應用科技接受模型探討護理人員對行動護理站接受度的影響因素

Applying Technology Acceptance Model to Examine Factors Related to Nurses' Acceptance for the Use of Mobile Nursing Station in Hospitals

隨著無線區域網路的應用與日俱增，帶動了行動醫療的發展，傳統護理站資訊化已無法滿足護理人員的需求。為了增進護理作業行動性、即時性及精確性，應用行動護理資訊系統可以增進病房護理作業的便利與品質。本研究探討護理人員對行動護理資訊系統的接受度之相關影響因素，文獻顯示對新科技的接受度與使用者對該新科技的使用經驗有關，在研究設計上以有無使用過行動護理車來分組比較護理人員對傳統護理作業系統及行動護理資訊系統看法的接受度之差異，並應用科技接受模型(Technology Acceptance Model)來檢驗影響使用者接受度之因素。研究方法為問卷調查法，共103位醫院護理人員填寫結構式問卷，其中有51位具有使用過行動護理車的護理人員為實驗組，而52位未使用過行動護理車的護理人員則為控制組。所使用的問卷工具包括有基本資料、護理作業系統形容詞區 分量表（包含信賴度、管理容易度、速度、和便利度四個分量表）、與行動護理資訊系統接受度量表（包含容易度、有用性、態度、使用意圖四個分量表）。結果顯示在護理作業系統的比較上，兩組均認為行動較傳統護理系統具有速度上顯著的優點(F=85.6，P<0.001)；在速度(F=9.2, p<0.01)與便利度(F=5.9, p<0.05)方面，則有顯著的交互作用，顯示控制組相較於實驗組更易高估行動護理系統在速度與便利度方面的優點。在行動護理資訊系統的接受度方面，顯示實驗組比控制組具有顯著較高的容易度(t=5.73，p<0.05)，在其它向度上則沒有顯著差異。以路徑分析兩組在影響行動護理系統上的使用意圖之相關因素也有差異，其中對實驗組而言最顯著的影響因素為「有用性」（整體效果=0.78，p<0.001）；而控制組則是以「態度」為關鍵因素（整體效果=0.31，p<0.05）。本研究結果對於醫院資訊管理者的意含將進一步討論。

The rapid development in the field of wireless local area networks makes mobile healthcare services feasible. Mobile nursing information systems have become an alternative improving hospitals' nursing operations by increasing mobility, immediateness, and accuracy. This survey research aims to examine factors related to nurses' acceptance towards mobile nursing stations by the application of the Technology Acceptance Model (TAM). According to literature review, experience of use is an important factor for acceptance. In order to examine this factor, a quasi-experimental design was applied. A total of 103 nurses were recruited and administered with structured questionnaires. Among them, 51 nurses with experience using mobile nursing-carts were recruited and assigned as the experimental group. A control group matched with those in the experimental group consisted of 52 nurses who don't have such experience. An 'Adjective Differential Scale of Nursing Operations' was developed to examine how nurses rated the traditional nursing operation in contrast to the mobile one, with respect to reliability, easiness, speed, and convenience. On the basis of TAM, the 'Mobile Nursing System Acceptance Scale' was developed and consisted of 4 factors: easiness, usability, attitude, and intention to use. The results showed that all nurses rated the mobile nursing system with a significantly higher degree in speed than the traditional one (F=85.6, p<0.001). A significant interaction effect was found between the groups (experimental versus control) and the systems (traditional versus mobile) on the ratings of nursing operation system. In contrast to the experimental group, nurses without prior experience over-estimated the benefits brought about by the mobile nursing system, with respect to speed (F=9.2, p<0.01) and convenience (F=5.9, p<0.05). With regard to acceptance, the results showed nurses rated significantly higher degree of easiness than those without experiences (t=5.73, p<0.05). In addition, the path analyses revealed that factors related to 'intention to use' were different between two groups. Usability (total effect=0.78, p<0.001) played the important part for nurses with experience, while attitude (total effect=0.31, p<0.05) played the most important part for those without experience. The implications of this model for healthcare information managers will be discussed.