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A conceptual framework for pragmatic acceptance of healthcare robots among older adults: a computational grounded
1School of Nursing, Naval Medical University, No. 800, Xiangyin Road, Shanghai, 200433, China.
Background:
Older adults' low adoption of healthcare robots indicates that their lived processes of acceptance remain insufficiently understood. This gap is not merely technical but also ethical, involving questions of dignity, relational integrity, and autonomy in later life. This study aimed to develop a theory-grounded framework of how older adults pragmatically evaluate healthcare robots in home-based aging contexts, with particular attention to the ethical and relational considerations shaping their acceptance decisions.
Methods:
We applied Computational Grounded Theory (CGT) to 16 in-depth interviews with community-dwelling older adults in Shanghai, China. Data collection continued until thematic saturation was reached. Data analysis followed a three-stage CGT procedure: (1) LDA topic modeling for initial pattern detection; (2) constant comparative analysis for thematic refinement; (3) Word2Vec-based semantic analysis for category-level coherence assessment.
Results:
Six themes emerged, converging into a model of pragmatic acceptance: acceptance is not a stable preference but a conditional stance triggered by anticipated self-care decline. Older adults consistently positioned robots as intergenerational supplements-not replacements-for family care, prioritizing preservation of filial bonds while offloading instrumental burdens. Acceptance was shaped by tensions between utility and interpersonal warmth, and further conditioned by perceived control, trust in human agents (e.g., children), and core ethical concerns regarding dignity and autonomy.
Conclusions:
This framework shifts focus from technology-centric models (e.g., TAM) to a care-centered, culturally-embedded process. By integrating self-care theory, culturally embedded care ethics, and technology acceptance, it provides an explanatory lens that goes beyond a narrow usefulness-trust paradigm. It reveals that ethical acceptability-not functional performance-is the ultimate gatekeeper of robot integration in intimate care settings. For designers, it supports avoiding anthropomorphism that implies substitution of children; for policymakers, it advocates family-technology collaborative care models. In the present study, the CGT approach incorporated computational tools within a researcher-led interpretive process to assist pattern detection and provide clearer documentation of analytic steps.
