Greener Journal of Medical Sciences

Excellence and Timeliness


Choose Language

Alkhatlan et al

Greener Journal of  Medical Sciences Vol. 6 (1), pp. 018-024, March 2016.

 ISSN: 2276-7797 © 2015 Greener Journals

Research Paper

Manuscript Number: 021716040



Knowledge, Attitude and Practice of Primary Health Care Providers Regarding E-health: A Validation Study


Alkhatlan H1, Almutairi B2, El-Shazly M3*


1,2Ph.D,Department of Medical Records, College of Health Sciences, The public Authority of Applied Training and Education, Kuwait.

3MD, Department of Medical Statistics, Medical Research Institute, Alexandria University, Egypt. &

Department of Planning, Ministry of Health, Kuwait.


Background:E-health refers to internet-based health care and information delivery and seeks to improvehealth service locally, regionally and worldwide. Health care providers must be equipped with the necessary knowledge, training and experience. We developed a questionnaire to obtain information from the physicians and nurses on various aspects of e-health.


Objectives:The aim of this study was to test the reliability and validity of this questionnaire to evaluate knowledge,attitude and practice of physicians and nurses towards e-health.


Methods: This study was carried out in Al-Sabah general hospital on 22 physicians and 20 nurses who were asked to complete a self-administered close-ended questionnaire that included 3 main aspects relevant to e-health, namely Knowledge, attitude, and practice. Each domain consisted of a number of questions (items). Test-retest reliability was tested by Spearman’s correlation coefficients. To evaluate for internal consistency, parity co-variances were used to estimate Cronbach’ alpha.Discrimination between participant groups (physicians and nurses) was tested by Mann-Whitney test. Spearman’s correlation was utilized to test the correlations between different domains to evaluate the convergent validity.


Results: Test re-test reliability of the questionnaire revealed that all scales were reliable, with significant strong correlation for overall knowledge score (r = 0.89), and overall attitude score (r = 0.80) and intermediate significant correlation for practice score (r = 0.46). Testing the internal consistency revealed that coefficients of Cronbach’sa were ≥ 0.80 for all domains except for items of participants’ attitude towards themselves (0.77) and practice (0.74).Overall, the scales of the questionnaire could discriminate between physicians and nurses with higher scores among physicians than nurses. Within each studied aspect, the scores of different domains in the questionnaire were positively correlated with each other significantly.


Conclusion: The questionnaire was reliable and valid for assessing knowledge, attitude and practice of e-health among health care providers.


Keywords: Questionnaire, validation, e-health


Short title: Validation of ane-health questionnaire.

Post-review Rundown

View/get involved, click [Post-Review Page]


Austin C. and Boxerman S. (2003): Information systems for healthcare management (6th ed.). Chicago: Health Administration Press.


Cashen M., Dykes P., Gerber, B. (2004): eHealth technology and internet resources: Barriers for vulnerable populations. J CardiovascNurs; 19(3), 209-17.


Croker L. and Algina J. (1986): Introduction to classical and modern test theory. Fort Worth Harcourt Brace Jovanovich College Publisher, Philadelphia: page 216.


Cronbach LJ. (1951): Coefficient alpha and the internal structure of tests. Psychometrika; 22: 293-6.


Deluca J. and Enmark R. (2000): E-health: The changing model of healthcare. Front Health Serv Manage; 17(1), 3-15. 


Ernstmann N., Ommen O., Neumann M., Hammer A., Voltz R., Pfaff H. (2009): Primary care physician's attitude towards the German e-health card project-determinants and implications. J Med Syst; 33(3):181-8.


Eysenbach G. (2001): What is e-health? J Med Internet Res; 3(2):E20.


Finlay AY. and Khan GK. Dermatology Life Quality Index (DLQI) - a simple practical measure for routine clinical use. ClinExpDermato 1994; 19: 210-6.


George JT., Rozario KS., Abraham A.(2007): A survey in India of doctors' knowledge, attitudes and practice regarding telemedicine and e-health. J TelemedTelecare; 13(6):322-9.


Glinkowski W., Pawłowska K., Kozłowska L. (2013): Telehealth and telenursing perception and knowledge among university students of nursing in Poland. Telemed J E Health; 19(7):523-9.


Gour N. and Srivastava D. (2010): Knowledge of computer among healthcare professionals of India: a key toward e-health. Telemed J E Health; 16(9): 957-62.


Hannan TJ.and Celia C. 2013: Are doctors the structural weakness in the e-health building? Intern Med J; 43(10): 1155-64.


Harrison JP., Nolin J., Suero E. (2004): The effect of case management on U.S. hospitals. Nurs Econ; 22(2): 64-71.


Katzman EM. (1989): Nurses' and physicians' perceptions of nursing authority. J Prof Nurs; 5(4): 208-14.


Kwankam S. (2004). What e-Health can offer. World Health Organization: Bull World Health Organ; 82(10): 800-2.


Morgan M., McCreedy R., Simpson J., Hay RJ. (1997): Dermatology quality of life scales – a measure of the impact of skin diseases. Br J Dermatol; 136: 202-6.


Ramsey C., Ormsby S., Marsh T. (2001): Performance-improvements strategies can reduce costs. HealthcFinanc Manage. Suppl.: 2-6. 


Siegle S (ed). (1957): Nonparametric statistics for the behavioral science. McGraw-Hill Book Company. New York Toronto London: pages 75-82, 116-26, 184-92.


United Nations (2000): UN Millennium Development Goals (MDG). New York


Weiner JP. (2012): Doctor-patient communication in the e-health era. Isr J Health Policy Res. 28;1(1):33.


Weiner JP., Yeh S., Blumenthal D. (2013): The impact of health information technology and e-health on the future demand for physician services. Health Aff (Millwood); 32(11):1998-2004.


WHO (1997): Health-for-all policy in the 21st century. Geneva.


WHO (2005): eHealth. World Health Assembly resolution A58/A/Conf.Paper No.13. Geneva.


Zikmund WG. Business research methods. 7thedn Thompson South-Western: Ohio.2003.

Call for Papers/Books/Thesis

Call for Scholarly Articles

Authors from around the world are invited to send scholary articles that suits the scope of this journal. The journal is currently open to submissions and will process and publish articles monthly in two yearly issues.

The journal is centered on quality and goes about its processes in a very timely fashion. Seasoned editors/reviewers will be consulted to review each article(s), profer quality evaluations and polish the articles with expertise before publication.

Simply send your article(s) as an e-mail attachment to or

Call for Books

You are also invited to submit your books for online or print publication. We publish books related to all academic subject areas.    Submit as an e-mail attachment to


Login Form

Other Journals