基于技术接受模型的慢性病远程监护服务使用意愿的影响因素研究

Influencing Factors of Patients' Willingness to Use Remote Monitoring Services for Chronic Diseases based on Technology Acceptance Model

目的从患者感知角度出发,构建慢性病远程监护服务使用意愿的理论模型,考察慢性病远程监护服务使用意愿的影响因素。方法基于技术接受模型(TAM),构建包括感知有用性、感知易用性、使用意愿、感知风险、环境因素、自我效能、感知疾病威胁等潜在变量在内的慢性病远程监护服务研究模型,根据参考文献建立各潜在变量的测量项,形成调查问卷。2016年10—11月,以慢性病患者为调查对象,于郑州大学第一附属医院、河南中医院及社区等公共活动场所发放纸质问卷,并通过在线进行调查。采用结构方程模型分析患者对慢性病远程监护服务使用意愿的影响因素。结果本研究共回收问卷260份,其中有效问卷205份,有效率为78.8%。结构方程模型显示,感知有用性与使用意愿呈正相关,标准关联系数为0.31;感知易用性与感知有用性呈正相关,标准关联系数为0.34;感知风险与感知有用性呈负相关,标准关联系数为-0.14;环境因素与感知有用性呈正相关,标准关联系数为0.46;自我效能与感知易用性呈正相关,标准关联系数为0.58;感知疾病威胁与感知有用性、使用意愿均呈正相关,标准关联系数均为0.24。未发现感知易用性、感知风险、环境因素对使用意愿的影响。结论感知易用性、感知风险、环境因素对使用意愿的直接影响均不显著,而是通过感知有用性间接影响患者的使用意愿;感知疾病威胁不仅通过感知有用性影响患者的使用意愿,而且对使用意愿具有直接影响作用;此外自我效能对感知易用性影响显著。

Objective To establish a theoretical model of patients'intention of using remote monitoring services for chronic diseases from the perspective of patients'perception and to explore its influencing factors.Methods Based on the technology acceptance model(TAM),a remote monitoring model of chronic diseases were constructed which contain potential variables,such as perceived usefulness,perceived ease of use,attitude toward using,perceived risk,environmental factors,self-efficacy,perceived disease threat.The questionnaire was formed by measurement metrics of potential variables based on the references.In October and November of the year 2016,the questionnaire was distributed to patients with chronic diseases in public places such as the First Affiliated Hospital of Zhengzhou University,Henan Traditional Chinese Medicine Hospital and communities.Meanwhile the investigation was also conducted online parallelly.The structural equation model was used to analyze the influencing factors of the willingness to use remote monitoring services for chronic diseases.Results In this study,260 questionnaires were collected and 205 valid questionnaires were obtained.The effective recovery rate was 78.8%.The structural equation model showed that the perceived usefulness was positively correlated with the attitude toward using,and the standard correlation coefficient was 0.31.The perceived ease of use was positively correlated with the perceived usefulness,and the standard correlation coefficient was 0.34.The perceived risk was negatively correlated with the perceived usefulness,and the standard correlation coefficient was-0.14.The environmental factors were positively correlated with perceived usefulness,and the standard correlation coefficient was 0.46.The self-efficacy was positively correlated with perceived ease of use,and the standard correlation coefficient was 0.58.The perceived disease threat was positively correlated with perceived usefulness and attitude toward using,and both of the correlation coefficient were 0.24.The results showed that perceived ease of use,perceived risk and the environmental factors had no effect on the attitude toward using.Conclusion The direct impact of perceived ease of use,perceived risk and environmental factors on the attitude toward using is not significant,but they indirectly affect patients'attitude toward using through perceived usefulness.And the perceived threat of disease not only affects patients'attitude toward using through perceived usefulness,but also has a direct impact on the attitude toward using.In addition,self-efficacy has a significant effect on perceived ease of use.