Background: Poor adherence and monotony in home-based pelvic floor muscle training (PFMT) often lead to suboptimal rehabilitation outcomes. Serious games using virtual reality (VR) may improve training motivation and precision. This study aimed to explore user demands for a VR pelvic floor rehabilitation training system with game-based features. Methods: A Kano model-based questionnaire was developed and distributed to patients receiving PFMT. The survey assessed 20 demand items spanning five dimensions: system operation, exercise guidance, personalization, device use, and interaction. Traditional Kano categorization and an optimized mixed-method classification were used to identify core demand attributes. Satisfaction and dissatisfaction indices were also calculated. Results: A total of 112 valid questionnaires were analyzed. Using the Kano model, 20 demand items were classified as attractive (n = 7), one-dimensional (n = 5), must-be (n = 6), or indifferent (n = 2). Personalization-related demands were mainly identified as attractive attributes, whereas exercise guidance-related demands were primarily classified as must-be or one-dimensional attributes. Satisfaction Index (SI) values ranged from 0.27 to 0.64, and absolute Dissatisfaction Index (DSI) values ranged from 0.34 to 0.71. Optimized Kano analysis identified nine mixed attributes. The questionnaire demonstrated excellent internal consistency (Cronbach’s α = 0.96). Conclusions: Participants demonstrated positive willingness to adopt a game-based VR system for PFMT, with diverse needs identified across functional and motivational dimensions. These findings suggest that integrating immersive, personalized, and gamified design features may hold promise for enhancing user engagement and anticipated training adherence, though direct evaluation of clinical effectiveness awaits future prototype-based studies. The identified demand priorities provide structured, evidence-informed guidance for the user-centered design of serious game–oriented VR pelvic floor rehabilitation systems.

Background: Midwifery education in China faces growing retention challenges, yet no validated instrument for assessing perceived career barriers exists for this population. Existing measures, such as the Career Barriers Inventory, were developed for Western adult working populations. They do not capture profession-specific obstacles relevant to Chinese midwifery undergraduates, including concerns about labour market conditions, clinical competence demands, and the influence of family socialisation norms on career decisions. This gap limits the ability to design targeted educational interventions. This study therefore aimed to develop and test a self-report tool measuring perceived career barriers among Chinese midwifery undergraduates, and to examine the impact of family socialisation environment on their perceived career barriers. Methods: A total of 767 midwifery undergraduates from eight universities across five regions of China completed the Perceived Career Barrier Scale for Midwifery Undergraduates (PCBS-MU), a 33-item instrument developed through literature review, expert consultation (content validity index ≥ 0.78), and cognitive interviews. Exploratory factor analysis (EFA) with parallel analysis, internal consistency, and corrected item-total correlations were computed. Confirmatory factor analysis (CFA) with modification indices was conducted to evaluate structural validity. Kruskal-Wallis and Mann-Whitney U tests, hierarchical linear regression, and Spearman correlations examined demographic associations. Results: EFA supported a single underlying factor (KMO = 0.962; Bartlett’s χ²(528) = 23185.95, p < .001; eigenvalue = 16.59, explaining 50.3% of variance; factor loadings 0.50–0.87). Internal consistency was excellent (α = 0.968; corrected item-total correlations 0.50–0.78). CFA with six pairs of within-domain correlated residuals demonstrated good structural validity (χ²/df = 4.38, CFI = 0.930, TLI = 0.917, RMSEA = 0.074, SRMR = 0.068). Parenting style was the strongest predictor. Compared with authoritative parenting, authoritarian (B = 11.03), permissive (B = 6.24), and uninvolved (B = 12.63) styles were independently associated with higher barrier scores (all p < .001). Conclusions: The PCBS-MU is a unidimensional measure of perceived career barriers for Chinese midwifery undergraduates with satisfactory initial psychometric properties. In an exploratory secondary analysis, family socialisation environment, particularly parenting style, emerged as the dominant correlate of career barrier perceptions, suggesting that educational interventions targeting psychological resources may help reduce attrition in this workforce-critical group.