Enhancing Self-Efficacy in Geriatric Chronic Care: A Literature-Based Grounded Theory Framework for Home Medical Product Design

Background The rapid aging of the global population has intensified the need for home-based medical products that enable older adults to manage chronic conditions independently. Despite technological advances, many products fail to address the multidimensional needs of elderly users, limiting sustained engagement and undermining self-efficacy. Purpose To synthesize existing qualitative evidence and construct a substantive theory regarding older adults’ experiences with chronic disease management, rehabilitation, and use of home based health technologies. Methods We employed a literature based grounded theory approach. The data source comprised peer reviewed qualitative studies (e.g., interviews, focus groups, observational methods) relevant to the research focus. A systematic literature search was conducted in databases (PubMed, PsycINFO, CINAHL) using predefined keywords. Following grounded theory principles, the analysis involved three iterative coding stages: (1) Open Coding: Findings and discussion sections of included studies were line by line analyzed to identify initial concepts. (2) Axial Coding: Concepts were grouped into categories and subcategories, with relationships explored through constant comparison; core categories forming the framework’s primary dimensions were identified. (3) Selective Coding: Categories were integrated and refined to form the central phenomenon of “self efficacy reconstruction,” systematically linking all other categories around this core. This process ensured the emerging theory was grounded in and fully supported by existing scholarly work. Results The study proposes the core concept of “Self-Efficacy Reconstruction,” indicating that the process through which older adults rebuild confidence in managing their health is driven by four dimensions: (1) Physical Adaptability(PA): product design must accommodate age-related functional decline to ensure safety and usability; (2) Cognitive Accessibility (CA): intuitive interfaces and low cognitive load designs lower the barrier to technology use; (3) Emotional Resonance (ER): design elements that alleviate anxiety and avoid feelings of surveillance foster positive self-care experiences; (4) Social Inclusion(SI): data-sharing features and non-stigmatizing designs strengthen social connections. These four dimensions form a positive feedback loop: when a product satisfies these characteristics, it enhances users’ self-efficacy, thereby promoting sustained use and improving health outcomes. Conclusion The design of home-based medical products should extend beyond basic functions and adopt an integrated human-centered approach that simultaneously addresses the four dimensions of PA, CA, ER, and SI. By optimizing these aspects, the process of self-efficacy reconstruction in older adults can be effectively facilitated, which is crucial for improving treatment adherence, ensuring rehabilitation outcomes, and achieving long-term management of chronic diseases. This framework provides theoretical insights for geriatric medicine and practical guidance for developing medical technologies that truly meet the needs of older adults.