影響診所病人使用個人健康記錄意願之因素

The Factors Affecting Intentions of Clinic Patients to Use Personal Health Record

蔡易樺(Yi-Hua Tsai)

指導教授 ： 溫信財

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2012年)

https://doi.org/10.6831/TMU.2012.00155

摘要

研究背景與目的：資訊科技在健康產業上的運用解決了相當多的管理問題，亦能有效達成醫療照護的目的。而「個人健康記錄」(Personal Health Record, PHR)，使病人可以存取、更新和查詢自己的健康記錄，並將新的健康資訊分享給醫療提供者，可避免重複的診療程序，減少醫療費用和時間。本研究目的為瞭解及探討診所病人對個人健康記錄的認知及使用意願。
方法：本研究以臺北市某診所之病人為研究對象。採用以科技接受模式及計畫行為理論為基礎之結構式問卷，問卷經效度、信度檢定後，以郵寄問卷及候診區發放方式進行檢測，調查期間為100年9月23日至101年2月29日，回收樣本總計225份，回收率為41.3%，並利用SPSS17.0及Amos18.0軟體進行描述性及結構方程模式(Structural Equation Modeling, SEM)統計分析。
結果：本研究發現主觀規範對健康知能、電腦自我效能有正向影響；健康知能、電腦自我效能對知覺易用性有正向影響；健康知能與主觀規範對知覺有用性有正向影響；知覺有用性與主觀規範對使用意願有正向影響。結構方程模式卡方值/自由度為1.532、GFI為0.897、AGFI為0.865、RMSEA為0.049，表示整體模式具合理的適配度。
結論：本研究由知覺易用性、知覺有用性、主觀規範、電腦自我效能及健康知能等變項取得SEM最佳解釋模型，相關變項可解釋使用意願60.8%之變異。而診所醫師應適時向病人解說及鼓勵病人使用個人健康記錄。

關鍵字

個人健康記錄、科技接受模式、計畫行為理論、健康知能、結構方程模式

並列摘要

Background and Objectives: The information technology not only solved a number of management problems in the health industry, but also assisted clinicians to deliver medical care services effectively. Personal Health Record (PHR) is a useful tool helps patients to access, update and query their own health information, and share them to medical providers. Therefore, PHR could avoid repeating procedures and reducing medical costs. The purpose of this study was to understand and explore the factors affecting patients’ intentions of PHR.
Methods: It was a cross-sectional study and conducted by structured questionnaire based on technology acceptance model and planned behavior theory. The subjects are patients who were volunteered to participate in this study from a Family medicine clinic in Taipei. After verifying validity and reliability of questionnaire, data were collected in the period of September 23, 2011 to February 29, 2012. There were a total of 225 valid questionnaires, and a response rate of 41.3%. Data analyzing used the SPSS 17.0 and AMOS 18.0 statistics software.
Results: This study found that subjective norm has a positive effect on health literacy and computer self-efficacy. Health literacy and computer self-efficacy has a positive effect on perceived ease of use. Health literacy and subjective norm has a positive effect on perceived usefulness. Perceived usefulness and subjective norm has a positive effect on Intention to use. The goodness of fit test of model were χ2/d f =1.532, GFI=0.897, AGFI=0.865 and RMSEA=0.049 respectively, which well fitted the theoretical model.
Conclusions: The best SEM model explained 60.8% variances of patients’ PHR intention by constructs of perceived ease of use, perceived usefulness, subjective norm, computer self-efficacy, and health literacy. We suggested clinic physicians should explain the PHR operation and encourage patients to use it.

並列關鍵字

Personal Health Record(PHR), Technology Acceptance Model(TAM), Theory of Planned Behavior(TPB), Health Literacy, Structural Equation Modeling(SEM)

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