Investigating the effect of managerial app use on nurse manager performance: A mediated model of user satisfaction and technostress

The rapid digital transformation of healthcare organizations has increased the use of managerial applications to improve leadership effectiveness and service quality. This study examines the effect of managerial app use on the performance of nurse managers, with user satisfaction and technostress proposed as potential mediating variables. Grounded in the DeLone and McLean Information System Success Model and Task–Technology Fit theory, a quantitative cross-sectional design was employed. Data were collected from 308 nurse managers across five government hospitals in North Sumatra, Indonesia, and analyzed using SEM-PLS. The findings indicate that managerial app use has a significant positive effect on individual performance, user satisfaction, and technostress. Both user satisfaction and technostress also positively influence performance; however, neither variable mediates the relationship between system use and performance. These results suggest that performance improvements are driven primarily by direct system utilization. Notably, technostress may function as a challenge stressor that enhances performance under manageable conditions. Overall, the study emphasizes the strategic role of digital systems in strengthening managerial effectiveness, decision-making quality, and organizational outcomes. It also offers practical insights for hospital leaders managing digital transformation initiatives and optimizing human–technology interaction in complex healthcare environments to support sustainable healthcare performance.