title: The Usage Behavior and Intention Stability of Nurses: An Empirical Study of a Nursing Information System.
abstract: BACKGROUND
  Many prior studies of technology adoption treat user intention as the single predictor of actual usage behavior. However, as many researchers of behavioral science have pointed out, multiple factors mediate the relationship between user intention and usage behavior.
  
  
  OBJECTIVE
  The present article explores the factors that mediate the relationship between intention and actual behavior. We develop a conceptual framework that is based on the Technology Acceptance Model III and behavior theory to further elicit system usage behavior and to confirm "intention stability" and "past experience" as two significant mediating factors in this relationship.
  
  
  METHODS
  The target system was a nursing information system that had been recently adopted by a medical center in central Taiwan. Data were collected using a questionnaire survey conducted in two rounds. Two hundred forty-five valid questionnaires were returned (response rate: 49%). Mediated moderation was analyzed to explore the presence of mediators or moderators between intention and behavior.
  
  
  RESULTS
  The results support that intention stability is a mediated moderator and that prior experience is a moderator of the relationship between intention and behavior. These two factors increased by over 13.6% the explanatory power of intention on actual behavior. Furthermore, this study expanded the scope of prior research by confirming intention stability as a moderating variable between intention and behavior. Finally, this study identified the moderating effect of past experience on the intention-behavior relationship, indicating that past experience enhances the predictive power of intention on behavior.
  
  
  CONCLUSIONS
  The findings of this study may assist hospital managers to better understand the nursing information system usage behaviors of nursing staff and to develop ways to enhance the intention stability of these staff. Managers may improve the familiarity of nursing staff with the system by increasing their system-related practice time. More experience should enhance staff system skills and resolve problems such as the need for extra work hours or overtime because of initial system unfamiliarity. Improved work efficiency should then allow nurses to divert more time from administrative work to patient care and training. This positive circle of support is expected to increase the willingness of nurses to accept and take advantage of the system.
authors.affiliation: 1PhD, Assistant Professor, Department of Industrial Management and Institute of Health Industry Management, National Yunlin University of Science and Technology 2PhD, Assistant Professor, Department of Healthcare Management, University of Kang Ning 3PhD, Professor, Department of Information Management, Chang Gung University 4PhD, Associate Professor, Department of Information Management, National Chung Cheng University 5PhD Candidate, Group Leader, Department of Information Management, St. Joseph Hospital 6PhD, Assistant Professor, Department of Healthcare Management, University of Kang Ning.
authors.forename: I-Chun
authors.initials: IC
authors.lastname: Lin
authors.forename: Chihung
authors.initials: C
authors.lastname: Lin
authors.forename: Chien-Lung
authors.initials: CL
authors.lastname: Hsu
authors.forename: Jinsheng
authors.initials: J
authors.lastname: Roan
authors.forename: Jehn-Shan
authors.initials: JS
authors.lastname: Yeh
authors.forename: Yu-Han
authors.initials: YH
authors.lastname: Cheng
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D048108:Nursing Informatics / Q000706:statistics & numerical data*; D009741:Nursing Staff, Hospital / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013624:Taiwan; D013997:Time Factors; D014584:User-Computer Interface