Xu Bin, Li Suyuan, Chen Keyu, Ding Lei, Liu Longxiu
Neurosurgical Intensive Care Unit, Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu Province, China.
School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, China.
JMIR Nurs. 2025 Oct 1;8:e72846. doi: 10.2196/72846.
"Internet Plus Nursing Service" (IPNS) offers innovative solutions for China's growing home health care demands. Understanding primary care nurses' participation intentions is crucial for service optimization.
This study evaluates primary health nurses' intention to participate in IPNS-a technology-mediated home care model combining mobile health platforms with in-person visits-and examines how digital readiness, safety perceptions, and organizational factors influence participation decisions, to guide policy optimization for scalable digital home health care delivery.
A cross-sectional survey was conducted in Jiangsu Province, China (December 2023-December 2024) using the validated Participation Intention of Nurses on IPNS Scale. Convenience sampling enrolled 3952 nurses from 13 prefecture-level cities in Jiangsu-the second-tier administrative divisions in China that typically encompass both urban and rural areas, each with independent health care systems governed by municipal health authorities. Statistical analyses included t tests and ANOVA with SPSS 22.
A total of 3952 surveys were completed. The participation intention scale yielded a mean (SD) total score of 66.13 (7.89) across respondents. Subscale analysis revealed mean (SD) scores of 18.57 (2.68) for participation attitude, 18.87 (2.49) for subjective norms, and 25.67 (3.48) for perceived behavioral control. Significant demographic predictors of participation intention were identified through statistical analysis. Male nurses demonstrated stronger intention (t72.974=-23.139, P<.0001), as did those over 30 years old (F39,51=27.215, P<.0001) and bachelor's degree holders (t2185.018=-4.994, P<.0001). Workplace characteristics also showed significant associations, with nursing management department staff (F39,51=45.877, P<.0001) and those with less organizational workloads (F39,51=9.829, P<.0001) displaying greater intention. Professional factors including higher positional rank (F39,51=37.32, P<.0001), more advanced titles (F39,51=30.176, P<.0001), and over 11 years of experience (F39,51=5.242, P=.001) predicted stronger participation intent. Finally, nurses earning 5000-10,000 RMB (a currency exchange rate of RMB 1=US $0.71 is applicable) monthly showed significantly higher intention scores (F39,51=16.141, P<.0001).
Policymakers should prioritize 3 interventions: (1) develop IPNS-specific safety protocols and legal safeguards, (2) optimize workload allocation through intelligent scheduling systems, and (3) establish tiered incentive mechanisms targeting middle-income nurses and experienced practitioners.
“互联网+护理服务”（IPNS）为中国日益增长的家庭医疗保健需求提供了创新解决方案。了解基层护理人员的参与意愿对于服务优化至关重要。
本研究评估基层医疗卫生护士参与IPNS（一种将移动健康平台与上门访视相结合的技术介导的家庭护理模式）的意愿，并探讨数字准备程度、安全认知和组织因素如何影响参与决策，以指导可扩展的数字家庭医疗保健服务的政策优化。
2023年12月至2024年12月在中国江苏省进行了一项横断面调查，使用经过验证的护士对IPNS参与意愿量表。便利抽样纳入了江苏省13个地级市的3952名护士，这些地级市是中国的二级行政区划，通常涵盖城乡地区，每个地区都有由市卫生当局管理的独立医疗保健系统。使用SPSS 22进行统计分析，包括t检验和方差分析。
共完成3952份调查问卷。参与意愿量表的受访者总分平均（标准差）为66.13（7.89）。子量表分析显示，参与态度的平均（标准差）得分为18.57（2.68），主观规范得分为18.87（2.49），感知行为控制得分为25.67（3.48）。通过统计分析确定了参与意愿的重要人口统计学预测因素。男性护士表现出更强的意愿（t72.974=-23.139，P<.0001），30岁以上的护士（F39,51=27.215，P<.0001）和本科毕业生（t2185.018=-4.994，P<.0001）也是如此。工作场所特征也显示出显著关联，护理管理部门的工作人员（F39,51=45.877，P<.0001）和组织工作量较少的人员（F39,51=9.829，P<.0001）表现出更高的意愿。包括更高职位等级（F39,51=37.32，P<.0001）、更高级别职称（F39,51=30.176，P<.0001）和超过11年工作经验（F39,51=5.242，P=.001）在内的专业因素预测了更强的参与意愿。最后，月收入在5000-10000元人民币（适用汇率为1元人民币=0.71美元）的护士意愿得分显著更高（F39,51=16.141，P<.0001）。
政策制定者应优先采取三项干预措施：（1）制定IPNS特定的安全协议和法律保障；（2）通过智能调度系统优化工作量分配；（3）针对中等收入护士和经验丰富的从业者建立分层激励机制。
