Cork R D, Detmer W M, Friedman C P
University of North Carolina, Chapel Hill.
J Am Med Inform Assoc. 1998 Mar-Apr;5(2):164-76. doi: 10.1136/jamia.1998.0050164.
This paper describes details of four scales of a questionnaire-- "Computers in Medical Care"--measuring attributes of computer use, self-reported computer knowledge, computer feature demand, and computer optimism of academic physicians. The reliability (i.e., precision, or degree to which the scale's result is reproducible) and validity (i.e., accuracy, or degree to which the scale actually measures what it is supposed to measure) of each scale were examined by analysis of the responses of 771 full-time academic physicians across four departments at five academic medical centers in the United States. The objectives of this paper were to define the psychometric properties of the scales as the basis for a future demonstration study and, pending the results of further validity studies, to provide the questionnaire and scales to the medical informatics community as a tool for measuring the attitudes of health care providers.
The dimensionality of each scale and degree of association of each item with the attribute of interest were determined by principal components factor analysis with orthogonal varimax rotation. Weakly associated items (factor loading < .40) were deleted. The reliability of each resultant scale was computed using Cronbach's alpha coefficient. Content validity was addressed during scale construction; construct validity was examined through factor analysis and by correlational analyses.
Attributes of computer use, computer knowledge, and computer optimism were unidimensional, with the corresponding scales having reliabilities of .79, .91, and .86, respectively. The computer-feature demand attribute differentiated into two dimensions: the first reflecting demand for high-level functionality with reliability of .81 and the second demand for usability with reliability of .69. There were significant positive correlations between computer use, computer knowledge, and computer optimism scale scores and respondents' hands-on computer use, computer training, and self-reported computer sophistication. In addition, items posited on the computer knowledge scale to be more difficult generated significantly lower scores.
The four scales of the questionnaire appear to measure with adequate reliability five attributes of academic physicians' attitudes toward computers in medical care: computer use, self-reported computer knowledge, demand for computer functionality, demand for computer usability, and computer optimism. Results of initial validity studies are positive, but further validation of the scales is needed. The URL of a downloadable HTML copy of the questionnaire is provided.
本文描述了一份调查问卷——“医疗保健中的计算机”——四个量表的详细信息，这些量表用于测量学术医生的计算机使用属性、自我报告的计算机知识、计算机功能需求以及对计算机的乐观态度。通过对美国五个学术医疗中心四个科室的771名全职学术医生的回答进行分析，检验了每个量表的信度（即精确度，或量表结果可重复的程度）和效度（即准确性，或量表实际测量其预期测量内容的程度）。本文的目的是确定量表的心理测量特性，作为未来示范研究的基础，并在进一步效度研究结果出来之前，将调查问卷和量表提供给医学信息学界，作为测量医疗保健提供者态度的工具。
通过主成分因子分析和正交方差最大化旋转，确定每个量表的维度以及每个项目与感兴趣属性的关联程度。删除弱相关项目（因子载荷<0.40）。使用克朗巴哈α系数计算每个最终量表的信度。在量表构建过程中考虑内容效度；通过因子分析和相关分析检验结构效度。
计算机使用属性、计算机知识和对计算机的乐观态度是单维的，相应量表的信度分别为0.79、0.91和0.86。计算机功能需求属性分为两个维度：第一个反映对高级功能的需求，信度为0.81，第二个反映对易用性的需求，信度为0.69。计算机使用、计算机知识和对计算机的乐观态度量表得分与受访者的实际计算机使用、计算机培训以及自我报告的计算机熟练程度之间存在显著正相关。此外，计算机知识量表上设定为更难的项目得分明显更低。
该调查问卷的四个量表似乎能够以足够的信度测量学术医生对医疗保健中计算机态度的五个属性：计算机使用、自我报告的计算机知识、对计算机功能的需求、对计算机易用性的需求以及对计算机的乐观态度。初步效度研究结果是积极的，但量表还需要进一步验证。提供了调查问卷可下载HTML副本的网址。
