Neurologists' discussion intentions regarding a medical innovation: an examination of psychological determinants and personal normative influences.

Abstract

Progression of Parkinson's disease (PD) and use of the mainstay drugs to treat the disease leads to severe movement disorders with accompanying disability in a portion of PD patients. Deep brain stimulation (DBS) surgery is an FDA-approved treatment innovation for disabled PD patients, improving mobility and quality-of-life over and above the effects found using mainstay drug therapy. This research used the theory of reasoned action and the theory of planned behavior to examine antecedents to neurologists initiating a discussion of DBS surgery with a hypothetical PD patient. A national, cross-sectional mail survey (with online option) was conducted among a random sample of practicing U.S. neurologists. Participants totaled 86, for a response rate of 13.9%. Hierarchical linear regression showed that adding perceived behavioral control (PBC) to attitude and subjective norm resulted in significant ÄR2 = .22 in the prediction of intention. Of the two personal normative influences proposed as extensions to the TPB, adding moral norm resulted in a significant ÄR2 = .02, whereas role identity was non-significant. Mediation analyses showed that attitude partially mediated the effects of beliefs about the target, DBS surgery. PBC fully mediated perceived knowledge, whereas treatment benefit certainty was mediated partially by PBC. Implications for communication campaigns are discussed.