Determinants of the intention to adopt digital-only banks in Malaysia: The extension of environmental concern

Digital-only banks have not achieved adoption expectations despite being one of the latest innovations in fintech. Several digital-only banks in the United States and Japan have gone bankrupt, and others continue to operate at a loss. Therefore, it is imperative to conduct this study in Malaysia to understand customers’ behavior, particularly regarding the adoption of digital-only banks. With climate change, environmental-friendly behavior, which has been ignored in digital-only bank literature, is becoming increasingly pertinent. This study addresses the lack of an integrated model that investigates the effect of external factors (i.e., critical mass, number of services, and environmental concerns), customer self-determination factors (i.e., trust), and mental perceptions of technology adoption (i.e., convenience, economic efficiency, functional and security risks, as well as perceived value) on the intention to adopt digital-only banks. Data were collected through an online survey targeting Klang Valley residents in the prime age range of 25–54 years old using stratified random sampling. The data was analyzed using structural equation modeling by performing confirmatory factor analysis (CFA) and SEM path analysis in AMOS.v26 software. The results show that convenience, economic efficiency, number of services, trust, perceived value, and environmental concern all have positive significant relationships with the intention to adopt digital-only banks. Further, environmental concern is the strongest indicator of behavioral intention. In contrast, functional and security risks have a negative but non-significant relationship with the intention to adopt digital-only banks. Finally, critical mass has a positive but non-significant effect on the behavioral intention. This study is among the first to examine the influence of environmental concern on behavioral intentions in a digital-only banking context. It also contributes to an expanding body of research investigating environmental sustainability by presenting empirical results in the context of digital-only banks

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Determinants of the Intention to Adopt Digital-Only Banks in Malaysia: The Extension of Environmental Concern

Digital-only banks have not achieved adoption expectations despite being one of the latest innovations in fintech. Several digital-only banks in the United States and Japan have gone bankrupt, and others continue to operate at a loss. Therefore, it is imperative to conduct this study in Malaysia to understand customers’ behavior, particularly regarding the adoption of digital-only banks. With climate change, environmental-friendly behavior, which has been ignored in digital-only bank literature, is becoming increasingly pertinent. This study addresses the lack of an integrated model that investigates the effect of external factors (i.e., critical mass, number of services, and environmental concerns), customer self-determination factors (i.e., trust), and mental perceptions of technology adoption (i.e., convenience, economic efficiency, functional and security risks, as well as perceived value) on the intention to adopt digital-only banks. Data were collected through an online survey targeting Klang Valley residents in the prime age range of 25–54 years old using stratified random sampling. The data was analyzed using structural equation modeling by performing confirmatory factor analysis (CFA) and SEM path analysis in AMOS.v26 software. The results show that convenience, economic efficiency, number of services, trust, perceived value, and environmental concern all have positive significant relationships with the intention to adopt digital-only banks. Further, environmental concern is the strongest indicator of behavioral intention. In contrast, functional and security risks have a negative but non-significant relationship with the intention to adopt digital-only banks. Finally, critical mass has a positive but non-significant effect on the behavioral intention. This study is among the first to examine the influence of environmental concern on behavioral intentions in a digital-only banking context. It also contributes to an expanding body of research investigating environmental sustainability by presenting empirical results in the context of digital-only banks