Gagnon Marie-Pierre, Godin Gaston, Gagné Camille, Fortin Jean-Paul, Lamothe Lise, Reinharz Daniel, Cloutier Alain
Department of Social and Preventive Medicine, Laval University, Pavillon de l'Est 2180, Chemin Ste-Foy, QC, G1K 7P4 Quebec, Canada.
Int J Med Inform. 2003 Sep;71(2-3):103-15. doi: 10.1016/s1386-5056(03)00094-7.
Physicians' acceptance of telemedicine constitutes a prerequisite for its diffusion on a national scale. Based upon the Theory of Interpersonal Behavior, this study was aimed at assessing the predictors of physicians' intention to use telemedicine in their clinical practice. All of the physicians involved in the RQTE, the extended provincial telemedicine network of Quebec (Canada) were mailed a questionnaire to identify the psychosocial determinants of their intention to adopt telemedicine. Confirmatory factor analysis (CFA) was performed to assess the measurement model and structural equation modelling (SEM) was applied to test the theoretical model. The adapted theoretical model explained 81% (P<0.001) of variance in physicians' intention to use telehealth. The main predictors of intentions were a composite normative factor, comprising personal as well as social norms (beta=1.08; P<0.001) and self identity (beta=-0.33; P<0.001). Thus, physicians who perceived professional and social responsibilities regarding adoption of telehealth in their clinical practice had stronger intention to use this technology. However, it is likely that personal identity had a suppression effect in the regression equation, indicating that physicians' intention to use telemedicine was better predicted if their self-perception as telemedicine users was considered. These results have several implications at the theoretical and practical levels that are discussed in this paper.
医生对远程医疗的接受程度是其在全国范围内推广的前提条件。基于人际行为理论,本研究旨在评估医生在临床实践中使用远程医疗意愿的预测因素。向参与加拿大魁北克省扩展远程医疗网络RQTE的所有医生邮寄了一份问卷,以确定他们采用远程医疗意愿的心理社会决定因素。进行验证性因素分析(CFA)以评估测量模型,并应用结构方程模型(SEM)来检验理论模型。调整后的理论模型解释了医生使用远程健康意愿中81%(P<0.001)的方差。意愿的主要预测因素是一个综合规范因素,包括个人规范和社会规范(β=1.08;P<0.001)以及自我认同(β=-0.33;P<0.001)。因此,在临床实践中认为在采用远程健康方面负有职业和社会责任的医生使用这项技术的意愿更强。然而,个人认同在回归方程中可能具有抑制作用,这表明如果考虑医生对自己作为远程医疗使用者的自我认知,能更好地预测他们使用远程医疗的意愿。本文讨论了这些结果在理论和实践层面的若干影响。