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Table 2 List of themes and codes

From: Acceptance and use of a clinical decision support system in musculoskeletal pain disorders – the SupportPrim project

Themes

Codes

1. Overall impression of usability and acceptability

 Patient profile

Understandable, self-explanatory, informative, acceptable amount of information, good design (figures, symbols, text, colour), easy to use, well-structured, reflects how the patient history is currently taken (anamnesis) and the current workflow, possible to integrate, enough/not enough time, quick picture of the patient and focus, relevant for prognosis

 Matching and treatment

Means to discuss patient preferences, valuable with multiple factors, interface: messy with excessive, irrelevant, confusing information, treatment suggestions: too extensive/too sparse, unsuitable, requiring explanation if to include patient (or not used)

2. A tool for exploring and preparing

 Patients

Data collection beneficial: less need for explanation, saves time, relief: do not forget, enables targeted questions, otherwise hard to open up, increased reflexivity: more aware, empowering, thinking differently about health, effects on sleep, work and social life, more/less severe than expected leading to questioning own coping skills/relief, physiotherapists seem prepared, enthusiastic, and reach heart of the matter faster

 Physiotherapists

Facilitates anamnesis and comprehensive thinking, maps all relevant aspects of health, careful: can shape therapists’ behaviour, should not rely on the system

3. Building a therapeutic relationship

 Physiotherapists

Good starting point for conversations, useful in building therapeutic relations, structures anamnesis, dialogue and focus, careful: prejudice if system shows high and multifaceted symptoms, cautious, not become deterministic

 Patients

First impression: felt seen and heard, not another in line, involved, physiotherapist explained in an understandable language, CDSS: makes it easier to explain, aligns understandings of the problem and treatment, already aware: visualisation is not scary/depressing

4. Patient involvement

 Patient profile and goals

Patient participation, elaboration, dialogues and discussions, joint goal- and activity setting, increases awareness and feeling of purpose

Matching and treatment

Varying involvement dependent on therapist and patient, high: actively participating in selection, discussing alternatives, deciding, low: not seen the screen/similar patients, physiotherapist decided treatment, patients: good feeling to participate, opportunity to omit, add, or question treatment and have it explained, included more than expected, could have used more time, surprised by activity level, rely on physiotherapists expertise, physiotherapists: support or substantiate treatment already decided/own practice, tool for maintaining biopsychosocial focus, reassess best practice, uncertain addressing some issues (mental health, sleep), open vs inappropriate to adapt some treatments, careful: can spread uncertainty when suggestions differ

5 Recovery expectations

 

Reassuring: someone similar/worse off has improved, not reassuring: similar matches are much older, patient trajectory graphs: motivating, timespan for and variations in improvement, can lead to positive beliefs, recovery expectations, careful: can create unrealistic expectations