Fakhfakh Maya, Blanchette Virginie, Plourde Karine V, Gadio Souleymane, Elf Marie, Jones C Allyson, Meijering Louise, Giguère Anik, Légaré France
Department of Social and Preventive Medicine, Université Laval, Quebec City, QC, Canada.
VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada.
JMIR Aging. 2023 Jan 18;6:e43106. doi: 10.2196/43106.
Older adults with disabilities such as loss of autonomy face the decision of whether to stay at home or move to a health care facility such as a nursing home. Therefore, they may need support for this difficult decision.
We assessed the intention of Canadian older adults to use an electronic decision aid (eDA) to make housing decisions and identified the factors that influenced their intention.
We conducted a cross-sectional study using a web-based survey targeting older adults across 10 Canadian provinces and 3 territories. We included respondents from a web-based panel who were aged ≥65 years, understood English or French, had access to an electronic device with an internet connection, and had made a housing decision over the past few months or were planning to make a decision in the coming year. We based the web-based survey on the Unified Theory of Acceptance and Use of Technology (UTAUT). We adapted 17 UTAUT items to measure respondents' intention to use the eDA for housing decisions, as well as items measuring 4 intention constructs (performance expectancy, effort expectancy, social influence, and facilitating conditions). We also assessed eHealth literacy using both subjective and objective scales. We used descriptive statistics and multivariable linear regression analyses to identify the factors influencing the intention to use the eDA.
Of the 11,972 invited panelists, 1176 (9.82%) met the eligibility criteria, and 1000 (85.03%) respondents completed the survey. The mean age was 72.5 (SD 5.59) years. Most respondents were male (548/1000, 54.8%), White (906/1000, 90.6%), English speakers (629/1000, 62.9%), and lived in Ontario or Quebec (628/1000, 62.8%) and in urban areas (850/1000, 85%). The mean scores were 27.8 (SD 5.88) out of 40 for subjective eHealth literacy and 3.00 (SD 0.97) out of 5 for objective eHealth literacy. In our sample, the intention score was 4.74 (SD 1.7) out of 7. The mean scores of intention constructs out of 7 were 5.63 (SD 1.28) for facilitating conditions, 4.94 (SD 1.48) for performance expectancy, 5.61 (SD 1.35) for effort expectancy, and 4.76 (SD 1.59) for social influence. In the final model, the factors associated with intention included mother tongue (β=.30; P<.001), objective eHealth literacy (β=-.06; P=.03), performance expectancy (β=.55; P<.001), social influence (β=.37; P<.001), and facilitating conditions (β=.15; P<.001).
Findings from this pan-Canadian web-based survey on Canadian older adults suggest that their intention to use the eDA to make housing decisions is similar to the findings in other studies using UTAUT. The factors identified as influencing intention were mother tongue, objective eHealth literacy, performance expectancy, social influence, and facilitating conditions. These will guide future strategies for the implementation of the eDA.
患有诸如失去自主能力等残疾的老年人面临着是居家养老还是搬到诸如养老院等医疗保健机构的决策。因此，他们在做出这一艰难决策时可能需要支持。
我们评估了加拿大老年人使用电子决策辅助工具（eDA）来做出住房决策的意愿，并确定了影响他们意愿的因素。
我们开展了一项横断面研究，使用基于网络的调查问卷，目标人群为加拿大10个省和3个地区的老年人。我们纳入了来自一个基于网络的样本小组中年龄≥65岁、懂英语或法语、能够使用可联网电子设备，并且在过去几个月内做出过住房决策或计划在来年做出决策的受访者。基于网络的调查问卷以技术接受与使用统一理论（UTAUT）为基础。我们改编了17个UTAUT项目，以衡量受访者使用eDA做出住房决策的意愿，以及衡量4个意愿结构（绩效期望、努力期望、社会影响和促成条件）的项目。我们还使用主观和客观量表评估了电子健康素养。我们使用描述性统计和多变量线性回归分析来确定影响使用eDA意愿的因素。
在11972名受邀样本小组成员中，1176名（9.82%）符合资格标准，1000名（85.03%）受访者完成了调查。平均年龄为72.5（标准差5.59）岁。大多数受访者为男性（548/1000，54.8%）、白人（906/1000，90.6%）、说英语者（629/1000，62.9%），居住在安大略省或魁北克省（628/1000，62.8%）以及城市地区（850/1000，85%）。主观电子健康素养的平均得分为40分制中的27.8（标准差5.88）分，客观电子健康素养的平均得分为5分制中的3.00（标准差0.97）分。在我们的样本中，意愿得分为7分制中的4.74（标准差1.7）分。意愿结构的平均得分（满分7分）分别为：促成条件5.63（标准差1.28）分、绩效期望4.94（标准差1.48）分、努力期望5.61（标准差1.35）分、社会影响4.76（标准差1.59）分。在最终模型中，与意愿相关的因素包括母语（β = 0.30；P < 0.001）、客观电子健康素养（β = - 0.06；P = 0.03）、绩效期望（β = 0.55；P < 0.001）、社会影响（β = 0.37；P < 0.001）和促成条件（β = 0.15；P < 0.001）。
这项针对加拿大老年人的全加拿大范围基于网络的调查结果表明，他们使用eDA做出住房决策的意愿与其他使用UTAUT的研究结果相似。确定的影响意愿的因素包括母语、客观电子健康素养、绩效期望、社会影响和促成条件。这些将为未来实施eDA的策略提供指导。
