Nurses' acceptance of the decision support computer program for cancer pain management

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Clinical care by nurses and other healthcare providers involves a series of decisions, with each branching point in the decision tree depending on the “correctness” of the previous decision. Decision support computer programs (DSCP) that attempt to mimic expert thinking and decision-making have become an important component of electronic health record systems. Very few of these systems have focused on nursing care by supporting nurses’ decision-making process. Im and Chee developed a nurse-focused DSCP that can be used to assess gender and ethnic differences in dealing with cancer pain. The aim of this study was to to investigate potential associations between socioeconomic, professional and demographic characteristics of nurses and their acceptance of the DCSP.

Subjects were Registered Nurses (RN) recruited via the Internet and community/hospital settings. A total of 122 RNs met the inclusion criteria (active RN status, working with cancer patients, and ability to read and write in English) and were provided user names and passwords to register on the DSCP website. Subjects logged into the website and entered data about patients being seen. This study evaluated the characteristics of the study subjects in addition to subject evaluation of the DSCP website. The authors used a validated tool for evaluation of the DSCP, the Questionnaire for User interaction Satisfaction (QUIS). QUIS consists of 27 questions in five sections with a rating scale from 0 to 9.

Study data was evaluated using SPSS v. 13 (SPSS, Chicago, IL). Descriptive statistics were used to analyze demographic data; QUIS scores were recoded to create a 1-10 scale and also analyzed using descriptive statistics (frequency, percentages, mean, standard deviation, and range). Associations between the QUIS scores and demographic data were analyzed using analysis of variance and correlation. Tukey’s Honestly Significant Differences was used for post hoc analyses.

Results showed significant associations between acceptance scores of the DSCP and gender and ethnicity (women and white subjects reported higher scores than male and African American subjects) study participants. Acceptance of the system by all subjects was positive with scores on the four major sections of QUIS ranging from 7.46 to 9.69.

The authors conclude that nurses are accepting of DSCP given inclusion of their design preferences in programs and that different nursing groups require different types of DSCP.

Overall, the results suggest that there are unique user characteristics that have the potential to influence use of DSCP. The current study is somewhat limited by small subgroup size but does support increased efforts to involve a heterogenous group of end users in the design process.