EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPTANCE OF TELEMONITORING...
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Transcript of EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPTANCE OF TELEMONITORING...
EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING
HEALTHCARE PROFESSIONAL ACCEPTANCE OF
TELEMONITORING FOR CHRONIC PATIENTS
Estibalitz Orruño1, Marie-Pierre Gagnon2-3, José Asua4, Eva Reviriego1
1 Basque Office for Health Technology Assessment (Osteba), Department of Health and Consumer Affairs, Basque Government, Vitoria-Gasteiz, Spain.
2 Faculty of Nursing Sciences, Université Laval, Québec, Canada.3 Research Centre of the Centre Hospitalier Universitaire de Québec, Québec, Canada.
4 Direction of Knowledge Management and Evaluation, Department of Health and Consumer Affairs, Basque Government, Vitoria-Gasteiz, Spain.
Outline of the presentation
Introduction Objectives Methodology Results Conclusions and Implications
Introduction
IT use in the health sector has an enormous potential to help to improve the quality of the services offered.
A key factor is that the health professionals are ready to accept those new technologies.
The acceptance of telemedicine applications by the health professionals constitutes an important requirement for the fruitful diffusion of this technology on a large scale.
Introduction
In the Basque Country, pilot telemedicine projects have been developed to support the delivery of care, inside the “Tackling the Challenge of Chronicity”.
For instance, home telemonitoring for patients with chronic diseases is viewed as a promising solution to lessen the burden on health care organisations and professionals.
However, we know little about the factors that could facilitate or impede health professionals’ willingness to engage in telehomecare.
Objetives
Based on the Technology Acceptance Model (TAM), this study examines the main factors that could affect healthcare professionals' intention to use telemonitoring technology.
Methods
A validated questionnaire, based on an extension of the TAM, was distributed to a total of 605 nurses, general practitioners and paediatricians.
Cronbach alpha were calculated to measure the reliability of the model.
Construct validity was evaluated using inter-item correlation analysis.
Logistic regression analysis was performed to test the theoretical model.
Adjusted odds ratios (OR) and their 95% confidence intervals (CI) were computed.
Adapted Technology Acceptance Model
Results A global response-rate of 44.3% was
achieved (n = 268): 131 Nurses 122 Physicians 15 Paediatricians
The internal consistency of theoretical constructs was high (Cronbach α between 0.80 and 0.96).
All theoretical variables were well correlated (r > 0.6) with Intention to use, except Habit.
Results
Charateristics frequency percent
Gender Women 209 78.0 Men 59 22.0Age <30 11 4.1 30-39 43 16.0 40-49 93 34.7 50-59 117 43.7 >60 4 1.5Years in clinical practice mean = 21.3 (SD=9.1)
Results The original TAM model was good at
predicting intention to use the telemonitoring system (χ2 was significant; Nagelkerke R2 = 0.63).
However, the extended model, which included other theoretical variables, was still significant and more powerful (Nagelkerke R2 = 0.72).
Perceived Usefulness, Compatibility and Facilitators were the significant predictors of intention.
Results
Independent variables
Multivariate regression
OR
95% CI p
Original TAM
Perceived usefulness
5.283.14-10.01
0.000
Perceived ease of use
1.93 1.11-2.37 0.020Nagelkerke R2 = 0.63
Results
Nagelkerke R2 = 0.72
Independent variables
Multivariate regression
OR
95% CI p
Extended TAM Perceived usefulness
2.65 1.15-6.12 0.022
Perceived ease of use
0.66 0.31-1.39 0.276
Compatibility 3.06 1.30-7.18 0.010Subjective Norm 1.06 0.56-2.03 0.851Facilitators 4.90 2.38-10.09 0.000Habit 2.56 0.56-11.70 0.226
Results
A detailed analysis showed that intention to use telemonitoring was best predicted by:
Healthcare professionals’ belief that they would obtain adequate training and technical support;
Belief that telemonitoring would require important changes in their practice.
Discussion
Our findings show that the extended TAM is a good predictive model of healthcare professionals’ intention to use a telemonitoring system for chronic care patients in primary care.
The perception of facilitators in the organisational context is the most important variable to consider for increasing healthcare professionals’ intention to use the new technology.
Implications for the health system/professionals/patients/society
This study confirms the value of this framework for examining telemonitoring acceptance among primary care professionals
The Modified TAM questionnaire provides a validated instrument for the investigation of key factors for successful telemedicine implementation.
For more detailed information:[email protected]@[email protected]