Factors affecting patients satisfaction to the use of nurse call system at hospitals

Design/Methodology/Approach - The study is constructed base on Technology Acceptance Model TAM with additional factor that are Perceived Usefulness, Perceived Ease-of-Use and Perceived

HO CHI MINH CITY OPEN

UNIVERSITY UNIVERSITÉ LIBRE DE BRUXELLES SOLVAY BRUSSELS SCHOOL OF

ECONOMICS & MANAGEMENT

HO CHI MINH CITY

2014

H KIM NGÂN

FACTORS AFFECTING PATIENT’S SATISFACTION

TO THE USE OF NURSE CALL SYSTEM AT

HOSPITALS

MASTER FINAL PROJECT MASTER IN BUSINESS QUALITY AND PERFORMANCE MANAGEMENT

MBQPM4

STATEMENT OF AUTHENTICATION

I certified that the research would contribute to open an opportunity to develop e-health technology in Viet Nam market as well as enhance the quality service of patient’s care in Viet Nam

I also certified that all helps and sources are acknowledged in the thesis

ACKOWLEDGEMENT

“Stay hungry, stay foolish”-Steven Job

Although I know a little about Steven Job, I am inspired by his philosophy and talent to build up Apple His stories become a legend to me To start and complete

something, it is necessary to “hungry” and “foolish” at the first moment That is my

feeling since I have conducted the final thesis

To get the value like that, I think I owe a debt of gratitude to people who have loved, cared, and supported me Therefore, I would like to express my first thanks

to parents for my present in life Thanks for their love, their teaching during my mature

I would like to express my thanks to Dr Jacques Martin who coaches me to complete the final thesis successfully His questions are the challenges for me to correct the orientation of the thesis

I would like to express my thanks to my sponsors - Ms Nguyen Thi Hong Thuy – Director of Viet Toan Phat Co., Ltd and Mr Nguyen Van Nam – Technical Expert of Viet Toan Phat Co., Ltd- who support me to conduct the survey in the hospital, provide the specific information and give the value advises in the healthcare sector

I would like to express my sincere thanks to my great master, PhD Nguyen Thi Bach Tuyet - Folk Music Artist, who has taught me the value methods to improve my performance in life

Last, I would like to express my thanks to Solvay program, all professors, coordinators and friends (Phan Vu An, Nguyen Thi Ngoc Le, Ngo Nguyen Thuy Phuong Thao) who give me the encouragements and the supports in my master journey

HCMC, May 15th, 2014

Ho Kim Ngan

1 Introduction of Nurse Calling System ……… …P11

2 Research Problem, Question, Objectives and Scope……….…P13

PART 1: LITERATURE REVIEW & RESEARCH FRAMEWORK …………P15

1 Technology Acceptance Model (TAM) ………P15

2 Framework for consumers’ intention to use Nurse Calling System P19

2.1 Categorization of Respondents………P19

2.2 Perceived Ease of Use……… P20 2.3 Perceived Credibility……… P21 2.4 Personal characteristics of consumers………P22 2.5 Framework of research……… P23

PART 2: METHODOLOGY AND RESEARCH DESIGN ………P24

1 Methodology ……… …P24

2 Questionnaire and Sampling ……….P25

3 Data Analysis Procedures ……… …P27

3.1 Descriptive statistics analysis……….P28 3.2 Data Examining and Reliability Test of the Measurement Variables.…P28

PART 3: ANALYSIS & DISCUSSION ………P29

1 Descriptive Analysis ……….P29

1.1 Demographic characteristics of Respondents……….…P29

1.2 Behavioral Characteristics of Respondents on Use……….…P32

CONCLUSION & RECOMMENDATIONS ……… P47 REFERENCE……….…P52 APPENDIX 1: QUESTIONAIRE……….P54 APPENDIX 2: DEVICE AND FUNCTION………P57 APPENDIX 3: CASE STUDY……… ……….P61

LIST OF ABBREVIATIONS

One Way ANOVA One Way Analysis of Variance

LIST OF FIGURES

Figure 1: Market share of Nurse Call System in Viet Nam ……… P12 Figure 2: Nurse call system capital yearly ……….P13 Figure 3: Thesis structure ……….P14 Figure 4: The Original TAM proposed by Fres Davis (Davis, 1986, p.24) ……P16 Figure 5: First modified version of TAM ……… P17 Figure 6: Final version of TAM ………P17 Figure 7: Research Framework ……… P23 Figure 8: Occupation and Treat Time ……… P30 Figure 9 : % Respondents Treatment in Hospitals ……… P30 Figure 10: Treatment time of 19% respondents said “NO” ……… P31 Figure 11: Diversity of Age & Gender ……… P31 Figure 12: Location Diversity ……….P32 Figure 13: Numbers of Hospital Used ………P33 Figure 14: Nurse Call System Used ………P34 Figure 15: Perceived Usefulness of Respondents ……….P41 Figure 16: Perceived Ease of Use of Respondents ……… P43 Figure 17: Perceived Credibility of Respondents……… P44

ABSTRACT

Purpose

– The purpose of the study is to present a new look of consumer’s

satisfaction in using Nurse Calling Device in Viet Nam

Design/Methodology/Approach

- The study is constructed base on Technology Acceptance Model (TAM) with additional factor that are Perceived Usefulness, Perceived Ease-of-Use and Perceived Creditability Paper questionnaire is distributed to consumers The selected respondents are categorized into the age and sex After reliability tests, in-depth analysis is conducted to understand factors affecting consumer’s use and independent sample t-tests are used to examine difference of demographic dimensions

Key Findings

- From 2007 to 2013, Government has planned to build general hospitals installed these devices in every province However, there is no research to study about consumer’s satisfaction until now This study attempts to choose an appropriate model to evaluate consumer decision in the device, evaluate factors affected to consumer intention to use these and contribute the understanding of consumer’s demand to improve the device in the future

Originality/Value

– The study provides the level of consumer’s satisfaction in using Nurse Calling System in Vietnam context However, the survey is only conducted in Ho Chi Minh City The result of the study may not cover all consumers’ level Therefore, the study will contribute to create a base for further study in the future

Key words – Nurse call system, Perceived Usefulness, Perceived Ease-To-Use, Perceived Creditability

INTRODUCTION:

1 Introduction of nurse call system:

Nurse call system is the system that ensures hospital staffs can quickly identify the location and level of the calls The system also provides the means that the patient can draw attention of a nurse from his bed whenever required The system has been applied in European countries for few decades

In Viet Nam, population growth is average 1.05%1 from 2011 to 2013 Until now, total population is 93 million Total hospital is about 1062 with nearly 100,000 doctors and nurses In below table 1, there is over 100 million times of visiting the hospitals in Viet Nam every year

Average days of inpatient day 113 113 Total doctors person 39,757 40,505 Total nurse & aid person 72,682 75,756 Times of inpatient treatment times 8,301,099 8,908,751 Times of visiting hospital times 98,806,044 103,844,948

Table 1 – General information in medical field in 2007 and 2008

Source: Ministry of Viet Nam healthcare, 2008

The figure shows that there is very high potential risk of medical errors for the patient because of the conflict between the increasing of diseases and limit medical employees Since 2006, Viet Nam government had planned a strategy to develop the hospital system with higher quality service

The signal leads to create a competitive game attracting some players such

as Commax (Korea), Ackerman (German), and Aiphone (Taiwan), Uniphone and

so on However, there is specific style for hospital projects in Viet Nam The product is only sold by the contractor that got the win in the tender In fact, the contractor joining in the tender has to match the basic requirement of experience, human resource capacity and financial capacity It means that the contractor has experienced at least 1 year to conduct the same project with at least amount of

650 million VND Resource capacity requires that the site supervisors have got engineer degree and experienced at least 3 years at the same position in the site

1 http://gso.gov.vn/

Financial capacity requires that the average margin profit has been matched at least 1.5 billion VND for 3 years continuously Actually, the requirement is a part to make a barrier for the contractors with limit capacity Therefore, contractor is rarely

to match the requirement and join in the tender That is the reason a contractor becomes a distributor of nurse call system product in Viet Nam market

In 2006, there are two players joining the game They are Viet Toan Phat Co., Ltd (VTP) and Danh Dang Co.,Ltd VTP was established to execute and provide nurse call systems (Ackerman and Commax) in the hospitals and shared the market from South to the centre Danh Dang only distributed Commax product in North

The figure 1 shows that Ackerman product shares 40% marketplace and leads

at the top In fact, Ackerman has been established since 1919 and developed in European market for a long term In the economic growth, the product has been conducted many phases of innovation about the design and the function to provide the better service to users Conversely, Commax has been established since 1974

in Korea The product is only developed in Asia market If comparing with European market, Commax development is lower

Figure 1 – Market share of Nurse Call System in Viet Nam

Source, Viet Toan Phat Co., Ltd, 2014

In addition, VTP has executed more 402 hospital projects until 2014 Among of them, French Vietnamese (FV) hospital is the first one installed Ackerman product

in Viet Nam In figure 2, based on the profitability yearly, Ackerman is shared over

2 http://viettoanphat.com.vn/

60% projects from 2010 and the trend is predicted to develop more in Viet Nam while Commax still keeps the same value

2006 2007 2008 2009 2010 2011 2012 2013 2014 Ackerman 150,256 152,045 156,004 172,212 176,645 184,952 195,423 204,145 210,040 Commax 119,985 125,005 136,147 146,852 154,520 156,201 158,201 158,456 160,142

50,000

Nurse Call Profitability Yearly

Figure 2: Nurse call system capital yearly

Source, Viet Toan Phat Co., Ltd, 2014

Finally, the growth of hospital contributes to create higher competitive advantage for nurse-call-system players It results a part of the impact to user’s behavior

2 Research problem, Question, Objectives and Scope:

2.1 Research problem:

There have been the researches to study nurse call system with different purpose However, the main aim is to provide the best service to prevent harms to the patients Moreover, the research was conducted in oversea Since 2007, nurse call system has been presented and developed in Viet Nam market and attracted some players with different level In addition, the device is installed in healthcare sector that is one of the government styles In the tender, the employer and contractors make a decision to select the product The seller cannot be presented Especially, there is no opportunity for the sellers to evaluate the user’s satisfaction directly The profit is only a measurement for their business in Viet Nam The benefit of consumer including hospital staffs and patients is not concerned in the game Especially, it is difficult for the seller or the manufacturer to set a strategy in Viet Nam

Therefore, the question has been called out “what are the opportunities to develop sustainable strategy in Viet Nam market?”

2.2 Research question:

Different nation is different culture The culture may be a factor to impact user’s behavior to the device In the game, the players are the employer, the contractor, the sub-contractor and the distributor or seller However, healthcare sector is very specific It creates a barrier for the sellers to develop the product

To understanding market opportunities, in the possibility, the study is addressed to find out the factors affecting patient’s satisfaction using the device The study is applied Technology Acceptance Model called TAM (Davis, 1985)

to evaluate the user’s behavior for the technical device The objectives of Usefulness and Ease to Use are implemented to study different user’s behavior and how demographic dimensions influence their behavior

The study is structured into 5 parts in Figure 3

Figure 3: Thesis structure

Part 3:

-Analysis -Discussion

Conclusion & Recommendation

PART 1: LITERATURE REVIEW & RESEARCH FRAMEWORK

The introduction has provided the background and problem area for this research In part 1, the theoretical framework that supports the purpose of this study will be presented

Undoubtedly, information technology contributes to develop standard living in every field in modern society From that, the concept of e- communication is appeared in healthcare sector It has been got the acceptance by users Especially, when people become patients, they place their trust in their health care providers and the role of information technology takes more important to provide safety benefits by enhancing communication and delivering decision-support (Barbara Van de Castle, Jeongeun Kim, Mavilde L.G Pedreira, Abel Paiva, William Goossen, David W Bates, 2004)

1 Technology Acceptance Model (TAM)

With growing technology needs in the 1970’s, and increasing failures of system adoption in organizations, predicting system use became an area of interest for many researchers However, most of the studies carried out failed to produce reliable measures that could explain system acceptance or rejection (Davis, 1989) In 1985, Fred Davis proposed Technology Acceptance Model (called TAM) in his doctoral thesis at MIT Sloan School of Management (Davis, 1985)

He proposed that system use a response explained or predicted by user motivation, which, in turn, is directly influenced by an external stimulus consisting

if the actual system features and capabilities

The Technology Acceptance Model (TAM) is an information systems theory stating how users come to accept and use a technology The model suggests that when users are presented with a new technology, a number of factors influence their decision about how and when they will use it

By relying on prior work by Fishbein and Ajzen (1975), who formulated the Theory of Reasoned Action (TRA), and other related research studies, Davis further refined his conceptual model to propose the Technology Acceptance

Model Both TRA and TAM that have strong behavioral elements assume that when someone forms an intention to act, that they will be free to act without limitation

In this proposal, Davis (1985) suggested that users’ motivation can be explained by three factors: Perceived Ease of Use (PEOU), Perceived Usefulness (PU) and Attitude Toward Using (ATU) the system He hypothesized that the attitude of user toward a system was a major determinant of whether the user will actually use or reject system The attitude of the user, in turn, was considered to be influenced by 2 major beliefs: Perceived Ease of Use and Perceived Usefulness, with perceived ease of use having a direct influence on perceived usefulness Finally, both these beliefs were hypothesized to be influenced by the system design characteristics, represented by X1, X2 and X3 in Figure 4

Figure 4: The Original TAM proposed by Fres Davis (Davis, 1986, p.24)

Later development of TAM would include behavioral intention as new variable that would be directly influenced by perceived usefulness of a system (Davis, Bagozzi and Warshaw, 1989) Davis et al (1989) suggested that there would be cases when, a given system which was perceived useful, an individual might form a strong behavioral intention to use the system without forming any attitude, this giving rise to a modified version of the TAM model as illustrated in Figure 5

Figure 5: First modified version of TAM (Davis, Bagozzi and Warshaw, 1989, p.985)

Davis, Bagozzi and Warshaw, (1989) used the above model to conduct a longitude study to measure the intention of 107 users to use system after 1 hour introduction system and again 14 weeks later In both cases, their results indicated a strong correlation between reported intention and self-reported system usage with perceived usefulness responsible for the greatest influence on the people’s intention However, Perceived Ease of Use was found to have a small but significant effect on behavioral intention that later subsided over time But the main finding was that both Perceived Usefulness and Perceived Ease of Use were found to have a direct influence on behavioral intention, thus eliminating the need for the attitude construct from model shown on Figure 5 The resultant model is shown in Figure 6

Figure 6 - Final version of TAM (Venkatesh & Davis, 1996, p.543) Thus, by eliminating the attitude construct and introducing the behavioral

intention construct, the result obtained for the direct influence of perceived usefulness on actual system use At the same time, removing the attitude variable eliminated any unexplained direct influence observed from system characteristics to attitude variable An additional change brought to the original TAM model, was the consideration if other factors, referred to as external variables that might influence the beliefs of a person towards a system External variables typically include system characteristics, user training, user participation in design and the nature of the implementation process (Vankatesh

& Davis, 1996)

By the final version in place, Chuttur M.Y (2009) urged that future research led

to replicate TAM and test its propositions and possible limitations; compare TAM with other models such as the Theory of Reasoned Action (TRA) and the Theory

of Planned Behavior (TPB); adapt TAM for the various setting such as mandatory scenarios, different applications, cultures In addition, future research led to extend the model including other variables such as subjective norm (SN), extrinsic motivation, and playfulness and so on

With more than 700 citations to Davis’s original proposal for TAM, Davis’s research (Davis, 1989) has been adapted and extended in many ways To date, there have been several attempts to consolidate the results obtained from these studies The most recent one is by Yousafzai, Foxall and Pallister (2007) who did meta-analysis of 145 articles publishing on TAM Table 2 highlights some main applications, participations, countries and setting for which TAM was used (Chuttur M.Y., 2009)

Table 2 - Applications, participants, country and setting used for applying TAM (Yousafzai

et al., 2007, Sharp, 2006, King et al., 2006, Ma et al, 2004, Lee et al 2003 and Legris et at.,

At the same view, Mikeal Rahmqvist (2001) argues that background factors such

as age, gender, health status are affected on the comparison of patient satisfaction and medical specialties Additionally, JL Campell, J Ramsay and J Green (2001) showed that the aspects of care quality are measured by patient’s evaluation Their work also studied that the patient characteristics such as age, gender, socioeconomic are variable to influence the result of the assessment of healthcare The different variation contributes to different response on the system use

Therefore, Respondents of the research is categorized two groups, age and gender It leads to different behavioral use of consumers The aim is to study what aspect of care quality is impacted by different characteristics By this categorization, study aims to clarify the understanding of 2 groups of respondents under 3 dimensions, Perceived Usefulness, Perceived Ease-of-Use and Perceived Creditability

2.2 Perceived Usefulness:

Perceived of Usefulness that is the first determinant of TAM (Davis, 1985) is defined “The degree to which an individual believes that using particular system would enhance or improve his or her job performance” Usefulness that is indicated on performance or productivity improvement refers to consumers’ perceptions regarding outcome of experience (Mosuwé et al., 2004) Besides, Usefulness is influenced by Ease-of-Use to determine consumers’ attitude toward using, because the easier a technology is to use, the more useful it can

be (Venkatesh, 2000; Dabholkar, 1996; Davis et al., 1989) Studies outside and within the consumer health informatics discipline have consistently found that perceived usefulness of a technology is associated with the acceptance of the technology This suggests that patients will be more likely to accept the technology if they believe that the technology is useful as it can convey health value or facilitate self-management (Calvin K L Or, Ben-Tzion Karsh, Dolores J Severtson, et al, 2011)

In this study, Perceived Usefulness is defines as a Physical Usefulness Physical Usefulness is the convenience and effectiveness brought when patients use Nurse Call System Warren J Winkelman, Kevin J Leonard and Peter G Rossos (2005) argued that there is a distinction for a patient from “look at” to

“use” to the health care device The way that the patient finds the trust to use the system depends on the physical feature and function of the system The integration between the patient and the system is expected to gain the performance and the value

Totally, nurse call system is believed to provide high quality of supportive health information for consumers People are expected to adapt the system physically including the effectiveness, productivity, performance and satisfaction

2.2 Perceived Ease of Use:

The second determinant of TAM (Davis, 1985) is Perceived Ease of Use which is “The degree to which an individual believes that using particular system would be free of physical and mental effort” Ease-of-Use is about the extent to

which a person believes that using new technology will be free of effort Whereas Usefulness referred to consumers’ perceptions regarding the outcome of the experience, Ease-of-Use refers to their perceptions regarding the process leading to the outcome In a simplified manner, it can be stated that Usefulness reflects how effective interaction on Nurse call system is helping consumers to accomplish their task with the best convenience, and Ease-of-Use is how easy the use of Nurse call system is This suggests that patients are more likely to accept Nurse call system and perceive the technology as useful if they feel that the technology is easy to use (Calvin K L Or, Ben-Tzion Karsh, Dolores J Severtson, et al, 2011)

According to TAM, the value of perceived ease-to-use is identified that patients become a little confused when using the system Their interaction with the system is easy to understand at the first introduction The hospital staffs could recover the errors easily during interacting with the system The easier and more effortless a technology is, the more likely consumers intend to use this technology These include differences in ease of use, usage convenience, reliability, ability to provide a record of the transaction, leverage potential, retailer acceptance and transaction speed ((Jackie L Boucher, 2010)

Finally, the research attempts to study the human perception of perceived ease to use through the interaction between the patient and the system easily The patient is expected to pay the effortlessness to perform their tasks

2.3 Perceived Credibility:

Bauer (1960) introduced the concept of perceived credibility in terms of the confidence and consequences associated with a consumer’s actions In addition, perceived credibility is the extent to which one partner believes that the other partner has the required expertise to perform the job effectively and reliably (Ganesan, 1994) According to Jacoby and Kaplan (1972), perceived credibility

is defined as the degree to which a user feels the certainty and pleasant consequences of using an electronic application service, when there is no financial risk, physical risk, functional risk, social risk, time-loss risk, opportunity cost risk, and information risk

Perceived Creditability is major factor affecting to human behavior to continue using of any new technology applications It refers to the 2 significant dimensions – design (safety) and data (care documentation) - that are identified across many studies as effecting user’s practice to adopt health information technology (Marianne Zachariah, Shobha Phansalkar, Hanna M Seidling, et al., 2011) Perceived risk in customer behavior research was introduced as any action of a consumer may lead to unpleasant consequences In other studies, perceived risk is the consumer’s expectation of suffering loss in pursuit of desired outcome With this definition, perceived risk is a multi-dimensional construct with overall risk that is divided into financial psychological, performance, physical and social loss, or risk of losing personal control (money, data and times) and system failure

Safety relates to the risk associated with the feature of health information system No one can refuse the role of risk in the decision to adopt new technology system Depending on different model, the risk level is defined differently In Nurse call system, all devices are connected through electrical signal Moreover, patient is a person touching directly on the devices Therefore, safety is the important credibility concerned

Besides, care documentation relates to the risk of the function of the system Data are expected to provide for suitable purpose To the new system, the error

is sometimes occurred due to the system failure or human knowledge It results the information is transferred wrong or missed It leads to reduce the satisfaction value Totally, care documentation refers to quick present in the patient room when making a call by nurse call system

As a summary, study will consider consumer awareness on safety and quick response

2.4 Personal characteristics of consumers:

Christian Homburg* and Annette Giering (2001) studied that personal characteristics influences the relationship between customer satisfaction and loyalty Besides, Lancaster (1966) noted that characteristics is the driver of

consumer utility or attributes The attributes are gender, age, nationality and so

on Triandis (1979) described characteristics as an individual’s positive or negative behavior towards innovation adaptation

TAM suggests that attitude is based on the salient beliefs that a person has about the consequences of a given behavior and his or her evaluation of those consequences Davis (1993) put forward that consumers’ characteristic toward technology system first associated with the direct possessions of relevant system features System features can be consumers’ characteristic of functional and utilitarian dimensions, like ease of use and usefulness (Menon & Kahn, 2002; Childers et al., 2001; Mathwick et al., 2001)

Finally, this study examines the different demographic factors including gender and age on three dimensions Perceived Usefulness, Perceived Ease of Use and Perceived Credibility

2.5 Framework of research:

For developing an in-depth understanding of consumer use of nurse call system, a framework built is based on the previous research on consumer adoption of new health technology services The core constructs of framework are adapted to Technology Acceptance Model by Davis (1989), an influential research model in the information systems field TAM constructs are used as

a basis for research framework

Based on review of literature, the theoretical framework for research are proposed as Figure 7 below

Figure 7: Research Framework

PART 2: METHODOLOGY AND RESEARCH DESIGN

1 Methodology:

1.1 Research design:

Research design is the framework where data are collected and analyzed in the study Burn and Bush (2006) indicated that there are 3 types including exploratory, descriptive and causal Exploratory is a step to find out the ideas Descriptive is to set a method to study the relationships among variables In the research framework, perceived usefulness, perceived ease of use and perceived credibility are independent variable, actual use of Nurse Call System is dependent variables Last, causal aims to define the relationship between the independent variables and dependent variable as a correlation study (Cooper and Schindler, 2003)

In the study, correlation research has been selected to figure out the appropriate answer to the research question The researcher uses co relational study to identify the existence of relationships between the variables and measure

a degree among them The findings will contributes to understand the factors affecting consumer satisfaction using Nurse Call System in the present as well as its barriers for further investigation

1.2 Research strategies:

A research design is a prediction of the consumer responses on large scale

As the result, the quantitative approach is applied It quantifies data and uses statistical analysis to fulfill the understanding of external causes that support to answer the questions The result from statistical method is reliable to decide which factors are affecting to consumers habits

1.3 Research approach:

There are two different research approaches: primary research, which data have not collected yet, and secondary research, which summary, collection of existing research This study is applied secondary research because data are obtained the information quickly and inexpensively, providing background information, identifying the concept, data, and terminology for primary research (Burn and Bush, 2006, p.159)

The research aims to study general circumstance of Nurse Call System in Viet Nam context The researcher gathers the information from existed patients in the hospitals Data are collected through questionnaire survey All participants conduct the survey by questionnaire paper They all are voluntary

List of key terms are developed such as “Technology Acceptance Model”,

“Nurse Call System”, “Patient satisfaction”, etc The sources and literature review include academy journals, books, Viet Toan Phat Co., Ltd In addition, the data is limit because the research is conducted in specific sector Therefore, the interview

of sponsors, experts, nurse and outpatients are conducted to get more information

to support the research

2 Questionnaire and Sampling:

The questionnaire consists of three sections The first section gathers the general information to classify gender, age and demographic information as external variables that influence the formulation of relevant perceptions The second asks consumers about the Perceived Usefulness, Perceived Credibility The third concentrates on Perceived Ease-of-Use In the second and third part, there are some questions for nurses or aid staff to get more information as expert’s idea Satisfaction is divided three levels: Agree; Disagree and Neural Question table:

Question 1 Q1 Demographic information Study how do external

variables affects the independent variables and dependent variable

Question 2 Q2 Demographic information

Question 3 Q3 Demographic information

Question 4 Q4 Demographic information

Question 5 Q5 Demographic information

Question 6 Q6 Demographic information

Question 7 Q7 Demographic information

Question 8 Q8 Perceived Usefulness Study how useful Nurse Call

System is to respondents

Q8 – Q11: patient Q14,17,18,19: nurse or aid staff

Question 9 Q9 Perceived Usefulness

Question 10 Q10 Perceived Usefulness

Question 11 Q11 Perceived Usefulness

Question 14 Q14 Perceived Usefulness

Question 17 Q17 Perceived Usefulness

Question 18 Q18 Perceived Usefulness

Question 19 Q19 Perceived Usefulness

Question 20 Q20 Perceived Ease-of-Use Study how easily Nurse Call

System is to respondents

Q21,22: patient

Q23,24: nurse or aid staff

Question 21 Q21 Perceived Ease-of-Use

Question 22 Q22 Perceived Ease-of-Use

Question 23 Q23 Perceived Ease-of-Use

Question 24 Q24 Perceived Ease-of-Use

The questions are piloted to identify whether they are understandable to the respondents and achievable to the objectives of the research A piloted questionnaire is first given to the professor, who is coaching for the project, to get his review Then, the questionnaire is translated a version into Vietnamese for Vietnamese patients to choose comfortable understanding Later, it is sent to 5 respondents to make sure their understanding ability of questionnaire as the pilot test Last, the questionnaire papers are sent to respondents in FV hospital, Binh Duong Columbia hospital, Thanh Do hospital and Hoan My hospital in Ho Chi Minh city Sample size is set minimum 100 Respondents are mainly patients Some nurses and technical expert are selected to join the survey to get more ideas to support the analysis of any aspect The survey is conducted on Ackerman product in French Vietnamese, Binh Duong Columbia and Thanh Do hospital and Commax on Hoan My Sai Gon hospital The difference is supported

to analyze demographic dimension affecting consumer’s use

3 Data Analysis Procedures

Descriptive analysis

-Demographic

-Corrected item to total correlation 0.3

Consumer response

-Perceived Usefullness -Perceived Ease of use -Perceived Credibility

Demographic analysis

-Gender -Age

3.1 Descriptive statistics analysis:

Descriptive statistics analysis has been used in order to figure out the characteristics and distribution of each variable, including its statistical significance, normal distribution, mean, variance and standard deviation of each research variables

3.2 Data Examining and Reliability Test of the Measurement Variables:

After collecting data survey, the researcher gains several insights into the characteristics of the data The aim is to attain basic understanding of data and relationships between variables and ensures that data underlying the analysis meet all requirements of analysis Frequency table, cross tabulation were used to detect missing, error, purify data before applying analysis technique

Cronbach's (alpha) is a coefficient of reliability It is commonly used as a measure of the internal consistency or reliability of a psychometric test score for a sample of examinees It helps to indicate and remove uncertain items or scale Theoretically, alpha varies from zero to 1, since it is the ratio of two variances Empirically, however, alpha can take on any value less than or equal to 1, including negative values, although only positive values make sense Higher values of alpha are more desirable Some professionals, as a rule of thumb, require a reliability of 0.70 or higher (obtained on a substantial sample) before use for other analysis For internal consistency measure, alpha higher than 0.8 is good, alpha in range 0.7 - 0.8 is acceptable In rare cases, researchers accepts alpha higher than 0.6, just use for new research concepts or new research circumstances (Nunnally, 1978; Peterson, 1994; Slater, 1995; Hoàng Tr ng and Chu Nguy n M ng Ng c, 2008)

In this study, required criteria are (1) Cronbach’s alpha higher than 0.7, (2) Corrected Item-Total Correlation higher than 0.3 Score is divided 3 levels – 1: Disagree, 2: Neutral, 3: Agree

PART 3: ANALYSIS AND DISCUSSION

This chapter consisted of 4 sections presents the characteristics of the

empirical research The first section is the descriptive analysis of the respondents including the demographic, behavioral attributes of the respondents, and the

results of the measurement variables The second section is the reliability tests of measurement scales that consist of the evaluations of the item-to-total correlation, and coefficient alpha (Cronbach’s alpha) The third section discusses on 3

dimensions, Perceived Usefulness - Perceived Ease-of-Use - Perceived

Creditability, which are factors affecting to consumer intention to use Nurse Call System The last section presents the result of independent sample to compare the difference base on hypothesis of demographics

1 Descriptive Analysis

1.1 Demographic characteristics of Respondents:

There are 162 respondents joined the survey Among of them, 131 respondents answered YES to confirm the use of Nurse Call System in the hospitals and 31 respondents answered NO The target of respondents is the answer of YES

Table 3 shows the cross tabulation between two variables “EVER USED NURSE CALL SYSTEM” and “OCCUPATION” The figure shows that the respondents saying YES, who are retirement, officer and business-man, share high percentage of use the device The respondents of housewife could be acceptable The respondents of other include nurses or aids that are considered

as the expert’s comment The respondents of self-employed are low Therefore, the samples of self-employed and other are detected on the analysis

Have you ever used Nurse Call System in hospital?

Table 3 – Cross Tabulation of EVER USED NURSE CALL SYSTEM & OCCUPATION

In addition, Figure 8 shows the relation between two variables selected: occupation and treatment time Based on data, most of respondents are treated within a week It is enough time for the respondents to touch the devices at least one times in the hospitals

Figure 8 – Occupation and Treat Time Figure 9 and 10 shows that the period of respondents saying NO are treated

in the hospital Most of them are treated less than 3 days They are self-employed

Figure 9 – % Respondents Treatment in Hospitals

Figure 10 – Treatment time of 19% respondents said “NO”

Figure 11 shows diversity of Age and Gender between the respondent selected when using Nurse Call System Among of these data, there is the difference of use between female 56.7% and male 43.2% At every age, females always use the device much more than male It is reasonable because female characteristic is carefulness and kindness They are worried about their health or their relative’s health Therefore, they expect to update the health information as soon as possible It results the use percentage of female is higher than male’s Besides, the age of 19-35 is shared the highest percentage on the use of Nurse Call System At the age, the respondents are young and dynamic to approach new technology

Figure 11 – Diversity of Age & Gender Figure 12 indicates the diversity of location between the respondents selected Most of respondents live in Ho Chi Minh city Others live in Binh Duong, a part