摘要
目的了解糖尿病患者对移动医疗服务的使用意愿及其影响因素,为糖尿病乃至慢性病管理类移动医疗行业发展提供参考依据。方法选取2016年6—8月在广州市某大型三级甲等综合医院内分泌科门诊就诊及住院的糖尿病患者250例。采用自行设计问卷进行调查,问卷内容包括糖尿病患者的基本情况、糖尿病移动医疗认知情况、糖尿病移动医疗使用意愿评价量表(包括绩效期望、努力期望、社会影响、感知威胁、健康信念、感知风险、使用意愿7个因素)。共发放问卷250份,回收有效问卷243份,问卷有效回收率为97.2%。结果 243例患者中,仅50例(20.6%)听说过糖尿病移动医疗;39例(16.0%)了解可以通过移动医疗管理糖尿病;11例(4.5%)使用过糖尿病移动医疗服务。糖尿病移动医疗使用意愿评价量表的Cronbach'sα系数为0.892,各因素的Cronbach'sα系数为0.868~0.980。主成分分析提取特征值>1的因子数为7,与量表设计的7个因素完全吻合,累计方差贡献率达76.178%。不同年龄、学历、月收入患者努力期望得分比较,差异有统计学意义(P<0.05)。不同学历患者社会影响得分比较,差异有统计学意义(P<0.05)。不同性别、学历、月收入患者感知威胁得分比较,差异有统计学意义(P<0.05)。不同学历患者健康信念得分比较,差异有统计学意义(P<0.05)。不同年龄患者感知风险得分比较,差异有统计学意义(P<0.05)。不同学历、月收入患者使用意愿得分比较,差异有统计学意义(P<0.05)。不同糖尿病类型、糖尿病病程及是否合并糖尿病并发症患者努力期望得分比较,差异有统计学意义(P<0.05)。是否合并糖尿病并发症患者社会影响得分比较,差异有统计学意义(P<0.05)。不同糖尿病类型患者健康信念得分比较,差异有统计学意义(P<0.05)。不同糖尿病类型患者感知风险得分比较,差异有统计学意义(P<0.05)。多元线性回归分析结果显示,努力期望、社会影响、感知风险是患者使用意愿的影响因素(P<0.05)。结论糖尿病患者对移动医疗服务的认知程度较低,使用意愿存在个体差异;努力期望、社会影响正向影响使用意愿,感知风险负向影响使用意愿。加强宣传,提高患者认知水平;优化设计,兼顾患者不同需求将有助于提高糖尿病患者对移动医疗服务的使用意愿。
Objective To investigate the willingness of diabetic patients to use mobile health services and the correlation factors, so as to provide reference for the development of mobile health services for diabetes and chronic disease management. Methods Two hundred and fifty diabetic outpatients and inpatients treated in Department of Endocrinology of a large tertiary grade A general hospital in Guangzhou from June to August 2016 were randomly sampled. A self - developed questionnaire was used to survey the participants, which covered the baseline characteristics, degree of understanding of the mobile health services for diabetes, and Diabetic Patients＇ Willingness to Use Mobile Health Services Assessment Scale （performance expectancy, effort expectancy, social influence, perceived threat, health belief, perceived risk and intention to use the mobile health services for diabetes） . Two hundred and forty - three （97.2% of the 250 participants） returning responsive questionnaires were selected as the final participants. Results Twenty point six percent of the 243 participants （50 /243 ） had heard of mobile health services for diabetes, 16. 0% （ 39/243 ） knew that diabetes could be managed by mobile health services, only 4. 5% （ 11/243 ） had used this kind of services. The Cronbach＇s α coefficient for the Diabetic Patients＇ Willingness to Use Mobile Health Services Assessment Scale was 0. 892, and it ranged from 0. 868 to 0. 980 for factors of the scale. Seven factors with characteristic value 〉 1 were extracted by the principal component analysis, which were right in line with the seven factors of the scale, interpreting 76. 178% of the total variance. Among the participants, age, educational attainment and monthly income were closely associated with the differences in effort expectancy scores （ P 〈 0. 05 ） ; educational attainment was remarkably attributed to the differences in social influence scores （ P 〈 0.05 ） ; gender, educational attainment and monthly income caused the differences in perceived threat scores （ P 〈 0. 05 ） ; educational attainment led to the differences in health belief scores （P 〈 0. 05 ） ; age was remarkably attributed to the differences in perceived risk scores （ P 〈 0. 05 ） ; educational attainment and monthly income resulted in the differences in scores of intention to use the mobile health services for diabetes （ P 〈 0. 05 ） ; types and duration of diabetes and history of diabetic complications brought about the differences in effort expectancy, scores （P 〈 0. 05 ） ; history of diabetic complications created the differences in social influence scores （ P 〈 0. 05 ） ; types of diabetes contributed to the differences in health belief scores （ P 〈 0.05 ） ; types of diabetes made the differences in perceived risk scores （ P 〈 0.05 ） . Multiple linear regression analysis found that effort expectancy, social influence and perceived risk were the correlation factors affecting the willingness to use mobile health services for diabetes （ P 〈 0. 05 ）. Conclusion In patients with diabetes, the publicity on mobile health services was unsatisfactory, willingness to use the services varied with each individual, effort expectancy and social influence positively while perceived risk negatively influenced the willingness to use the services. Therefore, improving the degree of understanding of the mobile health services for diabetes by strengthening publicity, and optimizing the services based on the needs of patients will help improve the willingness of diabetic patients to use the services.
出处
《中国全科医学》
CAS
北大核心
2017年第13期1619-1625,共7页
Chinese General Practice
基金
广东省自然科学基金资助项目(2015A030313708)
广州市健康医疗协同创新重大专项(201604020016)
广东省医学科学技术研究基金项目(B2016003)
关键词
糖尿病
移动医疗
使用意愿
影响因素分析
Diabetes mellitus
Mobile health
Willingness to use
Root cause analysis
