A Comparative Analysis of the 'Physician Attitudes and Intentions to use Telemedicine' (PAIT) Questionnaire Responses from General Practitioners in England and Sweden.

Oliver Engela Ras, Fredric Karlsson, Veronica Milos Nymberg, Miriam Pikkemaat, Gordon Taylor, Hans Thulesius, Michael Harris

Keywords: Telemedicine, general practitioners, theory of planned behaviour, intentions, attitudes, perceived behavioural control, subjective norms.

Background:

Although telemedicine grew rapidly during the COVID-19 pandemic, instruments to assess telemedicine usage and behavioural intentions are scarce. In Sweden, the “Physician Attitudes and Intentions to use Telemedicine” (PAIT) questionnaire was developed from the “Theory of Planned Behaviour” in 2019 and translated into English.

Research questions:

How do attitudes, behavioural intentions, and self-reported use of telemedicine compare between GPs in England and Sweden?

Method:

We compared survey data from 161 Swedish and 53 English GPs using exploratory factor analysis (EFA) and regression models.  PAIT has 33 items with 7-point Likert scale options ranging from “Strongly disagree” to “Strongly agree” examining three predictors of intentions: “Attitudes” (12 items), “Subjective Norms” (6 items), “Perceived Behavioural Control” (9 items), and “Intentions” (6 items) to use telemedicine; 22 items assess usage of telemedicine tools, general questions about telemedicine, training experience, free text comments, demographic and background questions.

Results:

Use of text communication was higher for English GPs (median 2 vs 1 for Swedish GPs, P<0.01); use of video and chronic disease monitoring was similar in both countries. Intentions to use telemedicine were lower in England than in Sweden (3.7 (SD 1.6), vs 4.8 (SD 1.7); P<0.001). For GPs in both countries, Attitudes and Perceived Behavioural Control had a significant effect on Intentions to use telemedicine according to linear regression models. The EFA showed that Attitudes for text usage was the strongest component in PAIT for English GPs, whilst Attitudes and Perceived Behavioural Control for video explained most variance in Swedish GPs. Chronic disease monitoring was a strong component in both countries.

Conclusions:

These findings provide insights into the similarities and differences between English and Swedish GPs' attitudes, behavioural intentions, and their use of telemedicine assessed by the PAIT questionnaire.

Points for discussion:

Why do behavioural intentions towards telemedicine vary between countries?

How do our findings compare with your personal experiences of telemedicine?

Would EGPRN members like to translate and adapt the PAIT questionnaire for their own countries

#49