TECHNOSTRESS IN HEALTHCARE: A MULTI-METHOD INVESTIGATION
Califf, Christopher B.
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Healthcare information technology (HIT) is regarded as a way to improve the quality of patient care in hospitals. Care providers worldwide are now reporting instances of psychological stress induced by HIT, also known as “technostress." IS researchers have established a valuable research program on which to study technostress and its impacts on care providers and subsequently on hospitals. In this dissertation, I investigate technostress in the context of hospitals through the perspective of registered nurses. Overall, the dissertation is comprised of three essays and subscribes to a mixed-methods approach. The first essay is a qualitative, interpretive case study in which I develop a novel theory of technostress that takes a transactional approach using dialectic theory as its philosophical core. Based on an analysis of interview data, I uncover several dialectics that relate to nurses’ appraisals of an EHR system, and in doing so, highlight the potential of HIT to be cognitively appraised in both positive and negative forms of psychological technostress (e.g., techno-eustress and techno-distress). Technostress is thus reframed as a relational concept dependent on the meaning an individual ascribes to his or her environment. In the second essay, I introduce and empirically validate a novel framework of technostress that places the perception of technology-induced stressful situations—techno-eustress and techno-distress—at the heart of technostress. Based on an analysis of survey data from nurses in the United States, I investigate the effects of technology characteristics and technostress creators on techno-eustress and techno-distress, the impact of techno-eustress and techno-distress on job satisfaction and turnover intention, and the direct effects of three organizational mechanisms—involvement facilitation, literacy facilitation, and technical support—on techno-eustress and techno-distress. In the third essay, I study how technostress and its outcomes are similar and different in three culturally diverse nations: India, Germany, and the United States. Using survey data provided by registered nurses in the three countries, I compare the perceptions of five techno-stressors and their relationships with techno-distress, job satisfaction, and turnover intention, as well as the moderating impact of each country on the relationships. Contributions to research and practice are also discussed within each essay.