What Makes Generation Z Insist on Using Virtual Nurses? Merging ELM and CASA to Discover the Factors for Continued Use

Drawing on the Elaboration Likelihood Model and Computers Are Social Actors framework, 786 valid questionnaires were analyzed via PLS-SEM. Central (information quality, perceived humanness) and peripheral (anthropomorphic appearance, subjective norms) factors positively predicted emotional cognition (<i>β</i> = 0.18–0.269, <i>p</i> < 0.001).

Emotional cognition boosted sustained use intention (<i>β</i> = 0.478, <i>p</i> < 0.001) and mediated these associations, while perceived risk significantly attenuated such relationships (<i>p</i> < 0.05). Generation Z’s continued virtual nurse use relies on rational evaluation and emotional resonance. Optimizing perceived humanness, balancing information quality and anthropomorphism, and lowering perceived risk facilitate long-term adoption, offering implications for healthcare amid nursing workforce shortages.</p>