Background The global population is ageing in a serious way and the number of disabled elderly people is increasing. Disability is a combination of physical and functional impairments, activity limitations, and social participation restrictions that significantly affect the quality of life of older adults. This study used the Roy adaptation model to examine the adaptive strategies of rural disabled elderly. Methods An interview outline was prepared based on the Roy Adaptation Model, in-depth interviews were conducted with eligible rural elderly with disabilities using purposive sampling. Interview data were analyzed using the colaizzi method to obtain relevant themes and sub-themes of the adaptation experience. Results Fifteen eligible disabled elderly participated in the interview, with an average age of 73.7 years old, showing different adaptation experiences in different aspects, a total of 5 themes and 18 sub-themes were extracted: (a)physiological function adaptation: learning to monitor physiological indicators, active medical compliance behavior, active rehabilitation exercise, adjusting lifestyle and coping with failure, (b) self-concept adaptation: adjustment of gratitude mentality, self-consolation, transferring the attention, seeking emotional comfort, and negative emotional response, (c) role function adaptation: positive self-care role, negative family role and escape of social role, (d) interdependence adaptation: actively seeking support and complex social coping, and (e) adaptation influencing factors: personal factors, caregiver factors and the policy factors. Conclusions The disabled elderly show different adaptation strategies in four ways, and are affected by personal factors, caregiver factors and policy factors. A multi-faceted support system for the disabled elderly is recommended, and the caregivers should be trained in all-round care knowledge and skills.

Background Smart hospital at home(HaH) have become a potential solution to the medical service needs of patients at home, but little is known about their application effects in the disabled elderly. It is necessary to map HaH management models and describe their forms, content, strategies, and evaluation indicators. Methods A scoping review was conducted based on the framework from Arksey and O’Malley. PubMed，Web of Science，Wangfang，CNKI，VIP and OpenGrey were searched until June 30,2022. Mapping existing the smart HaH management for the disabled elderly, including form, content, strategy, and evaluation. Results There were a total of 8 included studies，which focused on the following issues: The forms of management covering: mobile medical and telemedicine;The content covering clinical consultation, establishment of patient health records, guidance on equipment use, and alarm management; Strategy covering the formation of multidisciplinary teams, clarification of team members' responsibilities, comprehensive assessment before bed admission, and dynamic grade assessment throughout the process; Evaluation covering patient health outcomes, smart medical dependence, patient satisfaction evaluation, management program compliance and feasibility; Conclusions Smart HaH management presents comprehensive, holistic, targeted, and dynamic, and is relatively consistent in terms of management form, content, and strategy characteristics, and has achieved positive application effects. However, there is still a lack of high-quality research data and standardized and unified management evaluation criteria, and there is an urgent need to conduct a multi-center, large-sample study of smart HaH management programs for the disabled elderly.

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