Authors:
Suman Vashist, Reny Thomas, Charu Thakur, Pooja Chand, Nitesh Kumar Sain

Addresses:
Department of Mental Health Nursing, Teerthanker Mahaveer College of Nursing, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India. Department of Mental Health Nursing, Happy Child College of Nursing, Sonipat, Haryana, India. Department of Biochemistry, Dev Bhoomi Uttarakhand University, Dehradun, Uttarakhand, India. Department of Child Health Nursing, Government Nursing College Pithoragarh, Pithoragarh, Uttarakhand, India. Department of Mental Health Nursing, Jaipur Nursing College, Maharaj Vinayak Global University, Jaipur, Rajasthan, India.

Abstract:

Depressive symptoms often fluctuate between clinical visits, limiting timely detection and intervention. Wearables and smartphones offer continuous mood-relevant data, yet sustaining engagement and translating data into care remain challenges. This study evaluated the feasibility, adherence, and early-intervention potential of a nurse-led wearable and smartphone-based mood-monitoring pathway in routine outpatient care, and explored predictors of non-adherence. A prospective cohort study was conducted with 60 adults recruited from primary care and mental health clinics. Participants used a wrist-worn wearable (to track heart rate, sleep, and activity) and a smartphone app that delivered daily ecological momentary assessments (EMAs) of mood. Registered nurses provided on-boarding, technical support, and protocol-based outreach in response to mood deterioration, non-adherence, or concerning sleep patterns. Primary outcomes were adherence to wearable use and EMA completion (≥80% threshold). Logistic regression examined predictors of non-adherence. Mean wearable use was 19.24 ± 3.12 hours/day, with 73.33% achieving adherence ≥80%. Mean EMA completion was 76.45% ± 14.32, with 65.00% meeting adherence thresholds. Dropout was 10%. Nurse-initiated actions included supportive calls (26.67%), non-adherence reminders (25.00%), mood alerts (18.33%), sleep alerts (13.33%), and expedited referrals (8.33%). Lower education significantly predicted non-adherence (OR 3.14, p = 0.046). These findings demonstrate that nurse-led digital mood monitoring is feasible, supports timely interventions, and highlights the need for tailored strategies to address education-related engagement gaps for equitable implementation.

Keywords: Nurse-Led Monitoring; Ecological Momentary Assessment; Adherence and Early-Intervention; Health Challenges; Digital Mental Health; Depressive Disorders.

Received on: 02/08/2025, Revised on: 03/10/2025, Accepted on: 25/10/2025, Published on: 03/03/2026

DOI: 10.69888/FTSPS.2026.000658

FMDB Transactions on Sustainable Psychology Sequence, 2026 Vol. 1 No. 1, Pages: 39-48

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