背景與目的
隨著無線通訊網路的蓬勃發展與手持式電子設備的快速演進，「行動化」與「無線化」之電子病歷存取日趨可行。愈來愈多的電子病歷系統被發展與推動，其中具備電子簽章功能的行動護理站，亦如雨後春筍般的被許多醫院評估、規劃、發展與導入。本研究主要根據創新科技的接受與抵制之觀點，探討影響護理人員使用「行動電子病歷」意願之關鍵因素。
方法
本研究採橫斷性研究方法，以南部某醫學中心護理人員為調查對象，採問卷調查方式進行。研究使用驗證性因素分析以確認所提研究模式之建構效度，再以相關分析、變異數分析與階層迴歸分析，來實證本研究所提列之假說與相關探討。
結果
總計發出878份問卷，回收有效問卷為720份，有效回收率為82.0%。經由階層迴歸分析後發現，創新擴散構面之相容性、複雜性及可觀察性對護理人員使用行動電子病歷意向有顯著影響，相對優勢、可試驗性則未有顯著影響。此外，本研究證實護理人員的創新抵制類型會對使用行動電子病歷意願有顯著差異，尤其功能性抵制的使用者相較於雙重抵制對於行動電子病歷系統使用意願較高。
結論
護理人員對使用行動電子病歷，較在乎與現有的流程或習慣是否有改變、系統的學習與操作是否容易及系統的好處是否容易被察覺。此外，醫院亦需設法降低或消除護理人員對使用行動電子病歷之心理障礙，如此方能提高護理人員使用行動電子病歷之意願。相信本研究之成果，能作為醫院與健康資訊產業發展與推動行動電子病歷相關系統之參考，並強化學術界對於導入與使用行動電子病歷影響因素之相關研究。 Background and Purpose
With the rapid progress of wireless communication and hand-held electronic devices, “Mobility” and “Wireless” electronic medical records become increasingly feasible. More and more electronic medical record systems were developed and promoted. Mobile nursing stations which feature electronic signature have been evaluated, planned, developed and adopted by many hospitals. The purpose of this study is to explore the factors influencing nurses’ intention for using mobile electronic medical records (MEMR) based on the perspectives of diffusion of innovation and resistance of innovation.
Method
This cross-sectional study utilized a self-administered questionnaire for data collection, focusing on all the nurses of a medical center in southern Taiwan. Confirmatory Factor Analysis (CFA) technique was undertaken to confirm the construct validity of the proposed research framework while Correlation, Analysis of Variance (ANOVA), and Hierarchical Multiple Regression techniques were undertaken for hypotheses testing and related analysis.
Result
A total of 720 valid questionnaires yielded a response rate of 82.0%. After analyzing the responses through Hierarchical Multiple Regression technique, compatibility, complexity, and observability of innovation diffusion construct were found to be the key factors that significantly impact nurses’ intention to adopt MEMR while relative advantage and triability were not. In addition, this study revealed that types of innovative resistance of nurses were proven to be a significant factor that positively impacts the use intention for MEMR, especially functional-resistance nurses have higher use intention than dual-resistance ones.
Conclusion
For using MEMR, nurses concern more about whether MEMR will change their existing process and habits, whether MEMR is easy to learn and use, and whether the benefits of MEMR are well known. Besides, hospitals should also seek ways to reduce or eliminate nurses’ mental resistance to increase their intention to use MEMR. We believed this study could not only provide valuable reference for hospitals and health information management (HIM) providers while developing and promoting MEMR but also strengthen the academic to discover the factors influencing nurses to adopt MEMR in a systematical approach.
