护士使用电子个人健康记录管理自身健康的接受模型测试：一项横断面调查。
Testing the Electronic Personal Health Record Acceptance Model by Nurses for Managing Their Own Health: A Cross-sectional Survey.
作者信息
Gartrell K, Trinkoff A M, Storr C L, Wilson M L, Gurses A P
机构信息
National Institutes of Health/National Library of Medicine/Lister Hill National Center for Biomedical Communications , Bethesda, MD.
University of Maryland School of Nursing , Baltimore, MD.
出版信息
Appl Clin Inform. 2015 Apr 8;6(2):224-47. doi: 10.4338/ACI-2014-11-RA-0107. eCollection 2015.
BACKGROUND
To our knowledge, no evidence is available on health care professionals' use of electronic personal health records (ePHRs) for their health management. We therefore focused on nurses' personal use of ePHRs using a modified technology acceptance model.
OBJECTIVES
To examine (1) the psychometric properties of the ePHR acceptance model, (2) the associations of perceived usefulness, ease of use, data privacy and security protection, and perception of self as health-promoting role models to nurses' own ePHR use, and (3) the moderating influences of age, chronic illness and medication use, and providers' use of electronic health record (EHRs) on the associations between the ePHR acceptance constructs and ePHR use.
METHODS
A convenience sample of registered nurses, those working in one of 12 hospitals in the Maryland and Washington, DC areas and members of the nursing informatics community (AMIA and HIMSS), were invited to respond to an anonymous online survey; 847 responded. Multiple logistic regression identified associations between the model constructs and ePHR use, and the moderating effect.
RESULTS
Overall, ePHRs were used by 47%. Sufficient reliability for all scales was found. Three constructs were significantly related to nurses' own ePHR use after adjusting for covariates: usefulness, data privacy and security protection, and health-promoting role model. Nurses with providers that used EHRs who perceived a higher level of data privacy and security protection had greater odds of ePHR use than those whose providers did not use EHRs. Older nurses with a higher self-perception as health-promoting role models had greater odds of ePHR use than younger nurses.
CONCLUSIONS
Nurses who use ePHRs for their personal health might promote adoption by the general public by serving as health-promoting role models. They can contribute to improvements in patient education and ePHR design, and serve as crucial resources when working with their individual patients.
背景
据我们所知，尚无关于医疗保健专业人员使用电子个人健康记录（ePHR）进行自身健康管理的证据。因此，我们使用改进的技术接受模型，重点研究护士对ePHR的个人使用情况。
目的
研究（1）ePHR接受模型的心理测量特性；（2）感知有用性、易用性、数据隐私和安全保护以及自我作为健康促进榜样的认知与护士自身使用ePHR之间的关联；（3）年龄、慢性病和药物使用以及提供者对电子健康记录（EHR）的使用对ePHR接受结构与ePHR使用之间关联的调节作用。
方法
邀请在马里兰州和华盛顿特区地区12家医院之一工作的注册护士以及护理信息学社区（美国医学信息学会和医疗卫生信息与管理系统学会）成员作为便利样本，参与一项匿名在线调查；847人做出回应。多元逻辑回归确定了模型结构与ePHR使用之间的关联以及调节作用。
结果
总体而言，47%的护士使用ePHR。所有量表均具有足够的可靠性。在调整协变量后，有三个结构与护士自身使用ePHR显著相关：有用性、数据隐私和安全保护以及健康促进榜样。与提供者未使用EHR的护士相比，提供者使用EHR且感知到更高水平数据隐私和安全保护的护士使用ePHR的几率更高。自我认知为健康促进榜样程度较高的年长护士使用ePHR的几率高于年轻护士。
结论
将ePHR用于个人健康的护士可以通过充当健康促进榜样来推动公众采用ePHR。他们可以促进患者教育和ePHR设计的改进，并在与个体患者合作时充当关键资源。
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