Assessing Acceptance and Intention to Use of Home Telemonitoring Among Patients with Liver Cirrhosis: Development and Initial Psychometric Validation of a TAM-Based Questionnaire

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Background/Objectives: Liver cirrhosis (LC) is a major cause of morbidity and mortality requiring continuous monitoring and early recognition of clinical deterioration. Home telemonitoring is increasingly considered a supportive strategy for outpatient hepatology care; however, patient acceptance remains insufficiently characterized in Eastern Europe, and no validated instrument currently exists for this population. This study aimed to develop and provide the initial psychometric validation of a Technology Acceptance Model (TAM)-based questionnaire assessing acceptance of home telemonitoring among patients with LC. Methods: In this prospective cross-sectional study, 130 adult patients with LC (Child–Pugh A/B/C) were enrolled. A 25-item questionnaire, including 13 Likert-scale items mapped to Perceived Usefulness (PU), Perceived Ease of Use (PEU), and Intention to Use (ITU), was administered under supervision. Psychometric evaluation included internal consistency, exploratory and confirmatory factor analyses, structural equation modelling (SEM), convergent and discriminant validity, and known-groups validity. Results: Internal consistency was excellent (Cronbach’s α = 0.934; McDonald’s ω = 0.950). EFA identified a 2-factor structure explaining 77.9% of the variance, whereas CFA supported the theoretically driven 3-factor TAM, which showed improved incremental fit (CFI = 0.927; TLI = 0.908) and was retained on theoretical grounds. SEM confirmed the TAM pathway, with PU strongly predicting ITU (β = 0.823, p < 0.001), whereas PEU significantly influenced PU (β = 0.343, p < 0.001) but not ITU directly. The model explained 69.5% of the variance in ITU. Known-groups validity was supported across digital access, IT comfort, education level, and disease severity. Patients with advanced cirrhosis and lower digital confidence showed lower acceptance scores. Conclusions: The proposed 13-item Likert scale demonstrated good initial psychometric performance and may represent a useful tool for assessing telemonitoring acceptance and readiness for digital monitoring among patients with LC. Pending further multicentre validation and assessment of predictive validity, the instrument may support identification of patients requiring additional support for successful telemonitoring adoption.

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