醫師與非醫師對於電子病歷隱私保護行為意圖之比較研究

A comparative study of the intention to protect the privacy of the electronic medical record by physicians and non-physician staff

目標：本研究主要目的為探討醫院員工保護電子病歷隱私之影響因素，並進一步比較醫師以及醫院其他員工對於保護電子病歷隱私的認知。方法：以計畫行為理論為研究理論基礎，採橫斷性研究，並透過問卷調查法針對南部某大型軍醫院之員工進行立意調查。結果：共蒐集129份有效問卷，資料分析結果顯示態度（AT）、主觀規範（SN）與知覺行為控制（PBC）三個變數和電子病歷隱私保護行為意圖（I）間均呈現顯著正向相關；此外，醫師和醫院其他員工在態度（AT→I）、主觀規範（SN→I）與知覺行為控制（PBC→I）三個變數和保護電子病歷隱私行為意圖之關係呈現顯著差異，醫師在主觀規範（SN→I）和知覺行為控制（PBC→I）兩個變數與保護電子病歷隱私行為意圖之間的關係強度顯著高於其他員工。結論：依據分析結果，本研究建議醫院須積極舉辦電子病歷隱私保護相關教育訓練，並加強醫師的參與度；此外，亦可透過醫院中各單位主管或同儕的影響，並提供員工足夠的電子病歷隱私保護軟硬體，提高員工保護電子病歷隱私的行為意圖，藉由相關措施保護電子病歷隱私，降低民眾的隱私顧慮，將有益於電子病歷之推展。

Objectives: The aims of this study were to explore the factors that influenced hospital staff in protecting the privacy of the electronic medical record (EMR) and to conduct a multi-group analysis comparing perceptions about EMR privacy protection by physicians and other hospital staff. Methods: Based on the Theory of Planned Behavior, a cross-sectional survey was conducted to collect data from one military hospital in southern Taiwan. The study subjects were all hospital staff and were recruited via convenience sampling. Results: A total of 129 valid questionnaires was collected. Attitude (AT), subjective norm (SN), and perceived behavioral control (PBC) were positively related to hospital staffs' intention (I) to protect EMR privacy. Moreover, the relationships of AT→I, SN→I, and PBC→I varied significantly between physicians and other hospital staff. Physicians had stronger beliefs about the relationships between SN→I and PBC→I. Conclusions: This study suggested that the subject hospital should offer more training programs pertinent to the protection of EMR privacy. Physicians should also be reminded to engage in these training programs. The hospital could improve staff intention to protect EMR privacy through the influence of the director or their colleagues and also by providing sufficient software and hardware to protect EMR privacy. These measures could decrease patients' concerns about privacy of the EMR and be beneficial to the promotion of the EMR in the future.