title: Attitudes and perceptions about clinical guidelines: a qualitative study with Spanish physicians.
abstract: BACKGROUND
  Clinical guidelines (CGs) are popular for healthcare decision making but their acceptability and use by healthcare providers is influenced by numerous factors. Some of these factors are professional-related, such as knowledge and perceptions of and attitudes toward CGs in general. The aim of our study was to evaluate attitudes and perceptions of Spanish physicians towards CGs.
  
  
  METHODS
  We coordinated six discussion groups with a total of 46 physicians. The participants were drawn from 12 medical specialties from both specialized and primary care. We recorded the sessions and transcribed the content verbatim. We analyzed the data using an approach based on the grounded theory.
  
  
  RESULTS
  We identified two main constructs that defined the physicians' perceptions towards guidelines: knowledge and usefulness. "Knowledge" defined the theoretical meanings of guidelines, while "Usefulness" referred to the pragmatic approach to guidelines. These constructs were interrelated through a series of categories such as confidence, usability, accessibility, dissemination and formats.
  
  
  CONCLUSIONS
  In our study, the constructs that impacted most on physician's attitudes to clinical guidelines were knowledge and usefulness. The tension between the theoretical and the pragmatic constructs determined the attitudes and how physicians use guidelines. Groups developing guidelines should ask relevant clinical questions and develop implementable and context specific recommendations. Developers should be explicit and consistent in the development and presentation of recommendations.
authors: Iberoamerican Cochrane Centre - Clinical Epidemiology and Public Health Department, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain ; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors: Ivan
authors: I
authors: Solà
authors: University of Navarra, Institute for Culture and Society, Pamplona, Spain.
authors: José Miguel
authors: JM
authors: Carrasco
authors: Scientific Committee of Guíasalud - National Clinical Practice Guideline Programme of the NHS, Madrid, Spain.
authors: Petra
authors: P
authors: Díaz Del Campo
authors: Scientific Committee of Guíasalud - National Clinical Practice Guideline Programme of the NHS, Madrid, Spain.
authors: Javier
authors: J
authors: Gracia
authors: Avedis Donabedian Research Institute (FAD), Barcelona, Spain ; Universitat Autònoma de Barcelona, Barcelona, Spain ; Red de investigación en servicios de salud en enfermedades crónicas (REDISSEC), Barcelona, Spain.
authors: Carola
authors: C
authors: Orrego
authors: General Secretariat of Public Health, Social Inclusion and Quality of Life, Andalusian Regional Ministry of Health and Social Well-being, Seville, Spain.
authors: Flora
authors: F
authors: Martínez
authors: Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain.
authors: Anna
authors: A
authors: Kotzeva
authors: Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain.
authors: Imma
authors: I
authors: Guillamón
authors: Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.
authors: Enrique
authors: E
authors: Calderón
authors: Scientific Committee of Guíasalud - National Clinical Practice Guideline Programme of the NHS, Madrid, Spain ; Servicio de Docencia y Desarrollo Sanitarios, Departamento de Salud Gobierno de Navarra, Spain.
authors: Idoia
authors: I
authors: de Gaminde
authors: Centro de Saúde de Cambre. Xerencia de Atención Primaria A Coruña - SERGAS -, A Coruña, Spain.
authors: Arturo
authors: A
authors: Louro
authors: Scientific Committee of Guíasalud - National Clinical Practice Guideline Programme of the NHS, Madrid, Spain ; Grupo Kronikgune sobre gestión del conocimiento, Centro de Salud de Alza, Donostia-San Sebastián, Spain.
authors: Rafael
authors: R
authors: Rotaeche
authors: Scientific Committee of Guíasalud - National Clinical Practice Guideline Programme of the NHS, Madrid, Spain ; Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain.
authors: Flavia
authors: F
authors: Salcedo
authors: Iberoamerican Cochrane Centre - Clinical Epidemiology and Public Health Department, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
authors: Paola
authors: P
authors: Velázquez
authors: Iberoamerican Cochrane Centre - Clinical Epidemiology and Public Health Department, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain ; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain ; Scientific Committee of Guíasalud - National Clinical Practice Guideline Programme of the NHS, Madrid, Spain.
authors: Pablo
authors: P
authors: Alonso-Coello
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D010820:Physicians; D017410:Practice Guidelines as Topic; D013030:Spain