The Role of the 'Mekonsdara' Application in Enhancing Healthcare Access for People Living with HIV/AIDS: Assessing Patient Satisfaction with Telenursing

Defia Roza1*, Alfitri2, Nova Yanti1, Thifla Rafifa Wirza3

1Department of Nursing, Health Polytechnic Padang. Surau Gadang, Kec. Nanggalo, Kota Padang, 25146 Sumatera Barat, Indonesia

2Rumah Sakit Umum Pusat Dr. M. Djamil Kota Padang Sumatera Barat, 25129 Kota Padang, Indonesia

3Faculty of Dentistry, Andalas University, Limau Manis, Pauh, Padang City, 25175 West Sumatra, Indonesia

*Corresponding Author’s Email: defiaroza@rocketmail.com

ABSTRACT

Background: This study examined the satisfaction levels of people living with HIV/AIDS (PLWHA) using the "Mekonsdara" counselling service application. Access to quality healthcare services remains a significant challenge for PLWHA, especially in developing countries like Indonesia, where HIV/AIDS prevalence is high. Objectives: The objective was to assess patient satisfaction with the Mekonsdara application, a telenursing tool designed to enhance healthcare access. Methods: A descriptive observational survey was conducted with 50 respondents from the VCT clinic at Dr M. Jamil General Hospital Padang, Indonesia using purposive sampling. Data were collected via questionnaires and analysed using the End User Computing Satisfaction (EUCS) method. Results: Results showed that most respondents were highly satisfied, particularly with content (82%), accuracy (80%), format (64%), ease of use (76%), and timeliness (76%). Conclusion: These findings suggest that the Mekonsdara application effectively meets the needs of PLWHA for accessible, reliable, and user-friendly counselling services. The study highlights the potential of telenursing to improve healthcare access in resource-limited settings. Further research is recommended to explore the broader implications of telenursing on patient satisfaction and healthcare outcomes.

Keywords: AIDS; Counselling; HIV; Telenursing

INTRODUCTION

HIV/AIDS remains a major health issue, with ongoing challenges such as stigma, limited access to healthcare, and complexities in disease management. In Indonesia, the epidemic continues to spread at an alarming rate. As of September 2023, data from the Ministry of Health of the Republic of Indonesia reported 515,455 people living with HIV/AIDS (PLWHA), many of whom face significant barriers to accessing quality healthcare services (Byanyima & Kavanagh, 2022; Roza et al., 2023; Tian et al., 2023).

Every individual, including those living with HIV/AIDS (PLWHA), has a right to enjoy the highest attainable standard of health similar to the general population, which includes availability, accessibility, acceptability and quality. Research shows that many patients face difficulties in getting consistent care and adequate support (Fauk et al., 2021; Mulyawijaya et al., 2022). PLWHA often experience negative stigma and unfair or discriminatory treatment by health care providers and society (Demartoto et al., 2023). Telenursing can be a much- needed solution in the context of HIV/AIDS to address the challenges faced by PLWHA. Telenursing, also known as tele-nursing, is a combination of nursing services and technology- based telecommunications that facilitate healthcare delivery to patients through digital media. The emergence of telenursing is driven by several factors, including limited availability of human resources, which restricts reaching more patients; hospital and infrastructure capacity constraints; and minimising infection risk between patients and healthcare providers while ensuring access to healthcare services (Afik & Pandin, 2021; Locsin et al., 2021; Siriwardhana et al., 2021).

Research shows that telenursing technology can enhance access to healthcare services, increase participation among medically or socially marginalised individuals, reduce infection transmission, provide patient convenience by eliminating travel time or distance barriers, enable collaboration among various healthcare fields in patient care without requiring in-person meetings, and offer the emotional support and education that patients need (Boro & Hariyati, 2019; Kamal et al., 2023; Lanza et al., 2020).

Mekonsdara is an example of telenursing implementation in the context of HIV/AIDS patient counselling media (Wahyuni et al., 2025). It is a digital platform that allows patients to communicate with healthcare providers easily. The application has various features like chat, video calls and medical data management which are aimed at improving access to healthcare and counselling services for PLWHA. This study aims to assess the perspectives of PLWHA on the use of the “Mekonsdara” counselling media application.

METHODOLOGY

This study employed a descriptive observational design with a survey approach to assess the satisfaction levels of people living with HIV/AIDS (PLWHA) regarding their use of the "Mekonsdara" counselling service application. The sample consisted of 50 respondents, all of whom were HIV/AIDS patients attending the Voluntary Counselling and Testing (VCT) clinic at Dr M. Jamil General Hospital in Padang.

Sampling and Participants

A purposive sampling technique was used to select participants. This method was chosen due to its suitability for targeting a specific population (PLWHA) who were actively using the "Mekonsdara" application, ensuring the relevance and accuracy of the data (Ahmed, 2024; Rasad et al., 2023). The inclusion criteria for participants were as follows: individuals diagnosed with HIV/AIDS who were willing to participate in the study. Patients who were suffering from severe opportunistic infections or experiencing significant adverse drug reactions were excluded from the study to ensure that the data reflected the experiences of those who were able to use the application effectively.

Data Collection and Tool Validation

Primary data was collected through questionnaires designed to evaluate user satisfaction based on the End User Computing Satisfaction (EUCS) method, which was employed to assess five key variables: content, accuracy, format, ease of use, and timeliness. These variables were specifically chosen to capture the broad dimensions of user experience with the application. To ensure the reliability and validity of the tool, the questionnaire was pre-tested and revised as necessary before use in the study. The EUCS method, as shown in Table 1, as described by Putra and Prehanto (2021), has been widely used and validated in previous research, confirming its effectiveness in evaluating user satisfaction with digital services. All items on the questionnaire were tested for both validity and reliability, ensuring that the measurements were accurate and consistent.

Table 1: Questionnaire Design

The data measurement was done by using a Likert scale (Table 2) which ranged from Very Satisfied (5), Satisfied (4), Neutral (3), Dissatisfied (2) to Very Dissatisfied (1) (Putra & Prehanto, 2021). The data were analysed descriptively using univariate analysis to describe each variable studied. This research has passed the ethical feasibility review by the ethics committee of Dr M. Jamil General Hospital, Padang, Indonesia, in July 2022.

Table 2: User Satisfaction Scale

Ethical Considerations

The study received ethical approval from the Ethics Committee, Dr M. Djamil General Hospital, Padang, Indonesia, with reference number LB.02.02/5.7/345/2023 on 14th June 2023.

RESULTS

Characteristics of Respondents

This research was conducted with 50 respondents who visited the VCT clinic at Dr. M. Jamil General Hospital, Padang. Among them, 39 were male and 11 were female (Table 3).

Table 3: Distribution of Respondents Based on Gender and Ages (n = 50)

Content Variable

As shown in Table 4, most respondents were highly satisfied with counselling services provided through the Mekonsdara application based on the content variable. The availability of features such as live chat, educational articles and a nurse-counsellor information page enhance the satisfaction levels of respondents regarding the content variable. Clear and comprehensive educational articles make it easier for respondents to obtain information about counselling services for PLWHA. Moreover, patients can get detailed information about counsellors they consult through the Mekonsdara application.

Table 4: Overview of User Satisfaction with the Mekonsdara Application Based on Content

Figure 1 presents the home screen and profile view of the Mekonsdara application, which is designed to provide various services related to HIV education and consultation. The home screen features three main functionalities: History (Riwayat), Consultation (Konsultasi), and Chat with Consultant (Chat Konsultan), enabling users to easily access information or seek advice from experts. The Materials section offers educational topics, such as General Information on HIV and The Importance of Patient Counselling, aimed at enhancing public understanding of HIV. Additionally, the Research section provides access to a feature for research evaluation, highlighting the application’s role in supporting data collection for studies. The app's navigation is simplified with a bottom menu, including options like Home, Guide, and Search, allowing users to explore the application with ease. Its responsive design and intuitive interface enable a user-friendly experience.

Figure 1: Home Screen and Profile View of the Mekonsdara Application

Figure 2 illustrates the live chat interface of the Mekonsdara application. This feature facilitates real-time communication between users and consultants, as demonstrated by the profile of the consultant, Defia Roza. The interface is minimalist and user-friendly, with a clean layout designed to streamline interaction. At the bottom of the screen, users can input their messages through the text field, enhanced with a send button for ease of message delivery. The plus icon provides additional functionalities, such as attaching files or multimedia, which can enhance the consultation process by allowing users to share relevant documents or images. This live chat functionality emphasises the application’s commitment to fostering direct and personalised interaction between users and experts, ensuring timely responses and efficient communication. This feature supports the study's findings on the importance of integrating digital tools for accessible and real-time healthcare consultation services.

Figure 2: Live Chat Interface of the Mekonsdara Application

Figure 3 displays the information page for nurse counsellors available in the Mekonsdara application. This page provides users with details about the consultants, including their names, qualifications, areas of expertise, and availability. This feature ensures transparency and aids users in selecting the most suitable counsellor based on qualifications, availability, and user ratings. The system promotes user trust and supports personalised healthcare services. These functionalities align with the study’s findings on the significance of user-friendly interfaces and the accessibility of qualified professionals in enhancing the quality of digital healthcare applications.

Figure 3: Information Page for Nurse Counsellors in the Mekonsdara Application

Accuracy Variable

The accuracy variable is used to measure satisfaction by considering the accuracy of the data presented. The information must be error-free, clear, and non-misleading. As shown in Table 5, approximately 80% of respondents were very satisfied with the Mekonsdara app as a counselling service in terms of accuracy.

Table 5: Overview of User Satisfaction with the Mekonsdara Application Based on Accuracy

The educational information provided on the Mekonsdaradara app comes from journals, books and focus group discussions with counselling experts, which have been summarised into accurate and reliable information. The live chat feature used by respondents to obtain counselling on HIV is also valid because they directly consult with experts in HIV counselling. The system used in this application is considered accurate, without any errors in data input and with seamless navigation between application pages.

Figure 4 demonstrates accurate display of source articles within the Mekonsdara application. The figure highlights the detailed information provided in the section titled Peranan Konseling dalam Penanggulangan HIV/AIDS. Users are presented with a list of frequently asked questions (FAQs) related to HIV counselling. By selecting a specific question, users can access comprehensive and evidence-based answers sourced from credible articles and healthcare guidelines. For instance, in response to the question ‘How should a patient undergo prophylaxis treatment?', detailed steps and medical recommendations are provided to ensure clarity and actionable guidance. This feature ensures that users receive reliable and accurate information supported by verified sources. It enhances the application’s role in promoting health literacy and informed decision-making. The detailed answers are structured to provide both general advice and specific, actionable steps, making the content highly practical for users. The feature also supports the study’s findings on the importance of evidence-based information in digital healthcare platforms, ensuring users' trust and improving the quality of healthcare delivery.

Figure 4: Accuracy Display of Source Articles in the Mekonsdara Application

Format Variable

Table 6: Overview of User Satisfaction with the Mekonsdara Application Based on Format

In this study (Table 6), it was found that out of 50 respondents, 64% were very satisfied with the format of the Mekonsdara application. The Mekonsdara application has an interface that is appealing and easy to understand. The chosen colours are not monotonous; fonts are easy to read, while gestures used in its operation are highly universal, making it accessible to all age groups.

Figure 5 showcases the attractive and engaging interface design of the Mekonsdara application, emphasizing its user-centric approach. The design incorporates vibrant visuals, intuitive navigation, and engaging graphics to enhance user interaction and appeal. The top section highlights a feature for Research Evaluation (Evaluasi Penelitian) alongside guidance on How to Use the Application (Cara Menggunakan Aplikasi), making it easy for users to navigate the app's functionalities. Additionally, a dedicated section addresses User Enquiries About Mekonsdara (Punya Pertanyaan Seputar Mekonsdara), reflecting the application's focus on accessibility and responsiveness. The bottom section introduces the application as a solution for consultation and education about HIV, with illustrations and call-to-action prompts aimed at capturing the user's attention. This slide-based introduction ensures a smooth onboarding experience for new users. The visual appeal and simplicity of the interface contribute to the study's findings that a well-designed user interface plays a crucial role in improving engagement, usability, and the overall effectiveness of digital healthcare applications. The combination of engaging visuals and practical information creates an inviting environment that encourages continued usage.

Figure 5: Attractive Interface of the Mekonsdara Application

Perceived Ease of Use Variable

The respondents' satisfaction level indicates the effectiveness of the Mekonsdara application in terms of ease of use, as shown in Table 7, where 76% of the sample expressed being very satisfied with the ease of use of the application for HIV counselling services.

Table 7: Overview of User Satisfaction with Mekonsdara Application Based on Ease of Use

The Mekonsdara app has been designed to be easy to use, as shown by its intuitive and simple interface. Easy navigation, a rapid registration process, and a streamlined search function are some of the tools that ensure that individuals from diverse backgrounds can rapidly understand and effectively use the app. Multi-platform integration and customisation options also provide flexibility for users, allowing them to access and customise the app to their exact preferences, thereby enhancing convenience and the overall user experience.

Figure 6 displays the application settings interface of the Mekonsdara application, designed to enhance user convenience. The interface includes two main sections: the Medical Record (Rekam Medis) and the Profile Settings (Akun). These features ensure that users can easily manage their personal data and account settings, contributing to the study’s findings on the importance of intuitive design and data accuracy in digital healthcare applications. The emphasis on convenience and simplicity enhances user trust and engagement.

Figure 6: Application Settings Interface of Mekonsdara for User Convenience

Timeliness Variable

User satisfaction is a crucial indicator of timeliness, or the promptness in delivering information. As shown in Table 8, 76% of the respondents were very satisfied with the Mekonsdara application regarding timeliness.

Table 8: Overview of User Satisfaction with the Mekonsdara Application Based on Timeliness

The Mekonsdara application also excels in timeliness, as evidenced by its high responsiveness and fast loading times. Every feature within the application is designed to provide quick and efficient access. Additionally, Mekonsdara ensures that notifications and information updates are delivered in real-time, allowing users to always receive the latest information and make timely decisions.

DISCUSSION

The findings of this study highlight the significant role of the "Mekonsdara" application in improving patient satisfaction among people living with HIV/AIDS (PLWHA). The high satisfaction ratings across the variables of content, accuracy, format, ease of use, and timeliness underscore the potential of telenursing applications in addressing critical gaps in healthcare accessibility and quality for vulnerable populations.

The content variable, with an 82% "very satisfied" rating, demonstrates the effectiveness of the Mekonsdara application in providing comprehensive, clear, and relevant information to its users. This aligns with previous studies that emphasise the importance of high-quality content in enhancing user satisfaction in mobile health applications (Azzahrah et al., 2020; Kord et al., 2021). The inclusion of features such as live chat and educational articles likely contributes to this high level of satisfaction, as these tools provide users with the necessary resources to manage their health effectively.

Accuracy was another area of strength, with 80% of respondents expressing high satisfaction. The reliance on evidence-based information from journals, books, and expert consultations ensures that users receive reliable and non-misleading guidance. This finding corroborates the literature that highlights the critical role of accuracy in building trust and confidence among users of health applications (Yazid et al., 2019). Furthermore, the seamless navigation and error-free data input enhance the application's credibility and usability.

The format of the Mekonsdara application was rated "very satisfied" by 64% of respondents, reflecting its appealing and user-friendly design. Effective visual design, including colour schemes and font choices, plays a crucial role in maintaining user engagement and ensuring ease of understanding (Damayanti et al., 2018). The Mekonsdara application’s emphasis on accessibility for all age groups further demonstrates its inclusivity and adaptability to diverse user needs.

Ease of use emerged as a significant factor, with 76% of respondents indicating high satisfaction. The intuitive interface, rapid registration process, and streamlined navigation contribute to this positive perception. These findings align with the principles of user-centred design, which advocate for simplicity and accessibility to enhance user experience (Putra & Prehanto, 2021; Paneru et al., 2024). The ability of the application to cater to individuals with varying levels of digital literacy further underscores its effectiveness in reaching marginalised populations (Bansal & Choudhary, 2024; Prasastiningtyas et al., 2024).

Timeliness, rated "very satisfied" by 76% of respondents, highlights the importance of prompt and real-time information delivery in healthcare applications. The application’s high responsiveness and efficient notification system ensure that users can access up-to-date information without delays. This capability is particularly critical in the context of HIV/AIDS management, where timely interventions can significantly impact health outcomes (Siriwardhana et al., 2021; Van Zyl et al., 2021).

The overall high satisfaction ratings across all evaluated variables demonstrate the Mekonsdara application’s potential to overcome barriers to healthcare access, such as stigma, geographic limitations, and resource constraints. These findings are consistent with studies emphasizing the role of telenursing in improving healthcare delivery and patient satisfaction in resource- limited settings (Afik & Pandin, 2021; Bruce et al., 2024). Moreover, the application’s ability to facilitate direct communication with healthcare providers fosters a sense of support and reassurance among users.

Despite these positive findings, there are areas that warrant further exploration. For instance, future studies could investigate the long-term impact of the Mekonsdara application on health outcomes and adherence to treatment among PLWHA. Additionally, examining the scalability and cost-effectiveness of implementing similar telenursing solutions in other healthcare contexts could provide valuable insights for policymakers and healthcare providers.

The Mekonsdara application exemplifies the transformative potential of telenursing in enhancing healthcare access and satisfaction for PLWHA. By addressing key factors such as content quality, accuracy, design, ease of use, and timeliness, the application sets a benchmark for future innovations in digital health. These findings underscore the importance of adopting user-centred approaches in the development and implementation of healthcare technologies to meet the diverse needs of patients effectively.

Limitations

The study has several limitations that should be acknowledged. Conducted in a single healthcare setting, the VCT clinic at Dr M. Jamil General Hospital, Padang, Indonesia the findings may not be generalisable to other contexts or healthcare facilities. The cross-sectional design captures user satisfaction at a single point in time, leaving gaps in understanding changes over time or long-term outcomes of using the "Mekonsdara" application. Additionally, the small sample size of 50 respondents limits the representativeness of the broader population of PLWHA, suggesting the need for larger and more diverse samples in future research. Furthermore, this study focused solely on user satisfaction without exploring specific barriers, such as technological literacy or internet access, that could affect the adoption and utilisation of the application. Addressing these limitations in future studies could provide more comprehensive insights into the effectiveness and scalability of telenursing solutions.

CONCLUSION

The study aimed to assess the satisfaction levels of HIV/AIDS patients (PLWHA) using the "Mekonsdara" counselling service application, focusing on variables such as content, accuracy, format, ease of use, and timeliness. The results revealed that the majority of respondents were highly satisfied across all variables. Specifically, 82% of respondents were very satisfied with the content, which was clear, complete, and relevant to their needs. Accuracy was rated highly by 80% of respondents, who found the information reliable and error-free. The application’s format was praised by 64% of respondents for its appealing and user-friendly design. Ease of use was a notable strength, with 76% expressing satisfaction due to the intuitive interface. Timeliness also stood out, with 76% appreciating the quick and real-time updates provided by the application.

The "Mekonsdara" application effectively addresses the needs of PLWHA for accessible and reliable counselling services, illustrating the potential of telenursing to overcome healthcare access barriers in resource-limited settings. Long-term, the application could play a significant role in improving patient adherence to treatment and overall health outcomes. Future research should explore the scalability of the application in different healthcare contexts and regions, as well as its sustained impact on health behaviours. Additionally, investigating the integration of advanced features such as predictive analytics and personalised health recommendations could further enhance its effectiveness. Overcoming barriers to digital adoption, such as internet access and digital literacy, will be essential for ensuring the broader applicability and long- term success of telenursing solutions like "Mekonsdara".

Conflict of Interest

The authors declare have no competing of interest.

ACKNOWLEDGEMENT

The authors acknowledge the Ministry of Health of the Republic of Indonesia and the Health Polytechnic of the Ministry of Health, Padang, Indonesia together with their staff, for providing essential support and resources that facilitated the successful completion of this study.

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