• Eilidh M Duncan, Brian H Cuthbertson, Maria E Prior, Andrea P Marshall, Elisabeth C Wells, Laura E Todd, Denise Bolsover, Rumana S Newlands, Fiona Webster, Louise Rose, Marion K Campbell, Geoff Bellingan, Ian M Seppelt, Jill J Francis, and SuDDICU International Study Group.
• Aberdeen Health Psychology Group, Health Services Research Unit, University of Aberdeen, Aberdeen, UK; Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
• J Crit Care. 2014 Aug 1; 29 (4): 634-40.

PurposeSelective decontamination of the digestive tract (SDD) as a prophylactic intervention improves hospital-acquired infection and survival rates. Uptake of SDD is low and remains controversial. This study applied the theoretical domains framework to assess intensive care unit clinicians' views about SDD in regions with limited or no adoption of SDD.Materials And MethodsParticipants were health professionals with "decisional authority" for the adoption of SDD. Semistructured interviews were conducted as the first round of a Delphi study. Views about SDD adoption, delivery, and further SDD research were explored. Directed content analysis of interview data identified subthemes, which informed item development for subsequent Delphi rounds. Linguistic features of interview data were also explored.ResultsOne hundred forty-one participants provided interview data. Fifty-six subthemes were identified; 46 were common across regions. Beliefs about consequences were the most widely elaborated theme. Linguistic features of how participants discussed SDD included caution expressed when discussing the risks and benefits and words such as "worry," "anxiety," and "fear" when discussing potential antibiotic resistance associated with SDD.ConclusionsWe identified salient beliefs, barriers, and facilitators to SDD adoption and delivery. What participants said about SDD and the way in which they said it demonstrated the degree of clinical caution, uncertainty, and concern that SDD evokes.Copyright © 2014 Elsevier Inc. All rights reserved.

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