Digital Self-Monitoring of Intake and Output Among Individuals With Kidney Failure: Awareness, Usability, Acceptance,...

Manual intake and output (I&O) recording is often delayed and inaccurate, highlighting the need for patient-involved digital solutions. Evidence on kidney failure individuals' acceptance, usability and willingness to self-monitor remains limited.

To assess the awareness, acceptance and usability of the Food IN&OUT application among hospitalised adults with kidney failure, and to identify factors influencing their willingness to continue self-monitoring after discharge.

A single-centre cross-sectional study was conducted from February to July 2024 in a Singapore teaching hospital. Adults with kidney failure used the application and completed a questionnaire including demographics, the system usability scale and the theoretical framework of acceptability.

A total of 93 participants took part in the study. The application had a mean usability score of 66.2 (SD = 14.4), with 59 participants (63.4%) willing and 34 (36.6%) unwilling to continue self-monitoring I&O post-hospitalisation. Willing participants rated I&O monitoring as more important (p = 0.03), were nearly three times more likely to report confidence in using the app (OR = 2.68, p < 0.02), and gave higher ratings for ease of use and consistency (all p < 0.05). Acceptability scores exceeded 3.0 overall, with significant differences in self-efficacy, perceived effectiveness and opportunity costs between willing and unwilling groups (all p < 0.05). Key motivators for continued use included health benefits, adherence to professional advice and confidence in accurate self-monitoring. Barriers included time constraints, forgetfulness and perceived difficulty with consistent tracking.

The application showed potential to support self-monitoring in kidney failure individuals, but its moderate usability underscores the need for further refinement and patient support.