Predictors of digital health technology adoption among nurses at public hospitals in Bangladesh

Abstract

Background: Digitalizing the healthcare system presents significant challenges in nations like Bangladesh, where resources are extremely limited and there is a general hesitancy in technology adoption. The study aimed to assess the status of digital technology (DT) adoption among nurses in public hospitals across Bangladesh and to identify its predictors using the theory of planned behavior (TPB).

Methods: A cross-sectional study using a mixed-methods design was conducted in three levels of Bangladeshi hospitals during the first half of 2025. Quantitative data were gathered from 380 randomly selected nurses through face-to-face interviews. Qualitative data were collected via 16 in-depth interviews (IDIs) and 4 focus group discussions (FGDs)with various stakeholders.

Results: More than 80% of the surveyed nurses were female and Muslim, with a mean age of 39.1 years; 71.1% worked in a tertiary-level hospital. More than half of the nurses demonstrated poor knowledge (56.3%), attitude (54.2%), and practice (54.5%) regarding DT adoption, and 46.4% reported poor self-control. Statistical analysis using hierarchical regression and pathway analysis revealed that knowledge, attitude, motivation, and self-control had significant positive effects on DT practices (p<0.05). Key barriers to DT adoption included poor attitudes of nurses, inadequate organizational support, and a lack of policy-level emphasis on digital health. The poor capacity of nurses to adopt DT and inadequate logistics hindered services.

Conclusion: An integrated approach is essential to build nurses' capacity for DT adoption. Implementing a robust digital health policy and ensuring technology adoption at the user level is crucial for digital transformation in public healthcare settings.