Design, Implementation, and Evaluation of an Educational-Interactive Telenursing Web Application for Mothers of High-Risk Neonates Publisher Pubmed



Beykmirza R ; Ghofrani M ; Mehrabani ER ; Giv A ; Nasiri M ; Varzeshnejad M
Source: European Journal of Pediatrics Published:2026

Abstract

The transition of high-risk neonates from the neonatal intensive care unit (NICU) to home remains a complex process, often hindered by inadequate and fragmented discharge education. This study aimed to develop, implement, and evaluate an interactive telenursing web application designed to enhance discharge education for mothers of high-risk neonates. A multi-method study with a three-phase approach (design, implementation, and evaluation) was conducted to develop and assess a bilingual telenursing web application. The application was developed using the waterfall model. Implementation and evaluation phase in this study was conducted as a quasi-experimental study, involving 60 mothers of high-risk neonates. These mothers were randomly assigned to either an intervention group (N = 30), which received interactive, multimedia-based discharge education via the web application, or a control group (N = 30) that received standard discharge education. Maternal knowledge and user satisfaction were the primary outcome measures. The findings are structured into two distinct components: (1) web application design and (2) implementation, and its evaluation. This application was designed as a bilingual (Persian/English) platform. Its various components include the following: A- Login Page (this web application has three user roles: Mother, nurse, and Supervisor (Editor)), B- Home Page, C- Educational Icons Page, D- multiple questions to assess mothers’ understanding of the educational content. E- Nurses' Page, F-Messages Page. Evaluation of the Intervention on maternal knowledge showed that the mean knowledge score in the intervention group was significantly higher than in the control group (p = 0.008). User Satisfaction and Usability questionnaire results showed that the overall mean satisfaction score was 3.90 ± 0.77 out of 5. The highest-scoring domain was Information Quality (Mean ± SD = 4.13 ± 0.63), followed by Aesthetics (Mean ± SD = 3.96 ± 0.66) and Functionality (Mean ± SD = 3.90 ± 0.84). The lowest-rated domain was Subjective Quality (Mean ± SD = 3.63 ± 0.73). Conclusion: The findings indicate that the bilingual, competency-driven bilingual telenursing web application is an effective tool for improving maternal knowledge and engagement in post-NICU care. The platform’s features, including real-time nurse-mother communication and adaptive learning modalities, facilitate better discharge preparedness and may contribute to reduced emergency healthcare utilization. Future research should explore integration with electronic health record systems to enable personalized and continuous care pathways. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026.