G-2994

A Progressive Web Application for Self-Management of Patients with Spinal Cord Injury: A Usability Evaluation Study

 Amir Hossein Daeechini ¹ ℗, Azamossadat Hosseini ² ©, Somayeh Paydar ³, Saeed Oraee-Yazdani ⁴   

 
Abstract

Introduction: Spinal cord injury (SCI) is a complex condition associated with multisystemic and often rare complications, frequently resulting in severe disabilities and permanent impairments. Effective management of SCI requires ongoing self-management strategies to reduce secondary complications and improve patients’ quality of life. Mobile health (mHealth) applications have increasingly gained acceptance among individuals with SCI, playing a crucial role in enhancing patient awareness and empowerment for managing their condition and its related challenges. Despite the proliferation of mHealth tools, there remains a need to evaluate their usability to ensure they meet the specific needs of this. This study aims to evaluate the usability of a pioneering web-based mobile application designed for self-management in individuals with spinal cord injuries, enabling them to better manage their chronic condition and thereby improve their awareness and empowerment. Methods and Materials: The progressive web application (PWA) was developed through a comprehensive needs assessment and iterative design process, involving collaboration with relevant experts and individuals with SCI to ensure alignment with end-user requirements. The current study focuses on the evaluation phase of the application. Usability was assessed using the Mobile Application Usability Questionnaire (MAUQ), a validated instrument developed by Zhou et al. specifically for mobile health applications. The MAUQ comprises 18 items divided into three domains: ease of use (5 items), user interface and satisfaction (7 items), and usefulness (6 items). The questionnaire was translated by three expert translators, and its face validity was confirmed by a panel of 10 specialists, including medical informatics and health information management experts. The application was provided to 20 participants with varying levels of SCI who owned smartphones. They were instructed to use the app for a minimum of two weeks, after which they completed the MAUQ. Data were analyzed using SPSS version 26 with descriptive statistical methods. Results: The overall mean usability score was 5.51, indicating acceptable usability. Among the three domains, ease of use received the highest average score of 6.09, followed by user interface and satisfaction at 5.71, and usefulness at 4.73. These findings suggest that users found the application intuitive and satisfactory, though perceived usefulness was comparatively lower, highlighting potential areas for further enhancement. Conclusion and Discussion: By adopting an end-user-centered approach, this study engaged individuals with SCI throughout the development and evaluation phases to ensure the application effectively addresses their unique needs. The usability assessment identified strengths and areas for improvement, facilitating the refinement of the app to better support the complex self-management requirements of SCI patients. This participatory design model underscores the importance of involving target users in mHealth development to create comprehensive, user-friendly tools that can improve health outcomes and patient empowerment.

Keywords: mHealth, Mobile Applications, Spinal Cord Injury, Self-Management, Usability Testing