JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) applications offer valuable tools for clinical nursing practice, improving access to medical resources and enhancing patient care. However, understanding the factors that influence nurses’ intention to continue using these technologies is crucial for ensuring long-term adoption

Objective:

This study extends the Expectation-Confirmation Model (ECM) to explore the determinants of Iranian nurses’ continuance intention to use mHealth applications in their daily clinical routines.

Methods:

A cross-sectional, descriptive-analytical study was conducted among 315 nurses from hospitals affiliated with Kashan University of Medical Sciences. Participants completed structured questionnaires measuring variables including perceived usefulness, perceived ease of use, social influence, habits, and technology anxiety. Data were analyzed using structural equation modeling (SEM) through AMOS software (version 26). The model tested relationships among confirmation, perceived usefulness, social influence, technology anxiety, and mHealth continuance behavior

Results:

The analysis revealed that perceived usefulness was significantly influenced by both confirmation (p < 0.001) and social influence (p < 0.001). Perceived ease of use was negatively impacted by new technology anxiety (p < 0.001), indicating that higher anxiety levels reduced perceived ease of use. Additionally, mHealth continuance behavior was positively associated with habits (p = 0.002), social influence (p < 0.001), and perceived security risks (p = 0.008). Contrary to expectations, perceived usefulness did not directly influence mHealth continuance (p = 0.151), suggesting that other factors, such as habits and social influence, play a more significant role in long-term use.

Conclusions:

The findings highlight the importance of perceived social influence and the confirmation of initial expectations in encouraging nurses to continue using mHealth applications. While perceived usefulness is traditionally considered a key driver in technology adoption, this study indicates that habits and social influence are more crucial in sustaining mHealth use over time. Furthermore, new technology anxiety remains a significant barrier, suggesting that interventions should focus on reducing apprehension through training and support. Hospital managers and healthcare leaders should consider these factors when developing strategies to integrate mHealth technologies into nursing workflows, as well as create environments that foster positive social reinforcement and minimize security concerns. This study provides critical insights for improving the implementation of digital health tools in nursing practice, ultimately leading to enhanced patient care and more efficient clinical operations.