TY - JOUR AU -de Wit, Matthijs AU - Kleijnen, Mirella AU - Lissenberg-Witte, Birgit AU - van Uden-Kraan, Cornelia AU - Millet, Kobe AU - Frambach, Ruud AU - verdonke -de Leeuw, Irma PY - 2019 DA - 2019/12/17 TI -了解肿瘤护士在常规癌症护理中实施基于web的自我管理工具的阻力驱动因素:横断面调查研究JO - J Med Internet Res SP - e14985 VL - 21 IS - 12kw -心理肿瘤学KW -健康相关生活质量KW -自我管理KW -电子健康KW -实施科学KW -抵制创新AB -背景:支持患者参与(基于web的)自我管理工具越来越重要，但卫生保健专业人员的参与却落后了。这在一定程度上可以由卫生保健专业人员的抵制来解释。目的:本研究的目的是调查肿瘤护士在癌症护理中对基于网络的自我管理工具的抗拒因素。方法:借鉴以往的研究，结合临床和营销角度，以及几个变量和工具，我们开发了创新阻力模型(rti模型)。rti模型区分了被动抵抗和主动抵抗，这可以通过功能驱动因素(不兼容性、复杂性、缺乏价值和风险)和心理驱动因素(角色模糊、来自机构、同行和患者的社会压力)来增强或减少。这两种类型的驱动因素都可以受到员工、组织、患者和环境相关因素的调节。我们对荷兰肿瘤科护士的横断面样本进行了一项涵盖rti模型所有组成部分的调查。结构方程模型被用来测试完整的模型，使用层次方法。总共接触了2500名护士，其中285名(11.40%)护士做出了回应。 Results: The goodness of fit statistic of the uncorrected base model of the RTI-model (n=239) was acceptable (χ21=9.2; Comparative Fit Index=0.95; Tucker Lewis index=0.21; Root Mean Square Error of Approximation=0.19; Standardized Root Mean Square=0.016). In line with the RTI-model, we found that both passive and active resistance among oncology nurses toward (Web-based) self-management tools were driven by both functional and psychological drivers. Passive resistance toward Web-based self-management tools was enhanced by complexity, lack of value, and role ambiguity, and it was reduced by institutional social pressure. Active resistance was enhanced by complexity, lack of value, and social pressure from peers, and it was reduced by social pressure from the institute and patients. In contrast to what we expected, incompatibility with current routines was not a significant driver of either passive or active resistance. This study further showed that these drivers of resistance were moderated by expertise (P=.03), managerial support (P=.004), and influence from external stakeholders (government; P=.04). Conclusions: Both passive and active resistance in oncology nurses toward Web-based self-management tools for patients with cancer are driven by functional and psychological drivers, which may be more or less strong, depending on expertise, managerial support, and governmental influence. SN - 1438-8871 UR - //www.mybigtv.com/2019/12/e14985/ UR - https://doi.org/10.2196/14985 UR - http://www.ncbi.nlm.nih.gov/pubmed/31845900 DO - 10.2196/14985 ID - info:doi/10.2196/14985 ER -