Page 159 - Exploring the Potential of Self-Monitoring Kidney Function After Transplantation - Céline van Lint

considered as the main predictor of behavioural intention, whereas a less important factor is people’s affective response towards the system. In our study, however, the behavioural intention to start or to continue using the SMSS was very strongly related to patients affect towards the SMSS[29], with affect being represented by items that asked patients whether they considered using the ADMIRE system to be pleasant and whether it gave them peace of mind. Our diverging finding may be explained by the fact that the expected additional burden of self-monitoring after kidney transplantation was the main reason for patients to decline participation in the first place. This is different to what happens when an entire organization implements a new technology that replaces the old one, a situation where the TAM and UTAUT have traditionally been used to study user acceptance. When people are ‘free’ to choose whether to use a system or not, their affect towards the pertaining system may become much more important. Comments made by patients in the interviews at the end of participation confirm the role of affect in behavioural intention, especially the feelings of being safe. The majority of interviewed patients (75%) indicated that, if possible, they would have liked to continue using the SMSS beyond the first year post-transplantation as it gave them a feeling of safety. We do, however, need to take into account that patients were asked to evaluate the SMSS as a whole, including the measurement devices, eLearning, online personal health record and feedback system, while patients might have held different attitudes and feelings towards the various components of the SMSS. This could have influenced our findings. For example, logging of eLearning usage showed that intervention patients made very little use of the eLearning modules. More than 50% of the intervention patients had never used the eLearning modules or spent less than one minute looking at it. As patients knew they would also receive a live instruction, they may have considered using the eLearning as too much effort, especially given the timing: recipients of a living donor kidney were requested to look at the eLearning modules in the week(s) prior to their transplantation when they may have been more occupied with their upcoming surgery than with preparing for self-monitoring. This may suggest that effort expectancy instead of affect was the main factor contributing to the intention (not) to use the eLearning. For future studies, it would therefore be interesting to study whether the role of affect, effort expectancy and other factors of TAM and UTAUT is different for the various components of an SMSS.
The ADMIRE project was a cooperation between the Leiden University Medical Centre, the Technical University of Delft and TNO. Supported by the expertise of the TU Delft and TNO, different studies have been performed to investigate patients preferences for the interface design to optimize the acceptance of future SMSSs[33]. The results of these studies suggest that a patients’ preference is influenced by his level of experience with being a transplant patient (i.e. time since transplantation)
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