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First published June 23, 2006 as JAMIA PrePrint; doi:10.1197/jamia.M2096
Journal of the American Medical Informatics Association 2006;13(5):567-572
© 2006 American Medical Informatics Association


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Submitted on March 7, 2006
Accepted on June 5, 2006

Attitudes Toward Handheld Decision Support: Development and Testing of a Scale to Assess Physician Attitudes about Handheld Computers with Decision Support

Midge N. Ray MSN, RN1*, Thomas K. Houston MD2, Feliciano B. Yu MD1, Nir Menachemi MD, MPH3, Richard S. Maisiak PhD1, Jeroan J. Allison MD, MS1, and Eta S. Berner EdD1

Affiliation of the authors: 1 University of Alabama at Birmingham, Birmingham, AL; 2 University of Alabama at Birmingham, Birmingham, AL; Deep South Center for Effectiveness Research, Birmingham Veterans Affairs Medical Center, Birmingham, AL; Birmingham Veterans Affairs Medical Center, Birmingham, AL ; 3 The Florida State University, College of Medicine, Tallahassee, FL

* To whom correspondence should be addressed.

Objective We developed and evaluated a rating scale, the Attitudes Toward Handheld Decision Support Software Scale (H-DSS), to assess physician attitudes about handheld decision support systems.

Design We conducted a prospective assessment of psychometric characteristics of the H-DSS including reliability, validity, and responsiveness. Participants were 82 Internal Medicine residents. A higher score on each of the 14 five-point Likert scale items reflected a more positive attitude about handheld DSS. The H-DSS score is the mean across the fourteen items. Attitudes toward the use of the handheld DSS were assessed prior to and six months after receiving the handheld device.

Statistics Cronbach's Alpha was used to assess internal consistency reliability. Pearson correlations were used to estimate and detect significant associations between scale scores and other measures (validity). Paired sample t-tests were used to test for changes in the mean attitude scale score (responsiveness) and for differences between groups.

Results Internal consistency reliability for the scale was a = 0.73. In testing validity, moderate correlations were noted between the attitude scale scores and self-reported PDA usage in the hospital (correlation coefficient = 0.55) and clinic (0.48), p < 0.05 for both. The scale was responsive, in that it detected the expected increase in scores between the two administrations (3.99 (s.d. = 0.35) vs. 4.08, (s.d. = 0.34), p < 0.005).

Conclusion Our evaluation showed that the H-DSS scale was reliable, valid and responsive. The scale can be used to guide future handheld DSS development and implementation.







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