Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon.
Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
JMIR Mhealth Uhealth. 2020 Mar 31;8(3):e16917. doi: 10.2196/16917.
Health care provider usage of mobile devices is increasing globally; however, there is little understanding of patient perceptions on this behavior in a health care setting.
The aim of this study was to assess patients' attitudes toward mobile device usage by health care providers in the emergency department and to identify predictors of these attitudes.
The study was carried out at the emergency department of a large academic tertiary care medical center in Lebanon. A cross-sectional survey design was adopted by administering a questionnaire to medically stable adult patients who presented to the emergency department with an emergency severity index of 3, 4, or 5 between January 2017 and March 2018. The questionnaire collected relevant patient demographic information and included questions related to their mobile device usage along with those evaluating attitudes for the use of mobile devices by health care providers with respect to six major domains: role in health care, distraction potential, impact on communication, empathy, privacy, and professionalism. The attitude toward mobile device usage by health care providers in the emergency department was the main outcome variable. A stepwise logistic regression model was used to assess the association between the outcome variable and the demographic and attitude-related independent variables.
Among the 438 eligible patients, 338 patients responded to the questionnaire for a response rate of 70.0%. Overall, 313/338 (92.6%) respondents agreed that mobile devices improve health care delivery, whereas 132/338 (39.1%) respondents were opposed to their usage by health care providers in the emergency department (95% CI: 34.0-44.4). The majority (240/338, 71.0%) of patients agreed that mobile devices are a source of distraction to health care providers in the workplace. Females (odds ratio [OR]=1.67, 95% CI: 1.00-2.78) as well as all patients (OR=2.54, 95% CI 1.36-4.76) who believed that mobile devices were a source of distraction, reflecting a lack of professionalism (OR=2.77, 95% CI 1.59-4.82) and impacting the provider's ability to relate to the patient (OR=2.93, 95% CI 1.72-4.99), were more likely to agree that mobile devices should not be used in the emergency department.
Patients' negative attitude toward mobile device use in the emergency department is largely driven by patient gender (females), patient perception of the distraction potential of the devices, and their negative impact on the health care provider's empathy and professionalism. The findings of this study shed light on the importance of encouraging stakeholders to impose a digital professionalism code of conduct for providers working in acute health care settings.
移动设备在全球范围内被医疗保健提供者广泛使用；然而，对于患者在医疗环境中对这种行为的看法，我们知之甚少。
本研究旨在评估患者对急诊部医疗保健提供者使用移动设备的态度，并确定这些态度的预测因素。
该研究在黎巴嫩一家大型学术三级保健医疗中心的急诊部进行。采用横断面调查设计，对 2017 年 1 月至 2018 年 3 月期间急诊严重指数为 3、4 或 5 的稳定成年患者进行问卷调查。问卷收集了相关的患者人口统计学信息，包括与他们的移动设备使用相关的问题，以及评估移动设备对医疗保健提供者在六个主要领域的使用态度的问题：在医疗保健中的作用、潜在的干扰、对沟通的影响、同理心、隐私和专业性。医疗保健提供者在急诊部使用移动设备的态度是主要的结果变量。采用逐步逻辑回归模型评估结果变量与人口统计学和态度相关的独立变量之间的关系。
在 438 名合格患者中，有 338 名患者回答了问卷，应答率为 70.0%。总体而言，313/338（92.6%）名受访者认为移动设备改善了医疗服务的提供，而 132/338（39.1%）名受访者反对医疗保健提供者在急诊部使用移动设备（95%置信区间：34.0-44.4）。大多数（240/338，71.0%）患者认为移动设备是医疗保健提供者在工作场所分心的来源。女性（比值比[OR]=1.67，95%置信区间：1.00-2.78）和所有认为移动设备是分心来源的患者（OR=2.54，95%置信区间 1.36-4.76），反映缺乏专业性（OR=2.77，95%置信区间 1.59-4.82）和影响提供者与患者的关系能力（OR=2.93，95%置信区间 1.72-4.99），更有可能认为移动设备不应在急诊部使用。
患者对急诊部移动设备使用的负面态度主要受患者性别（女性）、患者对设备潜在干扰的感知以及对医疗保健提供者同理心和专业性的负面影响驱动。本研究结果表明，鼓励利益相关者为在急性保健环境中工作的提供者制定数字专业行为准则非常重要。
