Zacharias Fabiana Costa Machado, Schönholzer Tatiele Estefani, Oliveira Valeria Conceição de, Gaete Rodrigo André Cuevas, Perez Gilberto, Fabriz Luciana Aparecida, Amaral Gabriela Gonçalves, Pinto Ione Carvalho
Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
Programa de Pós-graduação em Enfermagem, Universidade Federal de São João del-Rei, São João del-Rei, Brasil.
Cad Saude Publica. 2021 Jun 23;37(6):e00219520. doi: 10.1590/0102-311X00219520. eCollection 2021.
The study aimed to analyze the adoption and use of the Primary Healthcare e-SUS (PHC e-SUS) as a technological innovation from the perspective of workers in primary healthcare (PHC). This was a sequential exploratory mixed-methods study (QUAN → qual) in municipalities in the interior of São Paulo state, Brazil, drawing on Diffusion of Innovation Theory. The quantitative component was analytical cross-sectional, applying a validated questionnaire to 114 PHC workers. The model was tested by applying partial least squares structural equation modeling (PLS-SEM) using SmartPLS 2.3.0. The qualitative study was descriptive-exploratory, using interviews (n = 10) with thematic content analysis, aimed at understanding the attributes that did not influence the adoption and use of PHC e-SUS. The attributes "experimentation", "ease of use", "relative advantage", and "compatibility" did not display statistical significance, indicating that they were not determinant attributes for the adoption and use of PHC e-SUS. Integration of the data evidenced failures in connectivity; lack of time to feed the system in real time and training; lack of prior experimentation; abrupt presentation of the system; and lack of skill with the technology. The results can assist other municipalities in Brazil with the implementation of the PHC e-SUS in relation to the importance of the organizational infrastructure, as well as training in the technology's use and handling. The study contributes to reflections and proposals for interventions in the problems faced in daily work with the adoption and use of a technological innovation such as the PHC e-SUS.
该研究旨在从初级卫生保健（PHC）工作人员的角度分析初级卫生保健电子统一卫生系统（PHC e-SUS）作为一项技术创新的采用和使用情况。这是一项在巴西圣保罗州内陆城市进行的顺序探索性混合方法研究（定量→定性），借鉴了创新扩散理论。定量部分为分析性横断面研究，对114名初级卫生保健工作人员应用了经过验证的问卷。使用SmartPLS 2.3.0通过应用偏最小二乘结构方程模型（PLS-SEM）对模型进行了测试。定性研究为描述性探索性研究，采用访谈（n = 10）并进行主题内容分析，旨在了解不影响PHC e-SUS采用和使用的属性。“试验”“易用性”“相对优势”和“兼容性”等属性未显示出统计学意义，表明它们不是PHC e-SUS采用和使用的决定性属性。数据整合证明存在连接故障；缺乏实时输入系统和培训的时间；缺乏预先试验；系统的突然呈现；以及缺乏技术技能。研究结果可协助巴西其他城市实施PHC e-SUS，涉及组织基础设施的重要性以及技术使用和操作方面的培训。该研究有助于对在采用和使用PHC e-SUS等技术创新的日常工作中所面临的问题进行反思并提出干预建议。
