Chinese General Practice ›› 2019, Vol. 22 ›› Issue (28): 3432-3437.DOI: 10.12114/j.issn.1007-9572.2019.00.442

• Monographic Research • Previous Articles     Next Articles

Intention of Using Internet-based Chronic Disease Management among Community Physicians and Nurses:an Analysis Using the Hierarchical Linear Model 

  

  1. 1.Guangzhou Huali Science and Technology Vocational College,Guangzhou 511325,China
    2.Futian Center for Chronic Disease Control,Shenzhen 518048,China
    *Corresponding author:ZHOU Zhiheng,Associate professor;E-mail:zhihengz@163.com
  • Published:2019-10-05 Online:2019-10-05

社区医护人员对“互联网+”慢性病管理使用意愿的多水平线性模型研究

  

  1. 1.511325广东省广州市,广州华立科技职业学院 2.518048广东省深圳市福田区慢性病防治院
    *通信作者:周志衡,副教授;E-mail:zhihengz@163.com
  • 基金资助:
    基金项目:广东省科学技术厅-广东省中医药科学院联合科研专项项目(2011B032200019);深圳市卫生系统科研项目(SZGW2018006);福田区卫生公益性科研项目(FTWS2018003、FTWS2018072);广州华立科技职业学院校级科研项目(HLZ121908)

Abstract: Background With the development of Internet-based medical care,Internet-based chronic disease management models have come into being,showing their unique advantages.Related studies have sprung up,among which the intention of using the models in physicians and nurses is rarely involved.Community physicians and nurses are chronic disease managers,understanding their intention of using the chronic disease management model,and associated factors is of great significance for developing the Internet-based chronic disease management model.Objective To explore the intention and associated factors of using Internet-based chronic disease management in community physicians and nurses.Methods This survey was carried out between February and March 2018 with a self-developed questionnaire based on unified theory of acceptance and use of technology (UTAUT).Participants were 261 physicians and nurses selected by stratified random sampling from 45 community health centers,Shenzhen's Futian District.The hierarchical linear model was used to analyze the factors associated with the intention of using the Internet-based chronic disease management.Results The average total evaluation score for the intention of using the Internet-based chronic disease management was (4.03±0.88) points.The scores of difference in perceived effectiveness (C6,C7) and the usage intention(C25) among medical staffs of different ages were statistically significant (P<0.05).The scores of perceived usefulness (C3,C5) and the usage intention (C25) among of medical staffs in different academic qualifications were statistically significant (P<0.05).The scores of differences in perceived effectiveness (C7),personal factors (C23),and the usage intention (C25,C26) among medical staffs in different professional titles were statistically significant (P<0.05).The scores of perceived risk (C15) and personal factors (C22) among medical staffs in different positions were statistically significant (P<0.05).The scores of perceived risk (C15,C16) and task technology matching (C20,C21) among medical staffs in different job categories were statistically significant (P<0.05).There was a statistically significant difference in the perceived risk (C17) scores among the health care professionals in different professional communities (P<0.05).The scores of perceived risk (C17) among medical staffs in different professions were statistically significant (P<0.05).Multi-level linear model analysis showed that the positive factors,the traditional method of identity (B3)〔β=0.110,95%CI(-0.041,0.258)〕,perceived usefulness (C3)〔β=0.110,95%CI(0.026,1.930))〕,social influence (C11,C13)〔β=0.165,95%CI(0.065,0.265);β=0.235,95%CI(0.094,0.403)〕,task-technology fit (C21)〔β=0.182,95%CI(0.084,0.277)〕 and personal factors (C22)〔β=0.454,95%CI(0.258,0.507)〕,affect the usage intention of medical staffs to use the Internet-based chronic disease(P<0.05).Conclusion Community physicians and nurses universally prefer to use the Internet-based chronic management model.Their intention of use grows with the increase of individual creativity,social impact,level of task-technology fit,perceived usefulness of the Internet-based chronic management model,and self-identification of the traditional management model.

Key words: Community health centers, General practitioners, Nursing staff, Computer communication networks, Internet-based, Chronic disease, Disease management, Linear models

摘要: 背景 随着“互联网+”医疗的发展,我国“互联网+”慢性病管理模式应运而生,并展现出其独特优势,相关研究如雨后春笋,但目前研究中忽略了医护人员的使用情况,而社区医护人员作为慢性病管理者,了解其对该管理的使用意愿及影响因素对构建“互联网+”慢性病管理模式具有重要意义。目的 探索社区医护人员对“互联网+”慢性病管理使用意愿的影响因素。方法 2018年2—3月,以整合型技术接纳模型(UTAUT)为基础设计问卷,利用分层随机抽样的方法调查了深圳市福田区45个社区卫生服务中心共261名医护人员,采用多水平线性模型分析社区医护人员对“互联网+”慢性病管理使用意愿的影响因素。结果 社区医护人员对“互联网+”慢性病管理的总体使用意愿得分为(4.03±0.88)分。不同年龄社区医护人员感知有效性(C6、C7)、使用意愿(C25)得分比较,不同学历社区医护人员感知有用性(C3、C5)、使用意愿(C25)得分比较,不同职称社区医护人员感知有效性(C7)、个人因素(C23)、使用意愿(C25、C26)得分比较,不同职务社区医护人员感知风险(C15)、个人因素(C22)得分比较,不同工作类别社区医护人员感知风险(C15、C16)、任务技术匹配度(C20、C21)得分比较,不同所学专业社区医护人员感知风险(C17)得分比较,差异有统计学意义(P<0.05)。多水平线性模型分析结果显示,传统法的认同感(B3)〔β=0.110,95%CI(-0.041,0.258)〕、感知有用性(C3)〔β=0.110,95%CI(0.026,1.930)〕、社会影响(C11、C13)〔β=0.165,95%CI(0.065,0.265);β=0.235,95%CI(0.094,0.403)〕、任务技术匹配度(C21)〔β=0.182,95%CI(0.084,0.277)〕和个人因素(C22)〔β=0.454,95%CI(0.258,0.507)〕等5个维度6个因素是医护人员对“互联网+”慢病管理的使用意愿的正向影响因素(P<0.05)。结论 社区医护人员普遍愿意使用“互联网+”慢性病管理模式,其中个人因素、社会影响、任务技术匹配度、感知有用性、传统法的认同感均正向影响社区医护人员对该模式的使用意愿。

关键词: 社区卫生中心;全科医生;护理人员;计算机通信网络;&ldquo, 互联网+&rdquo, ;慢性病;疾病管理;线性模型