Date of Award

Fall 12-12-2015

Document Type


Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Sewell, Jeanne

Second Advisor

MacMillan, Deborah

Third Advisor

Kitzmiller, Rebecca



The purpose of this study was to assess the computer-use attitudes among chronically ill adult primary care practice (PCP) patients. The goal was to examine the rate of portal personal health record (PHR) use of middle-aged and older adults, to evaluate the effectiveness of an educational intervention in improving PHR adoption, and to identify patients’ thoughts about the PHR. The quasi-experimental, pre-test/post-test design with a paired matched set was performed with a convenience sample of 50 subjects from a primary care group practice in Central Florida.

Participants were recruited on the day of their provider appointment. After participant’s consent was obtained, the Background and Computer Questionnaire was administered and the educational intervention completed. A four-week follow-up phone survey followed the educational intervention.

To evaluate the effectiveness of the educational intervention, the participants were pair matched, a technique that uses knowledge of participants’ characteristics such as age, gender, and ethnicity to form a comparison, or non-participant control group (Polit & Beck, 2012). Participants’ computer use comfort level increased significantly four weeks after the PHR educational intervention (Z = -1.668, p < .005). In addition, the amount of PHR use by the participant group (M = 1.08) was significantly higher as compared to the pair matched control group (M = 0.16), U = 735.5, p = .001. Analysis of the qualitative component indicated that patients are willing to use the PHR if their laboratory results are up-to-date and available for review.

Hands-on computer instructions are an effective method to increase PHR use among chronically ill adult PCP patients. Computer training and education promote and improve the overall computer use comfort level. Patients feel that the PHR is a valuable tool if their data are current and accessible.

Keywords: personal health record, patient portal, PHR adoption, computer education

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