【摘要】：中國人口老齡化已經(jīng)進(jìn)入快速發(fā)展期,為提高養(yǎng)老院的醫(yī)療服務(wù)質(zhì)量,養(yǎng)老機(jī)構(gòu)在醫(yī)療信息系統(tǒng)上投入了大量的財力和人力,但使用的效率并不高。象征接受被認(rèn)為是導(dǎo)致醫(yī)療信息系統(tǒng)無法實(shí)現(xiàn)其預(yù)期效用的根源,因此識別老人們象征接受的影響因素進(jìn)而制定相應(yīng)的管理策略已然變得十分迫切。選取一家公辦養(yǎng)老院和一家民辦養(yǎng)老院作為研究對象,調(diào)查對象為養(yǎng)老院內(nèi)的老人。采用現(xiàn)場發(fā)放問卷和現(xiàn)場回收的方式獲取數(shù)據(jù),以提高問卷的回收率。為避免共同方法偏差對研究結(jié)果的影響,采用分時間段的問卷調(diào)查法,對336位老人展開為期6個月的問卷調(diào)查。使用SPSS 20.0和AMOS 21.0對數(shù)據(jù)進(jìn)行探索性因子分析、驗(yàn)證性因子分析、描述性統(tǒng)計分析和內(nèi)部一致性分析等,采用多層線性分析和總效應(yīng)調(diào)節(jié)分析法驗(yàn)證認(rèn)知失調(diào)在象征接受與采納意愿之間的中介效應(yīng)和任務(wù)價值在象征接受與認(rèn)知失調(diào)之間的調(diào)節(jié)作用,以探討強(qiáng)制用戶使用醫(yī)療信息系統(tǒng)后,用戶認(rèn)知轉(zhuǎn)變的過程機(jī)制以及采納意愿形成的邊界條件。研究結(jié)果表明,在醫(yī)療信息系統(tǒng)實(shí)施過程中,對于服從個性較強(qiáng)的人,管理者的職位權(quán)力能直接導(dǎo)致用戶象征性采納行為,繼而在用戶內(nèi)部出現(xiàn)認(rèn)知失調(diào)的情緒,經(jīng)過一個試用期,認(rèn)知失調(diào)才能完全消失,最終產(chǎn)生實(shí)質(zhì)性的采納意愿;用戶的任務(wù)價值對認(rèn)知失調(diào)情緒起關(guān)鍵性的消除作用。對于服從性較弱的人,他們并沒有經(jīng)歷認(rèn)知失調(diào),其象征性采納可以直接轉(zhuǎn)化為實(shí)質(zhì)性采納。研究結(jié)果有助于厘清強(qiáng)迫服從情景下用戶認(rèn)知轉(zhuǎn)變的內(nèi)在機(jī)制,通過個體差異與組織情景交互視角,探討醫(yī)療信息系統(tǒng)采納意愿形成的邊界條件,對養(yǎng)老院的管理者有效消除醫(yī)療信息系統(tǒng)實(shí)施過程中的抗拒心理、提升系統(tǒng)的使用效率具有實(shí)踐意義。
[Abstract]:China's aging population has entered a period of rapid development. In order to improve the quality of medical services in nursing homes, pension institutions have invested a lot of financial and human resources in medical information systems, but the efficiency of using them is not high. Symbolic acceptance is considered to be the root cause of the failure of medical information system to achieve its expected utility, so it has become very urgent to identify the influencing factors of symbolic acceptance of the elderly and to formulate corresponding management strategies. A public nursing home and a private nursing home were selected as the research subjects. In order to improve the recovery rate of the questionnaire, the data were obtained by the way of field questionnaire and field recovery. In order to avoid the influence of common method deviation on the results of the study, 336 elderly people were investigated by a time-divided questionnaire for 6 months. Using SPSS 20.0 and AMOS 21.0 to analyze the data, such as exploratory factor analysis, confirmatory factor analysis, descriptive statistical analysis and internal consistency analysis, etc. Multilevel linear analysis and total effect regulation analysis were used to verify the mediating effect of cognitive disorder between symbolic acceptance and acceptance intention and the role of task value in the adjustment between symbolic acceptance and cognitive disorder. In order to explore the process mechanism and boundary conditions of user cognitive transformation after forced users to use medical information system. The results show that, in the process of implementing medical information system, the position power of managers can directly lead to the symbolic adoption behavior of users, and then the emotion of cognitive disorder appears within the users. After a trial period, the cognitive disorder can disappear completely, and finally produce a substantial willingness to adopt. The user's task value plays a key role in the elimination of cognitive disorder emotion. For the weaker subservient people, they do not experience cognitive disorder, and their symbolic adoption can be directly transformed into substantive adoption. The results are helpful to clarify the internal mechanism of the cognitive transformation of compulsive services from users in situations, and to explore the boundary conditions for the formation of medical information systems' willingness to adopt through the perspective of interaction between individual differences and organizational situations. It is of practical significance for the managers of nursing home to eliminate the resistance in the implementation of medical information system and to improve the efficiency of the system.
【作者單位】： 武漢大學(xué)信息資源研究中心;
【基金】：國家自然科學(xué)基金(71661167007)~~
【分類號】：D669.6

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