Department of Cardiology, University Medical Centre Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands.
BMC Med Inform Decis Mak. 2013 Apr 26;13:54. doi: 10.1186/1472-6947-13-54.
Clinical Decision Support Systems (CDSSs) can support guideline adherence in heart failure (HF) patients. However, the use of CDSSs is limited and barriers in working with CDSSs have been described as a major obstacle. It is unknown if barriers to CDSSs are present and differ between HF nurses and cardiologists. Therefore the aims of this study are; 1. Explore the type and number of perceived barriers of HF nurses and cardiologists to use a CDSS in the treatment of HF patients. 2. Explore possible differences in perceived barriers between two groups. 3. Assess the relevance and influence of knowledge management (KM) on Responsibility/Trust (R&T) and Barriers/Threats (B&T).
A questionnaire was developed including; B&T, R&T, and KM. For analyses, descriptive techniques, 2-tailed Pearson correlation tests, and multiple regression analyses were performed.
The response- rate of 220 questionnaires was 74%. Barriers were found for cardiologists and HF nurses in all the constructs. Sixty-five percent did not want to be dependent on a CDSS. Nevertheless thirty-six percent of HF nurses and 50% of cardiologists stated that a CDSS can optimize HF medication. No relationship between constructs and age; gender; years of work experience; general computer experience and email/internet were observed. In the group of HF nurses a positive correlation (r .33, P<.01) between years of using the internet and R&T was found. In both groups KM was associated with the constructs B&T (B=.55, P=<.01) and R&T (B=.50, P=<.01).
Both cardiologists and HF-nurses perceived barriers in working with a CDSS in all of the examined constructs. KM has a strong positive correlation with perceived barriers, indicating that increasing knowledge about CDSSs can decrease their barriers.
临床决策支持系统（CDSS）可以支持心力衰竭（HF）患者的指南依从性。然而，CDSS 的使用受到限制，并且已经描述了与 CDSS 合作的障碍是主要障碍。目前尚不清楚 CDSS 是否存在障碍，以及 HF 护士和心脏病专家之间是否存在差异。因此，本研究的目的是：1. 探讨 HF 护士和心脏病专家在使用 CDSS 治疗 HF 患者方面感知到的障碍的类型和数量。2. 探讨两组之间可能存在的差异。3. 评估知识管理（KM）对责任/信任（R&T）和障碍/威胁（B&T）的相关性和影响。
开发了一份包括 B&T、R&T 和 KM 的问卷。对于分析，采用描述性技术、双侧 Pearson 相关检验和多元回归分析。
220 份问卷的回复率为 74%。在所有结构中，都发现了心脏病专家和 HF 护士的障碍。65%的人不想依赖 CDSS。然而，36%的 HF 护士和 50%的心脏病专家表示 CDSS 可以优化 HF 药物治疗。未观察到结构与年龄、性别、工作经验年限、一般计算机经验和电子邮件/互联网之间存在关系。在 HF 护士组中，发现使用互联网的年限与 R&T 之间存在正相关（r.33，P<.01）。在两组中，KM 与 B&T（B=.55，P=<.01）和 R&T（B=.50，P=<.01）均相关。
心脏病专家和 HF 护士在所有检查结构中都感知到与 CDSS 合作的障碍。KM 与感知到的障碍具有很强的正相关性，这表明增加对 CDSS 的了解可以减少它们的障碍。
