Technology Adoption by Professional Caregivers

Abstract

Purpose. Technology acceptance is one of the most intense topics of discussion in the information system literature. We will refer to the state of the art of the theory of technology adoption (2021 onwards), particularly to the refinements and the critiques to the Technology Adoption Model (Davis, 1989), often referred as TAM. The core of the theory went unchanged for the decades: the emphasis is put on the perception of the potential user which would base its decision of accepting or rejecting a technology starting from the a) perceived usefulness and b) the perceived is of use. Developed from the TAM, The Unified Theory of Acceptance and Use of the Technology (UTAUT, Venkatesh, 2003) is one of the most widely cited theory. Along the perceived usefulness and ease of use, it introduces new contextual moderating variables, increasing its reliability. However, we will work with UTAUT adapted to the care sector by Wutz et al (2023). UTAUT2 per se has been developed in the context of adult working population, while the health care sector has its own idiosyncrasies and the post-working population its own market segmentation (Venkatesch, 2012; Golant 2017) Moreover, we will refer here to the Hofstede’s cultural dimensions which have a direct effect on technology acceptance. Latest research shows that there is a direct, moderating, and mediating role of cultural dimensions in technology acceptance models (Jan et al, 2022; Metallo et al, 2022). In the case of care organizations, the following three factors have a direct effect on the technology acceptance within the organization: Uncertainty avoidance, Individualism and Power Distance. It was shown that Uncertainty Avoidance is the best predictor for Perceived Ease of Use (Effort Expectancy) and has a positive effect. In cultures such as Portugal, users will try to avoid risk more than in Danmark. Individualism and Power Distance are best predictors of Behavioral Intension (Intension to use). Where is a higher degree of individualism, the intention to use is expected to be lower - When individualism is high, there is more to overcome for employees to use new technology.  Higher the Power Distance, higher the intension to use within care organization. In countries with high Power distance (i.e. Portugal), with the strong support of senior management, employees will be more likely to use the new technology.

Method. We have undertaken a qualitative approach to UTAUT and inquired into professional caregivers’ perceptions in 3 countries: Denmark, Portugal and Romania, though interviews and testimonials of those 10 involved.   

Results and Discussion Gender as a moderator. We argue in favor of mainstreaming gender in technology adoption needs and analysis because the care sector is overwhelmingly womenized. When senior management are men, performance expectancy matter most than effort expectancy. Women tend to give less emphasis on perceived usefulness and are inclined to adopt technology that requires little or no effort and, thus, they tend to emphasise perceived ease of use (A4A Field Work, 2024; Srite and Karahanna). Age as a moderator. Most of the PCPs were between 45-54 years old, one very young and one older. The large majority has more than 10 years’ experience as care provider. According to the interviews, those who are younger, would engage with the A4A Solution easier: they felt that their stress is reduced, while for the person aged between 55-65 yrs old, the stress is not reduced at all. Similar, except for the person aged between 55 and 65, everyone sees in the adoption of A4A Solution a more efficient time spending within the organization, time to feel more relaxed (less accidents, less emergencies), peace of mind and scaling up. Cultural factors as moderators. A) Uncertainty avoidance: It is emblematic how Denmark (which scores 23 points at Uncertainty Avoidance) perceived A4A Solution comparative to Romania, which scores 99 (Jan et al, 2024). PCPs from Denmark would try to adapt the Solution to their needs, put things in perspective and an emphasis on learning. The 2 PCPs from Romania or those from Portugal, tend to see if the A4A Solution is fit to their needs and show lower availability into making this work – extra effort. However, all PCPs supported tested but the perseverance, diligence and stubbornness would vary. It is relevant to notice that the willingness to involve into testing is common only to large businesses because small PCP businesses are already exhausted. In conclusion, based on the country of origin, the PCPs would risk to put effort for gaining efficiency, and therefore Effort expectancy stays as a cultural factor. Power Distance. In countries with high Power distance (i.e. Romania and Portugal), with the strong support of senior management, employees will be more likely to use the new technology. Hindering factors Our findings also show that PCPs in Portugal worried about efficiency and implementation. In Romania, it has been thoroughly discussed in the pre-recruitment stage that PCPs on the field do not have technology literacy and monitoring would be another task which is not in the job description. Moreover, taken data-based decision would require a legislative change in the job description. Comparatively, in Denmark, technology is part of the job and, therefore, the openness is higher.