Study On The Experience And Improvement Strategies Of Diabetes Internet Nursing Outpatient Services From The Perspective Of Both Nurses And Patients

Objective:Based on the Health Information Technology Acceptance Model(HITAM),we understand the experiences of diabetic patients with Internet nursing outpatient services,and clarify the main influencing factors affecting their use of Internet nursing outpatient services from the patient’s perspective;meanwhile,we understand the working experiences of nurses providing Internet nursing outpatient services for diabetic patients,and clarify the facilitating and hindering factors of diabetic patients’use of Internet nursing outpatient services from the nurse’s perspective;based on the results of patient and nurse interviews,we propose strategies to improve the quality of Internet nursing outpatient services.Methods:This study used a descriptive qualitative approach.From May to December 2022,14 diabetic patients who had used Internet nursing outpatient services were selected in the First Affiliated Hospital of Anhui Medical University through purpose sampling and maximum differentiation sampling,and an interview outline was developed using the Health Information Technology Acceptance Model(HITAM)as the theoretical framework to conduct face-to-face personal interviews.From December 2022 to January 2023,through purpose sampling and maximum differentiated sampling,7 nurses who provided endocrinology Internet nursing outpatient services were selected from the First Affiliated Hospital of Anhui Medical University and the First Affiliated Hospital of University of Science and Technology of China,and collected data by telephone interview.The entire interview process was recorded,and the data was transcribed and collated for data analysis.The traditional content analysis method was used for the interview materials such as the experience and suggestions of patients’Internet nursing outpatient service,the nurses’ Internet nursing outpatient service experience and suggestions,and the nurses’ views on the influencing factors of diabetic patients’ service adoption.According to the interview data of diabetic patients who believe that they influence the behavioral factors of Internet nursing outpatient services,the directional content analysis method is used.Results:The 4 themes of diabetic patients’ experiences with Internet nursing outpatient service were the content and effectiveness of Internet nursing outpatient services,nurses’ service attitude and level,service timeliness,and service platform design.Patients’ suggestions for Internet nursing outpatient services included two themes,namely,enriching service access,improving platform functions,and fixing intake hours to improve service efficiency.Based on the Health Information Technology Model(HITAM),the influencing factors of diabetic patients’ adoption behavior of Internet nursing outpatient services included 5 themes,namely,health status,perceived usefulness,perceived ease of use,subjective norms,and social influence.Among them,3 sub-themes were included under the social influence theme,namely,Internet development trend,new coronary pneumonia epidemic and difficulty of offline access to care.Nurses’ work experience of Internet nursing outpatient services contained two major themes of positive and negative experiences.Among them,positive experience had 3 sub-themes,namely,broadening the scope of nursing services and reflecting professional value;promoting long-term stability of patients’ blood glucose levels;and relieving the pressure of offline visits and promoting rational allocation of resources.The negative experience contains 2 sub-themes of long service time and worrying about the treatment effect.From the nurses’ perspective,the factors influencing patients’adoption of Internet nursing outpatient services had 2 major themes of facilitators and hindrances.Among them,facilitators included three sub-themes,namely strong health needs,subjective norms,and perceived benefits.The hindering factors consisted of 5 sub-themes,namely low service recognition,insufficient self-health awareness,difficulty in changing health care habits,low e-health literacy,and low service awareness.Nurses’ suggestions for Internet nursing outpatient services were to enhance the age-appropriate design of the service platform and to increase publicity to improve patient awareness.Conclusion:This study used a descriptive nature study design,and interviews revealed that both diabetic patients and nurses benefited from the Internet nursing outpatient service,but both expressed concerns about the effectiveness of the treatment.Health status,perceived usefulness,perceived ease of use,subjective norms,social influence,service awareness,service recognition,self-health awareness,health care habits,and ehealth literacy were the main factors affecting patients’ service experience.Increasing the publicity and promotion of the service,strengthening the selection and training of nurses,improving the functions of the service platform,realizing intelligent and ageappropriate design,and improving the scheduling system and incentive mechanism of service nurses can help promote the improvement of the Internet nursing outpatient service experience.