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Table 3 Descriptions of determinants most commonly mapped to constructs

From: Factors affecting the delivery of complex rehabilitation interventions in research with neurologically impaired adults: a systematic review

Construct Determinant example
‘Facilitation strategies’ • Experts used by clinicians for support (16, 24, 35, 39, 48, 52, 53, 65).
• Specific tools used to deliver an intervention (35, 39, 50, 51, 53, 63, 66, 67, 72, 73, 79)
• Naturalistic environments, e.g. home environment, in which to deliver the intervention (49, 69, 72, 79, 80).
‘Patient needs and resources’ • Acceptability, or not, of the intervention by the patient and or carer is part of this construct and was noted in the majority of studies. Reasons for acceptability were not always explored.
• Equipment, e.g. a DVD with practice exercises to watch, could not be used by all patients (72); batteries failed (73); unavailability of necessary equipment (16, 35, 38, 55); uncomfortable or inconvenient equipment (63, 68)
• Participation difficult due to competing work commitments of patients and or carers (72, 50, 75, 47, 57, 74, 54)
‘Readiness for implementation’ • The organisation’s ability to provide appropriate environments and appointments (16, 48, 62, 63, 64, 69, 74, 79,) or not (16, 35, 54, 55, 62, 64, 74)
• Difficulties obtaining staff backfill, or not receiving additional staff for which research funds had been allocated (24, 65)
• The availability of appropriate training to deliver the intervention (16, 24, 38, 39, 51, 52, 53, 54, 55, 62, 80, 82)
• Not using training resources (24, 62)
• Delay between training and starting intervention delivery (24, 54)
‘Participant responsiveness’ • Age, disease severity, physical limitations, sensory impairment, and symptoms such as fatigue were reported across most studies. Other aspects of participant responsiveness is reported in patient needs and resources above
‘knowledge and beliefs of the intervention’ • Reports by clinicians that training was only useful if adhered to (39)
• Clinicians’ acceptance of the intervention was reported across most studies