{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T19:09:23Z","timestamp":1777662563799,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,10,6]],"date-time":"2024-10-06T00:00:00Z","timestamp":1728172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Clinical practice guidelines (CPGs) are developed to guide physicians in providing consistent high-quality care. Despite availability of evidence-based guidelines for the treatment of distal radius fractures, prior work suggests many patients receive treatment that is misaligned with the CPG. We sought to explore barriers and facilitators of guideline-aligned care for distal radius fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted semistructured interviews of a purposive sample of surgeons who treat distal radius fractures. Our interview guide was based on the Theoretical Domains Framework (TDF). Interviews were transcribed and coded using a deductive analytical approach within the 14 TDF domains. Belief statements underlying similar codes were developed to describe barriers and facilitators of guideline-aligned care. A content analysis was performed to count the frequency of each TDF domain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We interviewed 14 surgeons. The most common TDF domains were beliefs about consequences (110), knowledge (49), and social influences (29). Belief statements representative of barriers of concordance to the CPGs included, \u201cI am more likely to deviate from the CPGs when the CPGs differ from my professional opinion,\u201d which was coded under beliefs about consequences. Similar belief statements were created for each theme within TDF domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Decision-making for patients with distal radius fractures is driven by beliefs about consequences, knowledge, and social influences. Strategies to address these beliefs in other fields such as including patient factors in a further structured shared decision-making process, developing implementation toolkits as part of the CPG development process, and implementing payment programs may improve CPG alignment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447241277843","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T05:35:57Z","timestamp":1728365757000},"page":"124-131","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgeon Alignment With Clinical Practice Guidelines: A Qualitative Analysis of Treatment of Distal Radius Fractures"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2064-8392","authenticated-orcid":false,"given":"Emily A.","family":"Schultz","sequence":"first","affiliation":[{"name":"Stanford University VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Redwood City, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3296-8396","authenticated-orcid":false,"given":"Sara L.","family":"Eppler","sequence":"additional","affiliation":[{"name":"Stanford University VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Redwood City, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren M.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"University of California at San Francisco, Department of Orthopaedic Surgery, San Francisco, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3011-6712","authenticated-orcid":false,"given":"Robin N.","family":"Kamal","sequence":"additional","affiliation":[{"name":"Stanford University VOICES Health Policy Research Center, Department of Orthopaedic Surgery, Redwood City, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,10,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0555-2"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3152\/147154403781776618"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.2011.110180"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281334"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.04.130"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.5.190060"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2012.02.001"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2011.09.039"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10195-022-00663-6"},{"key":"e_1_3_2_11_2","unstructured":"American Academy of Orthopaedic Surgeons. Management of distal radius fractures evidence-based clinical practice guideline. Published December 2020. Accessed August 27 2024. www.aaos.org\/drfcpg"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2021.07.014"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-015-1324-9"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.01297"},{"key":"e_1_3_2_15_2","unstructured":"American Academy of Orthopaedic Surgeons. AAOS clinical practice guideline methodology v4.0. Published 2022. Accessed August 27 2024. https:\/\/www.aaos.org\/globalassets\/quality-and-practice-resources\/methodology\/cpg-methodology.pdf"},{"key":"e_1_3_2_16_2","unstructured":"American Academy of Orthopaedic Surgeons; American Society for Surgery of the Hand. Management of distal radius fractures evidence-based clinical practice guideline. Published December 2020. 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