User experience and perceived usability of nurse-led telemonitoring among women with gestational diabetes in Dhulikhel, Nepal

Kalpana Chaudhary; Jyoti Nepal; Shraddha Thapaliya; Sangam Banjara; Abha Shrestha; Prabin Raj Shakya; Archana Shrestha; Shristi Rawal

doi:10.1007/s40200-024-01540-1

User experience and perceived usability of nurse-led telemonitoring among women with gestational diabetes in Dhulikhel, Nepal

J Diabetes Metab Disord. 2024 Dec 16;24(1):10. doi: 10.1007/s40200-024-01540-1. eCollection 2025 Jun.

Authors

Kalpana Chaudhary^{1

2}, Jyoti Nepal³, Shraddha Thapaliya³, Sangam Banjara³, Abha Shrestha⁴, Prabin Raj Shakya⁵, Archana Shrestha^{1

2

6}, Shristi Rawal⁷

Affiliations

¹ Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
² Institute for Implementation Science and Health, Bhaktapur, Nepal.
³ Department of Research and Development, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal.
⁴ Department of Obstetrics and Gynecology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal.
⁵ Biomedical Knowledge Engineering Lab, Seoul National University, Seoul, Korea.
⁶ Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA.
⁷ Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, USA.

Abstract

Objective: To assess the usability and acceptability of nurse-led telemonitoring in managing gestational diabetes among Nepalese women.

Methods: We conducted a convergent mixed-method study among 91 pregnant women diagnosed with gestational diabetes at Dhulikhel Hospital, Nepal. Participants received glucometers and blood pressure monitors, along with training and instructions to measure and record their blood pressure and glucose levels at home once a week. Starting from the 28th gestational week, the study nurse reviewed measurements obtained at home during the biweekly telemonitoring follow ups, alternating with hospital visits. We used the System Usability Scale (SUS) to assess perceived usability and conducted in-depth interviews to understand participants' experiences with telemonitoring and related technologies, including feasibility, acceptability, satisfaction with treatment, usability, as well as any difficulties or unmet needs. The quantitative analysis included descriptive statistics to summarize participant characteristics and System Usability Scale (SUS) responses, while a framework analysis was applied to examine the qualitative data.

Results: The mean SUS score for telemonitoring services was 72.1 ± 7.6, indicating good usability (a score ≥ 68 indicates good usability). 93% of participants wanted to use the service frequently; 88% found it easy to use; 81% considered it well-integrated with their typical prenatal care. Participants acknowledged the benefits of virtual health visits, such as frequent health monitoring, facilitation of communication with healthcare providers, appointment reminders, added motivation for home monitoring, increased access to health information, and prevention of unnecessary anxiety. Overall, participants expressed satisfaction with the quality and features of the nurse-led telemonitoring for managing gestational diabetes, emphasizing its role in ensuring uninterrupted prenatal care.

Conclusions: Telemonitoring is a feasible and acceptable tool to facilitate close monitoring of pregnant women with gestational diabetes in peri-urban hospital settings in Nepal.

Keywords: Gestational diabetes mellitus; Pregnancy; Telemonitoring.