Exploring factors influencing e-health adoption and use among healthcare professionals in the clinical area in Sub-Saharan Africa: using Q-Methodology and models of technology acceptance

Background: Despite the reported advantages of utilising healthcare technology within the clinical area in developed countries, there has been limited information on factors influencing e-health adoption and use in developing countries including sub-Saharan Africa. Thus, this study using Q-methodology provided insight into those salient factors that influences these group of participants’ choices about e-health adoption and use in their clinical practices. Methods: This research study utilised models of technology acceptance and use: Technology Acceptance Model (TAM) and Unified Theory of Acceptance and Use of Technology (UTAUT) together with Q-methodology to explore e-health adoption and use among healthcare professionals (HCPs) in the clinical area sub-Saharan Africa. Results: Findings from this study identified four divergent views (Factors) that these participants hold about adoption and use of e-health within their respective clinical practices. The first view represented a group of participants identified as “patient-focused e-health advocates” whose choices about using e-health in their clinical practice are informed by their patient/families’ preferences. The second view represented a view identified as “task-focused e-health advocates”. This group of HCPs are driven to adoption and use of e-health by the need to complete their allocated tasks. The third view that emerged represented the “traditionalistic-pragmatists” who recognised that e-health has its advantages within clinical practice, but do not integrate it within their work. This group sees technology as a separate entity to routine clinical practice. The final view represents the “tech-focused e-health advocates”. This group recognise the value that e-health adds to their clinical practice and integrates it into their practice. In addition, this group also look for opportunities to utilise the e-health tools beyond their respective departments. Discussion: The use of Q-methodology as a unique methodology to explore the HCPs subjectivity together with both TAM and UTAUT provided in depth understanding of what influences HCPs e-health adoption and use. The findings from this study identified that personal viewpoints about technologies held by the participants’ influences their choices about e-health. These viewpoints manifests as Factors within this research study. This research study also provided insight to the equivocal tripartite relationship that exist between these HCPs, e-health/clinical practice and the patients/families’. Conclusion: This identifies how HCPs interpret the contribution that e-health makes and how this view influences their clinical practice. In addition, findings from this study will also inform stakeholders when implementing an e-health policy to consider the views of the HCPs who use these technologies

Understanding technology adoption and use by healthcare proferssionals using models of technology acceptance and q-methodology

This study explores the use of models of technology acceptance (TAM and UTAUT) to understand technology adoption and use among healthcare professionals (HCPs) in the clinical area in Sub-Saharan Africa (SSA). Six themes were developed from both models and this generated forty-six specific statements that explore those barriers and motivators to e-health adoption and use in clinical practice. Each HCP ranked each of the statements based on how they agree or disagree with the statement in order to identify a shared perspective using Q-methodology; a methodology that explores subjectivity. Thirty-six HCPs working in the clinical area in SSA participated in the study. Analysis was done using a Q-methodology dedicated software called the PQMethod 2.35. Four perspectives identifying the aspect(s) of the model the HCPs identify to influence their use of technology in their clinical practice. Keywords: Q-methodology, Technology-Acceptance-Model (TAM), Unified-Theory-of-Acceptance-and-Use-of-Technology (UTAUT), Healthcare professional

Drivers and Barriers to eLearning Adoption by Academic Staff in Bayero University, Kano, Nigeria

eLearning is the utilization of electronic technology and media for teaching and learning. This type of pedagogy has become a main stay in higher institutions in developed countries. Despite its advantages over traditional methods of teaching as found in the literature, only few have made it requirement for teaching or have adopted it their pedagogy. As such, this paper seeks to uncover the drivers and barriers to eLearning adoption by academic staff in Bayero University, Kano one of the Second generation universities in Nigeria. A descriptive cross-sectional approach was adopted for this study which involved 187 respondents (179 retrieved). Data was descriptively analyzed using SPSS version 27. Majority of the respondents reported to have a Master degree as their highest level of qualification. Also, more than half of the respondents(58.1%) strongly disagreed that the management is aware of the benefits of eLearning while more than one third of the respondents stated that they intend to use eLearning if given the opportunity. Furthermore, nearly half of the respondents strongly disagreed that eLearning increases workload, and more than half of the respondents representing (59.8%) strongly agreed that eLearning eases work and more than one third of the respondents (45.3%) believed that access to ICT is a facilitating factor in adoption of e-leaning among academic staff in Bayero University, Kano. In this regard, the university management need to encourage staff to use eLearning including provision of supportive infrastructure and personnel.&nbsp

Exploring healthcare professionals adoption and use of Information and Communication Technology using Q-methodology and Models of Technology Acceptance

Background: Information and communication technologies (ICTs) and more specifically e-health are viewed as important tools within healthcare. They are used to support clinical activities such as interactions between healthcare professionals and patients, clinical self-development, patient education, routine clinical activities, and also have the potential to address many challenges affecting healthcare sectors globally. However, there is still limited information on how technologies are adopted and used within clinical practice by health professionals particularly in countries in Sub Saharan Africa (SSA). Methodology: This study used Q-methodology and models of technology acceptance (TAM and UTUAT) to explore the factors that influence ICT adoption among nurses and physicians in clinical practice in SSA. Thirty six participants from a tertiary hospital in SSA conducted Q-sorts of 46 statements relating to their interaction with technologies in their clinical practice. Results: Four factors; the patient-driven adopters, the task-driven adopters, the pragmatists and the e-health champions emerged after Q-analysis representing the distinct views of this group of healthcare professionals. Conclusion: The findings suggest different viewpoints to the adoption and use of e-health resources in clinical practise. These views may help understand how these health professionals make their choices when it comes to ICT in health care

Occupational stress amongmhealth professionals in Ahmadu Bello University Teaching Hospital (A.B.U.T.H.),Shika, Zaria, Nigeria

This study was carried out to survey occupational stress among health professionals in Ahmadu Bello University Teaching Hospital (ABUTH),Shika, Zaria. The study was aimed at investigating the differences in perception of stress among different health professionals in ABUTH. The descriptive survey design method was used. Questionnaires were distributed based on availability to the different dusters o f health professionals in the study group. A sample size of 107 was used comprising 45 nurses, 48 doctors, 5 pharmacists, 3 physiotherapists and 6 medical lab scientists. The findings showed that most of the respondents (36.5%) were within the age range of 31-40 years and very few of them were aged 55 years and above. More than fifty six percent(56.7%) o f the total respondents were males. Seventy five percent (75%>) of the respondents stay long (7-1 0hours) at work which could be a contributing factor to the development of occupational stress in them. Most of the respondents (90.4%) were identified to be stressed due to work overload because the number of health professionals available to carry out a particular function is inadequate. Eighty percent (80%) of respondents exhibit anger and irritability while twenty seven percent (27%>) engaged in absenteeism when they are stressed up. A lot of respondents (78.8%) combat these signs and symptoms of stress by the use of physical exercise. The following measures were recommended to help prevent stress at work: respondents should ensure that the workload is in line with their capabilities and resources, jobs should be designed so that they provide meaning, there should be positive stimulation and opportunities for workers to use their skills, workers' roles and responsibilities should be clearly defined, communication within the work place should be dear and unambiguous, there should also be opportunities for career development and future employment prospects

Pressure ulcer stages among bed-ridden patients in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria- Nigeria

This study was carried out to assesspressure ulcer stages among bed-ridden patients in Medical, Neurosurgical and Orthopaedic wards inAhmadu Bello University Teaching Hospital (ABUTH) Shika-Zaria. The main aim of this study is to determine the prevalence as well as the stages of pressure ulcers among bed-ridden patients and to assess the Nurses’ awareness and application of the awareness in the stage-based treatment of pressure ulcer in ABUTH. The descriptive survey design was adopted and data was collected with the help of questionnaire and observation checklist. A convenient sampling method was used among the bed-ridden patients and a single-stage cluster method was used among the nurses in the three wards. The study sample consisted of 51 Nurses whom answered a pre-established Questionnaire and 129 bed-ridden patients whom were observed using Observational Checklist. The Major Findings were as follows: the cumulative point prevalence of Pressure ulcer was noted to be 18.6% which is significantly high; Pressure ulcer stages were observed to be highest for Stages III (37.5%), and Stage IV (33.3%) which are the advanced stages, and then low in Stage II (20.8%) and Stage I (8.3%). Furthermore, 96% of Nurses were observed to be aware of pressure ulcer stages and 82% apply their awareness in the stage-based treatment of pressure ulcer. In conclusion, there was a high prevalence of pressure ulcer among bed-ridden patients majority of which were the advanced stage of the condition. Therefore it is recommended that, use of a risk assessment tool such as theBraden Scale on admission will identify if the client has pressure ulcer or not, and if they do, at which stage, health care professionals should be more informed about secondary conditions that may occur in the course of patient’s stay in the hospital rather than emphasis only on primary condition that warranted admission, and patient’s relatives should be informed about the risk factors for the development of pressure ulcers since they are also fully involved in the care

eHealth adoption and use among healthcare professionals in a tertiary hospital in Sub-Saharan Africa: a Qmethodology study

Copyright 2019 Ladan et al. Background. The aim of the study was to explore the viewpoints of healthcare professionals (HCPs) on the adoption and use of eHealth in clinical practice in sub-Saharan Africa (SSA). Information and communication technologies (ICTs) including eHealth provide HCPs the opportunity to provide quality healthcare to their patients while also improving their own clinical practices. Despite this, previous research has identified these technologies have their associated challenges when adopting them for clinical practice. But more research is needed to identify how these eHealth resources influence clinical practice. In addition, there is still little information about adoption and use of these technologies by HCPs inclinical practice in Sub-Saharan Africa. Method. An exploratory descriptive design was adopted for this study. Thirty-six (36) HCPs (18 nurses and 18 physicians) working in the clinical area in a tertiary health institution in SSA participated in this study. Using Qmethodology, study participants rank-ordered forty-six statementsin relation to their adoption and use of eHealth within their clinical practice.This was analysed using by-person factor analysis and complemented with audio-taped interviews. Results. The analysis yielded four factors i.e., distinct viewpoints the HCPs hold about adoption and use of eHealth within their clinical practice. These factors include: Patient-focused eHealth advocates" who use the eHealth because they are motivated by patients and their families preferences; Task-focused eHealth advocates" use eHealth because it helps them complete clinical tasks; Traditionalistic-pragmatists" recognise contributions eHealth makes in clinical practice but separate from their routine clinical activities; and the Tech-focused eHealth advocates" who use the eHealth because they are motivated by the technology itself. Conclusion. The study shows the equivocal viewpoints that HCPs have about eHealth within their clinical practice. This, in addition to adding to existing literature, will help policymakers/decision makers to consider HCPs views about these technologies prior to implementing an eHealth resource

Assessment of availability of visual inspection with acetic –acid (VIA) requirements for cervical cancer screening in secondary health care institutions of Kaduna State, Nigeria

The study determined the availability of visual inspection with acetic-acid requirements for cervical cancer screening in secondary health care institutions of Kaduna state. A cross-sectional descriptive survey was used for the study. The study population comprises all nurses, midwives, and nurse-midwives working in all the secondary healthcare institutions of the state. The sample size used for the study was 300 using the Yamane sample size selection formula. The technique involved was stratified sampling method whereby the three existing senatorial zones served as strata. Each of the stratum was clustered according to the existing local government areas. A purposive sampling was further used to select nine local governments, three from each senatorial zone that have secondary health care institutions. A proportionate sampling was used to distribute questionnaire copies to the health workers. The instrument used for data collection was a questionnaire which has been modified to four point likert scale. Three hundred (300) questionnaire copies were administered out of which (297) were retrieved. The data collected was analyzed using one way analysis of variance (ANOVA) at 0.05 level of confidence to answer the hypotheses. A post-hoc scheffe test was further used to determine were th differences are. Findings from the study shows that VIA requirements are not available in the secondary health care institutions for cervical cancer screening with an aggregate mean score of (2.1458). There is a significant difference among the secondary health care institutions in the availability of VIA requirements to screen for cervical cancer in Kaduna state where (P<0.05). It is therefore recommended that the hospital management board should make provision of VIA requirements so that they can be available in the institutions for VIA screening services

Uncovering a tripartite relationship between patient, eHealth and healthcare professionals

Background: Patients preferences have recently been identified as important factors in clinical practice. However, there is little information on how patient eHealth preferences influence healthcare professionals’ (HCPs) choices to use technology in their clinical practice especially in Sub-Saharan Africa (SSA). Aim: This is part of a study which explored factors influencing eHealth adoption and use among healthcare professionals in SSA. This section of the study aimed to uncover how patient preferences influence HCPs decisions on eHealth for clinical practice. Method: A mixed-method approach was adopted using Q-methodology. The viewpoints of thirty-six HCPs were explored in relation to eHealth adoption in their clinical practice. Each participant rank-ordered forty-six statements in relation to how they agreed or disagreed with them in their own clinical practice. This was followed by an interview to explore the reasons for their individual rankings. Results: Four viewpoints emerged showing how HCPs consider patient preferences when making decisions to use eHealth in their clinical practice. Conclusion: Findings suggest divergent viewpoints in relation to the role patient preferences play HCPs eHealth adoption in their clinical practices. These viewpoints could be seen as a tripartite relationship identifying how important patient eHealth preference influence HCP clinical choices

Towards understanding healthcare professionals’ adoption and use of technologies in clinical practice: using Qmethodology and models of technology acceptance

Background: Globally, technologies have been recognised to improve productivity across different areas of practice including healthcare. This has been achieved by the expansion of computers and other forms of information technologies (IT). Despite this advancement, there have also been growing challenges to the adoption and use of these technologies within practice sometimes with unintended or unexpected consequences. However, the barriers and drivers to IT, and more specifically e-health adoption within healthcare are little understood, especially in areas such as Sub-Saharan Africa (SSA) where e-health adoption is relatively new. Methodology: This paper describes a pilot study to develop and validate sample statements for use within a later substantive Q-methodology study. The aim of the main study was to understand factors that influence healthcare professionals’ (HCPs) attitudes towards IT adoption and use in SSA. We report on the use of this methodology to explore the subjectivity of HCPs together with the models of technology acceptance (Technology-Acceptance-Model: TAM and the Unified-Theory-of-Acceptance-and-Use-of-Technology: UTUAT) used in combination for the first time. Results: Following various stages and mapping of the two models of technology acceptance used, forty-six statements were developed at the end of the pilot study. These statements were grouped into six themes to capture the constructs of the two models used in the study. Conclusion: Findings suggest it is possible to use TAM and UTAUT to develop a comprehensive set of statements. These statements reflect choices that HCPs consider on IT/e-health adoption and use in SSA which can be used in a Q study. Keywords: E-health, Q-methodology, Healthcare professionals, Technology Acceptance Model, Unified Theory of Acceptance and Use of Technology, Sub-Saharan Africa