Factors Influencing the Acceptance of Pediatric Telemedicine Services in China: A Cross-Sectional Study
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ABSTRACT:
SUBMITTER: Shi J
PROVIDER: S-EPMC8558490 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:With the continuous large-scale development of the COVID-19 vaccine, the acceptance of vaccination and its influencing factors at the individual level have become crucial to stemming the pandemic. This study aims to explore the factors that influence the acceptance of the COVID-19 vaccine among international college students. The target population constituted international students pursuing various degrees in Jiangsu Province through an online cross-sectional study. A cluster random sampling was performed using a self-administered questionnaire. The Health Belief Model and Knowledge, Attitude/Beliefs, and Practice Theory served as the underlying theories to understanding the factors that influence vaccine acceptance. We received 330 responses. About 36.4% intended to accept the vaccine. The acceptance varied across respondents' place of residence, program of study, continent of origin, knowledge, susceptibility, severity, benefits, and cues to action (p < 0.05). A multivariable logistics regression revealed cues to action (p < 0.001), the perception of COVID-19 vaccination benefits (p = 0.002), and the perception of barriers (p < 0.001) that were associated with vaccine acceptance. The acceptance of the COVID-19 vaccine was low among international students. The correct and comprehensive beliefs of the target groups regarding the benefits and barriers of the vaccination must be raised. Various effective social strategies must be adopted to trigger the intention of COVID-19 vaccination. The study findings will inform the decisions of public health campaigners, aimed at reducing vaccine hesitation when the COVID-19 vaccine is widely available.
| S-EPMC8228371 | biostudies-literature
Project description:BACKGROUND:Gatekeeper policy, requiring a patient to visit a primary care provider first, and the patient needs to get his or her primary care provider's referral before seeing a specialist or going to a hospital, has been implemented in China for about ten years, and it is necessary to assess the patients' acceptance of gatekeeper policy and to explore the factors influencing patients' acceptance. METHODS:A cross-sectional study with 1162 respondents was conducted between July and September 2015 at four community health centers (CHCs) in Wuhan, China. Face-to-face interview was used to collect information on demographics, acceptance of the gate keeper policy and satisfaction with community health services. Patients' satisfaction with community health service was evaluated using the European Patients Evaluate General/Family Practice scale and binary logistic regression model was used to examine the factors influencing patients' acceptance of community health services as gate keepers. RESULTS:A total of 512 (43.06%) patients accepted gatekeeper policy. Mandatory reimbursement provision (OR: 1.63, 95% CI: 1.23-2.15), patient satisfaction with the aspects of medical care (OR: 1.92, 95% CI: 1.12-3.29) and organization of care (OR: 1.66, 95% CI: 1.05-2.62) were associated with acceptance of gatekeeper policy, after adjusting for potential confounders. Moreover, young people (OR: 0.35, 95%CI: 0.22-0.56) seemed to be more reluctant to accept the policy, when compared with the elder. CONCLUSIONS:Our study suggests that mandatory reimbursement provision greatly affects patients' acceptance of gatekeeper policy, therefore, the policy-maker should pay attention to the negative effect of its mandatory reimbursement provision on patients' acceptance of the policy. However, improving the aspects of medical care and organization of care will contribute to implementation of gatekeeper policy.
| S-EPMC5883636 | biostudies-literature
Project description:BackgroundThe shortage of medical resources in rural China reflects the health inequity in resource-limited settings, whereas telemedicine could provide opportunities to fill this gap. However, evidence of patient acceptance of telemedicine services from low- and middle-income countries is still lacking.ObjectiveWe aimed to understand the profile of patient end-user telemedicine use and identify factors influencing telemedicine service use in rural China.MethodsOur study followed a mixed methods approach, with a quantitative cross-sectional survey followed by in-depth semistructured interviews to describe telemedicine use and its associated factors among rural residents in Guangdong Province, China. In the quantitative analysis, explanatory variables included environmental and context factors, household-level factors, individual sociodemographic factors, access to digital health care, and health needs and demand factors. We conducted univariate and multivariate analyses using Firth logistic regression to examine the correlations of telemedicine uptake. A thematic approach was used, guided by the Social Cognitive Theory for the qualitative analysis.ResultsA total of 2101 households were recruited for the quantitative survey. With a mean age of 61.4 (SD 14.41) years, >70% (1364/2101, 72.94%) of the household respondents were male. Less than 1% (14/2101, 0.67%) of the respondents reported experience of using telemedicine. The quantitative results supported that villagers living with family members who had a fever in the past 2 weeks (adjusted odds ratio 6.96, 95% CI 2.20-21.98; P=.001) or having smartphones or computers (adjusted odds ratio 3.71, 95% CI 0.64-21.32; P=.14) had marginally higher telemedicine uptake, whereas the qualitative results endorse these findings. The results of qualitative interviews (n=27) also supplemented the potential barriers to telemedicine use from the lack of knowledge, trust, demand, low self-efficacy, and sufficient physical and social support.ConclusionsThis study found extremely low use of telemedicine in rural China and identified potential factors affecting telemedicine uptake. The main barriers to telemedicine adoption among rural residents were found, including lack of knowledge, trust, demand as well as low self-efficacy, and insufficient physical and social support. Our study also suggests strategies to facilitate telemedicine engagement in low-resource settings: improving digital literacy and self-efficacy, building trust, and strengthening telemedicine infrastructure support.
| S-EPMC9823570 | biostudies-literature
Project description:BackgroundOnline hospitals are part of an innovative model that allows China to explore telemedicine services based on national conditions with large populations, uneven distribution of medical resources, and lack of quality medical resources, especially among residents needing to be protected from COVID-19 infection.ObjectiveIn this study, we built a hypothesis model based on the Unified Theory of Acceptance and Use of Technology (UTAUT) in order to analyze the factors that may influence patients’ willingness to use mobile medical services. This research was designed to assist in the development of mobile medical services. Residents who do not live in urban areas and cannot access medical assistance would greatly benefit from this research, as they could immediately go to the online hospital when needed.MethodsA cross-sectional study based at the West China Hospital, Sichuan University, was conducted in July 2020. A total of 407 respondents, 18 to 59 years old, in Western China were recruited by convenience sampling. We also conducted an empirical test for the hypothesis model and applied structural equation modeling to estimate the significance of path coefficients so that we could better understand the influencing factors.ResultsOut of 407 respondents, 95 (23.3%) were aware of online hospitals, while 312 (76.7%) indicated that they have never heard of online hospitals before. Gender (P=.048) and education level (P=.04) affected people's willingness to use online hospitals, and both of these factors promoted the use of online hospitals (odds ratio [OR] 2.844, 95% CI 1.010-8.003, and OR 2.187, 95% CI 1.031-4.636, respectively). According to structural equation modeling, the results of the path coefficient analysis indicated that performance expectancy, effort expectancy, and facilitating conditions have positive effects on patients' willingness to use online hospitals.ConclusionsThe goal of our research was to determine the factors that influence patients' awareness and willingness to use online hospitals. Currently, the public's awareness and usage of online hospitals is low. In fact, effort expectancy was the most important factor that influenced the use of online hospitals; being female and having a high education also played positive roles toward the use of mobile medical services.
| S-EPMC7869921 | biostudies-literature
Project description:BackgroundMyopia, strabismus, and ptosis are common pediatric eye diseases, which have a negative impact on children and adolescents in terms of visual function, mental health, and health-related quality of life (HRQoL). Therefore, this study focused on those pediatric eye diseases by analyzing their risk factors and HRQoL for the comprehensive management of myopia, strabismus, and ptosis.MethodsA total of 363 participants (2-18 years old) were included in this study for risk factors analysis of myopia, strabismus, and ptosis. We collected demographic characteristics, lifestyle habits and eye care habits of these children and analyzed them by using univariable and multivariable logistic regression. In addition, we applied the Chinese version of Pediatric Quality of Life Inventory-Version 4.0 (PedsQL 4.0) to assess HRQoL in 256 children with strabismus and ptosis. Univariable and multivariable linear regression models were applied to evaluate potential influencing factors of HRQoL.ResultsOf all the participants, 140 had myopia, 127 had strabismus, and 145 had ptosis. Based on the multivariable logistic regression analysis model, we found that the history of parental myopia and daily average near-distance eye usage time were risk factors for myopia, and increased body mass index (BMI) was identified as a risk factor for strabismus and ptosis. Individuals with ptosis possessed decreased HRQoL. The multivariable linear regression model suggested that daily average near-distance eye usage time, light intensity during visual tasks, and daily average sleep duration had potential influences on HRQoL.ConclusionThis is the first study to assess the risk factors and HRQoL of myopia, strabismus, and ptosis together. We identified risk factors for these common pediatric eye diseases to help doctors, parents, and teachers better manage them. Our study discovered that children with eye disorders exhibit a notably diminished HRQoL. Consequently, it emphasizes the necessity for increased social attention and mental health assistance for these children.
| S-EPMC11319247 | biostudies-literature
Project description:BackgroundHealth care technologies can help improve workers' health and productivity by supporting workplace health promotion. A personal health record app is used to manage medical data such as results from medical checkups, which facilitates decision making for medical personnel. However, an analysis of users' technology acceptance is required to provide appropriate services based on personal health record apps.ObjectiveThe purpose of this study was to analyze the factors influencing the behavioral intention of health experts and workers to use an app in workers' health centers and to examine differences in their perception of the main variables.MethodsThe study involved health experts and workers who visited 21 workers' health centers in Korea to verify a research model in which perceived risk was added to the unified theory of acceptance and use of technology, a representative theory of information technology acceptance. After receiving ethical approval from the Korea National Institute for Bioethics Policy, 1050 questionnaires were distributed over 7 weeks with cooperation of the Korea Occupational Safety and Health Agency. A multiple linear regression analysis and multigroup path analysis were performed to verify the hypotheses, and independent samples t tests were performed to analyze differences between workers' and health experts' perception of the main variables.ResultsThe analysis included data from 866 respondents (687 workers and 179 health experts). Effort expectancy (beta=.08, P=.03), social influence (beta=.43, P<.001), performance expectancy (beta=.07, P=.008), and facilitating conditions (beta=.13, P<.001) exerted significant positive effects on behavioral intention, whereas perceived risk (beta=-.29, P<.001) exerted a significant negative effect on behavioral intention. Performance expectancy had a significant effect on path differences depending on gender (critical ratio=-3.38) and age (critical ratio=1.97). Workers' mean scores for the main variables were higher relative to those of health experts for all remaining variables except perceived risk, and significant differences were observed for all remaining variables except facilitating condition.ConclusionsSocial influence exerted the strongest effect on behavioral intention to use the personal health record app. Consequently, it is necessary to coordinate health promotion activities in the workplace as well as the operational direction of community institutions such as in workers' health centers to allow workers to manage their own health via continuous use of the app. In addition, the app should be developed based on a requirement analysis of the balance between both interest groups in consideration of differences in perspective between consumers and service providers.
| S-EPMC7303838 | biostudies-literature
Project description:This study aimed to investigate the current status of decent work among psychiatric nurses and analyze its influencing factors. In February 2024, a cross-sectional study was conducted with a cluster sample of 358 nurses from a tertiary Grade A psychiatric hospital in Hangzhou, Zhejiang Province, China. Data were collected using a custom-made nurse demographic scale to gather demographic information. The Effort-Reward Imbalance Questionnaire (ERIQ) was used to assess the imbalance between effort and reward through the effort-reward ratio (ERR). The Social Support Rating Scale (SSRS) measured subjective support, objective support, and support utilization. The Decent Work Perception Scale (DWPS) was used to evaluate nurses' perceptions of decent work. T-tests, one-way ANOVA, Pearson's correlation analysis, and multiple linear regression analyses were employed for data analysis. The study found that the correlation between decent work and social support was positive (r = 0.360, p < 0.001), while it was negative for effort-reward imbalance (r = -0.584, p < 0.001). Factors influencing perceptions of decent work included years of work experience (β = -0.164, p = 0.046 for < 5 years; β = -0.157, p = 0.040 for > 25 years), social support (β = 0.259, p < 0.001), and the effort-reward imbalance (β=-0.458, p < 0.001). These factors collectively explained 40.2% of the variance in perceptions of decent work. Furthermore, social support plays a mediating role between effort-reward imbalance and decent work (β=-0.062, Bootstrap 95% CI: -0.107, -0.023). The findings suggest that years of work experience, social support, and the effort-reward imbalance are factors influencing decent work among psychiatric nurses. By offering career development opportunities, fostering supportive work environments, and ensuring fair compensation, we can empower psychiatric nurses to navigate job challenges effectively and sustain a sense of decency in their work.
| S-EPMC11292887 | biostudies-literature
Project description:BackgroundTelemedicine has been used widely in China and has benefited a large number of patients, but little is known about the overall development of telemedicine.ObjectiveThe aim of this study was to perform a national survey to identify the overall implementation and application of telemedicine in Chinese tertiary hospitals and provide a scientific basis for the successful expansion of telemedicine in the future.MethodsThe method of probability proportionate to size sampling was adopted to collect data from 161 tertiary hospitals in 29 provinces, autonomous regions, and municipalities. Charts and statistical tests were applied to compare the development of telemedicine, including management, network, data storage, software and hardware equipment, and application of telemedicine. Ordinal logistic regression was used to analyze the relationship between these factors and telemedicine service effect.ResultsApproximately 93.8% (151/161) of the tertiary hospitals carried out telemedicine services in business-to-business mode. The most widely used type of telemedicine network was the virtual private network with a usage rate of 55.3% (89/161). Only a few tertiary hospitals did not establish data security and cybersecurity measures. Of the 161 hospitals that took part in the survey, 100 (62.1%) conducted remote videoconferencing supported by hardware instead of software. The top 5 telemedicine services implemented in the hospitals were teleconsultation, remote education, telediagnosis of medical images, tele-electrocardiography, and telepathology, with coverage rates of 86.3% (139/161), 57.1% (92/161), 49.7% (80/161), 37.9% (61/161), and 33.5% (54/161), respectively. The average annual service volume of teleconsultation reached 714 cases per hospital. Teleconsultation and telediagnosis were the core charging services. Multivariate analysis indicated that the adoption of direct-to-consumer mode (P=.003), support from scientific research funds (P=.01), charging for services (P<.001), number of medical professionals (P=.04), network type (P=.02), sharing data with other hospitals (P=.04), and expertise level (P=.03) were related to the effect of teleconsultation. Direct-to-consumer mode (P=.01), research funding (P=.01), charging for services (P=.01), establishment of professional management departments (P=.04), and 15 or more instances of remote education every month (P=.01) were found to significantly influence the effect of remote education.ConclusionsA variety of telemedicine services have been implemented in tertiary hospitals in China with a promising prospect, but the sustainability and further standardization of telemedicine in China are still far from accomplished.
| S-EPMC7647817 | biostudies-literature
Project description:BackgroundMale circumcision (MC) has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore the acceptability of MC among the Chinese and to identify factors associated with circumcision preference.MethodsA cross-sectional survey was conducted between September 2009 and December 2010. We interviewed 2,219 male community participants, from three high HIV prevalence provinces in western China. A structured questionnaire was used to collect data on MC knowledge, willingness to accept MC, reasons to accept or refuse MC, and sexual behaviors and health. For those who refused MC, a health education intervention providing information on the benefits of circumcision was conducted. We used multiple logistic regression models to identify factors associated with the acceptability of MC.ResultsOf the respondents (n?=?2,219), 44.6% (989/2,219) reported they would accept MC for the following reasons: promotion of female partners' hygiene (60.3%), redundant foreskin (59.4%), prevention of penile cancer (50.2%), enhanced sexual pleasure (41.4%), and protection against HIV and STDs (34.2%). The multivariable logistic regression showed that five factors were associated with MC willingness: long foreskin (OR?=?15.98), residing in Xinjiang province (OR?=?3.69), being younger than 25 (OR?=?1.60), knowing hazards of redundant foreskin (OR?=?1.78), and having a friend who underwent circumcision (OR?=?1.36).ConclusionThe acceptability of male circumcision was high among the general population in China. Our study elucidates the factors associated with circumcision preference and suggests that more health education campaigns about positive health effects are necessary to increase the MC rate in China.
| S-EPMC3257276 | biostudies-literature
Project description:BackgroundNurses' turnover has been a major concern globally, which is strongly influenced by nurses' intent to leave. However, only a few large sample studies on the predictive factors associated with nurses' turnover intention were conducted in Jiangsu Province. This study mainly aims to examine the level and factors that influence nurses to leave their work in Jiangsu Province of Eastern China.MethodsA cross-sectional survey of 1978 nurses was conducted at 48 hospitals in 14 key cities throughout Jiangsu Province. The turnover intention in nurses was measured by the scale of intent to leave the profession. The work environment of nurses was measured by the Chinese version of the Practice Environment Scale. A multiple linear regression model was applied to analyse the factors associated with turnover intention.ResultsThe resignation rate of nurses in the hospitals of Jiangsu Province ranged from 0.64% to 12.71% in 2016.The mean scores were 15.50 ± 3.44 for turnover intention, and 3.06 ± 0.51 for work environment. Involvement in hospital affairs, resource adequacy, age, professional title, year(s) working, employment type and education level were the predictors of nurse intent to leave(P < 0.05).ConclusionThe work environment of nurses in hospitals must be improved in staffing and resource and nurses' involvement in hospital affairs. The current study corroborates that nurses have high turnover intention. Thus, effective measures are needed to improve nurse accomplishment, professional status, participation in hospital affairs and career planning to reduce their turnover intention.
| S-EPMC6626264 | biostudies-literature