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EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPTANCE OF TELEMONITORING FOR CHRONIC PATIENTS
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EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPTANCE OF TELEMONITORING FOR CHRONIC PATIENTS

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EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPTANCE OF TELEMONITORING FOR CHRONIC PATIENTS …

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.

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  • 1. EVALUATION OF PSYCHOSOCIAL FACTORS INFLUENCING HEALTHCARE PROFESSIONAL ACCEPTANCE OFTELEMONITORING 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.
  • 2. Outline of the presentation Introduction Objectives Methodology Results Conclusions and Implications
  • 3. 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.
  • 4. 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.
  • 5. Objetives Based on the Technology Acceptance Model (TAM), this study examines the main factors that could affect healthcare professionals intention to use telemonitoring technology.
  • 6. 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.
  • 7. Adapted Technology AcceptanceModel
  • 8. 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.
  • 9. ResultsCharateristics frequency percentGender        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) 
  • 10. 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 R 2 = 0.72). Perceived Usefulness, Compatibility and Facilitators were the significant predictors of intention.
  • 11. ResultsIndependent Multivariate 95% CI pvariables regression OROriginal      TAMPerceived 5.28 3.14-10.01 0.000usefulnessPerceived 1.93 1.11-2.37 0.020ease of use Nagelkerke R2 = 0.63
  • 12. ResultsIndependent Multivariate 95% CI pvariables regression ORExtended TAM      Perceived 2.65 1.15-6.12 0.022usefulnessPerceived ease of 0.66 0.31-1.39 0.276useCompatibility 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 Nagelkerke R2 = 0.72
  • 13. 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.
  • 14. 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.
  • 15. 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.
  • 16. For more detailed information:e-orruno@ej-gv.esmarie-pierre.gagnon@fsi.ulaval.cajasua@ej-gv.es