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巴勒斯坦医院医生在采用临床决策支持系统方面未得到满足的需求。

The unmet needs of adopting clinical decision support system among physicians in Palestinian hospitals.

作者信息

Sultan Haya, Najjar Shahenaz, Awartani Faisal, Abu-Odah Hammoda

机构信息

Department of Pharmacy, Nursing and Health Professions, Birzeit University, Ramallah, Palestine.

Faculty of Graduate Studies, Arab American University, Ramallah, Palestine.

出版信息

PLoS One. 2024 Dec 12;19(12):e0310765. doi: 10.1371/journal.pone.0310765. eCollection 2024.

Abstract

INTRODUCTION

Clinical decision support system (CDSS) is an application used to aid decision-making and provide knowledge regarding treatment, diagnosis, and laboratory testing. Despite the associated benefits, the underutilization of CDSS is causing a global challenge. In Palestine, CDSS remains unimplemented, prompting a study on knowledge levels and factors influencing CDSS acceptance among physicians.

OBJECTIVE

The study aimed to assess physicians' knowledge of CDSS and understand factors impacting CDSS adoption, including performance expectancy (PE), effort expectancy (EE), computer self-efficacy, involvement in decision-making, perceived threat to autonomy, and social influence.

METHODS

A validated questionnaire-based survey consisting of seven constructs was used in this study. The constructs were derived from the unified theory of acceptance and use of technology (UTAUT). The target population was 363 resident physicians and general practitioners (GPs) from three governmental hospitals. In total, 124 participants were enrolled, and data was collected between June 1 and June 30, 2022. Generalized linear regression was used for data analysis.

RESULTS

Most participants were males (75%), with an average of 2.9 years of experience. Despite limited CDSS knowledge, participants strongly intended to adopt it (mean = 3.91, SD = 0.65). Our results showed a significant effect of PE (p = 0.000, r = 0.469), EE (p = 0.001, r = 0.294), computer self-efficacy level (p = 0.015, r = 0.218), perceived threat to professional autonomy (p = 0.001, r = -0.302), and social influence (p = 0.047, r = 0.179) on the intention to adopt CDSS. However, involvement in decision-making about CDSS had no significant impact (p = 0.123, r = 0.140).

CONCLUSION

This study provides the basis for implementing CDSS in Palestinian settings. Despite the readiness of Palestinian healthcare providers, introducing CDSS as an aiding, effort-free tool is a prerequisite for successful CDSS adoption in Palestine.

摘要

引言

临床决策支持系统(CDSS)是一种用于辅助决策并提供有关治疗、诊断和实验室检测知识的应用程序。尽管有相关益处,但CDSS的未充分利用正引发全球挑战。在巴勒斯坦,CDSS仍未实施,这促使开展一项关于医生对CDSS的知识水平及影响其接受度的因素的研究。

目的

该研究旨在评估医生对CDSS的了解,并了解影响CDSS采用的因素,包括绩效期望(PE)、努力期望(EE)、计算机自我效能感、参与决策、对自主性的感知威胁以及社会影响。

方法

本研究采用了一份经过验证的基于问卷的调查,该调查由七个构面组成。这些构面源自技术接受与使用统一理论(UTAUT)。目标人群是来自三家政府医院的363名住院医师和全科医生(GP)。总共招募了124名参与者,并于2022年6月1日至6月30日收集数据。采用广义线性回归进行数据分析。

结果

大多数参与者为男性(75%),平均有2.9年工作经验。尽管对CDSS的了解有限,但参与者强烈打算采用它(均值 = 3.91,标准差 = 0.65)。我们的结果显示,PE(p = 0.000,r = 0.469)、EE(p = 0.001,r = 0.294)、计算机自我效能感水平(p = 0.015,r = 0.218)、对职业自主性的感知威胁(p = 0.001,r = -0.302)和社会影响(p = 0.047,r = 0.179)对采用CDSS的意愿有显著影响。然而,参与CDSS相关决策没有显著影响(p = 0.123,r = 0.140)。

结论

本研究为在巴勒斯坦实施CDSS提供了依据。尽管巴勒斯坦医疗保健提供者有意愿,但将CDSS作为一种辅助性、无需费力的工具引入是在巴勒斯坦成功采用CDSS的先决条件。

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