Date of Award

August 2022

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Julia Snethen

Committee Members

Seok Hyun Gwon, Julie Ellis, Priya Nambisan

Abstract

Technology is rapidly being implemented into healthcare. The electronic personal health record (ePHR) has been implemented to improve health outcomes, patient engagement, self-management of chronic disease, and decrease cost of healthcare. Research has examined the impact on older adult’s ePHR use, and which characteristics influence an older adult’s willingness to use the ePHR. However, there is little evidence to describe facilitators and barriers, and the hypothesized consequences. A correlational design with a convenience sample of older adults (n = 210). Measures included a self-reported survey, adapted U.S.A.B.I.L.I.T.Y. survey, Geriatric Depression Scale: Short Form, UCLA Loneliness Scale, and an observation checklist. Descriptive statistics, frequency distributions, Pearson r and standard multiple regression used for data analysis. Multiple regression analysis for the dependent variable of intent to use indicates the overall model explains 70.3% of the total variance in older adults’ intent to use ePHR (F (7, 200) = 67.6, p <.001). User experience (β = .50, p <.001) and perceived control (β = .367, p <.001) were statistically significant predictors on older adult’s intent to use ePHRs. Multiple regression analysis for the dependent variable of performance indicates the overall model explains 26.3% of the total variance in older adult’s performance with ePHR (F (7, 49) = 2.5, p <.028). The measure of depression was statistically significant in predicting older adults’ performance with ePHRs (β = .32, p <.037). This study identified several facilitators and barriers to older adults’ intent to use and performance with electronic personal health records (ePHRs). Understanding facilitators and barriers to ePHR use could inform healthcare progress. Further research is needed to identify the influence of depression and loneliness on older adults’ intent to use and performance with ePHRs.

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