Ready for Remote Care?: A Mixed-Methods Study of Nurse Perceptions and Implementation Barriers of Telenursing.

Authors

Ahmed Khalaf Mekdad, Mohamed Ali Zoromba, Ahmed Ali Hafez, Ahmed Shaaban Attia, Shimaa Ramadan Ahmed

Published in

Computers, informatics, nursing : CIN. Apr 27, 2026. Epub Apr 27, 2026.

Abstract

Integrating telenursing into health care offers opportunities and challenges, but gaps remain in understanding nurses' perceptions, implementation barriers, and practical use across clinical settings.
This study aimed to assess nurses' perceptions of telenursing implementation and identify key barriers in various health care settings in Egypt, providing insights from a resource-limited, middle-income country undergoing digital transformation.
A convergent mixed-methods design was employed, involving 240 nurses from 42 private hospitals across Egypt, selected via multistage random and convenience sampling. The study was conducted between January and May 2025. Quantitative data were collected using a 12-item structured questionnaire measuring perceptions across 4 dimensions (methods, patterns, advantages, and disadvantages of telenursing). Qualitative data were gathered through open-ended questions exploring implementation barriers, which were analyzed using inductive thematic analysis following Braun and Clarke's 6-phase framework.
The findings indicated a generally positive perception of telenursing among participating nurses, with a mean perception score of 36.4±11.3; 62.9% of nurses held favorable views. A statistically significant association was found between nurses' perceptions and age, educational level, years of experience, and prior training in telenursing. Regression analysis revealed that these factors explained 18.5% of the variance in perception scores (R2=0.185, adjusted R2=0.164). Thematic analysis of qualitative responses identified 5 major barrier themes: (1) lack of institutional support and unclear policies, (2) technological infrastructure deficits, (3) training and competency gaps, (4) patient-related challenges, including digital literacy limitations, and (5) privacy and ethical concerns regarding data security.
While nurses in this resource-limited Egyptian context demonstrate positive perceptions of telenursing (mean 36.4±11.3), successful implementation hinges on addressing multilevel barriers that are more acute than those reported in high-income systems. Implications include developing clear institutional policies, providing comprehensive training programs, establishing standardized protocols, and creating supportive technological infrastructure to optimize telenursing adoption and patient outcomes.

PMID:
42429783
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

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