Abstract
OBJECTIVE: To evaluate the acceptance of 5G-enabled bedside interactive terminal health education among elderly patients with chronic diseases and analyze its impact on treatment adherence, focusing on the mediating role of self-efficacy. METHODS: A cross-sectional survey was conducted with 294 elderly inpatients with chronic diseases (January 2022-January 2023). Acceptance was measured using a technology acceptance model (TAM)-based Health Education Acceptance Scale, self-efficacy with the Chronic Disease Self-Efficacy Scale (CDSES), and adherence via the 5-item Medication Adherence Report Scale, Exercise Adherence Rating Scale, and self-developed Dietary Adherence Scale. Hierarchical linear regression was constructed to analyze the impact of acceptance on adherence, controlling for demographics/clinical variables. The mediating effect of self-efficacy was examined by Bootstrap testing. RESULTS: Participants reported moderately high acceptance (TAM_score: 64.29 ± 17.26) and moderate self-efficacy (CDSES score: 6.95 ± 1.97). Adherence scores were 19.99 ± 3.22 (medication), 16.29 ± 4.30 (exercise), and 27.93 ± 5.73 (diet). Acceptance was significantly associated with all adherence domains (all P < 0.001). Self-efficacy partially mediated the effects on medication (indirect effect = 0.0159, 95% CI: 0.0075-0.0252) and exercise adherence (indirect effect = 0.0218, 95% CI: 0.0098-0.0360). Among TAM dimensions, perceived usefulness most stably predicted adherence, independently and positively influencing exercise adherence (B = 0.212, 95% CI: 0.062-0.361, P = 0.006). CONCLUSION: 5G terminal-based health education was significantly associated with better treatment adherence among elderly patients with chronic diseases. Self-efficacy serves as a crucial mediator, particularly for medication and exercise behaviors. Optimizing terminal interactivity and enhancing self-efficacy are crucial for improving long-term disease management outcomes.