探討知識分享行為對於社會交換理論與跨院電子病歷交換意願之中介效果

Social exchange theory and the intent to exchange cross-hospital electronic medical records – the mediating effect of knowledge sharing behavior

目標：社會交換理論為探討社會交換行為理論，跨院電子病歷屬社會交換行為並涉及知識分享。本研究以社會交換理論為基礎，探討醫師知識分享行為對社會交換理論主要構念與跨院電子病歷交換意願之中介效果。方法：以問卷調查法，針對南部某醫學中心之醫師，發放260份問卷進行調查，有效回收220份，有效回收率84.62%。採用偏最小平方法進行資料分析，進行收斂效度和區別效度檢測，並以Sobel test進行中介效果檢驗。結果：社會交換理論中，承諾、依賴與互惠、溝通對知識分享行為具顯著正向影響；依賴與互惠對跨院電子病歷交換具顯著正向影響；知識分享行為對於社會交換理論中承諾、依賴與互惠對於跨院電子病歷交換意願具有中介效果。結論：跨院醫師間的承諾、依賴與互惠，可透過落實知識分享行為，強化跨院電子病歷交換的意願。本研究認為醫學研討會、雲端專業知識平台乃至於醫療知識社群可促使醫師間知識分享行為，改善工作績效與病患醫療照護品質，提升跨院電子病歷交換之成效。

Objectives: Social exchange theory (SET) explores social exchange behavior. Electronic medical record (EMR) exchange includes social exchange behaviors and knowledge sharing behaviors. This study used SET as the theoretical foundation and explored the mediating effect of physicians' knowledge sharing behavior on SET factors and physicians' intent to exchange crosshospital EMRs. Methods: A total of 260 questionnaires were distributed to the physicians of a medical center in southern Taiwan and 220 were returned, yielding a response rate of 84.62%. The data were analyzed with the partial least squares method. The Sobel test was used to determine the mediating effect. Results: Commitment, dependence and reciprocity, and communication had a positive effect on knowledge sharing behavior. Dependence and reciprocity had a positive effect on the intent to exchange cross-hospital EMRs. Knowledge sharing behavior had a mediating effect on commitment, dependence and reciprocity, and the intent to exchange cross-hospital EMRs. Conclusions: Commitment and dependence and reciprocity can enhance physicians' intent to exchange cross-hospital EMRs by increasing knowledge sharing behavior. This study suggested that conferences, a cloud platform for professional knowledge, and a community of knowledge can increase physicians' knowledge sharing behavior, and enhance the performance of crosshospital EMR exchange to improve work efficiency and the quality of health care.