社区医护人员对”互联网+”慢性病管理使用意愿的多水平线性模型研究

Background: With the development of Internet-based medical care,Internet-based chronic disease management models have come into being,showing their unique advantages.Related studies have sprung up,among which the intention of using the models in physicians and nurses is rarely involved.Community physicians and nurses are chronic disease managers,understanding their intention of using the chronic disease management model,and associated factors is of great significance for developing the Internet-based chronic disease management model.Objective: To explore the intention and associated factors of using Internet-based chronic disease management in community physicians and nurses.Methods: This survey was carried out between February and March 2018 with a self-developed questionnaire based on unified theory of acceptance and use of technology (UTAUT).Participants were 261 physicians and nurses selected by stratified random sampling from 45 community health centers,Shenzhen's Futian District.The hierarchical linear model was used to analyze the factors associated with the intention of using the Internet-based chronic disease management.Results: The average total evaluation score for the intention of using the Internet-based chronic disease management was (4.03±0.88) points.The scores of difference in perceived effectiveness (C6,C7) and the usage intention(C25) among medical staffs of different ages were statistically significant (P<0.05).The scores of perceived usefulness (C3,C5) and the usage intention (C25) among of medical staffs in different academic qualifications were statistically significant (P<0.05).The scores of differences in perceived effectiveness (C7),personal factors (C23),and the usage intention (C25,C26) among medical staffs in different professional titles were statistically significant (P<0.05).The scores of perceived risk (C15) and personal factors (C22) among medical staffs in different positions were statistically significant (P<0.05).The scores of perceived risk (C15,C16) and task technology matching (C20,C21) among medical staffs in different job categories were statistically significant (P<0.05).There was a statistically significant difference in the perceived risk (C17) scores among the health care professionals in different professional communities (P<0.05).The scores of perceived risk (C17) among medical staffs in different professions were statistically significant (P<0.05).Multi-level linear model analysis showed that the positive factors,the traditional method of identity (B3)〔β=0.110,95%CI(-0.041,0.258)〕,perceived usefulness (C3)〔β=0.110,95%CI(0.026,1.930))〕,social influence (C11,C13)〔β=0.165,95%CI(0.065,0.265);β=0.235,95%CI(0.094,0.403)〕,task-technology fit (C21)〔β=0.182,95%CI(0.084,0.277)〕 and personal factors (C22)〔β=0.454,95%CI(0.258,0.507)〕,affect the usage intention of medical staffs to use the Internet-based chronic disease(P<0.05).Conclusion :Community physicians and nurses universally prefer to use the Internet-based chronic management model.Their intention of use grows with the increase of individual creativity,social impact,level of task-technology fit,perceived usefulness of the Internet-based chronic management model,and self-identification of the traditional management model.