The Usage Behavior and Intention Stability of Nurses: An Empirical Study of a Nursing Information System

護理人員的使用行為及意圖穩定性探討：以護理資訊系統為例

10.1097/jnr.0000000000000103

林怡君(I-Chun Lin)；林器弘(Chi-Hung Lin)；許建隆(Chien-Lung Hsu)；阮金聲(Jin-Sheng Roan)；葉振山(Jehn-Shan Yeh)；鄭宇涵(Yu-Han Cheng)

科技接受模式 ； 中介變數 ； 調節變數 ； 中介調節效果 ； 護理資訊系統 ； Technology Acceptance Model (TAM) ； mediator ； moderator ； mediated moderation ； Nursing Information System (NIS)

The Journal of Nursing Research

24卷1期（2016 / 03 / 01）

48 - 57

英文

背景：過去科技採用的研究多以意圖作為預測行為的變數，但行為科學家證實這兩者間存在落差且單以意圖作為預測行為是不足的，學者們更指出這兩者間尚存在其他變數。目的：有鑑於相關研究短缺，本研究以TAM3為基礎，建構一個更完整的模式以探討使用者對系統的行為，並驗證意圖和行為間是否存在兩個影響變數—意圖穩定性與過去經驗。方法：台灣某醫學中心新上線的護理資訊系統為標的系統，系統的主要使用者—護理人員為研究對象。兩階段問卷發放，最後共回收245 份有效問卷，有效回收率為49%。結果：模式驗證顯示意圖與行為間存在調節中介變數—意圖穩定性與調節變數—過去經驗，並提昇意圖對行為超過13.6%的解釋力。本研究主要發現意圖與行為之間存在意圖穩定這個變數，過去在資訊科技的研究中，主要都僅僅以意圖當作行為的預測變數；另外，過去經驗會正向調節意圖與行為的關係，顯示出過去經驗會促進意圖對於行為的預測能力。結論／實務應用：研究結果可提供醫院管理者參考，管理階層可經由增加護理人員對系統的使用經驗來提昇他們對NIS的有用性認知，讓護理人員了解NIS有助於提昇工作成效。當成效提升時，護理人員可以有更多的時間專注於病患照顧或進修，且日後較會真正去使用系統，NIS的導入才能達到預期的成效與目的。

Background: Many prior studies of technology adoption treat user intention as the single predictor of actual usage behavior. However, as many researchers of behavioral science have pointed out, multiple factors mediate the relationship between user intention and usage behavior. Purpose: The present article explores the factors that mediate the relationship between intention and actual behavior. We develop a conceptual framework that is based on the Technology Acceptance Model III and behavior theory to further elicit system usage behavior and to confirm ＂intention stability＂ and ＂past experience＂ as two significant mediating factors in this relationship. Methods: The target system was a nursing information system that had been recently adopted by a medical center in central Taiwan. Data were collected using a questionnaire survey conducted in two rounds. Two hundred forty-five valid questionnaires were returned (response rate: 49%). Mediated moderation was analyzed to explore the presence of mediators or moderators between intention and behavior. Results: The results support that intention stability is a mediated moderator and that prior experience is a moderator of the relationship between intention and behavior. These two factors increased by over 13.6% the explanatory power of intention on actual behavior. Furthermore, this study expanded the scope of prior research by confirming intention stability as a moderating variable between intention and behavior. Finally, this study identified the moderating effect of past experience on the intention-behavior relationship, indicating that past experience enhances the predictive power of intention on behavior. Conclusions/Implications for Practice: The findings of this study may assist hospital managers to better understand the nursing information system usage behaviors of nursing staff and to develop ways to enhance the intention stability of these staff. Managers may improve the familiarity of nursing staff with the system by increasing their system-related practice time. More experience should enhance staff system skills and resolve problems such as the need for extra work hours or overtime because of initial system unfamiliarity. Improved work efficiency should then allow nurses to divert more time from administrative work to patient care and training. This positive circle of support is expected to increase the willingness of nurses to accept and take advantage of the system.

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