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Sabbe K, van der Mast R, Dilles T, Van Rompaey B. Validation of the Delirium Observation Screening Scale in long-term care facilities in Flanders. Geriatr Gerontol Int 2024; 24:619-625. [PMID: 38624223 DOI: 10.1111/ggi.14878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/22/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024]
Abstract
AIM The aim of this study was to validate the Delirium Observation Screening Scale (DOSS) in a population of long-term care facility (LTCF) residents in Flanders. Currently there is no validated screening tool for delirium available for the population in this setting in Flanders. METHODS A multisite, cross-sectional study was conducted in six LTCFs. A total of 338 residents aged 65 years and older were included. Sociodemographic and clinical data, including data from the Montreal Cognitive Assessment (MoCA), Confusion Assessment Method (CAM) and DOSS, were obtained by three trained nurse researchers. For the DOSS, internal consistency was determined, and inter-rater reliability was calculated. To validate the DOSS, the sensitivity, specificity, and positive and negative predictive value of the DOSS relative to the CAM were determined through receiver operating characteristic analysis. This article adheres to the Strengthening the Reporting of Observational Studies (STROBE) checklist for observational research. RESULTS For 338 residents, delirium assessments were completed during an early or late shift. The prevalence of delirium was 14.2% as measured with the DOSS. The reliability (α) for the CAM and DOSS was assessed, as was the inter-rater reliability (κ) and the area under the curve. The sensitivity and specificity for a cut-off value of 3 on the DOSS by Youden's index were very high, as was the negative predictive value. The positive predictive value was good. CONCLUSIONS This study showed that the DOSS is a reliable and valid instrument to screen for delirium in LTCF residents in Flanders. Geriatr Gerontol Int 2024; 24: 619-625.
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Affiliation(s)
- Kelly Sabbe
- Faculty of Medicine and Health Sciences, Department of Nursing and Midwifery, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium
- Health Service Research, Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | - Roos van der Mast
- Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
- Leiden University Medical Centre, University of Leiden, Leiden, The Netherlands
| | - Tinne Dilles
- Faculty of Medicine and Health Sciences, Department of Nursing and Midwifery, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium
| | - Bart Van Rompaey
- Faculty of Medicine and Health Sciences, Department of Family Medicine and Population Health (FAMPOP), University of Antwerp, Antwerp, Belgium
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De Mesa RYH, Galingana CLT, Tan-Lim CSC, Javelosa MAU, Panganiban JMS, Fabian NMC, Calderon Y, Rey MP, Bernal-Sundiang N, Sanchez JT, Dans LF, Casile RU, Dans AL. Facing the digital frontier: exploring user acceptance of electronic health records in an urban, rural and remote setting in the Philippines. BMJ Open Qual 2024; 13:e002621. [PMID: 38637020 PMCID: PMC11029422 DOI: 10.1136/bmjoq-2023-002621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/12/2024] [Indexed: 04/20/2024] Open
Abstract
OBJECTIVES A thorough understanding of user needs and behavioural intent-to-use underpins the development of a responsive health information system. This study aimed to examine health workers' intent-to-use an electronic health record (EHR) system in an urban, rural and remote setting in the Philippines. METHODS Following the Unified Theory of Acceptance and Use of Technology framework, user acceptance and the factors influencing intent-to-use the EHR were examined through a self-administered questionnaire. A total of 128 EHR users, comprising physicians, nurses, midwives, barangay health workers and administrative staff, were surveyed. Median scores for each domain were compared across the sites using the Kruskal-Wallis test. Ridge regression analysis was used to identify factors associated with behavioural intent-to-use. RESULTS Over 94% of users across all sites reported their intent-to-use the EHR in the near future. Of the seven predictor variables examined, only self-efficacy was found to be significantly associated with behavioural intent-to-use. Intent-to-use the EHR increased by 31% (p=0.007) for each unit increase in self-efficacy score among participants. DISCUSSION Acceptance was high across the three sites, with self-efficacy being a predictor of intent-to-use the technology. This suggests that users are more likely to adopt an EHR if they believe they have the capacity to successfully navigate the technology and perform their designated tasks with it. CONCLUSION Co-producing interventions with primary care providers is crucial in sustaining EHR systems. Rather than developing a technology based on the surveillance needs of policymakers, an EHR developed from the grassroots was shown to be well-received by end-users.
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Affiliation(s)
- Regine Ynez H De Mesa
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Cara Lois T Galingana
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Carol Stephanie C Tan-Lim
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
| | - Mark Anthony U Javelosa
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
| | | | - Noleen Marie C Fabian
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
- University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines
| | - Ysabela Calderon
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Mia P Rey
- Department of Accounting and Finance, Cesar E.A. Virata School of Business, University of the Philippines Diliman, Quezon City, Philippines
| | - Nannette Bernal-Sundiang
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Josephine T Sanchez
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Leonila F Dans
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
| | - Ray U Casile
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Antonio L Dans
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
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Lee J, Park S, Cho MH, Kang JW, Kim M, Choi S, Kim SG, Choi JH, Han K, Kim CO, Moon IC, Choi M, Jang SN. Development of a web-based care networking system to support visiting healthcare professionals in the community. BMC Health Serv Res 2023; 23:1427. [PMID: 38104086 PMCID: PMC10725602 DOI: 10.1186/s12913-023-10434-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The role of visiting health services has been proven to be effective in promoting the health of older populations. Hence, developing a web system for nurses may help improve the quality of visiting health services for community-dwelling frail older adults. This study was conducted to develop a web application that reflects the needs of visiting nurses. METHODS Visiting nurses of public health centers and community centers in South Korea participated in the design and evaluation process. Six nurses took part in the focus group interviews, and 21 visiting nurses and community center managers participated in the satisfaction evaluation. Focus group interviews were conducted to identify the needs of visiting nurses with respect to system function. Based on the findings, a web application that can support the effective delivery of home visiting services in the community was developed. An artificial intelligence (AI) algorithm was also developed to recommend health and welfare services according to each patient's health status. After development, a structured survey was conducted to evaluate user satisfaction with system features using Kano's model. RESULTS The new system can be used with mobile devices to increase the mobility of visiting nurses. The system includes 13 features that support the management of patient data and enhance the efficiency of visiting services (e.g., map, navigation, scheduler, protocol archives, professional advice, and online case conferencing). The user satisfaction survey revealed that nurses showed high satisfaction with the system. Among all features, the nurses were most satisfied with the care plan, which included AI-based recommendations for community referral. CONCLUSIONS The system developed from the study has attractive features for visiting nurses and supports their essential tasks. The system can help with effective case management for older adults requiring in-home care and reduce nurses' workload. It can also improve communication and networking between healthcare and long-term care institutions.
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Affiliation(s)
- Jakyung Lee
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Susan Park
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Mi-Hee Cho
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Ro, Dongjak-Gu, Seoul, 06974, Republic of Korea
| | - Ji-Won Kang
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Minkyoung Kim
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Suhyeon Choi
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Seok-Gyu Kim
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Ji-Hee Choi
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Keumhee Han
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Chang-O Kim
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea
| | - Il-Chul Moon
- Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Moon Choi
- Graduate School of Science and Technology Policy, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Soong-Nang Jang
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of Korea.
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Ro, Dongjak-Gu, Seoul, 06974, Republic of Korea.
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Walle AD, Hunde MK, Demsash AW. Healthcare professionals' intention to adopt mobile phone-based SMS and its predictors for adherence support and care of TB patients in a resource-limited setting: a structural equation modelling analysis. BMJ Open 2023; 13:e070813. [PMID: 38149411 PMCID: PMC10711927 DOI: 10.1136/bmjopen-2022-070813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 11/08/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVE To assess healthcare providers' intentions and the associated factors to use mobile phone-based short message service (SMS) to support adherence and care of tuberculosis (TB) patients in the Oromia region of southwest Ethiopia. STUDY DESIGN An institutional-based cross-sectional study was conducted from October to November 2022. STUDY SETTING The study was conducted in public hospitals which include Mettu Karl referral hospital, Dembi Hospital, Bedelle Hospital, Darimu Hospital and Chora Hospital in Ilu Aba Bor and Buno Bedelle zones. PARTICIPANTS A total of 625 (54.9% male and 45.1% female) health professionals participated in the study. The study participants were selected using a simple random sampling technique. All health professionals permanently working in Ilu Aba Bor and Buno Bedelle zone hospitals were included in this study. However, health professionals with less than 6 months of experience and those who were not present during the data collection period were excluded from this study. OUTCOME MEASURE The intention to use mobile phone-based SMS to support TB patients. RESULTS Healthcare professionals' intention to use mobile SMS was 54.4%. Effort expectancy had a significant direct effect on attitude (β=0.162, p<0.01) and intention towards using mobile phone SMS (β=0.329, p<0.001). The intention to use mobile phone SMS was directly influenced by facilitating conditions (β=0.104, p<0.01) and attitude (β=0.26, p<0.001). The relationship between effort expectancy and intention to use SMS was mediated by attitude (β=0.043, p<0.01). CONCLUSIONS Overall, intention to use of mobile-based SMS was high. Effort expectancy, attitude and facilitating conditions were significant factors that determined healthcare professionals' behavioural intention to use mobile phone SMS. Effort expectancy had a more significant prediction power than others. As a result, system forms that are easily interactive and applicable should be implemented to improve capacity building and support the adherence and care of TB patients.
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Affiliation(s)
- Agmasie Damtew Walle
- Department of Health Informatics, College of Health Sciences, Mattu University, Mettu, Ethiopia
| | - Mekonnen Kenate Hunde
- Department of Lifelong Learning and Community Development, College of Education and Behavioral sciences, Mettu University, Mettu, Ethiopia
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Wei S, Ge P, Zhang J, Xu S, Wang Y, Li Q, Feng B, Yu W, Suo B, Zhang Y, Wang M, Sun X, Song Z, Wu Y. Exploring factors that influence the behavioural intention of medical students to use 3D gastroscopic model to learn how to operate gastroscope using UTAUT Model. BMC MEDICAL EDUCATION 2023; 23:554. [PMID: 37550684 PMCID: PMC10408095 DOI: 10.1186/s12909-023-04532-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 07/23/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND The application of virtual reality (VR) in gastroscopic operation teaching can be safe and effective, but the advantages can be realized only when students accept and use it. This study aims to identify the factors influencing Chinese clinical medical postgraduates on their intention to use the 3D gastroscopic model constructed based on VR technology using Unified Theory of Acceptance and Use of Technology (UTAUT) model. Students' demographic factors are also taken into consideration. METHODS All methods were carried out in accordance with relevant guidelines. Data were collected from clinical medical postgraduates students in China using stratified sampling. A total of 292 questionnaires including valid responses were used in this study. Data were processed using Amos 24.0 and SPSS 26.0 software and the statistical analysis technique was based on structural equation modeling (SEM). RESULTS The results showed that different from the mediator of home location and year of clinical learning, mediator of gender, university kind and graduate degree did not affect the behavioral intention. In addition, performance expectancy, facilitating condition, and social influence directly and indirectly have effect on behavioral intention. Also, the significance between social influence and performance expectancy, social influence and effort expectancy were verified. CONCLUSIONS This study manifested that the proposed framework based on the UTAUT had explanatory power to identify the factors influencing the students' behavioral intention to use the 3D gastroscopic model constructed based on VR technology. Whereas, an important variable of effort expectancy in the frame of the SEM were not certified, thereby indicating that particular attention should be paid to this variable by universities and teachers before applying 3D gastroscopic model constructed based on VR technology in teaching. Added preparatory work is required such as explaining the basic knowledge of the operating steps of VR model and make students adequately understand its accessibility, which can probably improve the intentions of them to use it. The positive effects of social influence on performance expectancy and effort expectancy we proposed was also verified in this study, which provided a direction for future research.
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Affiliation(s)
- Shuting Wei
- Translational Medicine Research Center, Medical Innovation Research Division, Fourth Medical Center of the Chinese PLA General Hospital, Beijing, China
| | - Pu Ge
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jinzi Zhang
- College of Humanities and Social Sciences, Harbin Medical University, Heilongjiang, China
| | - Shuxian Xu
- China Pharmaceutical University, Nanjing, China
| | - Yujia Wang
- College of Humanities and Social Sciences, Harbin Medical University, Heilongjiang, China
| | - Qiyu Li
- School of Humanities and health management, Jinzhou Medical University, Jinzhou, China
| | - Bojunhao Feng
- School of Medicine, Macau University of Science and Technology, Macao, China
| | - Wenli Yu
- School for Sports Humanities and Social Science, Jilin Sport University, Changchun, China
| | - Baojun Suo
- Department of Gastroenterology, Peking University Third Hospital, Beijing, China
| | - Yueyang Zhang
- Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Tsinghua University, Beijing, China
| | - Mingxing Wang
- The Third Clinical Medical College, Harbin Medical University, Heilongjiang, China
| | - Xinying Sun
- School of Public Health, Peking University, Beijing, China
| | - Zhiqiang Song
- Department of Gastroenterology, Peking University Third Hospital, Beijing, China.
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
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Deng W, Yang T, Deng J, Liu R, Sun X, Li G, Wen X. Investigating Factors Influencing Medical Practitioners' Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study. J Med Internet Res 2023; 25:e46621. [PMID: 37523226 PMCID: PMC10425818 DOI: 10.2196/46621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND The swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners. OBJECTIVE This study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework. METHODS A mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model. RESULTS On the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (β=-.55; P<.001) and work overload (β=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms. CONCLUSIONS This study investigated the factors that facilitate or hinder medical practitioners' resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.
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Affiliation(s)
- Wenhao Deng
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Tianan Yang
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Jianwei Deng
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Ran Liu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xueqin Sun
- Department of Medical Insurance Management, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Gang Li
- TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinmei Wen
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Gallant NL, Hadjistavropoulos T, Stopyn RJN, Feere EK. Integrating Technology Adoption Models Into Implementation Science Methodologies: A Mixed-Methods Preimplementation Study. THE GERONTOLOGIST 2023; 63:416-427. [PMID: 35810405 PMCID: PMC10028232 DOI: 10.1093/geront/gnac098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Sustainable implementation of patient-oriented technologies in health care settings is challenging. Preimplementation studies guided by the Consolidated Framework for Implementation Research (CFIR) can provide opportunities to address barriers and leverage facilitators that can maximize the likelihood of successful implementation. When looking to implement patient-oriented technologies, preimplementation studies may also benefit from guidance from a conceptual framework specific to technology adoption such as the Unified Theory of Acceptance and Use of Technology. This study was, therefore, aimed at identifying determinants for the successful implementation of a patient-oriented technology (i.e., automated pain behavior monitoring [APBM] system) within a health care setting (i.e., long-term care [LTC] facility). RESEARCH DESIGN AND METHODS Using a mixed-methods study design, 164 LTC nurses completed a set of questionnaires and 68 LTC staff participated in individual interviews involving their perceptions of an APBM system in LTC environments. Quantitative data were analyzed using a series of mediation analyses and narrative responses were examined using directed content analysis. RESULTS Performance expectancy and effort expectancy partially and fully mediated the influence of implementation, readiness for organizational change, and technology readiness constructs on behavioral intentions to use the APBM system in LTC environments. Findings from the qualitative portion of this study provide guidance for the development of an intervention that is grounded in the CFIR. DISCUSSION AND IMPLICATIONS Based on our results, we offer recommendations for the implementation of patient-oriented technologies in health care settings.
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Affiliation(s)
- Natasha L Gallant
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
- Centre on Aging and Health, University of Regina, Regina, Saskatchewan, Canada
| | - Thomas Hadjistavropoulos
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
- Centre on Aging and Health, University of Regina, Regina, Saskatchewan, Canada
| | - Rhonda J N Stopyn
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
- Centre on Aging and Health, University of Regina, Regina, Saskatchewan, Canada
| | - Emma K Feere
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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The Implementation of Integrated Health Information Systems - Research Studies from 7 Countries Involving the InterRAI Assessment System. Int J Integr Care 2023; 23:8. [PMID: 36819613 PMCID: PMC9936911 DOI: 10.5334/ijic.6968] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/24/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction In the past years, governments from several countries have shown interest in implementing integrated health information systems. The interRAI Suite of instruments fits this concept, as it is a set of standardised, evidence-based assessments, which have been validated for different care settings. The system allows the electronic transfer of information across care settings, enabling integration of care and providing support for care planning and quality monitoring. The main purpose of this research is to describe the recent implementation process of the interRAI instruments in seven countries: Belgium, Switzerland, France, Ireland, Iceland, Finland and New Zealand. Methods The study applied a case study methodology with the focus on the implementation strategies in each country. Principal investigators gathered relevant information from multiple sources and summarised it according to specific aspects of the implementation process, comparing them across countries. The main implementation aspects are described, as well as the main advantages and barriers perceived by the users. Results The seven case studies showed that adequate staffing, appropriate information technology, availability of hardware, professional collaboration and continuous training are perceived as important factors which can contribute to the implementation of the interRAI instruments. In addition, the use of electronic standardised assessment instruments such as the interRAI Suite provided evidence to improve decision-making and quality of care, enabling resource planning and benchmarking. Conclusion In practice, the implementation of health information systems is a process that requires a cultural shift of policymakers and professional caregivers at all levels of health policy and service delivery. Information about the implementation process of the interRAI Suite in different countries can help investigators and policymakers to better plan this implementation. This research sheds light on the advantages and pitfalls of the implementation of the interRAI Suite of instruments and proposes approaches to overcome difficulties.
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Yao Y, Li Z, He Y, Zhang Y, Guo Z, Lei Y, Zhao Q, Li D, Zhang Z, Zhang Y, Liao X. Factors affecting wearable ECG device adoption by general practitioners for atrial fibrillation screening: cross-sectional study. Front Public Health 2023; 11:1128127. [PMID: 37213597 PMCID: PMC10196261 DOI: 10.3389/fpubh.2023.1128127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/11/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction Atrial fibrillation (AF) is a challenging cardiovascular disease worldwide. Wearable electrocardiograph devices (WEDs) have great potential to improve the detection rate of AF in primary care. However, the factors that influence general practitioners' (GPs) perception and acceptance of WEDs are not well understood. To identify factors that influence the intention of GPs to utilize WEDs in a clinical setting to screen patients for AF. Method The research hypotheses and questionnaire items were designed and developed based on the unified theory of acceptance and technology (UTAUT) framework. We used stratified sampling and obtained the data through an online survey. Structural equation modeling was used to analyze the collected data.Results: A total of 1,004 valid questionnaires from GPs across Sichuan province in China were collected. Three factors increased GPs' intention to utilize WEDs to screen patients for AF, including performance expectancy (β = 0.121, p = 0.004), social influence (β = 0.356, p < 0.001), and price perception (β = 0.587, p < 0.001). Perception risk (β = -0.059, p < 0.001) decreased usage intention, while effort expectancy (β = -0.079, p = 0.155) and facilitating conditions (β = -0.014, p = 0.868) did not affect usage intention. Gender (β = -0.022, p = 0.179), age (β = 0.006, p = 0.699), education level (β = -0.22, p = 0.184) and training (β = 0.007, p = 0.69) were not significantly correlated with usage intention, and these four factors had no moderating effect on the path coefficients. Discussion GPs' intention to utilize WEDs is affected by performance expectancy, price perception, perception risk and social influence. Researcher should improve the usability and perception of WEDs for screening and carry out studies to provide high-quality evidence for the security and efficacy of wearable devices.
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Affiliation(s)
- Yi Yao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhichao Li
- Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yi He
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
- Chengdu Seventh People Hospital, Chengdu, China
| | - Yalin Zhang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaoxia Guo
- Business School, Sichuan University, Chengdu, China
| | - Yi Lei
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Zhao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
| | - Dongze Li
- Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi Zhang
- Chengdu Shuangliu District Xihanggang Community Hospital, Chengdu, China
| | - Yonggang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Yonggang Zhang,
| | - Xiaoyang Liao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xiaoyang Liao,
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10
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Molinari-Ulate M, Mahmoudi A, Parra-Vidales E, Muñoz-Sánchez JL, Franco-Martín MA, van der Roest HG. Digital health technologies supporting the application of comprehensive geriatric assessments in long-term care settings or community care: A systematic review. Digit Health 2023; 9:20552076231191008. [PMID: 37529535 PMCID: PMC10388630 DOI: 10.1177/20552076231191008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/13/2023] [Indexed: 08/03/2023] Open
Abstract
Objective To provide high-quality elderly care, digital health technologies (DHTs) can potentially assist in reaching the full capacity of comprehensive geriatric assessments (CGAs) to improve communication and data transfer on patients' medical and treatment plan information and health decision-making. This systematic review aimed to describe the evidence on the feasibility and usability, efficacy and effectiveness, and implementation outcomes of DHTs developed to facilitate the administration of CGAs for long-term care settings or community care and to describe their technical features and components. Methods A search strategy was conducted in three databases, targeting studies evaluating the DHTs facilitating the administration of CGAs used in long-term care settings or community care. Studies in English and Spanish published up to 5 April 2023 were considered. Results Four DHTs supporting the administration of the CGAs were identified. Limited information was found on the technical features and required hardware. Some of the barriers identified regarding usability can be overcome with novel technologies; however, training of health professionals on the assessments and staff knowledge regarding the purpose of the data collected are not technology related and need to be addressed. Conclusions Barriers regarding usability were related to experienced difficulties navigating the software, unstable network connectivity, and length of the assessment. Feasibility obstacles were associated with the lack of training to use the DHT, availability and accessibility to hardware (e.g. laptops), and lack of insight into the clinical benefits of collected data. Further research must focus on these areas to improve the implementation and usefulness of these DHTs.
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Affiliation(s)
- Mauricio Molinari-Ulate
- Psycho-Sciences Research Group, Institute of Biomedical Research of Salamanca, University of Salamanca, Salamanca, Spain
- Department of Research and Development, Iberian Institute of Research in Psycho-Sciences, INTRAS Foundation, Zamora, Spain
| | - Aysan Mahmoudi
- Psycho-Sciences Research Group, Institute of Biomedical Research of Salamanca, University of Salamanca, Salamanca, Spain
- Department of Research and Development, Iberian Institute of Research in Psycho-Sciences, INTRAS Foundation, Zamora, Spain
| | - Esther Parra-Vidales
- Department of Research and Development, Iberian Institute of Research in Psycho-Sciences, INTRAS Foundation, Zamora, Spain
| | - Juan-Luis Muñoz-Sánchez
- Psychiatry and Mental Health Department, Hospital Universitario Río Hortega, Valladolid, Spain
| | - Manuel A Franco-Martín
- Psycho-Sciences Research Group, Institute of Biomedical Research of Salamanca, University of Salamanca, Salamanca, Spain
- Psychiatric and Mental Health Department, Zamora Healthcare Complex, Zamora, Spain
| | - Henriëtte G van der Roest
- Department on Aging, Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
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11
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Factors influencing the elderly’s adoption of mHealth: an empirical study using extended UTAUT2 model. BMC Med Inform Decis Mak 2022; 22:191. [PMID: 35871682 PMCID: PMC9308955 DOI: 10.1186/s12911-022-01917-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Despite the high usage of mobile phones in daily life in developing countries like Bangladesh, the adoption and usage of mHealth services have been significantly low among the elderly population. When searching previous studies, the researchers have found that no studies have empirically investigated whether the quality of life and service quality are significant for mHealth adoption by elderlies in Bangladesh. Hence, this study aimed to extend the Unified Theory of Acceptance and Use of Technology by adding service quality and the quality of life to empirically find the key factors that influence elderlies’ intention to adopt and use mHealth services in Bangladesh.
Methods A face-to-face structured questionnaire survey method was used to collect data from 493 elderlies (aged 60 years and above) in Bangladesh. The data were analyzed with the Structural Equations Modelling (SEM) and Fuzzy Set Qualitative Comparative Analysis (fsQCA). Results SEM results suggested that Social Influence, Hedonic Motivation, Price Value, Habit, and Service Quality had significant impact (p < 0.05) on the elderlies’ behavioral intention to adopt mHealth services. Service Quality, Quality of Life, and elderlies’ Habit were found significant in explaining the Use Behavior of mHealth services. Quality of Life did not show significant (p > 0.05) effect on Behavioral Intention, which is inconsistent with existing literature. In addition, fsQCA findings suggest how the intensity of the influencers may contribute to high versus low m-health behavioral outcomes. Conclusions The findings have significant implications for theory, practice and future research as explained in the paper. The originality of this study is the integration of quality of life and service quality into UTUAT2 to explain the users’ behavioural intention and use behaviour. Overall, the findings may contribute to shaping appropriate policies for designing and implementing mHealth services effectively for elderlies in developing countries.
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12
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Mensah IK, Zeng G, Mwakapesa DS. The behavioral intention to adopt mobile health services: The moderating impact of mobile self-efficacy. Front Public Health 2022; 10:1020474. [PMID: 36238232 PMCID: PMC9553028 DOI: 10.3389/fpubh.2022.1020474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 09/12/2022] [Indexed: 01/28/2023] Open
Abstract
This study explored the moderating impact of mobile self-efficacy on the adoption of mobile health services. The UTAUT was used as the theoretical foundation for this study. The results have indicated that mobile self-efficacy was significant in moderating the impact of both performance expectancy (β = -0.005, p < 0.05) and effort expectancy (β = -010, p < 0.05) on the adoption of mobile health services. In addition, it was revealed to our surprise that both performance (β = 0.521, t = 9.311, p > 0.05) and effort expectancy (β = 0.406, t = 7.577, p > 0.05) do not determine the behavioral intention to use mobile health services. Effort expectancy and behavioral intention to use were also, respectively, not significant in influencing performance expectancy (β = 0.702, t = 12.601, p > 0.05) and intention to recommend the adoption of mobile health services (β = 0.866, t = 13.814, p > 0.05). Mobile self-efficacy, however, was found to significantly predict the citizen's intention to recommend the adoption of mobile health services (β = 0.139, t = 2.548, p < 0.05). The implications of these findings on mobile health are discussed.
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Affiliation(s)
- Isaac Kofi Mensah
- School of Business Administration, Fujian Jiangxia University, Fuzhou, China,*Correspondence: Isaac Kofi Mensah
| | - Guohua Zeng
- School of Economics and Management, Jiangxi University of Science and Technology, Ganzhou, China,Guohua Zeng
| | - Deborah Simon Mwakapesa
- School of Civil and Surveying Engineering, Jiangxi University of Science and Technology, Ganzhou, China
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13
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Using health information technology in residential aged care homes: An integrative review to identify service and quality outcomes. Int J Med Inform 2022; 165:104824. [DOI: 10.1016/j.ijmedinf.2022.104824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/07/2022] [Accepted: 06/22/2022] [Indexed: 11/24/2022]
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14
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Liu Y, Lu X, Zhao G, Li C, Shi J. Adoption of mobile health services using the unified theory of acceptance and use of technology model: Self-efficacy and privacy concerns. Front Psychol 2022; 13:944976. [PMID: 36033004 PMCID: PMC9403893 DOI: 10.3389/fpsyg.2022.944976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/15/2022] [Indexed: 11/17/2022] Open
Abstract
Mobile health (mHealth) services have been widely used in medical services and health management through mobile devices and multiple channels, such as smartphones, wearable equipment, healthcare applications (Apps), and medical platforms. However, the number of the users who are currently receiving the mHealth services is small. In China, more than 70% of internet users have never used mHealth services. Such imbalanced situation could be attributed to users’ traditional concept of medical treatment, psychological factors (such as low self-efficacy) and privacy concerns. The purpose of this study is to explore the direct and indirect effects of mHealth users’ self-efficacy and privacy concerns on their intention to adopt mHealth services, providing guidelines for mHealth service providers to enhance users’ intention of adoption. A questionnaire was designed by the research team and 386 valid responses were collected from domestic participants in China. Based on the unified theory of acceptance and use of technology (UTAUT) model, a research model integrated self-efficacy and privacy concerns was constructed to investigate their effects on users’ intention to adopt mobile mHealth services. The results show that self-efficacy could facilitate users’ intention to adopt mHealth services, and had a significantly positive effect on perceived ubiquity, effort expectancy, performance expectancy and subjective norm. This study verifies the direct and indirect effects of self-efficacy and privacy concerns on users’ intention to adopt mHealth services, providing a different perspective for studying mHealth adoption behavior. The findings could provide guidelines for mHealth service providers to improve their service quality and enhance users’ intention of adoption.
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Affiliation(s)
- Yizhi Liu
- College of Management, Guizhou University, Guiyang, China
| | - Xuan Lu
- College of Management, Guizhou University, Guiyang, China
| | - Gang Zhao
- School of Engineering, University of Tasmania, Hobart, TAS, Australia
| | - Chengjiang Li
- College of Management, Guizhou University, Guiyang, China
- School of Engineering, University of Tasmania, Hobart, TAS, Australia
- *Correspondence: Chengjiang Li,
| | - Junyi Shi
- School of Humanities and Social Sciences, Xi’an Jiaotong-Liverpool University, Suzhou, China
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15
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Deandrea S, Ferrè F, D’Antona R, Angiolini C, Bortul M, Bucchi L, Caumo F, Fortunato L, Giordano L, Giordano M, Mantellini P, Martelli I, Melucci G, Naldoni C, Paci E, Pau L, Saguatti G, Sestini E, Tinterri C, Vainieri M, Cataliotti L. Integrating mammography screening programmes into specialist breast centres in Italy: insights from a national survey of Senonetwork breast centres. BMC Health Serv Res 2022; 22:723. [PMID: 35641985 PMCID: PMC9153866 DOI: 10.1186/s12913-022-08111-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Despite recommendations, mammography screening is often insufficiently integrated into specialist breast centres. A national, cross-sectional, voluntary, online survey on this issue was carried out among the Italian breast centres associated with Senonetwork, the Italian network of breast cancer services.
Methods
A 73-item questionnaire was created, pre-tested and piloted. Centres integrating and not integrating a screening programme were compared using the unified theory of acceptance and use of technology (UTAUT) model. Centres’ clustering was performed using the Gower’s distance metric. Groups and clusters were compared with the equality-of-means test.
Results
The response rate was 82/128 (65%). Overall, 84% (69/82) breast centres reported a collaboration with a screening programme in performing and/or reading mammograms and in the diagnostic work-up of women with abnormal screening results. The same proportion was observed among those centres responding to all questions (62/74). Performance expectancies (or the perceived usefulness of integration in terms of clinical quality, patient convenience, ease of job, and professional growth), satisfaction and motivation were higher in those centres collaborating with the screening programme. Effort expectancy indicators (or the degree to which the respondents believe that the integration is easy to implement) and those concerning the existence of facilitating conditions were lower both in centres collaborating and not collaborating with the screening programme. Among the former, six clusters of centres, distributed from ‘no integration’ to ‘high’, were identified. In cluster analysis, the highest level of integration was associated with higher agreement that integration eases the job, offers better opportunities for professional growth, and makes the working environment more satisfactory. The least integrated cluster assigned the lowest score to the statement that local health authority made available the resources needed.
Conclusions
While confirming the positive effects of integrating screening programmes into breast centres, this survey has brought to light specific difficulties that must be faced. The results provide insights into the importance of integration focusing on the perspectives of professional career and motivation. The deficiency of facilitating conditions to integration is modifiable. Screening professionals’ societies may have a role as initiators of the integration. Other supporting actions may be included in health laws at the national and regional level.
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16
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Research on the Construction of a Nursing Education Management Model Based on a Small Data-Driven Model and Its Application. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:3099794. [PMID: 35371234 PMCID: PMC8970898 DOI: 10.1155/2022/3099794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 11/20/2022]
Abstract
Based on the concept of responsible holistic nursing care, a whole-process dual-tutor nursing practice model is established and its application effects are explored. This paper firstly reviews the research progress of nursing workload prediction methods at home and abroad, in order to provide a reference for clinical nursing workers in China to choose a scientific, reasonable, and easy-to-use nursing workload prediction method. It is proposed to construct a nursing education management model based on small data to provide ideas and references for nursing education management to effectively predict the evolutionary trend of students' behaviour and improve the level of accurate services. The experimental group adopted a dual-tutor responsibility system for the whole-process nursing practice model, including a complete three-level supervision system: a dual-tutor teaching system, a PDCA responsibility system for continuous improvement, and a multichannel teacher-student interaction platform; the control group adopted the traditional nursing practice model.
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17
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Rouidi M, Elouadi A, Hamdoune A. Acceptance and use of telemedicine technology by health professionals: Development of a conceptual model. Digit Health 2022; 8:20552076221081693. [PMID: 35223077 PMCID: PMC8864260 DOI: 10.1177/20552076221081693] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/30/2022] [Indexed: 11/16/2022] Open
Abstract
Recent developments in information technology (IT) in health are extended to highly specialized services, an example is telemedicine technology, understood as the use of IT to enable the transfer of medical information for diagnostic purposes, therapeutic and educational. Despite the benefits of implementing such technology, healthcare professionals, as end users, do not fully utilize it. The Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT), are among the models applied to assess and predict the acceptance and use of telemedicine. This article aims to identify the relevant literature related to these two models, to review and summarize the methodologies and results, and propose a conceptual model for the acceptance and use of telemedicine technology by healthcare professionals.
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Affiliation(s)
- Mohammed Rouidi
- Ensak, Ibn Tofail University, B.P 242 Kenitra, Kénitra, Morocco
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18
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Perez H, Neubauer N, Marshall S, Philip S, Miguel-Cruz A, Liu L. Barriers and Benefits of Information Communication Technologies Used by Health Care Aides. Appl Clin Inform 2022; 13:270-286. [PMID: 35263800 PMCID: PMC8906996 DOI: 10.1055/s-0042-1743238] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Although information and communication technologies (ICT) are becoming more common among health care providers, there is little evidence on how ICT can support health care aides. Health care aides, also known as personal care workers, are unlicensed service providers who encompass the second largest workforce, next to nurses, that provide care to older adults in Canada. OBJECTIVE The purpose of this literature review is to examine the range and extent of barriers and benefits of ICT used by health care workers to manage and coordinate the care-delivery workflow for their clients. METHODS We conducted a literature review to examine the range and extent of ICT used by health care aides to manage and coordinate their care delivery, workflow, and activities. We identified 8,958 studies of which 40 were included for descriptive analyses. RESULTS We distinguished the following five different purposes for the use and implementation of ICT by health care aides: (1) improve everyday work, (2) access electronic health records for home care, (3) facilitate client assessment and care planning, (4) enhance communication, and (5) provide care remotely. We identified 128 barriers and 130 benefits related to adopting ICT. Most of the barriers referred to incomplete hardware and software features, time-consuming ICT adoption, heavy or increased workloads, perceived lack of usefulness of ICT, cost or budget restrictions, security and privacy concerns, and lack of integration with technologies. The benefits for health care aides' adoption of ICT were improvements in communication, support to workflows and processes, improvements in resource planning and health care aides' services, and improvements in access to information and documentation. CONCLUSION Health care aides are an essential part of the health care system. They provide one-on-one care to their clients in everyday tasks. Despite the scarce information related to health care aides, we identified many benefits of ICT adoption.
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Affiliation(s)
- Hector Perez
- School of Publich Health Sciences, Faculty of Health, University of Waterloo, Waterloo (ON), Canada
| | - Noelannah Neubauer
- School of Publich Health Sciences, Faculty of Health, University of Waterloo, Waterloo (ON), Canada
| | - Samantha Marshall
- School of Publich Health Sciences, Faculty of Health, University of Waterloo, Waterloo (ON), Canada
| | - Serrina Philip
- School of Publich Health Sciences, Faculty of Health, University of Waterloo, Waterloo (ON), Canada
| | - Antonio Miguel-Cruz
- School of Publich Health Sciences, Faculty of Health, University of Waterloo, Waterloo (ON), Canada.,Glenrose Rehabilitation Hospital, Edmonton (AB), Canada.,Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton (AB), Canada
| | - Lili Liu
- School of Publich Health Sciences, Faculty of Health, University of Waterloo, Waterloo (ON), Canada
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19
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Abstract
Understanding the factors affecting the use of healthcare technologies is a crucial topic that has been extensively studied, specifically during the last decade. These factors were studied using different technology acceptance models and theories. However, a systematic review that offers extensive understanding into what affects healthcare technologies and services and covers distinctive trends in large-scale research remains lacking. Therefore, this review aims to systematically review the articles published on technology acceptance in healthcare. From a yield of 1768 studies collected, 142 empirical studies have met the eligibility criteria and were extensively analyzed. The key findings confirmed that TAM and UTAUT are the most prevailing models in explaining what affects the acceptance of various healthcare technologies through different user groups, settings, and countries. Apart from the core constructs of TAM and UTAUT, the results showed that anxiety, computer self-efficacy, innovativeness, and trust are the most influential factors affecting various healthcare technologies. The results also revealed that Taiwan and the USA are leading the research of technology acceptance in healthcare, with a remarkable increase in studies focusing on telemedicine and electronic medical records solutions. This review is believed to enhance our understanding through a number of theoretical contributions and practical implications by unveiling the full potential of technology acceptance in healthcare and opening the door for further research opportunities.
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20
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Nida EK, Bekele S, Geurts L, Vanden Abeele V. Acceptance of a Smartphone-Based Visual Field Screening Platform for Glaucoma: Pre-Post Study. JMIR Form Res 2021; 5:e26602. [PMID: 34533462 PMCID: PMC8486992 DOI: 10.2196/26602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/10/2021] [Accepted: 07/06/2021] [Indexed: 11/21/2022] Open
Abstract
Background Glaucoma, the silent thief of sight, is a major cause of blindness worldwide. It is a burden for people in low-income countries, specifically countries where glaucoma-induced blindness accounts for 15% of the total incidence of blindness. More than half the people living with glaucoma in low-income countries are unaware of the disease until it progresses to an advanced stage, resulting in permanent visual impairment. Objective This study aims to evaluate the acceptability of the Glaucoma Easy Screener (GES), a low-cost and portable visual field screening platform comprising a smartphone, a stereoscopic virtual reality headset, and a gaming joystick. Methods A mixed methods study that included 24 eye care professionals from 4 hospitals in Southwest Ethiopia was conducted to evaluate the acceptability of GES. A pre-post design was used to collect perspectives before and after using the GES by using questionnaires and semistructured interviews. A Wilcoxon signed-rank test was used to determine the significance of any change in the scores of the questionnaire items (two-tailed, 95% CI; α=.05). The questionnaire and interview questions were guided by the Unified Theory of Acceptance and Use of Technology. Results Positive results were obtained both before and after use, suggesting the acceptance of mobile health solutions for conducting glaucoma screening by using a low-cost headset with a smartphone and a game controller. There was a significant increase (two-tailed, 95% CI; α=.05) in the average scores of 86% (19/22) of postuse questionnaire items compared with those of preuse questionnaire items. Ophthalmic professionals perceived GES as easy to use and as a tool that enabled the conduct of glaucoma screening tests, especially during outreach to rural areas. However, positive evaluations are contingent on the accuracy of the tool. Moreover, ophthalmologists voiced the need to limit the tool to screening only (ie, not for making diagnoses). Conclusions This study supports the feasibility of using a mobile device in combination with a low-cost virtual reality headset and classic controller for glaucoma screening in rural areas. GES has the potential to reduce the burden of irreversible blindness caused by glaucoma. However, further assessment of its sensitivity and specificity is required.
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Affiliation(s)
| | - Sisay Bekele
- Department of Ophthalmology, Institute of Health, Jimma University, Jimma, Ethiopia
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21
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Khan I, Saleh MA, Quazi A, Johns R. Health consumers' social media adoption behaviours in Australia. Health Informatics J 2021; 27:14604582211009917. [PMID: 33887968 DOI: 10.1177/14604582211009917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This research identifies the underlying drivers impacting on health consumers' social media usage and acceptance behaviours using technology acceptance model (TAM) as the theoretical lens. A cross-sectional survey of 265 health consumers was conducted through a mall intercept technique. Participants in the survey were over the age of 18 and had access to a public or private healthcare service provider. The data were analysed using structural equation modelling (SEM). The major findings show that perceived ease of use, privacy threat, information quality, social influence and self-efficacy influence health consumers' social media adoption behaviours. Perceived usefulness was not found to affect health consumers' social media adoption behaviours. The moderation analysis showed that influences of privacy threats are non-significant for mature age respondents and non-frequent users of social media. This study's findings have important implications for designing social media strategies for the healthcare industry. The drivers that positively impact on health consumers' social media usages can be integrated into meaningful strategies to capture the attention of potential consumers. They need to be educated, informed and engaged as health consumers so that they employ social media effectively to their advantage.
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22
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Shiferaw KB, Mengiste SA, Gullslett MK, Zeleke AA, Tilahun B, Tebeje T, Wondimu R, Desalegn S, Mehari EA. Healthcare providers' acceptance of telemedicine and preference of modalities during COVID-19 pandemics in a low-resource setting: An extended UTAUT model. PLoS One 2021; 16:e0250220. [PMID: 33886625 PMCID: PMC8061916 DOI: 10.1371/journal.pone.0250220] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/02/2021] [Indexed: 11/18/2022] Open
Abstract
Background In almost all lower and lower middle-income countries, the healthcare system is structured in the customary model of in-person or face to face model of care. With the current global COVID-19 pandemics, the usual health care service has been significantly altered in many aspects. Given the fragile health system and high number of immunocompromised populations in lower and lower-middle income countries, the economic impacts of COVID-19 are anticipated to be worse. In such scenarios, technological solutions like, Telemedicine which is defined as the delivery of healthcare service remotely using telecommunication technologies for exchange of medical information, diagnosis, consultation and treatment is critical. The aim of this study was to assess healthcare providers’ acceptance and preferred modality of telemedicine and factors thereof among health professionals working in Ethiopia. Methods A multi-centric online survey was conducted via social media platforms such as telegram channels, Facebook groups/pages and email during Jul 1- Sep 21, 2020. The questionnaire was adopted from previously validated model in low income setting. Internal consistency of items was assessed using Cronbach alpha (α), composite reliability (CR) and average variance extracted (AVE) to evaluate both discriminant and convergent validity of constructs. The extent of relationship among variables were evaluated by Structural equation modeling (SEM) using SPSS Amos version 23. Results From the expected 423 responses, 319 (75.4%) participants responded to the survey questionnaire during the data collection period. The majority of participants were male (78.1%), age <30 (76.8%) and had less than five years of work experience (78.1%). The structural model result confirmed the hypothesis “self-efficacy has a significant positive effect on effort expectancy” with a standardized coefficient estimate (β) of 0.76 and p-value <0.001. The result also indicated that self-efficacy, effort expectancy, performance expectancy, facilitating conditions and social influence have a significant direct effect on user’s attitude toward using telemedicine. User’s behavioral intention to use telemedicine was also influenced by effort expectancy and attitude. The model also ruled out that performance expectancy, facilitating conditions and social influence does not directly influence user’s intention to use telemedicine. The squared multiple correlations (r2) value indicated that 57.1% of the variance in attitude toward using telemedicine and 63.6% of the variance in behavioral intention to use telemedicine is explained by the current structural model. Conclusion This study found that effort expectancy and attitude were significantly predictors of healthcare professionals’ acceptance of telemedicine. Attitude toward using telemedicine systems was also highly influenced by performance expectancy, self-efficacy and facilitating conditions. effort expectancy and attitude were also significant mediators in predicting users’ acceptance of telemedicine. In addition, mHealth approach was the most preferred modality of telemedicine and this opens an opportunity to integrate telemedicine systems in the health system during and post pandemic health services in low-income countries.
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Affiliation(s)
- Kirubel Biruk Shiferaw
- Health Informatics Department, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Shegaw Anagaw Mengiste
- School of Business, Institute of Business, History & Social Sciences, University of South-Eastern Norway, Notodden, Norway
| | - Monika Knudsen Gullslett
- Faculty of Health & Social Sciences, Science Center Health & Technology, University of South-Eastern Norway, Drammen, Norway
| | - Atinkut Alamirrew Zeleke
- Medical Informatics, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tsion Tebeje
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Robel Wondimu
- Department of Internal Medicine, Borre General Hospital, Borre, Ethiopia
| | - Surafel Desalegn
- Department of Emergency Medicine, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Eden Abetu Mehari
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Peel NM, Hornby-Turner YC, Osborne SR, Henderson A, Hubbard RE, Gray LC. Implementation and Evaluation of a Standardized Nurse-Administered Assessment of Functional and Psychosocial Issues for Patients in Acute Care. Worldviews Evid Based Nurs 2021; 18:161-169. [PMID: 33529455 DOI: 10.1111/wvn.12490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Increasingly, adults presenting to healthcare facilities have multiple morbidities that impact medical management and require initial and ongoing assessment. The interRAI Acute Care (AC), one of a suite of instruments used for integrated care, is a nurse-administered standardized assessment of functional and psychosocial domains that contribute to complexity of patients admitted to acute care. AIM This study aimed to implement and evaluate the interRAI AC assessment system using a multi-strategy approach based on the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. METHODS This nurse-led quality improvement study was piloted in a 200-bed public hospital in Brisbane, Australia, over the period 2017 to 2018. The interRAI AC is a set of clinical observations of functional and psychosocial domains, supported by software to derive diagnostic and risk screeners, scales to measure and monitor severity, and alerts to assist in care planning. Empirical data, surveys, and qualitative feedback were used to measure process and impact outcomes using the RE-AIM evaluation framework (Reach, Efficacy, Adoption, Implementation, and Maintenance). RESULTS In comparison to usual practice, the interRAI assessment system and supporting software was able to improve the integrity and compliance of nurse assessments, identifying key risk domains to facilitate management of care. Pre-implementation documentation (630 items in 45 patient admissions) had 39% missing data compared with 1% missing data during the interRAI implementation phase (9,030 items in 645 patient admissions). Qualitative feedback from nurses in relation to staff engagement and behavioral intention to use the new technology was mixed. LINKING EVIDENCE TO ACTION Despite challenges to implementing a system-wide change, evaluation results demonstrated considerable efficiency gains in the nursing assessment system. For successful implementation of the interRAI AC, study findings suggest the need for interoperability with other information systems, access to training, and continued leadership support.
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Affiliation(s)
- Nancye M Peel
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Yvonne C Hornby-Turner
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Sonya R Osborne
- School of Nursing and Midwifery, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia.,Australian Centre for Health Services Innovation, School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Amanda Henderson
- Nursing Practice Development Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia.,Faculty of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, QLD, Australia
| | - Ruth E Hubbard
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Princess Alexandra Hospital Southside Clinical Unit, The University of Queensland, Brisbane, QLD, Australia
| | - Leonard C Gray
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Abstract
This research identifies the underlying drivers impacting on healthcare professionals’ social media usage behaviours using the technology acceptance model (TAM) as the theoretical lens. A self-administered survey questionnaire was developed and administered to 219 healthcare professionals. Data are analysed applying the structural equation modelling (SEM) technique. The SEM model demonstrated an acceptable model fit (χ2 = 534.241; df, 239, χ2/df = 2.235, RMSEA = 0.06, IFI = 0.92, TLI = 0.93, and CFI = 0.92) and indicates content quality, perceived risk, perceived credibility, peer influence, confirmation of expectations, supporting conditions, and perceived cost significantly influence the notion of perceived social media usefulness. Furthermore, perceived social media usefulness positively affects social media usage behaviour of healthcare professionals. This research generates important insights into what drives the adoption of social media by healthcare professionals. These insights could help develop social media guidelines and strategies to improve the state of professional interactions between health professionals and their clients.
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Lulin Z, Owusu-Marfo J, Antwi HA, Xu X. The Contributing Factors to Nurses' Behavioral Intention to Use Hospital Information Technologies in Ghana. SAGE Open Nurs 2021; 6:2377960820922024. [PMID: 33415277 PMCID: PMC7774388 DOI: 10.1177/2377960820922024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/02/2020] [Accepted: 04/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background Medical care facilities in both developed and developing countries
around the world continue to invest in hospital information
technologies (HITs). Nevertheless, it has been discovered that
user acceptance of these technologies is one of the imperative
issues during their implementation and management in developing
countries such as Ghana. Purpose Notably, the technology acceptance assessment of nurses is a timely
one since they play a very important role in the medical sector.
Based on the model of “Unified Theory of Acceptance and Use of
Technology,” this study explored the factors that affect
Ghanaian nurses’ acceptance of HIT. Design/Method/Approach: A descriptive nonexperimental
research design was employed in this study to recruit 660 nurses
(404 females and 256 males) from 3 teaching and 2 regional
hospitals in Ghana. A standardized electronic platform
questionnaire (based on the Unified Theory of Acceptance and Use
of Technology model) was designed on smartphones and was
self-administered, while the data collected were analyzed via
the SmartPLS Structural Equation Modeling path analysis. The
“Social Influence” (t = 3.656,
p < .001), “Attitude towards the Use
of Technology” (t = 5.861,
p < .001), and “Facilitating
Conditions” (t = 2.616,
p < .001) were the main predictors of
the nurses’ behavioral intention to use HIT. The effects of the
aforementioned constructs explained 60.7%
(R2= 0.607)
of the variance in the nurses’ intentions to use the HIT
systems. Conclusions Precisely, HIT systems are essential in the quality and the
enhancement of nursing services provision and in the
effectiveness of the performance of nursing staff. This study,
therefore, offers a piece of empirical evidence for hospital
administrators in developing countries especially Ghana, to
assess the success probability of new HITs before and after
their implementation.
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Affiliation(s)
- Zhou Lulin
- Centre for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University
| | - Joseph Owusu-Marfo
- Centre for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University
| | | | - Xinglong Xu
- Centre for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University
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Iskandar YHP, Subramaniam G, Majid MIA, Ariff AM, Rao GKL. Predicting healthcare professionals' intention to use poison information system in a Malaysian public hospital. Health Inf Sci Syst 2020; 8:6. [PMID: 31949893 PMCID: PMC6942115 DOI: 10.1007/s13755-019-0094-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/21/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE The main objective of this paper is to determine the predicting factors that influence the intention to use Poison Information System (PIS) among healthcare professionals. METHODS A quantitative approach was applied, using a five-point Likert scale questionnaire, adapted from previous studies. Data were collected from 167 healthcare professionals working for Malaysian Public Hospitals in Penang. Smart Partial Least Square (PLS) version 3.2.7 were used to analyse the proposed relationships. RESULTS The results indicated that attitude and computer anxiety had a significant positive relation to the intention to use PIS among healthcare professionals wherein computer knowledge was found to have had a significant relationship with attitude and computer habit. Apart from that, technical support and training had a positive relationship with perceived ease of use. Surprisingly, computer habit, perceived usefulness, perceived ease of use, compatibility and facilitating condition did not significantly influence intention to use PIS. CONCLUSION The results of this study provided useful insights for healthcare agencies to understand the underlying elements that could improve the poison information management. The results proved that attitude and computer anxiety were critical factors among healthcare professionals managing poisoning cases in a highly stressful and unpredictable work environment. These factors must, therefore, be considered before implementing PIS in managing poisoning cases. The study also provided an understanding of how to improve system development by utilising the end user's expectation on the implementation of the system.
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Khadjesari Z, Boufkhed S, Vitoratou S, Schatte L, Ziemann A, Daskalopoulou C, Uglik-Marucha E, Sevdalis N, Hull L. Implementation outcome instruments for use in physical healthcare settings: a systematic review. Implement Sci 2020; 15:66. [PMID: 32811517 PMCID: PMC7433178 DOI: 10.1186/s13012-020-01027-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/29/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Implementation research aims to facilitate the timely and routine implementation and sustainment of evidence-based interventions and services. A glaring gap in this endeavour is the capability of researchers, healthcare practitioners and managers to quantitatively evaluate implementation efforts using psychometrically sound instruments. To encourage and support the use of precise and accurate implementation outcome measures, this systematic review aimed to identify and appraise studies that assess the measurement properties of quantitative implementation outcome instruments used in physical healthcare settings. METHOD The following data sources were searched from inception to March 2019, with no language restrictions: MEDLINE, EMBASE, PsycINFO, HMIC, CINAHL and the Cochrane library. Studies that evaluated the measurement properties of implementation outcome instruments in physical healthcare settings were eligible for inclusion. Proctor et al.'s taxonomy of implementation outcomes was used to guide the inclusion of implementation outcomes: acceptability, appropriateness, feasibility, adoption, penetration, implementation cost and sustainability. Methodological quality of the included studies was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Psychometric quality of the included instruments was assessed using the Contemporary Psychometrics checklist (ConPsy). Usability was determined by number of items per instrument. RESULTS Fifty-eight publications reporting on the measurement properties of 55 implementation outcome instruments (65 scales) were identified. The majority of instruments assessed acceptability (n = 33), followed by appropriateness (n = 7), adoption (n = 4), feasibility (n = 4), penetration (n = 4) and sustainability (n = 3) of evidence-based practice. The methodological quality of individual scales was low, with few studies rated as 'excellent' for reliability (6/62) and validity (7/63), and both studies that assessed responsiveness rated as 'poor' (2/2). The psychometric quality of the scales was also low, with 12/65 scales scoring 7 or more out of 22, indicating greater psychometric strength. Six scales (6/65) rated as 'excellent' for usability. CONCLUSION Investigators assessing implementation outcomes quantitatively should select instruments based on their methodological and psychometric quality to promote consistent and comparable implementation evaluations. Rather than developing ad hoc instruments, we encourage further psychometric testing of instruments with promising methodological and psychometric evidence. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2017 CRD42017065348.
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Affiliation(s)
- Zarnie Khadjesari
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
- Behavioural and Implementation Science research group, School of Health Sciences, University of East Anglia, Edith Cavell Building, Norwich Research Park, Norwich, NR4 7TJ, UK.
| | - Sabah Boufkhed
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Silia Vitoratou
- Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Laura Schatte
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Alexandra Ziemann
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
- Centre for Healthcare Innovation Research, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Christina Daskalopoulou
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Eleonora Uglik-Marucha
- Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Louise Hull
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
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Huang Y, Zhu P, Chen L, Wang X, Valentijn P. Validation of the care providers version of the Rainbow Model of Integrated Care-measurement tool in Chinese primary care systems. BMC Health Serv Res 2020; 20:727. [PMID: 32770995 PMCID: PMC7414573 DOI: 10.1186/s12913-020-05562-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. To translate and adapt the original care provider version of the RMIC-MT and evaluate its psychometric properties by a pilot study in Chinese primary care systems. Methods The translation and adaptation process were performed in four steps, forward and back-translation, experts review and pre-testing. We conducted a cross-sectional study with 1610 community care professionals in all 79 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method and promax rotation was used to assess the construct validity. Cronbach’s alpha was utilized to ascertain the internal consistency reliability. Lastly, confirmation factor analysis was used to evaluate the exploratory factor analysis model fit. Results During the translation and adaptation process, all 48 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Six factors (person- & community-centeredness, care integration, professional integration, organizational integration, cultural competence and technical competence) with 45 items were determined by exploratory factor analysis, accounting for 61.46% of the total variance. A standard Cronbach’s alpha of 0.940 and significant correlation among all items in the scale (> 0.4) showed good internal consistency reliability of the tool. And, the model passed the majority of goodness-to-fit test by confirmation factor analysis. Conclusions The results showed initial satisfactory psychometric properties for the validation of the Chinese RMIC-MT provider version. Its application in China will promote the development of people-centered integrated primary care. However, further psychometric testing is needed in multiple primary care settings with both public and private community institutes.
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Affiliation(s)
- Yixiang Huang
- School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Paiyi Zhu
- School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Lijin Chen
- School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Xin Wang
- School of Public Health, Health Development Research Center, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Pim Valentijn
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Integrated Care Evaluation, Essenburgh, Hierden, The Netherlands
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29
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Advanced Technology Use by Care Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030742. [PMID: 31979307 PMCID: PMC7036776 DOI: 10.3390/ijerph17030742] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/19/2020] [Accepted: 01/21/2020] [Indexed: 11/23/2022]
Abstract
Advanced technology is a primary solution for the shortage of care professionals and increasing demand for care, and thus acceptance of such technology is paramount. This study investigates factors that increase use of advanced technology during elderly care, focusing on current use of advanced technology, factors that influence its use, and care professionals’ experiences with the use. This study uses a mixed-method design. Logfiles were used (longitudinal design) to determine current use of advanced technology, questionnaires assessed which factors increase such use, and in-depth interviews were administered to retrieve care professionals’ experiences. Findings suggest that 73% of care professionals use advanced technology, such as camera monitoring, and consult clients’ records electronically. Six of nine hypotheses tested in this study were supported, with correlations strongest between performance expectancy and attitudes toward use, attitudes toward use and satisfaction, and effort expectancy and performance expectancy. Suggested improvements for advanced technology include expanding client information, adding report functionality, solving log-in problems, and increasing speed. Moreover, the quickest way to increase acceptance is by improving performance expectancy. Care professionals scored performance expectancy of advanced technology lowest, though it had the strongest effect on attitudes toward the technology.
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Registered Nurses’ experiences with, and feelings and attitudes towards, the International Resident Assessment Instrument for Long-Term Care Facilities in New Zealand in 2017. J Res Nurs 2019. [DOI: 10.1177/1744987119890651] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background The International Resident Assessment Instrument for Long-Term Care Facilities (interRAI-LTCF) is a Web-based assessment tool designed to comprehensively assess older adults (≥65 years) living in aged residential care. In 2015 New Zealand was the first country where it was made mandatory nationwide. Aims The purpose of this study was to explore Registered Nurses’ (RNs’) experiences, feelings and attitudes towards interRAI-LTCF. Methods Twelve interviews were conducted 18 months after interRAI-LTCF became mandatory. The interview questions were based on a United Theory of Acceptance and Use of Technology model. Findings were analysed thematically. Results The findings reveal that RNs of all ages embrace technology, and have mostly positive attitudes towards interRAI-LTCF. Limited value, however, is seen in dementia and end-of-life care. RNs reported good experiences with trainers and venues, but inconsistency between training courses. Negative feelings towards interRAI-LTCF were caused by insufficient time to complete assessments. RNs also feel apprehensive about the Assessment & Intelligence Systems, Inc. competency tests. Conclusions Overall RNs supported the use of interRAI-LTCF as a comprehensive assessment tool. Duplication in data entry, insufficient training, and the annual tests caused most stress and negative feelings. Recommendations were made to rectify issues.
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Vuorinen M. Registered Nurses' experiences with, and feelings and attitudes towards, the International Resident Assessment Instrument for Long-Term Care Facilities in New Zealand in 2017. J Res Nurs 2019; 25:141-155. [PMID: 34394619 DOI: 10.1177/174498711989065126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The International Resident Assessment Instrument for Long-Term Care Facilities (interRAI-LTCF) is a Web-based assessment tool designed to comprehensively assess older adults (≥65 years) living in aged residential care. In 2015 New Zealand was the first country where it was made mandatory nationwide. Aims The purpose of this study was to explore Registered Nurses' (RNs') experiences, feelings and attitudes towards interRAI-LTCF. Methods Twelve interviews were conducted 18 months after interRAI-LTCF became mandatory. The interview questions were based on a United Theory of Acceptance and Use of Technology model. Findings were analysed thematically. Results The findings reveal that RNs of all ages embrace technology, and have mostly positive attitudes towards interRAI-LTCF. Limited value, however, is seen in dementia and end-of-life care. RNs reported good experiences with trainers and venues, but inconsistency between training courses. Negative feelings towards interRAI-LTCF were caused by insufficient time to complete assessments. RNs also feel apprehensive about the Assessment & Intelligence Systems, Inc. competency tests. Conclusions Overall RNs supported the use of interRAI-LTCF as a comprehensive assessment tool. Duplication in data entry, insufficient training, and the annual tests caused most stress and negative feelings. Recommendations were made to rectify issues.
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Affiliation(s)
- Minna Vuorinen
- RN, MPhil (Health), Massey University, Auckland, New Zealand; Clinical Manager, Oceania Healthcare, Auckland, New Zealand
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32
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Harst L, Lantzsch H, Scheibe M. Theories Predicting End-User Acceptance of Telemedicine Use: Systematic Review. J Med Internet Res 2019; 21:e13117. [PMID: 31115340 PMCID: PMC6547771 DOI: 10.2196/13117] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/08/2019] [Accepted: 03/29/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Only a few telemedicine applications have made their way into regular care. One reason is the lack of acceptance of telemedicine by potential end users. OBJECTIVE The aim of this systematic review was to identify theoretical predictors that influence the acceptance of telemedicine. METHODS An electronic search was conducted in PubMed and PsycINFO in June 2018 and supplemented by a hand search. Articles were identified using predefined inclusion and exclusion criteria. In total, two reviewers independently assessed the title, abstract, and full-text screening and then individually performed a quality assessment of all included studies. RESULTS Out of 5917 potentially relevant titles (duplicates excluded), 24 studies were included. The Axis Tool for quality assessment of cross-sectional studies revealed a high risk of bias for all studies except for one study. The most commonly used models were the Technology Acceptance Model (n=11) and the Unified Theory of Acceptance and Use of Technology (n=9). The main significant predictors of acceptance were perceived usefulness (n=11), social influences (n=6), and attitude (n=6). The results show a superiority of technology acceptance versus original behavioral models. CONCLUSIONS The main finding of this review is the applicability of technology acceptance models and theories on telemedicine adoption. Characteristics of the technology, such as its usefulness, as well as attributes of the individual, such as his or her need for social support, inform end-user acceptance. Therefore, in the future, requirements of the target group and the group's social environment should already be taken into account when planning telemedicine applications. The results support the importance of theory-guided user-centered design approaches to telemedicine development.
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Affiliation(s)
- Lorenz Harst
- Research Association Public Health, Center of Evidence-based Healthcare, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Hendrikje Lantzsch
- Master Program Health Sciences / Public Health, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Madlen Scheibe
- Center for Evidence-Based Healthcare, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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33
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Idoga PE, Toycan M, Nadiri H, Çelebi E. Assessing factors militating against the acceptance and successful implementation of a cloud based health center from the healthcare professionals' perspective: a survey of hospitals in Benue state, northcentral Nigeria. BMC Med Inform Decis Mak 2019; 19:34. [PMID: 30782166 PMCID: PMC6381757 DOI: 10.1186/s12911-019-0751-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 02/01/2019] [Indexed: 11/10/2022] Open
Abstract
Background Cloud based health platforms (CBHP) have tremendous capacity to meet patient’s health needs. The benefits inherent in CBHP position it to be relevant for efficient healthcare delivery. Nonetheless, studies have shown that the adoption of new technologies is sometimes a challenge especially in developing nations. This study, therefore, aim to examine, identify and evaluate the factors affecting healthcare professionals’ intention to accept the cloud-based health center (CBHC) in developing countries. The research study focuses on hospitals in North-central of Nigeria. Methods Using questionnaire adopted from related studies, a cross-sectional study was carried out of 300 healthcare professionals selected from medical health institutions in Benue State Nigeria. The study adopted the Unified Theory of Acceptance and use of Technology Extended (UTAUT2). Data analysis was carried out using SPSS (V20.0) and LISREL (V9.30) generally employed in Structural Equation Modeling to examine components and path model. The Socio technical design method was used to develop the CBHC. Results Findings portrays performance expectancy, cloud based health knowledge, IT infrastructure and social influence to have significant effects on the intentions of healthcare professionals to accept and use the CBHC. These findings, agrees with prior related studies. Conclusions Our findings impacts the body of knowledge in that it identifies important areas the studies can be useful, especially, to managers and healthcare policy makers in the planning/implementation of health cloud. Research findings from the theoretical acceptance model identifies the factors and barriers towards sustainable cloud based health center solutions to meet the healthcare needs of people in remote communities.
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Affiliation(s)
- Patience E Idoga
- Management Information System Department, School of Applied Sciences, Cyprus International University, via Mersin 10, Nicosia, North-Cyprus, Turkey
| | - Mehmet Toycan
- Management Information System Department, School of Applied Sciences, Cyprus International University, via Mersin 10, Nicosia, North-Cyprus, Turkey.
| | - Halil Nadiri
- Business Administration Department, Cyprus International University, via Mersin 10, Nicosia, North-Cyprus, Turkey
| | - Erbuğ Çelebi
- Department of Computer Engineering, Cyprus International University, via Mersin 10, Nicosia, North-Cyprus, Turkey
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Investigating factors influencing the physicians’ adoption of electronic health record (EHR) in healthcare system of Bangladesh: An empirical study. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2019. [DOI: 10.1016/j.ijinfomgt.2018.09.016] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tavares J, Oliveira T. New Integrated Model Approach to Understand the Factors That Drive Electronic Health Record Portal Adoption: Cross-Sectional National Survey. J Med Internet Res 2018; 20:e11032. [PMID: 30455169 PMCID: PMC6318146 DOI: 10.2196/11032] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/17/2018] [Accepted: 07/17/2018] [Indexed: 12/13/2022] Open
Abstract
Background The future of health care delivery is becoming more patient-focused, and electronic health record (EHR) portals are gaining more attention from worldwide governments that consider this technology as a valuable asset for the future sustainability of the national health care systems. Overall, this makes the adoption of EHR portals an important field to study. Objective The aim of this study is to understand the factors that drive individuals to adopt EHR portals. Methods We applied a new adoption model that combines 3 different theories, namely, extended unified theory of acceptance and use of technology, health belief model, and the diffusion of innovation; all the 3 theories provided relevant contributions for the understanding of EHR portals. To test the research model, we used the partial least squares causal modeling approach. We executed a national survey based on randomly generated mobile phone numbers. We collected 139 questionnaires. Results Performance expectancy (beta=.203; t=2.699), compatibility (beta=.530; t=6.189), and habit (beta=.251; t=2.660) have a statistically significant impact on behavior intention (R2=76.0%). Habit (beta=.378; t=3.821), self-perception (beta=.233; t=2.971), and behavior intention (beta=.263; t=2.379) have a statistically significant impact on use behavior (R2=61.8%). In addition, behavior intention (beta=.747; t=10.737) has a statistically significant impact on intention to recommend (R2=69.0%), results demonstrability (beta=.403; t=2.888) and compatibility (beta=.337; t=2.243) have a statistically significant impact on effort expectancy (R2=48.3%), and compatibility (beta=.594; t=6.141) has a statistically significant impact on performance expectancy (R2=42.7%). Conclusions Our research model yields very good results, with relevant R2 in the most important dependent variables that help explain the adoption of EHR portals, behavior intention, and use behavior.
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Affiliation(s)
- Jorge Tavares
- NOVA Information Management School, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Tiago Oliveira
- NOVA Information Management School, Universidade NOVA de Lisboa, Lisboa, Portugal
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Assessing healthcare professionals' experiences of integrated care: do surveys tell the full story? INT J EVID-BASED HEA 2018; 15:90-101. [PMID: 28704279 DOI: 10.1097/xeb.0000000000000116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Integrated care is the combination of different healthcare services with the goal to provide comprehensive, seamless, effective and efficient patient care. Assessing the experiences of healthcare professionals (HCPs) is an important aspect when evaluating integrated care strategies. AIMS The aim of this rapid review was to investigate if quantitative surveys used to assess HCPs' experiences with integrated care capture all the aspects highlighted as being important in qualitative research, with a view to informing future survey development. METHODS The review considered all types of health professionals in primary care, and hospital and specialist services, with a specific focus on the provision of integrated care aimed at improving the patient journey. PubMed, CINAHL and grey literature sources were searched for relevant surveys/program evaluations and qualitative research studies. Full text articles deemed to be of relevance to the review were appraised for methodological quality using abridged critical appraisal instruments from the Joanna Briggs Institute. Data were extracted from included studies using standardized data extraction templates. Findings from included studies were grouped into domains based on similarity of meaning. Similarities and differences in the domains covered in quantitative surveys and those identified as being important in qualitative research were explored. RESULTS A total of 37 studies (19 quantitative surveys, 14 qualitative studies and four mixed-method studies) were included in the review. A range of healthcare professions participated in the included studies, the majority being primary care providers. Common domains identified from quantitative surveys and qualitative studies included Communication, Agreement on Clear Roles and Responsibilities, Facilities, Information Systems, and Coordination of Care and Access. Qualitative research highlighted domains identified by HCPs as being relevant to their experiences with integrated care that have not routinely being surveyed, including Workload, Clear Leadership/Decision-Making, Management, Flexibility of Integrated Care Model, Engagement, Usefulness of Integrated Care and Collaboration, and Positive Impact/Clinical Benefits/Practice Level Benefits. CONCLUSION There were several domains identified from qualitative research that are not routinely included in quantitative surveys to assess health professionals' experiences of integrated care. In addition, the qualitative findings suggest that the experiences of HCPs are often impacted by deeper aspects than those measured by existing surveys. Incorporation of targeted items within these domains in the design of surveys should enhance the capture of data that are relevant to the experiences of HCPs with integrated care, which may assist in more comprehensive evaluation and subsequent improvement of integrated care programs.
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Ifinedo P. Empirical Study of Nova Scotia Nurses' Adoption of Healthcare Information Systems: Implications for Management and Policy-Making. Int J Health Policy Manag 2018; 7:317-327. [PMID: 29626399 PMCID: PMC5949222 DOI: 10.15171/ijhpm.2017.96] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/05/2017] [Indexed: 11/18/2022] Open
Abstract
Background: This paper used the Theory of Planned Behavior (TPB), which was extended, to investigate nurses’ adoption of healthcare information systems (HIS) in Nova Scotia, Canada.
Methods: Data was collected from 197 nurses in a survey and data analysis was carried out using the partial least squares (PLS) technique.
Results: In contrast to findings in prior studies that used TPB to investigate clinicians’ adoption of technologies in Canada and elsewhere, this study found no statistical significance for the relationships between attitude and subjective norm in relation to nurses’ intention to use HIS. Rather, facilitating organizational conditions was the only TPB variable that explained sampled nurses’ intention to use HIS at work. In particular, effects of computer habit and computer anxiety among older nurses were signified.
Conclusion: To encourage nurses’ adoption of HIS, healthcare administrators need to pay attention to facilitating organization conditions at work. Enhancing computer knowledge or competence is important for acceptance. Information presented in the study can be used by administrators of healthcare facilities in the research location and comparable parts of the world to further improve HIS adoption among nurses. The management of nursing professionals, especially in certain contexts (eg, prevalence of older nursing professionals), can make use of this study’s insights.
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Affiliation(s)
- Princely Ifinedo
- Department of Financial and Information Management, Shannon School of Business, Cape Breton University, Sydney, NSW, Canada
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Baitar A, Buntinx F, De Burghgraeve T, Deckx L, Bulens P, Wildiers H, van den Akker M. The utilization of formal and informal home care by older patients with cancer: a Belgian cohort study with two control groups. BMC Health Serv Res 2017; 17:644. [PMID: 28899389 PMCID: PMC5596475 DOI: 10.1186/s12913-017-2594-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this paper is to analyse the utilization of formal and informal home care among older patients with cancer (OCP) and to compare this with middle-aged patients with cancer (MCP) and older patients without cancer (ONC). Additionally, we examined predictors of transitions towards formal care one year after a cancer diagnosis. METHODS OCP and MCP had to be recruited within three months after a cancer diagnosis and have an estimated life expectancy over six months. ONC consisted of patients without known cancer, seen by the general practitioner. Formal and informal care were compared between the patient groups at baseline, i.e. shortly after a cancer diagnosis and changes in care were studied after one year. RESULTS A total of 844 patients were evaluable for formal care at baseline and 469 patients (56%) at follow-up. At baseline, about half of older adults and 18% of MCP used formal care, while about 85% of cancer patients and 57% ONC used informal care. Formal care increased for all groups after one year though not significantly in OCP. The amount of informal care only changed in MCP which decreased after one year. Cancer-related factors and changes in need factors predict a transition towards formal care after a cancer diagnosis. CONCLUSIONS A cancer diagnosis has a different impact on the use of formal and informal care than ageing as such. The first year after a cancer diagnosis is an important time to follow-up on the patients' needs for home care.
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Affiliation(s)
| | - Frank Buntinx
- Academic Centre for General Practice/ Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Tine De Burghgraeve
- Academic Centre for General Practice/ Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Laura Deckx
- Department of General Practice, University of Queensland, Brisbane, Australia
| | - Paul Bulens
- Limburgs Oncologisch centrum, Jessa hospital, Hasselt, Belgium
| | - Hans Wildiers
- Department of General Medical Oncology, University hospitals Leuven, Leuven, Belgium
| | - Marjan van den Akker
- Academic Centre for General Practice/ Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands
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Tavares J, Oliveira T. Electronic Health Record Portal Adoption: a cross country analysis. BMC Med Inform Decis Mak 2017; 17:97. [PMID: 28679423 PMCID: PMC5499062 DOI: 10.1186/s12911-017-0482-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 06/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study's goal is to understand the factors that drive individuals to adopt Electronic Health Record (EHR) portals and to estimate if there are differences between countries with different healthcare models. METHODS We applied a new adoption model using as a starting point the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) by incorporating the Concern for Information Privacy (CFIP) framework. To evaluate the research model we used the partial least squares (PLS) - structural equation modelling (SEM) approach. An online questionnaire was administrated in the United States (US) and Europe (Portugal). We collected 597 valid responses. RESULTS The statistically significant factors of behavioural intention are performance expectancy ([Formula: see text] total = 0.285; P < 0.01), effort expectancy ([Formula: see text] total = 0.160; P < 0.01), social influence ([Formula: see text] total = 0.198; P < 0.01), hedonic motivation ([Formula: see text] total = -0.141; P < 0.01), price value ([Formula: see text] total = 0.152; P < 0.01), and habit ([Formula: see text] total = 0.255; P < 0.01). The predictors of use behaviour are habit ([Formula: see text] total = 0.145; P < 0.01), and behavioural intention ([Formula: see text] total = 0.480; P < 0.01). Social influence, hedonic motivation, and price value are only predictors in the US group. The model explained 53% of the variance in behavioural intention and 36% of the variance in use behaviour. CONCLUSIONS Our study identified critical factors for the adoption of EHR portals and significant differences between the countries. Confidentiality issues do not seem to influence acceptance. The EHR portals usage patterns are significantly higher in US compared to Portugal.
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Affiliation(s)
- Jorge Tavares
- NOVA IMS, Universidade Nova de Lisboa, Campus de Campolide, 1070-312, Lisbon, Portugal.
| | - Tiago Oliveira
- NOVA IMS, Universidade Nova de Lisboa, Campus de Campolide, 1070-312, Lisbon, Portugal
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Emmert M, Wiener M. What factors determine the intention to use hospital report cards? The perspectives of users and non-users. PATIENT EDUCATION AND COUNSELING 2017; 100:1394-1401. [PMID: 28189471 DOI: 10.1016/j.pec.2017.01.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/10/2017] [Accepted: 01/28/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Hospitals report cards (HRC) are publicly available Internet websites that provide patients with quality-related information on hospitals and enable hospital comparisons. We aim to identify factors that explain the (intended) use of HRC, including differences between current users and non-users. METHODS Drawing on UTAUT (Unified Theory of Acceptance and Use of Technology), a cross-sectional study was conducted. Data were derived from an online survey with 1350 respondents and analyzed using structural equation modeling. RESULTS 42% of the survey participants had already used HRC to search for a hospital. Performance expectancy, facilitating conditions, and attitude were found to be significantly related to HRC use intention, with notable differences between users and non-users. Effort expectancy and social influence did not show any significant effects in both subsamples. CONCLUSION Patients consider HRC to be a useful instrument and are willing to make the efforts it takes to use HRC. The greater effect of performance expectancy in the non-user sample (compared to the user sample) indicates a certain disillusion among users. PRACTICE IMPLICATIONS Health policy makers should focus on reviewing and restructuring the information content of HRC. In addition, coordinated efforts are still required to facilitate HRC access, especially for the 'less fortunate'.
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Affiliation(s)
- Martin Emmert
- Department of Health Policy and Management, Yale University, New Haven, CT, USA; School of Business and Economics, Friedrich-Alexander-University of Erlangen-Nuremberg, Nuremberg, Germany.
| | - Martin Wiener
- Department of Information and Process Management (IPM), Bentley University, Waltham, MA, USA
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Holden RJ, Asan O, Wozniak EM, Flynn KE, Scanlon MC. Nurses' perceptions, acceptance, and use of a novel in-room pediatric ICU technology: testing an expanded technology acceptance model. BMC Med Inform Decis Mak 2016; 16:145. [PMID: 27846827 PMCID: PMC5109818 DOI: 10.1186/s12911-016-0388-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 11/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The value of health information technology (IT) ultimately depends on end users accepting and appropriately using it for patient care. This study examined pediatric intensive care unit nurses' perceptions, acceptance, and use of a novel health IT, the Large Customizable Interactive Monitor. METHODS An expanded technology acceptance model was tested by applying stepwise linear regression to data from a standardized survey of 167 nurses. RESULTS Nurses reported low-moderate ratings of the novel IT's ease of use and low to very low ratings of usefulness, social influence, and training. Perceived ease of use, usefulness for patient/family involvement, and usefulness for care delivery were associated with system satisfaction (R2 = 70%). Perceived usefulness for care delivery and patient/family social influence were associated with intention to use the system (R2 = 65%). Satisfaction and intention were associated with actual system use (R2 = 51%). CONCLUSIONS The findings have implications for research, design, implementation, and policies for nursing informatics, particularly novel nursing IT. Several changes are recommended to improve the design and implementation of the studied IT.
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Affiliation(s)
- Richard J Holden
- Department of BioHealth Informatics, Indiana University School of Informatics and Computing, Indianapolis, IN, USA
| | - Onur Asan
- Center for Patient Care and Outcomes Research, Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
| | - Erica M Wozniak
- Center for Patient Care and Outcomes Research, Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Kathryn E Flynn
- Center for Patient Care and Outcomes Research, Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Matthew C Scanlon
- Department of Pediatrics, Division of Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA
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Vanneste D, De Almeida Mello J, Macq J, Van Audenhove C, Declercq A. Missing data at follow-up: The case of the interRAI home care assessment instrument in Belgium. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2016.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Tavares J, Oliveira T. Electronic Health Record Patient Portal Adoption by Health Care Consumers: An Acceptance Model and Survey. J Med Internet Res 2016; 18:e49. [PMID: 26935646 PMCID: PMC4795321 DOI: 10.2196/jmir.5069] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/15/2015] [Accepted: 01/04/2016] [Indexed: 01/29/2023] Open
Abstract
Background The future of health care delivery is becoming more citizen centered, as today’s user is more active, better informed, and more demanding. Worldwide governments are promoting online health services, such as electronic health record (EHR) patient portals and, as a result, the deployment and use of these services. Overall, this makes the adoption of patient-accessible EHR portals an important field to study and understand. Objective The aim of this study is to understand the factors that drive individuals to adopt EHR portals. Methods We applied a new adoption model using, as a starting point, Ventkatesh's Unified Theory of Acceptance and Use of Technology in a consumer context (UTAUT2) by integrating a new construct specific to health care, a new moderator, and new relationships. To test the research model, we used the partial least squares (PLS) causal modelling approach. An online questionnaire was administrated. We collected 360 valid responses. Results The statistically significant drivers of behavioral intention are performance expectancy (beta=.200; t=3.619), effort expectancy (beta=.185; t=2.907), habit (beta=.388; t=7.320), and self-perception (beta=.098; t=2.285). The predictors of use behavior are habit (beta=0.206; t=2.752) and behavioral intention (beta=0.258; t=4.036). The model explained 49.7% of the variance in behavioral intention and 26.8% of the variance in use behavior. Conclusions Our research helps to understand the desired technology characteristics of EHR portals. By testing an information technology acceptance model, we are able to determine what is more valued by patients when it comes to deciding whether to adopt EHR portals or not. The inclusion of specific constructs and relationships related to the health care consumer area also had a significant impact on understanding the adoption of EHR portals.
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Affiliation(s)
- Jorge Tavares
- NOVA Information Management School (IMS), Universidade Nova de Lisboa, Lisboa, Portugal.
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Vanneste D, De Almeida Mello J, Macq J, Van Audenhove C, Declercq A. Incomplete assessments: towards a better understanding of causes and solutions. The case of the interRAI home care instrument in Belgium. PLoS One 2015; 10:e0123760. [PMID: 25875281 PMCID: PMC4395293 DOI: 10.1371/journal.pone.0123760] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 02/21/2015] [Indexed: 11/18/2022] Open
Abstract
The chronic diseases, comorbidities and rapidly changing needs of frail older persons increase the complexity of caregiving. A comprehensive, systematic and structured collection of data on the status of the frail older person is presumed to be essential in facilitating decision-making and thus improving the quality of care provided. However, the way in which an assessment is completed has a substantial impact on the quality and value of the results. This study examines the online completion of interRAI Home Care assessments, the possible causes for incomplete assessments and the consequences of these factors with respect to the quality of care received. Our findings indicate high nurse engagement and poor physician participation. We also observed the poor completion of items in predominantly medically- oriented sections characterized by, first, the fact that the assessors felt incapable of answering certain questions, second, the absence of required data or of a competent person to fill out the data, and third, the lack of tools necessary for essential measurements. The incompleteness of assessments has a clear negative influence on outcome generation. Moreover, without the added value of support outcomes, the improvement of care quality can be impeded and information technology can easily be seen as burdensome by the assessors. We have observed that multidisciplinary cooperation is an important prerequisite to establishing high-quality assessments aimed at improving the quality of care.
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Affiliation(s)
- Dirk Vanneste
- Lucas, Center for Care Research and Consultancy, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Johanna De Almeida Mello
- Lucas, Center for Care Research and Consultancy, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Jean Macq
- Ecole de Santé Publique, Institut de Recherche Santé et Société, Université Catholique de Louvain, Brussels, Belgium
| | - Chantal Van Audenhove
- Lucas, Center for Care Research and Consultancy, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Anja Declercq
- Lucas, Center for Care Research and Consultancy, Katholieke Universiteit Leuven, Leuven, Belgium
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