Factors of accepting pain management decision support systems by nurse anesthetists

Abstract

BackgroundPain management is a critical but complex issue for the relief of acute pain, particularly for postoperative pain and severe pain in cancer patients. It also plays important roles in promoting quality of care. The introduction of pain management decision support systems (PM-DSS) is considered a potential solution for addressing the complex problems encountered in pain management. This study aims to investigate factors affecting acceptance of PM-DSS from a nurse anesthetist perspective.MethodsA questionnaire survey was conducted to collect data from nurse anesthetists in a case hospital. A total of 113 questionnaires were distributed, and 101 complete copies were returned, indicating a valid response rate of 89.3%. Collected data were analyzed by structure equation modeling using the partial least square tool.ResultsThe results show that perceived information quality (γ=.451, p<.001), computer self-efficacy (γ=.315, p<.01), and organizational structure (γ=.210, p<.05), both significantly impact nurse anesthetists’ perceived usefulness of PM-DSS. Information quality (γ=.267, p<.05) significantly impacts nurse anesthetists’ perceptions of PM-DSS ease of use. Furthermore, both perceived ease of use (β=.436, p<.001, R2=.487) and perceived usefulness (β=.443, p<.001, R2=.646) significantly affected nurse anesthetists’ PM-DSS acceptance (R2=.640). Thus, the critical role of information quality in the development of clinical decision support system is demonstrated.ConclusionsThe findings of this study enable hospital managers to understand the important considerations for nurse anesthetists in accepting PM-DSS, particularly for the issues related to the improvement of information quality, perceived usefulness and perceived ease of use of the system. In addition, the results also provide useful suggestions for designers and implementers of PM-DSS in improving system development.

A Critical Review of the Theoretical Frameworks and the Conceptual Factors in the Adoption of Clinical Decision Support Systems

“…These theories were drawn from the theory of planned behavior, 19,21,24,25,[29][30][31] theory of reasoned action, 19,21,24,25,30,31 sociotechnology theory, 11,32 longitudinal acceptance theory, 3,31 diffusion of innovation theory, 3,26 information technology organization fit, 25 organization theory, 20 Bandura's social learning theory, 26 and intrinsic motivation theory. 29 The most widely used framework was the TAM, which had borrowed its root concepts from the theory of planned behavior and theory of reasoned action.…”

“…11 The CDSSs were all developed for voluntary use by either nurses or physicians alone, or both, or with other allied health professionals, except for two that required mandatory use by nurses. 11,20,25 These studies adopted either qualitative (five studies), quantitative (six studies), or mixed research methods (five studies). Multiple methods such as face-to-face interviews, focus group interviews, surveys, utilization rates, observations, case studies, and feedback discussions were deployed in data collection, with findings triangulated to ensure reliability and validity of the studies.…”

“…32 For the purpose of this study, only the term clinical decision support system was used in order to avoid confusion of names. The CDSSs studied were designed to support a wide range of decisions such as diagnosis and nursing care plan, 28 clinical practice guidelines 26,30 or protocols, 29 diagnosis and treatments, 3,11,[19][20][21][22][23][24][25]32 rehabilitation, 27 and reminder systems. 31 Twelve of the 16 studies were conducted in Western countries (the United States, the United Kingdom, the Netherlands, Spain, and Australia).…”

Aceptación y uso de los sistemas e-learning por estudiantes de Grado de Ecuador: El caso de una universidad estatal

“…La auto-eficacia es definidacomo una percepción individual de la eficacia en el uso de una aplicación o sistema específico dentro del dominio de la informática en general (Hsiao, Wu & Chen, 2013;Yi & Hwang, 2003).…”

“…Esto coincide con los resultados que se obtuvieron en otras investigaciones similares (Al-Mushasha & Ieee, 2013;Arteaga & Duarte, 2010;Cheng, 2011;Hsiao et al, 2013;Kiliç, 2014;Y.-H. Lee, Hsieh & Ma, 2011;Mbarek & Zaddem, 2013;Ong, Lai & Wang, 2004;RamirezAnormaliza et al, 2015).…”