PDF(Pubmed)
Abstract：
BACKGROUND: Since expanding the use of appropriate and effective health technologies will greatly benefit the diagnosis and treatment of some major diseases at an early stage, understanding the mechanism of technology use is crucial for its successful implementation. Few previous studies focused on the healthcare providers and involved multi-facets factors at individual, technical, organizational, and environmental levels.
OBJECTIVE: To examine the influencing mechanism of technology use among Chinese physicians by integrating multilevel factors, Des-gamma-Carboxy Prothrombin (DCP) was taken as an example.
METHODS: Through multistage random sampling, a cross-sectional questionnaire survey was conducted among physicians in charge of direct use of DCP of sampled secondary and tertiary hospitals. Since the sample data comprised two hierarchical levels (physicians and hospitals), multilevel structural equation modeling was used to link five aspects of factors with physicians\' technology use and estimate the effects.
RESULTS: Totally, 229 physicians completed the investigation. The use of DCP appears to be at a relatively low level. Intra-class coefficients of the null model (unadjusted baseline model) suggested that physicians\' DCP use has a significant variation between hospitals. The final model identified that value cognition (B = 0.447, P < 0.01), experienced organizational practice (B = 0.203, P < 0.05), and perceived organizational atmosphere (B = -0.237, P < 0.01) contributed directly to physicians\' DCP use. Additionally, technical assessment, perceived organizational atmosphere, and perceived environmental pressure had indirect impacts on physicians\' DCP use that were mediated by value cognition and experienced organizational practice (P < 0.05).
CONCLUSIONS: This study incorporated and determined the significant direct or indirect role of value cognition, technical assessment, experienced organizational practice, perceived organizational atmosphere, and perceived environmental pressure. This influencing mechanism with integrated multilevel factors could serve as a theoretical basis for tailoring interventions to promote technology use among Chinese physicians.
OBJECTIVE: To examine the influencing mechanism of technology use among Chinese physicians by integrating multilevel factors, Des-gamma-Carboxy Prothrombin (DCP) was taken as an example.
METHODS: Through multistage random sampling, a cross-sectional questionnaire survey was conducted among physicians in charge of direct use of DCP of sampled secondary and tertiary hospitals. Since the sample data comprised two hierarchical levels (physicians and hospitals), multilevel structural equation modeling was used to link five aspects of factors with physicians\' technology use and estimate the effects.
RESULTS: Totally, 229 physicians completed the investigation. The use of DCP appears to be at a relatively low level. Intra-class coefficients of the null model (unadjusted baseline model) suggested that physicians\' DCP use has a significant variation between hospitals. The final model identified that value cognition (B = 0.447, P < 0.01), experienced organizational practice (B = 0.203, P < 0.05), and perceived organizational atmosphere (B = -0.237, P < 0.01) contributed directly to physicians\' DCP use. Additionally, technical assessment, perceived organizational atmosphere, and perceived environmental pressure had indirect impacts on physicians\' DCP use that were mediated by value cognition and experienced organizational practice (P < 0.05).
CONCLUSIONS: This study incorporated and determined the significant direct or indirect role of value cognition, technical assessment, experienced organizational practice, perceived organizational atmosphere, and perceived environmental pressure. This influencing mechanism with integrated multilevel factors could serve as a theoretical basis for tailoring interventions to promote technology use among Chinese physicians.
摘要：
背景：由于扩大使用适当和有效的卫生技术将大大有利于早期诊断和治疗某些重大疾病，了解技术使用机制对于其成功实施至关重要。以前很少有研究关注医疗保健提供者，涉及个人的多方面因素，技术,组织，和环境水平。
目的：综合多层次因素，探讨中国医师技术使用的影响机制。以Des-γ-羧基凝血酶原(DCP)为例。
方法：通过多阶段随机抽样，对抽样的二级和三级医院负责直接使用DCP的医生进行了横断面问卷调查。由于样本数据包括两个层次(医生和医院)，多层次结构方程模型被用来将五个方面的因素与医生的技术使用联系起来，并估计效果。
结果：完全，229名医生完成了调查。DCP的使用似乎处于相对较低的水平。零模型（未调整的基线模型）的类内系数表明，医生的DCP使用在医院之间存在显着差异。最终模型确定了价值认知(B=0.447，P<0.01)，有经验的组织实践(B=0.203，P<0.05)，和感知的组织氛围（B=-0.237，P<0.01）直接导致医生使用DCP。此外,技术评估,感知的组织氛围，和感知的环境压力对医生的DCP使用有间接影响，这是由价值认知和经历的组织实践介导的（P<0.05）。
结论：本研究纳入并确定了价值认知的重要直接或间接作用，技术评估,经验丰富的组织实践，感知的组织氛围，和感知到的环境压力。这种具有综合多层次因素的影响机制可以作为定制干预措施以促进中国医生使用技术的理论基础。
目的：综合多层次因素，探讨中国医师技术使用的影响机制。以Des-γ-羧基凝血酶原(DCP)为例。
方法：通过多阶段随机抽样，对抽样的二级和三级医院负责直接使用DCP的医生进行了横断面问卷调查。由于样本数据包括两个层次(医生和医院)，多层次结构方程模型被用来将五个方面的因素与医生的技术使用联系起来，并估计效果。
结果：完全，229名医生完成了调查。DCP的使用似乎处于相对较低的水平。零模型（未调整的基线模型）的类内系数表明，医生的DCP使用在医院之间存在显着差异。最终模型确定了价值认知(B=0.447，P<0.01)，有经验的组织实践(B=0.203，P<0.05)，和感知的组织氛围（B=-0.237，P<0.01）直接导致医生使用DCP。此外,技术评估,感知的组织氛围，和感知的环境压力对医生的DCP使用有间接影响，这是由价值认知和经历的组织实践介导的（P<0.05）。
结论：本研究纳入并确定了价值认知的重要直接或间接作用，技术评估,经验丰富的组织实践，感知的组织氛围，和感知到的环境压力。这种具有综合多层次因素的影响机制可以作为定制干预措施以促进中国医生使用技术的理论基础。
