Research Article: Theoretical integration of user satisfaction and technology acceptance of the nursing process information system

Date Published: June 4, 2019

Publisher: Public Library of Science

Author(s): Kuei-Fang Ho, Cheng-Hsun Ho, Min-Huey Chung, Katie MacLure.


The nursing process system (NPS) is used to establish the nursing process involving assessment, diagnosis, planning, intervention, and evaluation in solving the health problems of patients.

The factors influencing the use of the NPS by nurses were analyzed based on user satisfaction and technology acceptance within the 3Q (service quality, information quality, and system quality) model.

In this cross-sectional quantitative study, the valid responses of 222 nurses to a questionnaire were obtained; these nurses worked at eight hospitals affiliated with public organizations in Taiwan. Structural equation modeling was used to analyze information quality, system quality, service quality, user satisfaction, perceived usefulness, perceived ease of use, perceived enjoyment, behavioral attitude, and intention after the nurses had used the NPS system for more than 1 month.

Information quality, service quality, and system quality influenced user satisfaction. User satisfaction affected perceived usefulness, perceived ease of use, and perceived enjoyment and had the highest explanatory power (R2 = 0.75). Furthermore, perceived usefulness, perceived ease of use, and perceived enjoyment influenced behavioral attitude and intention to use the system. The proposed model explained 53% of the variance in the intention to use the NPS.

The relationships between the variables of the 3Q model were successfully used to examine the intention of nurses toward using the NPS. Using the findings of this study, designers and programmers can comprehensively understand the perceptions of nurses and further improve the performance of the NPS.

Partial Text

Nurses manage electronic health and clinical care records in routine practice; their usage of electronic health records has correspondingly increased to up to 80% [1]. The nursing information system (NIS) is crucial to delivering eHealth services [2], and this system comprises an integrated module of electronic health records [3]. The NIS can provide technological assistance for the management of all aspects of a task and can improve workflow efficiency [3–5]. The nursing process system (NPS) is a part of the NIS and is widely used by nurses to improve the quality of care. The NPS is different from decision support systems, which help nurses make decisions. The NPS involves assessment, diagnosis, planning, intervention, and continual evaluation of the effectiveness of the patient care plan by using information technology. The nursing process is the core of practice through which nurses from various domains deliver holistic and patient-focused care [6].

Our study used the extended WT model to construct a 3Q model, which was originally proposed by Xu, Benbasat [10]; only one model was discussed and used as our research framework, which may have decreased the strength of this research. Furthermore, we referred to the information system success model employed in medical information system research [19] and combined service satisfaction, information satisfaction, and system satisfaction to determine the effect of US on intention to use the NPS. Because this is inconsistent with the research by Xu et al.Xu, Benbasat [10], we could not determine the influence of object-based beliefs on each object-based attitude. Future research should consider these relationships when constructing the 3Q model.

We investigated the intention of nursing staff to use the NPS by employing a 3Q (IQ, SQ, and SysQ) model that integrated US and technology acceptance. Our study provides a methodology for exploring users’ beliefs, attitudes, and intentions.