Digital Self‐Monitoring of Intake and Output Among Individuals With Kidney Failure: Awareness, Usability, Acceptance, Attitudes and Key Engagement Factors

Background Manual intake and output (I&O) recording is often delayed and inaccurate, highlighting the need for patient‐involved digital solutions. Evidence on kidney failure individuals’ acceptance, usability and willingness to self‐monitor remains limited. Objective To assess the awareness, acceptance and usability of the Food IN&OUT application among hospitalised adults with kidney failure, and to identify factors influencing their willingness to continue self‐monitoring after discharge. Methods A single‐centre cross‐sectional study was conducted from February to July 2024 in a Singapore teaching hospital. Adults with kidney failure used the application and completed a questionnaire including demographics, the system usability scale and the theoretical framework of acceptability. Results A total of 93 participants took part in the study. The application had a mean usability score of 66.2 (SD = 14.4), with 59 participants (63.4%) willing and 34 (36.6%) unwilling to continue self‐monitoring I&O post‐hospitalisation. Willing participants rated I&O monitoring as more important ( p = 0.03), were nearly three times more likely to report confidence in using the app (OR = 2.68, p < 0.02), and gave higher ratings for ease of use and consistency (all p < 0.05). Acceptability scores exceeded 3.0 overall, with significant differences in self‐efficacy, perceived effectiveness and opportunity costs between willing and unwilling groups (all p < 0.05). Key motivators for continued use included health benefits, adherence to professional advice and confidence in accurate self‐monitoring. Barriers included time constraints, forgetfulness and perceived difficulty with consistent tracking. Conclusion The application showed potential to support self‐monitoring in kidney failure individuals, but its moderate usability underscores the need for further refinement and patient support.