theory of planned behavior (TPB) has been commonly used in studies of health advocacy. The purpose of this study was to develop a questionnaire measuring clinicians’ intention to prescribe transfusion based on the TPB. Method: A questionnaire comprising 15 items for assessing clinicians’ intention to prescribe blood transfusion was developed, and it collected demographic characteristics tested patient blood management (PBM) and perceived knowledge of PBM. Furthermore, it contained four subscales related to the TPB. A total of 129 clinicians participated in this pilot study between July and December, 2020. Item analysis and exploratory factor analysis were conducted to examine the validity and reliability of this measurement instrument. Results: The results indicated no statistically significant correlations between the demographic characteristics and test scores. Regarding perceived knowledge, the results of a one-way analysis of variance revealed that the effect of age, hierarchy of doctors, and education level was significant. In terms of subjective norms, a significant effect for education level was noted [t (129) = 2.28, p < 0.05], with graduate school graduates receiving higher scores than college graduates. An analysis of variance demonstrated the effect of hierarchy, education level, and medical specialty on perceived behavioral control. The results of the regression analyses revealed that perceived knowledge (β = 0.32, p < 0.01) and subjective norms (β = 0.22, p < 0.05) were significantly related to clinicians’ behavioral intention. Conclusions: This study revealed that factors affecting clinicians’ blood transfusion management can be explained using the TPB-based questionnaire. This study demonstrated that physicians’ perception of whether most people approve of PBM and their self-assessment of their PBM knowledge affect their intention to proceed with PBM. According to this finding, a support system among physicians must be established and maintained to increase physician’s confidence in promoting PBM.