Barriers to home-based vaginal pessary management and perceptions of potential mobile health support among Chinese women with pelvic organ prolapse: a constructivist grounded theory study

Vaginal pessaries are a first-line nonsurgical treatment for symptomatic pelvic organ prolapse (POP), but home management requires women to handle the device, interpret symptoms, and access professional advice when needed. Evidence describing these day-to-day challenges in China, particularly from the perspectives of family caregivers and healthcare professionals, remains limited.Objective: To explore the experiences and barriers of Chinese women managing vaginal pessaries at home and to examine how patients, family caregivers, and healthcare professionals perceive the potential role of mobile health (mHealth) support. To explore the experiences and barriers of Chinese women managing vaginal pessaries at home and to examine how patients, family caregivers, and healthcare professionals perceive the potential role of mobile health (mHealth) support. A constructivist grounded theory study was conducted in a specialist pelvic floor clinic at a tertiary teaching hospital in Hefei, Anhui Province. Semi-structured interviews were conducted with 12 women who had used a pessary for at least three months (10 current users and two previous users who had discontinued use), two family caregivers involved in pessary care, and four healthcare professionals. The initial sample was drawn from a predominantly urban clinic population; all four rural women in the final sample were recruited later to elaborate emerging access-related categories. Family caregivers were subsequently recruited to explore the role of relatives in day-to-day care. The final two caregiver interviews generated new family-role codes. Data collection ended for practical and time-related reasons before theoretical saturation was reached. Perceptions of mHealth were elicited through interview discussion; no application, prototype, or structured mock-up was shown or tested. The analysis identified the core category of “fragmented home-based pessary management” and four interconnected themes: interacting physical, psychosocial, cognitive, and environmental barriers; fragmented professional and informational support after fitting; dynamic management responses shaped by individual capacity and available support; and conditional interest in potential mHealth support. These relationships were integrated into the Synergistic Barriers and Fragmented Support (SBF) interpretive framework. Participants identified potential value in reminders, repeatable visual education, symptom guidance, and clinician communication, while also emphasizing limited digital literacy, the need for family involvement, professional workload, and the continuing importance of telephone and face-to-face care. In this single-center qualitative sample, home-based pessary management was shaped by interacting individual and service-level factors rather than by technical skill alone. The findings support the further development and prospective evaluation of individualized follow-up pathways. Potential mHealth support should be considered an anticipated adjunct, rather than a demonstrated substitute, for accessible professional and non-digital care.