User Acceptance Level of and Attitudes towards Telemedicine in the United Arab Emirates: A quantitative study

Predictors of the Use of a Mental Health-Focused eHealth System in Patients With Breast and Prostate Cancer: Bayesian Structural Equation Modeling Analysis of a Prospective Study

BACKGROUND

eHealth systems have been increasingly used to manage depressive symptoms in patients with somatic illnesses. However, understanding the factors that drive their use, particularly among patients with breast and prostate cancer, remains a critical area of research.

OBJECTIVE

This study aimed to determine the factors influencing use of the NEVERMIND eHealth system among patients with breast and prostate cancer over 12 weeks, with a focus on the Technology Acceptance Model.

METHODS

Data from the NEVERMIND trial, which included 129 patients with breast and prostate cancer, were retrieved. At baseline, participants completed questionnaires detailing demographic data and measuring depressive and stress symptoms using the Beck Depression Inventory-II and the Depression, Anxiety, and Stress Scale-21, respectively. Over a 12-week period, patients engaged with the NEVERMIND system, with follow-up questionnaires administered at 4 weeks and after 12 weeks assessing the system's perceived ease of use and usefulness. Use log data were collected at the 2- and 12-week marks. The relationships among sex, education, baseline depressive and stress symptoms, perceived ease of use, perceived usefulness (PU), and system use at various stages were examined using Bayesian structural equation modeling in a path analysis, a technique that differs from traditional frequentist methods.

RESULTS

The path analysis was conducted among 100 patients with breast and prostate cancer, with 66% (n=66) being female and 81% (n=81) having a college education. Patients reported good mental health scores, with low levels of depression and stress at baseline. System use was approximately 6 days in the initial 2 weeks and 45 days over the 12-week study period. The results revealed that PU was the strongest predictor of system use at 12 weeks (βuse at 12 weeks is predicted by PU at 12 weeks=.384), whereas system use at 2 weeks moderately predicted system use at 12 weeks (βuse at 12 weeks is predicted by use at 2 weeks=.239). Notably, there were uncertain associations between baseline variables (education, sex, and mental health symptoms) and system use at 2 weeks, indicating a need for better predictors for early system use.

CONCLUSIONS

This study underscores the importance of PU and early engagement in patient engagement with eHealth systems such as NEVERMIND. This suggests that, in general eHealth implementations, caregivers should educate patients about the benefits and functionalities of such systems, thus enhancing their understanding of potential health impacts. Concentrating resources on promoting early engagement is also essential given its influence on sustained use. Further research is necessary to clarify the remaining uncertainties, enabling us to refine our strategies and maximize the benefits of eHealth systems in health care settings.

Determinants Influencing the Adoption of Internet Health Care Technology Among Chinese Health Care Professionals: Extension of the Value-Based Adoption Model With Burnout Theory

BACKGROUND

The global COVID-19 pandemic has been widely regarded as a catalyst for adopting internet health care technology (IHT) in China. IHT consists of new health care technologies that are shaping health services and medical consultations. Health care professionals play a substantial role in the adoption of any IHT, but the consequences of doing so can often be challenging, particularly when employee burnout is prevalent. Few studies have explored whether employee burnout influences the adoption intention of IHT in health care professionals.

OBJECTIVE

This study aims to explain the determinants influencing the adoption of IHT from the perspective of health care professionals. To do so, the study extends the value-based adoption model (VAM) with consideration for employee burnout as a determining factor.

METHODS

A cross-sectional web-based survey using a sample of 12,031 health care professionals selected through multistage cluster sampling from 3 provinces in mainland China was conducted. The hypotheses of our research model were developed based on the VAM and employee burnout theory. Structural equation modeling was then used to test the research hypotheses.

RESULTS

The results indicate that perceived usefulness, perceived enjoyment, and perceived complexity positively correlate with perceived value (β=.131, P=.01; β=.638, P<.001; β=.198, P<.001, respectively). Perceived value had a positive direct effect on adoption intention (β=.725, P<.001), perceived risk negatively correlated with perceived value (β=-.083, P<.001), and perceived value negatively correlated with employee burnout (β=-.308, P<.001). In addition, employee burnout was negatively related to adoption intention (β=-.170, P<.001) and mediated the relationship between perceived value and adoption intention (β=.052, P<.001).

CONCLUSIONS

Perceived value, perceived enjoyment, and employee burnout were the most important determinants of IHT adoption intention by health care professionals. In addition, while employee burnout was negatively related to adoption intention, perceived value inhibited employee burnout. Therefore, this study finds that it is necessary to develop strategies to improve the perceived value and reduce employee burnout, which will benefit the promotion of the adoption intention of IHT in health care professionals. This study supports the use of the VAM and employee burnout in explaining health care professionals' adoption intention regarding IHT.

Knowledge, Attitudes, and Perceptions of Jordanians Toward Adopting and Using Telemedicine: National Cross-sectional Study

Background

Due to the upsurge of COVID-19, nations are increasingly adopting telemedicine programs in anticipation of similar crises. Similar to all nations worldwide, Jordan is implementing efforts to adopt such technologies, yet it is far from complete.

Objective

This study aims to assess the knowledge, attitudes, and perceptions of Jordanians toward telemedicine, to identify key factors predisposing individuals to its use or acting as barriers to its implementation.

Methods

We implemented a cross-sectional design using an online, self-administered questionnaire executed in Google Forms and distributed through social media. Differences in knowledge and attitude scores were examined using independent sample t tests and ANOVA. A multivariate linear regression model was computed to assess predictors of awareness toward telemedicine.

Results

A total of 1201 participants fully completed the questionnaire. Participants were characterized by a mean age of 36.3 (SD 14.4) years and a male-to-female ratio of nearly 1:1. About 50% (619/1201, 51.5%) of our studied population were aware of telemedicine, while nearly 25% (299/1201, 24.9%) declared they had observed it in action. Approximatively 68% (814/1201, 67.8%) of respondents were willing to use telemedicine. The majority of the sample portrayed favorable and positive views toward telemedicine. Higher educational degrees, living in urban districts, and having a higher perception of electronic usage ability were associated with higher knowledge and better attitudes toward telemedicine (all P<.05). The multivariate linear regression analysis demonstrated that perceived ability to use electronics was associated with positive attitudes (β=0.394; 95% CI 0.224 to 0.563), while living in Southern Jordan predicted poor attitudes toward telemedicine (β=–2.896; 95% CI –4.873 to –0.919).

Conclusions

Jordanians portray favorable perceptions of telemedicine. Nonetheless, concerns with regards to privacy, medical errors, and capacity for accurate diagnoses are prevalent. Furthermore, Jordanians believe that integrating telemedicine within the health care system is not applicable due to limited resources.

The Patterns and Determinants of Telemedicine Use during the COVID-19 Crisis: A Nationwide Study

Background

Although telemedicine services have been adopted on a large scale in the United Arab Emirates (UAE) during the coronavirus disease 2019 (COVID-19) pandemic, a little is known about the public experience.

Objectives

This study aimed to investigate consumers’ patterns, nature, and predictors of telemedicine utilization and consumers’ attitude toward this technology.

Methods

A quantitative, self-administered questionnaire was developed, validated, and delivered randomly to adults living across the United Arab Emirates (UAE) between January 2021 and January 2022. The questionnaire included questions about categories of telemedicine used, purpose of use, challenges encountered during the use of telemedicine, and reasons for not using telemedicine technology. We adopted a proportionate random sampling technique to recruit participants by 3 ways: social media, phone calls, and face to face.

Results

The final dataset included 1584 participants, of which 496 (31.3%) used telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. The most common reasons for not using telemedicine during COVID-19 was having no idea that telemedicine exists (38.3%, 417 of 1088) or having no idea how to use it (33.5%, 365 of 1088). Telemedicine users reported that that telepharmacy (89.7%), teleconsultation (78.2%), and telediagnosis (23.0%) were the most frequently used telemedicine services during the COVID-19 crisis. Of the 496 telemedicine users, 469 (94.6%) reported using telemedicine for seeking a pharmacist advice about medication instructions, 422 (85.1%) for ordering nonprescription drugs, and 401 (80.8%) for seeking a physician advice. Those with high activity on social media were less likely to be associated with telemedicine users versus nonusers.

Discussion

Although telepharmacy has been increasingly used by consumers, more attention is needed to fix its limitations and improve patient safety.

Conclusion

This study shows a positive attitude and a general acceptance of telemedicine services among the UAE population. Some sociodemographic and clinical characteristics were significantly associated with the use of telemedicine during the pandemic.

Effect of COVID-19 Pandemic on Patient Utilization of the Telemedicine Services in Dubai

<b><i>Introduction:</i></b> Telemedicine was launched in Dubai in December 2019. The service provided live interaction between patients and physicians through videos simulating a consultation in a clinic. <b><i>Methods:</i></b> This study is a multicenter comparative cross-sectional retrospective study that included 13 health centers in Dubai. The data in this study were taken before and during the coronavirus (COVID-19) pandemic retrospectively. All patients from both telemedicine and primary health care (PHC) clinic visits were included. <b><i>Results and Discussion:</i></b> A total of 121,035 patients were involved in this study; there were 55,622 patients before COVID-19 and 65,413 patients during the COVID-19 pandemic. During the coronavirus pandemic, patient utilization of telemedicine increased significantly in comparison to patient visits to the PHC centers. Before the COVID-19 pandemic, only 104 (0.2%) patients used telemedicine, while during the pandemic, the utilization of telemedicine increased to 9,183 (14%). More females than males preferred telemedicine use over visiting the PHC center. With the pandemic, elder patients used telemedicine more than the younger age groups. Telemedicine was used for different types of consultations such as acute, chronic, and COVID-19 related. The most common type of consultation in telemedicine during the pandemic was for chronic diseases (67.7%). <b><i>Conclusion:</i></b> In this comparative study, more patients used telemedicine in the time of COVID-19 pandemic whether it was for acute, chronic, or CO­VID-19-related consultations. Telemedicine proved to be a very useful tool at the time of disasters such as the COVID-19 pandemic.