Huvila Isto, Rexhepi Hanife, Moll Jonas, Ghorbanian Zolbin Maedeh, Blease Charlotte, Bärkås Annika, Åhlfeldt Rose-Mharie, Hagström Josefin, Kane Bridget, Scandurra Isabella, Hägglund Maria, Klein Gunnar O, Wang Bo, Kharko Anna
Department of ALM, Uppsala University, Uppsala, Sweden.
School of Informatics, University of Skövde, Skövde, Sweden.
Digit Health. 2024 Oct 21;10:20552076241287354. doi: 10.1177/20552076241287354. eCollection 2024 Jan-Dec.
The current understanding of the breadth of individual differences in how eHealth technologies are perceived as useful for different purposes is incomprehensive. The aim/purpose of the study is to improve the understanding of diverse perceptions of the usefulness of technologies by exploring older adults' use of their patient-accessible electronic health records (PAEHRs).
The study applies and extends Affordance Theory based on an empirical analysis of data from the NORDeHEALTH 2022 Patient Survey on attitudes toward PAEHR in Norway, Sweden, Finland, and Estonia. Responses from 3964 participants in Sweden, aged 65 + years were analysed. Data included demographics and agreement ratings to reasons for using PAEHR. To analyse variation in the reasons for using PAEHR, group comparisons were conducted based on gender (male/female), age group (65-74, 75-84 and 85+) and earlier encouragement to use PAEHR.
Overall, the findings suggest that PAEHRs have multiple parallel affordance trajectories and affordance potencies that actualise differently depending on needs. The top reasons, pointing to both orientational and goal-oriented affordances for using PAEHR, were improving understanding of health issues, getting an overview of medical history/treatment and ensuring understanding of what the doctor said. Men reported more often sharing information with relatives or friends as a reason to access PAEHR. Women were more inclined, albeit similarly to men less frequently, to read their PAEHR for detecting errors. Age had little influence on reasons for using PAEHR.
The study applies and extends Affordance Theory in the context of older adults' PAEHR use based on findings from the largest national investigation of reasons for older users to access PAEHR in Sweden demonstrating the applicability of the theory in improving the understanding of the diversity of individual perceptions on eHealth technologies.
目前对于电子健康技术在不同用途上被视为有用的个体差异广度的理解并不全面。本研究的目的是通过探索老年人对其可访问的电子健康记录（PAEHRs）的使用情况，来增进对技术有用性的不同认知的理解。
本研究基于对挪威、瑞典、芬兰和爱沙尼亚2022年NORDeHEALTH患者对PAEHR态度调查数据的实证分析，应用并扩展了可供性理论。对瑞典3964名65岁及以上参与者的回复进行了分析。数据包括人口统计学信息以及对使用PAEHR原因的认同评分。为了分析使用PAEHR原因的差异，基于性别（男/女）、年龄组（65 - 74岁、75 - 84岁和85岁及以上）以及先前对使用PAEHR的鼓励进行了组间比较。
总体而言，研究结果表明PAEHRs具有多条并行的可供性轨迹和可供性潜力，它们会根据需求以不同方式实现。使用PAEHR的首要原因，既指向了定向性可供性，也指向了目标导向性可供性，包括增进对健康问题的理解、全面了解病史/治疗情况以及确保理解医生所说的内容。男性报告将与亲属或朋友分享信息作为访问PAEHR的原因更为频繁。女性更倾向于（尽管与男性一样频率较低）查看自己的PAEHR以发现错误。年龄对使用PAEHR的原因影响不大。
本研究基于瑞典针对老年用户访问PAEHR原因的最大规模全国性调查结果，在老年人使用PAEHR的背景下应用并扩展了可供性理论，证明了该理论在增进对电子健康技术个体认知多样性理解方面的适用性。
