背景:在COVID-19期间,许多支持性癌症治疗(SCC)服务都被远程保护,但什么促进患者使用远程保护SCC的意图尚不清楚。
目的:这项研究旨在利用接受和使用技术的统一理论,调查与香港乳腺癌幸存者(BCS)使用各种类型的远程监护SCC(包括社会心理护理,医疗咨询,补充护理,同行支持团体)。与远程健康相关的良好看法(更高的性能预期,较低的预期努力,更多便利条件,积极的社会影响),更少的技术焦虑,假设对COVID-19的更大恐惧与使用远程转移SCC的更高意图相关。此外,假设与远程医疗相关的观念和使用远程监护SCC的意图之间的关联受教育程度的调节,因此,在受教育程度较高的人群中,与远程医疗相关的认知和使用远程监控SCC的意图之间的关联会更强。
方法:自香港COVID-19爆发以来被诊断患有乳腺癌的209名(209/287,完成率72.8%)妇女的样本(即,2020年1月)从香港乳腺癌登记处招募,以在2022年6月至2022年12月之间完成横断面调查。参与者使用各种类型的远程授权SCC(因变量)的意图,与远程健康相关的感知(独立变量),和社会人口统计学变量(例如,教育,作为调节变量)使用自我报告进行测量,经过验证的措施。
结果:分层回归分析结果表明,使用远程医疗的置信度更高,预期表现(相信远程医疗有助于日常任务),社会影响(其他重要的鼓励使用远程医疗),和便利条件(具有远程医疗使用资源)与使用远程监护SCC的更高意愿相关(范围:β=0.16,P=.03至β=0.34,P<.001)。此外,教育水平和2个远程健康感知变量之间出现了双向互动。教育水平缓和了(1)预期表现和使用远程监护补充护理的意愿(β=0.34,P=.04)和(2)促进条件和使用远程监护同伴支持小组的意愿(β=0.36,P=.03)之间的关联。这些远程医疗观念和意图之间的积极关联仅在受过高等教育的人群中很重要。
结论:这项研究的结果表明,提高BCS使用远程医疗的技能,BCS和他们重要的其他人认为远程医疗的好处,为远程医疗使用提供帮助可能会增加BCS使用远程监护SCC的意图。对于使用特定类型的SCC的意图,解决相关因素(预期性能,便利条件)可能对那些受过高等教育的人特别有利。
BACKGROUND: Many supportive cancer care (SCC) services were teledelivered during COVID-19, but what facilitates patients\' intentions to use teledelivered SCC is unknown.
OBJECTIVE: The study aimed to use the unified theory of acceptance and use of technology to investigate the factors associated with the intentions of breast cancer survivors (BCS) in Hong Kong to use various types of teledelivered SCC (including psychosocial care, medical consultation, complementary care, peer support groups). Favorable telehealth-related perceptions (higher performance expectancy, lower effort expectancy, more facilitating conditions, positive social influences), less technological anxiety, and greater fear of COVID-19 were hypothesized to be associated with higher intentions to use teledelivered SCC. Moreover, the associations between telehealth-related perceptions and intentions to use teledelivered SCC were hypothesized to be moderated by education level, such that associations between telehealth-related perceptions and intentions to use teledelivered SCC would be stronger among those with a higher education level.
METHODS: A sample of 209 (209/287, 72.8% completion rate) women diagnosed with breast cancer since the start of the COVID-19 outbreak in Hong Kong (ie, January 2020) were recruited from the Hong Kong Breast Cancer Registry to complete a cross-sectional survey between June 2022 and December 2022. Participants\' intentions to use various types of teledelivered SCC (dependent variables), telehealth-related perceptions (independent variables), and sociodemographic variables (eg, education, as a moderator variable) were measured using self-reported, validated measures.
RESULTS: Hierarchical regression analysis results showed that greater confidence using telehealth, performance expectancy (believing telehealth helps with daily tasks), social influence (important others encouraging telehealth use), and facilitating conditions (having resources for telehealth use) were associated with higher intentions to use teledelivered SCC (range: β=0.16, P=.03 to β=0.34, P<.001). Moreover, 2-way interactions emerged between education level and 2 of the telehealth perception variables. Education level moderated the associations between (1) performance expectancy and intention to use teledelivered complementary care (β=0.34, P=.04) and (2) facilitating conditions and intention to use teledelivered peer support groups (β=0.36, P=.03). The positive associations between those telehealth perceptions and intentions were only significant among those with a higher education level.
CONCLUSIONS: The findings of this study implied that enhancing BCS\' skills at using telehealth, BCS\' and their important others\' perceived benefits of telehealth, and providing assistance for telehealth use could increase BCS\' intentions to use teledelivered SCC. For intentions to use specific types of SCC, addressing relevant factors (performance expectancy, facilitating conditions) might be particularly beneficial for those with a higher education level.