Factors determining patients' intentions to use point-of-care testing medical devices for self-monitoring: the case of international normalized ratio self-testing.
Factors determining patients' intentions to use point-of-care testing medical devices for self-monitoring: the case of international normalized ratio self-testing.
复制标题
决定患者使用医疗点检测医疗设备进行自我监测意愿的因素：国际正常化比率自我检测案例。
DOI：
10.2147/ppa.s38328
复制
发表时间：
2013
影响因子：
2.2
通讯作者：
Kaczmarski R
中科院分区：
文献类型：
--
作者：
Shah SG;Barnett J;Kuljis J;Hone K;Kaczmarski R
确定决定患者使用床旁医疗器械（即用于自测国际标准化比值（INR）的便携式凝血仪器械）的意向的因素，该国际标准化比值（INR）是持续监测长期口服维生素K拮抗剂（如华法林）抗凝治疗患者凝血强度所需的。一项横断面研究，通过自我完成的问卷调查应用技术接受模型，该问卷调查对英国伦敦一家地区综合医院的125名门诊抗凝服务门诊患者进行了便利样本管理。资料以描述性统计、因子分析及结构方程式模式进行分析。参与者主要为男性（64%）和年龄≥ 71岁（60%）。所有这些患者都在医院门诊抗凝门诊接受INR检测;目前只有2例患者使用INR自测，84%的患者不了解使用便携式凝血仪设备进行INR自测，96%的患者从未选择INR自测。观察到一个显着的结构方程模型解释了患者使用INR自我检测意图的79%的方差。直接影响患者使用INR自测意愿的显著预测因素是对技术的感知（β = 0.92，P < 0.001）、对医生的信任（β =-0.24，P = 0.028）和负担能力（β = 0.15，P = 0.016）。此外，对医生的信任对技术感知有显著影响（β = 0.43，P = 0.002），年龄（β =-0.32，P < 0.001）和可负担性（β = 0.23，P = 0.013）;因此，使用INR自我测试的意图间接受到对医生的信任的影响（β = 0.40）、年龄（β =-0.29）和可负担性（β = 0.21）。患者使用便携式凝血仪进行INR自测的意图受到患者对INR检测设备的看法、设备成本、对医生/临床医生的信任以及患者年龄的影响，这些都需要在涉及患者INR自测的任何干预之前加以考虑。制造商应专注于提高患者自测INR检测设备的可负担性，以及随着患者从医院转移到家庭检测，医疗从业人员在支持使用这些医疗设备方面的潜在作用。
To identify factors that determine patients’ intentions to use point-of-care medical devices, ie, portable coagulometer devices for self-testing of the international normalized ratio (INR) required for ongoing monitoring of blood-coagulation intensity among patients on long-term oral anticoagulation therapy with vitamin K antagonists, eg, warfarin. A cross-sectional study that applied the technology-acceptance model through a self-completed questionnaire, which was administered to a convenience sample of 125 outpatients attending outpatient anticoagulation services at a district general hospital in London, UK. Data were analyzed using descriptive statistics, factor analyses, and structural equation modeling. The participants were mainly male (64%) and aged ≥ 71 years (60%). All these patients were attending the hospital outpatient anticoagulation clinic for INR testing; only two patients were currently using INR self-testing, 84% of patients had no knowledge about INR self-testing using a portable coagulometer device, and 96% of patients were never offered the option of the INR self-testing. A significant structural equation model explaining 79% of the variance in patients’ intentions to use INR self-testing was observed. The significant predictors that directly affected patients’ intention to use INR self-testing were the perception of technology (β = 0.92, P < 0.001), trust in doctor (β = −0.24, P = 0.028), and affordability (β = 0.15, P = 0.016). In addition, the perception of technology was significantly affected by trust in doctor (β = 0.43, P = 0.002), age (β = −0.32, P < 0.001), and affordability (β = 0.23, P = 0.013); thereby, the intention to use INR self-testing was indirectly affected by trust in doctor (β = 0.40), age (β = −0.29), and affordability (β = 0.21) via the perception of technology. Patients’ intentions to use portable coagulometers for INR self-testing are affected by patients’ perceptions about the INR testing device, the cost of device, trust in doctors/clinicians, and the age of the patient, which need to be considered prior to any intervention involving INR self-testing by patients. Manufacturers should focus on increasing the affordability of INR testing devices for patients’ self-testing and on the potential role of medical practitioners in supporting use of these medical devices as patients move from hospital to home testing.