## 3 Results  
In this section, we present the results of our study on the effectiveness and usability of the proposed HRS aimed at improving the QoL on users with chronic diseases. The study focused on a specific population of users who were recruited from different geographic region. The patients were monitored by the help of caregivers and healthcare professionals. The study was conducted over a period of four weeks, during which participants were asked to use the given devices and the mobile application, where they received the notifications from the HRS. The results of QoL proxy about the study are presented in Figure 4 using heatmaps. Each heatmap represents the weekly counts of responses for a specific question. The heatmap graphic provides a visual representation of the distribution of responses over time, allowing for a quick overview of the data. Any changes in the distribution of responses can be easily identified, highlighting potential areas of response. Figure 3: Screenshot of mobile app notification. Results showed that the patients had positive responses towards the TeNDER system. The majority of the responses for QP1 (easy access to health information), QP3 (daily support), QP4 (improving self-care), and QP6 (QoL increasing) fell within the range of 4 (agree) to 5 (completely agree). However, there were two questions, namely QP2 (improving autonomy), and QP5 (safer and security), where the responses were more varied. These questions received lower scores than the other questions, indicating that participants may not have experienced the same level of improvement in autonomy and feelings of safety and security as they did in other areas. At the end of the four weeks, post-interviews were conducted to gather feedback, as well as surveys to assess user satisfaction with the HRS. Figure 5 depicts the results of the QoL post-survey. In terms of evaluation of QoL for the patients, over 50% of the patients rated their QoL below 5 points, while the remaining patients were distributed across the higher scale. There was no reported decline in QoL for the patients, with mixed responses indicating either a maintained or improved QoL. Furthermore, regarding recommending the HRS to other friends or family members, most patients expressed a positive willingness to recommend the system to a friend or family member. The SUS surveys conducted after the pilot showed that the HRS was appropiate in terms of usability. The first set of surveys is presented in Figure 6. The system was well received by the patients, with SUS1 indicating a stable trend and positive responses. Figure 4: Weekly surveys analysis for QoL proxy patients. Figure 5: Post-interviews based on quality of life represented as pie charts. The system was not considered complex by the patients, as shown by the mostly low values (1 and 2) in SUS2. SUS3 and SUS5 showed that the system was intuitive and well-integrated as most responses were positive and high. The results for SUS4 (need for technical support) were mixed, indicating that some patients required technical support while others did not. The results of the second set are shown in Figure 7. Based on SUS6, they did not show any noticeable inconsistency in the system. SUS7 (learn to use quickly) had mixed results, which implied that some patients had difficulty learning to use the system quickly. SUS8 (too cumbersome) had more responses in the lower range (1 and 2), indicating that some patients found it somewhat complicated to use. SUS9 (confident using the tool) had mixed results, suggesting that some patients felt confident while others did not. Lastly, SUS10 (learn a lot before using the tool) showed results in the middle of the table, suggesting that patients did not need to learn a lot before using the tool. The results of the recommender satisfaction and feedback surveys were generally positive, as reported in Figure 8. The satisfaction rate was mixed on the positive side, with no negative responses.