Liu Chung-Feng, Kuo Kuang-Ming
Department of Information Management, Chia-Nan University of Pharmacy and Science, No.60, Erh-Jen Rd., Sec.1, Jen-Te District, Tainan City 71710, Taiwan, ROC.
Department of Healthcare Administration, I-Shou University, No.8, Yida Rd., Yanchao District, Kaohsiung City 82445, Taiwan, ROC.
Int J Med Inform. 2016 May;89:1-8. doi: 10.1016/j.ijmedinf.2016.01.012. Epub 2016 Feb 6.
Self-care management is becoming an important part of care for chronic patients. However, various kinds of self-management educational materials which government or healthcare institutions provide for patients may not achieve the expected outcome. One of the critical reasons affecting patients' use intention could be patients' perceived information overload regarding the self-management educational materials.
This study proposed an extended model of the Theory of Planned Behavior (TPB), which incorporated perceived information overload, to explore if information overload will prevent chronic patients from reading educational materials for self-care management. The independent variables are attitude, subject norm, perceived behavior control and perceived information overload while the dependent variable is behavior intention to use the self-management educational materials. Perceived information overload is also referred to as an antecedent variable which may has impacts on attitude and perceived behavior control.
The cross-sectional study interviewed newly diagnosed chronic patients with coronary artery disease, who are the potential users of the self-management educational materials, in a medical center in Taiwan. Data were analyzed using descriptive statistics of the basic information distribution of the respondents, and structural equation modeling to study the reliability and validity for testing hypotheses.
A total of 110 respondents were enrolled in this study and successful interview data were collected from 106 respondents. The result indicates that the patients' perceived information overload of self-management educational materials was validated to have impacts on attitude and perceived behavioral control constructs of the TPB as well as contributing a direct impact on patients' intentions to use self-management educational materials. Besides, subjective norm and perceived behavioral control constructs were validated to have significant impacts on behavioral intentions, whereas the attitude construct was not. Finally, the relationships between information overload and attitude, information overload and intention, subjective norm and intention, as well as perceived behavioral control and intention varied significantly between highly- and less-educated respondents. Differing self-management educational materials for respondents of various educational levels could be formulated to substantially boost the use of self-management educational materials.
This study demonstrated a comprehensive framework, which extended perceived information overload into the TPB model, to predict patients' behavioral intention of using self-management educational materials. We expect the results of this study will provide useful insights for studying self-management educational materials usage and information overload from the perspectives of academia, governments, and healthcare providers.
自我护理管理正成为慢性病患者护理的重要组成部分。然而，政府或医疗机构为患者提供的各类自我管理教育材料可能无法达到预期效果。影响患者使用意愿的一个关键原因可能是患者对自我管理教育材料存在感知信息过载。
本研究提出了一个扩展的计划行为理论（TPB）模型，纳入了感知信息过载，以探讨信息过载是否会阻碍慢性病患者阅读自我护理管理的教育材料。自变量为态度、主观规范、感知行为控制和感知信息过载，因变量为使用自我管理教育材料的行为意愿。感知信息过载也被视为一个可能影响态度和感知行为控制的前因变量。
这项横断面研究对台湾一家医疗中心新诊断出的冠心病慢性病患者进行了访谈，这些患者是自我管理教育材料的潜在使用者。使用受访者基本信息分布的描述性统计分析数据，并采用结构方程模型研究检验假设的可靠性和有效性。
本研究共招募了110名受访者，从106名受访者处成功收集到访谈数据。结果表明，患者对自我管理教育材料的感知信息过载被证实会影响TPB的态度和感知行为控制结构，并且对患者使用自我管理教育材料的意愿有直接影响。此外，主观规范和感知行为控制结构被证实对行为意愿有显著影响，而态度结构则没有。最后，信息过载与态度、信息过载与意愿、主观规范与意愿以及感知行为控制与意愿之间的关系在高学历和低学历受访者之间存在显著差异。可以为不同教育水平的受访者制定不同的自我管理教育材料，以大幅提高自我管理教育材料的使用率。
本研究展示了一个综合框架，将感知信息过载扩展到TPB模型中，以预测患者使用自我管理教育材料的行为意愿。我们期望本研究结果能为学术界、政府和医疗服务提供者从自我管理教育材料使用和信息过载的角度提供有用的见解。
