Factors associated with nurses' user resistance to change of electronic health record systems

Younghee Cho, Mihui Kim, Mona Choi

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: Electronic health record (EHR) systems often face user resistance in hospitals, which results in a failure to acquire their full benefits. To implement the EHR successfully, it is crucial to reduce nurses’ resistance to use the system. This study aimed to investigate the factors associated with nurses’ resistance to use the EHR system. Methods: A descriptive correlational study was conducted with nurses working at four university hospitals in Korea using self-administered questionnaires to measure user resistance behavior, resistance to change, perceived usefulness, perceived ease of use, perceived value, colleagues’ opinions, self-efficacy for change, and organizational support for change. Path analysis was performed to examine direct and indirect association with user resistance behavior. Results: A total of 223 nurses completed the questionnaires. All seven factors were found to be significantly associated with user resistance, either directly or indirectly. The total effect on user resistance behavior was highest in resistance to change (0.65), followed by perceived usefulness (− 0.33); both had direct but no indirect effects. Conversely, self-efficacy for change (− 0.25), perceived value (− 0.21), colleagues’ opinions (− 0.16), perceived ease of use (− 0.16), and organizational support for change (− 0.05) had indirect but no direct effects. Conclusions: The study examined the factors associated with nurses’ user resistance behavior after the implementation of a new EHR system. These findings could help hospitals develop better EHR implementation strategies to reduce user resistance behavior among the nursing staff.

Original languageEnglish
Article number218
JournalBMC Medical Informatics and Decision Making
Issue number1
Publication statusPublished - 2021 Dec

Bibliographical note

Funding Information:
This work is supported by the 2019 Faculty-Student Research Fund granted by the College of Nursing of Yonsei University. Mihui Kim received a scholarship from Brain Korea 21 FOUR Project funded by National Research Foundation (NRF) of Korea, Yonsei University College of Nursing.

Publisher Copyright:
© 2021, The Author(s).

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Health Informatics


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