Abstract
BACKGROUND: Continuance utilization of rehabilitation services among children with disabilities is not optimal. However, little is known about the factors that influence whether rehabilitation is continued. Therefore, a cross-sectional study was conducted in a sample of family caregivers in China to explore the relationship between perceived rehabilitation benefit, expectation, satisfaction, self-efficacy, continuance intention and continuance behavior. METHODS: A total of 368 family caregivers of children with disabilities were recruited from rehabilitation institutions through the convenience sampling method in Shanghai and Kunshan, China. We developed a research model that drives continuance utilization of rehabilitation services and proposed 13 research hypotheses based on the Expectation Disconfirmation Theory (EDT) and the extended Expectation-Conformation Model of Information System Continuance (extended ECM-ISC model). A structure equation model was built to test the hypotheses. RESULTS: Among the 13 research hypotheses we proposed, 11 of them were supported. The results suggest that family caregivers' continuance intention of taking children with disabilities for rehabilitation services was associated with their continuance behavior. Satisfaction and self-efficacy were associated with continuance intention. Perceived rehabilitation benefit and expectation were associated with satisfaction. Expectation was associated with perceived rehabilitation benefit. Furthermore, we found that perceived rehabilitation benefit was positively associated with continuance behavior from three different paths, whereas expectation had an indirect correlation with continuance behavior via the sequential mediation variables of satisfaction and continuance intention. In addition, satisfaction and self-efficacy were found to have a significant indirect correlation with continuance behavior via continuance intention. CONCLUSIONS: Based on these findings, improvements in perceived rehabilitation benefit, expectation, self-efficacy, satisfaction, and continuance intention are the important issues contributing to the enhancement of continuance utilization of rehabilitation services among children with disabilities.