title: Validation of a nurses' views on electronic medical record systems (EMR) questionnaire in Turkish health system.
abstract: Using of EMR in health services and organizations is steadily increasing for quality improvement, cost effectiveness and performance development. However, no validated national and international instruments (scale, questionnaire, index, and inventory) have assessed the effectiveness, satisfaction, health care savings, patient safety and cost minimization of electronic medical and health systems from the viewpoint and perceptions of nurses in Turkish health services. The perceptions of health care professionals especially physicians and nurses can contribute important information that may predict their acceptance of EMR and desired mode of use for EMR, evaluation performance of EMR thus guiding EMR implementation in hospitals. This article is a report of validation of the instrument to measure nurses' views on the use, quality and user satisfaction with EMR in Turkish health system. Items in the questionnaire were designed and obtained following O.G. Otieno, H. Toyama, M. Asonuma, M. Kanai-Pak, K. Naitoh's questionnaire about Use, Quality and User Satisfaction with EMR systems. Reliability and validity were examined and investigated in terms of responses from 487 nurses from one education hospital in Ankara, Turkey. This study was planned and conducted at a university hospital. The validation process was based on construct validity in this study. The response rate was 74.92%. Cronbach's alphas of three factors (use, quality and satisfaction of EMR) ranged from 0.78 to 0.94. Goodness-of-fit indices from the confirmatory factor analysis showed a reasonable model fit. Results of confirmatory factor analysis showed that χ2 statistic indicated significant result (p < 0.001) and model fit was acceptable according to relative χ2 statistic (χ2/df = 2.8 < 5). Further validation of the instrument could yield positive results in health systems in the different countries. Also further validation and reliability studies could be planned on physicians and other health professionals.
authors.affiliation: Faculty of Economics and Administrative Sciences, Department of Health Care Management, Hacettepe University, Ankara, Turkey, mtop@hacettepe.edu.tr.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Top
authors.forename: Ali
authors.initials: A
authors.lastname: Yilmaz
authors.forename: Erdem
authors.initials: E
authors.lastname: Karabulut
authors.forename: Ochieng George
authors.initials: OG
authors.lastname: Otieno
authors.forename: Melahat
authors.initials: M
authors.lastname: Saylam
authors.forename: Sevgi
authors.initials: S
authors.lastname: Bakır
authors.forename: Sümbül
authors.initials: S
authors.lastname: Top
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003627:Data Interpretation, Statistical; D057286:Electronic Health Records / Q000458:organization & administration / Q000592:standards*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008490:Medical Informatics / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000523:psychology*; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014421:Turkey; D055815:Young Adult