JMIR Publications

ABSTRACT

Background:

There is no validated, context-adapted instrument in Kazakhstan for assessing the usability and effectiveness of telemedicine services among physicians. Existing international tools (TUQ, MAST) require linguistic, cultural, and methodological adaptation to ensure their proper application in the national context.

Objective:

To develop and validate TUQ-MAST-KZ, an adapted Kazakhstani version of the TUQ-MAST questionnaire, for evaluating the usability and perceived effectiveness of telemedicine services among physicians.

Methods:

A multiphase cross-sectional study was conducted, including a literature review, expert content validity assessment, linguistic and cultural adaptation, and pilot testing. An online survey (Google Forms) was administered to 156 physicians from urban and rural medical institutions in Kazakhstan (including polyclinics, hospitals, medical universities, and health authorities). Participants represented various specialties: general practitioners, surgeons, pediatricians, nephrologists, cardiologists, anesthesiologists, and others. Primary outcomes included Cronbach's alpha for internal consistency and expert evaluation of content validity; secondary outcomes focused on participant feedback regarding the clarity and practical use of the questionnaire.

Results:

The adapted TUQ-MAST-KZ questionnaire consists of 27 items organized into 7 thematic domains, reflecting a multidimensional approach to telemedicine assessment. Of these, 11 items are evaluated using a Likert scale, while the remaining 16 are dichotomous or open-ended, addressing organizational and systemic factors such as leadership support, regulatory barriers, and infrastructure. The Cronbach's alpha was 0.93, indicating excellent internal consistency. Expert review confirmed the relevance and clarity of all items. Respondents noted the clear structure, readability, and practical applicability of the questionnaire. Including questions on systemic aspects helped identify key factors influencing the implementation of telemedicine.

Conclusions:

TUQ-MAST-KZ is the first validated instrument for comprehensive assessment of telemedicine among physicians in Kazakhstan and Central Asia. The pilot survey among 156 specialists demonstrated high reliability (α=0.93) and strong content validity. TUQ-MAST-KZ can be used for monitoring digital health, educational programs, and strategic implementation of telemedicine. Further studies are needed for large-scale validation of the instrument and development of a digital maturity index for healthcare organizations. Clinical Trial: Not applicable (this study was not a clinical trial and therefore was not registered).