Otieno Ochieng George, Toyama Hinako, Asonuma Motohiro, Kanai-Pak Masako, Naitoh Keiko
Health and Welfare Information System, Division of Health Service Management, Graduate School, International University of Health and Welfare, Kitakanemaru, Ohtawara, Tochigi, Japan.
J Adv Nurs. 2007 Oct;60(2):209-19. doi: 10.1111/j.1365-2648.2007.04384.x.
This paper is a report of the development of an instrument to measure nurses' views on the use, quality and user satisfaction with electronic medical records systems.
Use of electronic medical records systems in hospitals is steadily increasing, yet no validated instruments have assessed the effectiveness of these systems from the viewpoint of nurses.
Items were designed following a literature review based on three main constructs: use, quality and user satisfaction with electronic medical records. Reliability and validity were examined based on responses from 1,666 nurses from 42 hospitals in Japan in February 2006. Exploratory factor analysis was conducted to determine the degree to which each item within a construct was associated. The reliability of each resultant factor was computed using Cronbach's alpha coefficient. Content validity was addressed by basing the items on previous surveys and review of the instrument by a panel of nurses experienced in nursing informatics. Construct validity was examined through factor analysis and correlational analyses.
Extent of 'use' of electronic medical records resulted into three factors with good factor loadings, but only two had acceptable reliability. 'Quality' of electronic medical records had two factors with good factor loadings and reliability. 'User satisfaction' with electronic medical records had three factors, but only one had acceptable reliability. 'Use' and 'quality' constructs were positively correlated with 'user satisfaction'.
The final instrument incorporates 34 items from the original 44-item pool. Initial validity results were positive and therefore the instrument can be used in evaluating electronic medical records in hospitals.
本文报告了一项用于测量护士对电子病历系统的使用、质量及用户满意度看法的工具的开发情况。
医院中电子病历系统的使用正在稳步增加,但尚无经过验证的工具从护士的角度评估这些系统的有效性。
基于文献综述,围绕使用、质量和对电子病历的用户满意度这三个主要结构设计项目。根据2006年2月日本42家医院的1666名护士的回答,检验了信度和效度。进行探索性因素分析以确定一个结构内每个项目的关联程度。使用克朗巴哈α系数计算每个结果因素的信度。通过以先前调查为基础设计项目并由护理信息学方面经验丰富的护士小组对该工具进行审查来解决内容效度问题。通过因素分析和相关分析检验结构效度。
电子病历“使用”程度产生了三个具有良好因素负荷的因素,但只有两个具有可接受的信度。电子病历“质量”有两个具有良好因素负荷和信度的因素。对电子病历的“用户满意度”有三个因素,但只有一个具有可接受的信度。“使用”和“质量”结构与“用户满意度”呈正相关。
最终工具纳入了原始44个项目中的34个。初步效度结果是积极的,因此该工具可用于评估医院中的电子病历。