A usability evaluation framework for a mobile application in supporting home-based rehabilitation for stroke patients: A qualitative study

Background: Digital health tools can enhance stroke patient care by promoting home-based self-management for clinicians and patients. However, these tools often face poor market adoption and low adherence due to insufficient analysis and lack of context for end-users. Objective: To enable stroke patients to manage their health independently after discharge and receive care at home, the purpose of this study was to determine the usability, satisfaction, and performance levels of a mobile app designed for the clinical monitoring of stroke patients. The feedback obtained serves as a reference for design improvements, with the overall aim of assisting and encouraging patients to continue long-term care and rehabilitation plans at home, thereby enhancing the effectiveness and quality of healthcare. Methods: This study employed a mixed-methods approach in three phases: (1) design of mobile app mockups, (2) execution of a usability test for both healthcare professionals and patients, assessing operational skills and acceptance, and (3) evaluation of satisfaction and performance levels regarding the usability of the app. Participants were selected through purposive sampling to ensure a representative sample and then divided into two groups: healthcare professionals (n = 10) and patients (n = 10). Each participant was provided with a tablet containing the mockup designs, and usability tests were conducted through interviews. Audio recordings of participants were transcribed anonymously and analyzed using NVivo12.0 software, focusing on the application interface and usability test. Task difficulty was assessed from (1) “very easy” to (5) “very difficult,” with task non-completion considered a critical mistake. Satisfaction and performance with the usability testing were measured using a 5-point Likert scale, from (1) “totally disagree” to (5) “totally agree.” Results: Overall, both groups of participants found the app easy to use, despite some differences in their perceptions of app difficulty, which could have been attributed to the variations in the interface designs for each group. On average, 70% of healthcare professionals described most tasks as “very easy,” compared to only 40% of patients. No participants made critical mistakes or withdrew from the experiment during the trial. In the satisfaction and performance survey, both groups expressed high satisfaction with the interface design and the usability of the app. On average, the healthcare professionals group completed all usability tasks within 20 min, whereas patients required around 40 min to complete all tasks. Conclusions: Satisfaction and performance surveys and qualitative data analysis revealed that most participants described the interface design of the app as intuitive and easy to use. Although some functions presented challenges, there was still a high level of satisfaction among both groups. These outcomes from usability evaluation contribute to a deeper understanding of the usage patterns of mobile healthcare applications and help to identify areas for improvement in the current design, thereby enhancing the potential for the use of the app in home-based long-term care and rehabilitation.