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Table 2 Matrix of change objectives created by crossing the performance objectives (behavioural performance objectives 1–4 and environmental performance objectives 5–6) with the theoretical determinants

From: Using an intervention mapping approach to develop prevention and rehabilitation strategies for musculoskeletal pain among surgeons

Performance objectives Theoretical determinants
Knowledge Skills Attitudes Social influence Self-efficacy Outcome expectations
1. Surgeons perform strength training to reduce the relative load on muscles Have knowledge about strength training effects and how to perform training Possess the skills to perform strength training Acknowledge the meaning of strength training as health promoting Management and surgeons give priority to strength training and surgeons support each other Feel confident with performing strength training and believe in own abilities Expectation that strength training prevents musculoskeletal pain
2. Surgeons gain knowledge on how their work impacts their health Have knowledge about how operations can impact on the musculoskeletal system Possess the skills to prevent negative physical influence of work Accept that musculoskeletal pain may be a consequence of being a surgeon Management and surgeons build a common understanding of potential negative impacts on health Believe they are capable of preventing work-related musculoskeletal pain Expectation that prevention of musculoskeletal pain will lead to a healthier working life
3. Surgeons learn to use physical ergonomic guidelines and available equipment Have knowledge about physical ergonomic guidelines and how to use available equipment Possess the skills to use physical ergonomics and available equipment Accept and are positive about the use of physical ergonomics Management and surgeons support colleagues’ use of ergonomic equipment Feel confident with using ergonomic equipment and believe in own abilities Expectation that physical ergonomics has a preventive effect on musculoskeletal pain
4. Surgeons incorporate micro-breaks during surgery to prevent muscle fatigue Have knowledge about how to use micro-breaks Possess the skills to implement micro-breaks during operations Accept and are positive about the usefulness of micro-breaks during operations Management and surgeons support colleagues’ use of micro-breaks. Believe in their ability to implement micro-breaks Expectation that use of micro-breaks has a preventive effect on musculoskeletal pain
5. Management prioritise surgeons’ health Have knowledge about surgeons’ work-related challenges and impact on musculoskeletal health Possesses the skills for continuously prioritising surgeons’ musculoskeletal health Make clear the meaningfulness and importance of giving priority to preventive and rehabilitating strategies Support relevant strategies e.g. physical ergonomics and physical exercise training Believes that strategies for prevention of musculoskeletal pain are feasible and effective Expectation that if the management actively prioritises prevention of musculoskeletal pain among surgeons, the surgeons will also prioritise the issue themselves.
6. The hospital incorporates strategies and action plans focusing on surgeons’ musculoskeletal pain Has knowledge about prevention and rehabilitation of work-related musculoskeletal pain Possesses the skills to continuously perform and renew strategies for prevention and rehabilitation of musculoskeletal pain Makes clear the meaningfulness and importance of surgeons’ musculoskeletal health Provides support to strategies that allow surgeons to perform their job without experiencing work-related musculoskeletal pain Believes that strategies and action plans can prevent and rehabilitate musculoskeletal pain among surgeons Expectation that by having strategies and action plans ready for the surgeons, the surgeons feel more obliged to engage, which is likely to improve efficiency