An mHealth Application for the Rehabilitation of Community-Dwelling Individuals with Chronic Mental Health Conditions: A Randomized Controlled Trial

Abstract

Background: Developing a nursing service system to promote rehabilitation among individuals with chronic mental health conditions is essential for maintaining self-care and social functioning. This study examined the effectiveness of the BUU True Friends mobile application (mHealth) in enhancing rehabilitation and reducing relapse risk. Methods: A two-arm, pretest–posttest randomized controlled trial (RCT) was conducted with 80 participants (aged 20–59) recruited from an outpatient service in Eastern Thailand. Participants were randomly assigned to an intervention group (n=40) receiving standard care plus the mHealth app, or a control group (n=40). Outcomes were assessed at baseline and after an eight-week intervention. Data were analyzed using ANCOVA, controlling for baseline gender, education, and pretest scores. Results: After controlling for covariates, the intervention group showed significantly superior post-intervention scores in psychiatric rehabilitation domains, specifically self-care (p=0.002), family (p=0.015), relaxation (p=0.025), and community functioning (p=0.042). Additionally, the intervention group achieved significantly greater psychological well-being (p=0.001) and lower psychiatric symptom severity (p=0.002) than the control group. Longitudinal analysis confirmed significant improvements in medication adherence (p=0.009) within the intervention group. Conclusions: The BUU True Friends mHealth app is an effective digital nursing intervention for community-based mental health rehabilitation. Future research should evaluate long-term behavioral changes and caregiver involvement. Keywords: Chronic mental health conditions, Nursing service system, Rehabilitation, Mental health intervention, Smartphone application