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A social robot intervention on depression, loneliness, and quality of life for Taiwanese older adults in long-term care. Int Psychogeriatr 2020; 32:981-991. [PMID: 32284080 DOI: 10.1017/s1041610220000459] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To investigate the effect of a social robot intervention on depression, loneliness, and quality of life of older adults in long-term care (LTC) and to explore participants' experiences and perceptions after the intervention. DESIGN A mixed-methods approach consisting of a single group, before and after quasi-experimental design, and individual interview. PARTICIPANTS Twenty older adults with depression from four LTC facilities in Taiwan were recruited. INTERVENTION Each participant participated in 8 weeks of observation and 8 weeks of intervention. In the observation stage, participants received usual care or activities without any research intervention. In the intervention stage, each participant was given a Paro (Personal Assistive RobOt) to keep for 24 hours, 7 days a week. MEASUREMENTS The Geriatric Depression Scale, the UCLA Loneliness Scale Version 3, and the World Health Organization Quality of Life Questionnaire for older adults were administered at four time points. Individual qualitative interviews with thematic analysis followed. RESULTS A repeated multivariate analysis of variance and Friedman's test showed no significant changes during the observation stage between T1 and T2 for depression and quality of life (p >.5). For the intervention stage, statistically significant changes in decreasing depression and loneliness and improving quality of life over time were identified. Three themes emerged from the interviews: (i) humanizing Paro through referring to personal experiences and engagement; (ii) increased social interaction with other people; and (iii) companionship resulting in improved mental well-being. CONCLUSIONS There were significant improvements in mental well-being in using Paro. Further research may help us to understand the advantages of using a Paro intervention as depression therapy.
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Park S, Bak A, Kim S, Nam Y, Kim HS, Yoo DH, Moon M. Animal-Assisted and Pet-Robot Interventions for Ameliorating Behavioral and Psychological Symptoms of Dementia: A Systematic Review and Meta-Analysis. Biomedicines 2020; 8:biomedicines8060150. [PMID: 32498454 PMCID: PMC7345589 DOI: 10.3390/biomedicines8060150] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 01/12/2023] Open
Abstract
Patients with dementia suffer from psychological symptoms such as depression, agitation, and aggression. One purpose of dementia intervention is to manage patients’ inappropriate behaviors and psychological symptoms while taking into consideration their quality of life (QOL). Animal-assisted intervention (AAI) and pet-robot intervention (PRI) are effective intervention strategies for older people with cognitive impairment and dementia. In addition, AAI and PRI have been shown to have positive effects on behavioral and psychological symptoms of dementia (BPSD). However, studies into the association between AAI/PRI and BPSD have elicited inconsistent results. Thus, we performed a meta-analysis to investigate this association. We analyzed nine randomized controlled trials on AAI and PRI for dementia patients published between January 2000 and August 2019 and evaluated the impact of AAI/PRI on agitation, depression, and QOL. We found that AAI and PRI significantly reduce depression in patients with dementia. Subsequent studies should investigate the impact of AAI and PRI on the physical ability and cognitive function of dementia patients and conduct a follow-up to investigate their effects on the rate of progression and reduction of symptoms of dementia. Our research will help with neuropsychological and environmental intervention to delay or improve the development and progression of BPSD.
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Affiliation(s)
- Sangki Park
- Department of Occupational Therapy, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea;
| | - Ahream Bak
- Department of Occupational Therapy, Jeonju Kijeon College, 267, Jeonjucheonseo-ro, Wansan-gu, Junju 54989, Korea;
| | - Sujin Kim
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
| | - Yunkwon Nam
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
| | - Hyeon soo Kim
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
| | - Doo-Han Yoo
- Department of Occupational Therapy, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea;
- Correspondence: (D.-H.Y.); ; (M.M.); Tel.: +82-42-600-8414 (D.-H.Y.); +82-42-600-8691 (M.M.)
| | - Minho Moon
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
- Correspondence: (D.-H.Y.); ; (M.M.); Tel.: +82-42-600-8414 (D.-H.Y.); +82-42-600-8691 (M.M.)
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Koutentakis D, Pilozzi A, Huang X. Designing Socially Assistive Robots for Alzheimer's Disease and Related Dementia Patients and Their Caregivers: Where We are and Where We are Headed. Healthcare (Basel) 2020; 8:E73. [PMID: 32225117 PMCID: PMC7349047 DOI: 10.3390/healthcare8020073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 01/06/2023] Open
Abstract
Over the past few years there has been a large rise in the field of robotics. Robots are being in used in many industries, but there has not been a large surge of robots in the medical field, especially the robots for healthcare use. However, as the aging population keeps growing, current medical staff and healthcare providers are increasingly burdened by caring for the ever-growing number of senior patients, especially those with cognitive impairment of Alzheimer's disease (AD) and Alzheimer's disease-related dementia (ADRD) patients. As a result, we can expect to see a large increase in the field of medical robotics, especially in forms of socially assistive robots (SARs) for senior patients and healthcare providers. In fact, SARs can alleviate AD and ADRD patients and their caregivers' unmet medical needs. Herein, we propose a design outline for such a SAR, based on a review of the current literature. We believe the next generation of SARs will enhance health and well-being, reduce illness and disability, and improve quality of life for AD and ADRD patients and their caregivers.
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Affiliation(s)
| | | | - Xudong Huang
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA; (D.K.); (A.P.)
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Krick T, Huter K, Seibert K, Domhoff D, Wolf-Ostermann K. Measuring the effectiveness of digital nursing technologies: development of a comprehensive digital nursing technology outcome framework based on a scoping review. BMC Health Serv Res 2020; 20:243. [PMID: 32209099 PMCID: PMC7092516 DOI: 10.1186/s12913-020-05106-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 03/12/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Digital nursing technologies (DNT) comprise an expanding, highly diverse field of research, explored using a wide variety of methods and tools. Study results are therefore difficult to compare, which raises the question how effectiveness of DNT can be adequately measured. Methods currently used might not be sufficient for certain specific nursing contexts. A comprehensive outcome framework that shows the multitude of possible outcome areas could be useful to generate more comparable results. The aim of the present study is to develop an outcome framework for DNT and to indicate which outcome areas have been most frequently evaluated in previous studies and how this has been done. METHODS We combined an inductive and deductive approach to develop the framework. The numerical analysis is based on a scoping review focussing on the effectiveness of DNT for persons in need of care, formal or informal caregivers or care institutions. Nine databases were included in the screening: Medline, Scopus, CINAHL, Cochrane Library, ACM Digital Library, IEEE Xplore, the Collection of Computer Science Bibliographies, GeroLit and CareLit. Additional literature searches and expert interviews were included. RESULTS The developed framework comprises four outcome target groups and 47 outcome areas. There are considerable differences in the researched outcome areas for the individual outcome target groups. Persons in need of care were by far the most frequently surveyed, particularly with respect to their psychological health. There are much fewer studies on formal and informal caregivers, and it is particularly noticeable that the quality of life of both groups has rarely been investigated. Care process quality was most frequently researched for organisations. CONCLUSION We were able to provide a comprehensive DNT outcome framework, thereby identifying the outcome tools used and the less researched outcome areas. We recommend a detailed investigation of all areas and tools in future research projects with a view to initiating a discussion on the differing importance of existing outcome areas and on a standardisation of outcome tools. We also recommend the development of outcome areas for the macro level of effectiveness assessment.
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Affiliation(s)
- Tobias Krick
- SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 3, 28359, Bremen, Germany.
- High-profile Area of Health Sciences, University of Bremen, 28359, Bremen, Germany.
| | - Kai Huter
- SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 3, 28359, Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, 28359, Bremen, Germany
| | - Kathrin Seibert
- High-profile Area of Health Sciences, University of Bremen, 28359, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359, Bremen, Germany
| | - Dominik Domhoff
- High-profile Area of Health Sciences, University of Bremen, 28359, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359, Bremen, Germany
| | - Karin Wolf-Ostermann
- High-profile Area of Health Sciences, University of Bremen, 28359, Bremen, Germany
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359, Bremen, Germany
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Four-Week, Home-Based, Robot Cognitive Intervention for Patients with Mild Cognitive Impairment: a Pilot Randomized Controlled Trial. Dement Neurocogn Disord 2020; 19:96-107. [PMID: 32985149 PMCID: PMC7521954 DOI: 10.12779/dnd.2020.19.3.96] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022] Open
Abstract
Background and Purpose Previous studies suggest that cognitive intervention can mitigate the development of dementia in patients with mild cognitive impairment (MCI). However, the previous cognitive intervention was mostly provided as a group session, in which MCI patients sometimes had difficulty in regularly attending sessions or were reluctant to participate in group-based classes. Additionally, experienced instructors for traditional cognitive intervention may be unavailable in some chronic-care facilities or community centers. Considering these reasons, we have developed 5 programs for home-based cognitive intervention using a personal robot for MCI patients. In this preliminary study, we aimed to demonstrate the effects of our newly developed home-based cognitive intervention with robots on cognitive function in MCI patients. Methods We conducted a single-blind randomized controlled trial enrolling 46 MCI patients. Participants were randomized into 2 groups: the robot cognitive intervention (robot) (n=24) group and without cognitive intervention (control) (n=22) group. The interventions comprised 60-min sessions per day for 4 weeks. The primary outcome was the change in cognitive function measured using the Cambridge Neuropsychological Test Automated Battery. Results There were no significant baseline demographic or clinical differences between the robot and control groups. After the 4-week cognitive intervention, the robot group showed greater improvement in working memory than did the control group. Conclusions Our home-based cognitive intervention with a personal robot improved the working memory in MCI patients. Further studies with larger samples and longer study periods are required to demonstrate the effects of these programs in other cognitive domains in MCI patients.
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Jenkins C, Germaine C. Living well in older age: what can we learn from the Japanese experience? Nurs Older People 2019; 31:30-35. [PMID: 31468920 DOI: 10.7748/nop.2019.e1107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2018] [Indexed: 11/09/2022]
Abstract
Japan has the most aged population in the world. Not only do people live longer in Japan, they also age better. While the ageing population reflects a success story driven by lifestyle factors and health promotion initiatives, it also results in challenges for policymakers, families and older people. Other countries with ageing population profiles, such as the UK, can learn from the Japanese experience. In this article, the authors focus on the potential of health promotion strategies, social connections and technology to enhance well-being in older age.
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Alnajjar F, Khalid S, Vogan AA, Shimoda S, Nouchi R, Kawashima R. Emerging Cognitive Intervention Technologies to Meet the Needs of an Aging Population: A Systematic Review. Front Aging Neurosci 2019; 11:291. [PMID: 31798439 PMCID: PMC6821684 DOI: 10.3389/fnagi.2019.00291] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/09/2019] [Indexed: 12/19/2022] Open
Abstract
Background: Cognitive training helps to promote healthy aging and ease activities of daily living for older adults. Recently, experiments have been conducted using robots to perform this cognitive training. Methods: A review was conducted to examine the effects of computer-based cognitive interventions for older adults who were either healthy or experiencing mild cognitive impairment (MCI). A second study also examined the evolution of socially assistive robots (SAR) and their effectiveness at administering cognitive training for older adults. Results: Eighty-one studies published between 2009 and 2019 were identified for review, 56 of which focused on computerized cognitive training (CCT) while 25 examined the use of robotics. Twenty-four of the 56 CCT studies met the inclusion criteria. These were further classified into two groups: studies which used self-designed programs, and studies using commercially available ones. Of the 25 studies examining the use of robotics in cognitive intervention 7 met the inclusion criteria. Review shows that CCT improves cognitive function but that robots are more effective tools for improving cognition. Conclusion: It can be concluded that CCT is beneficial for older adults and though there are drawbacks to this approach they are overcome by the introduction of robots into the training process. Culture, language, and socio-economic considerations vis-a-vis robot design and training methodology should be included in future research.
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Affiliation(s)
- Fady Alnajjar
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates.,Intelligent Behavior Control Unit, CBS-TOYOTA Collaboration Center, RIKEN, Nagoya, Japan
| | - Sumayya Khalid
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Alistair A Vogan
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Shingo Shimoda
- Intelligent Behavior Control Unit, CBS-TOYOTA Collaboration Center, RIKEN, Nagoya, Japan
| | - Rui Nouchi
- Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Ryuta Kawashima
- Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan
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Kang HS, Makimoto K, Konno R, Koh IS. Review of outcome measures in PARO robot intervention studies for dementia care. Geriatr Nurs 2019; 41:207-214. [PMID: 31668459 DOI: 10.1016/j.gerinurse.2019.09.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022]
Abstract
The aim of this study was to describe interventions for PARO, as well as the outcomes evaluated and found following use of PARO, and to identify outcome measures in PARO intervention studies for older adults with dementia. Multiple databases (Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane, and Scopus) were searched and eight studies were included in the systematic review. The review demonstrated that interventions using PARO can be beneficial for improving QOL, affect, social interaction, and reducing NPS and psychotropic or pain medication use. This study identified three domains of outcome measures used to assess the effects of interventions using the PARO robot: quality of life, biological and physiological conditions, and medical treatment.
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Affiliation(s)
- Hee Sun Kang
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-Rd, Dongjak-Gu, Seoul 156-756, South Korea.
| | - Kiyoko Makimoto
- School of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Rie Konno
- Kansai University of International Studies, Hyogo, Japan
| | - In Soon Koh
- Department of Nursing, Andong Science College, South Korea.
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Abbott R, Orr N, McGill P, Whear R, Bethel A, Garside R, Stein K, Thompson‐Coon J. How do "robopets" impact the health and well-being of residents in care homes? A systematic review of qualitative and quantitative evidence. Int J Older People Nurs 2019; 14:e12239. [PMID: 31070870 PMCID: PMC6766882 DOI: 10.1111/opn.12239] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 04/05/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Robopets are small animal-like robots which have the appearance and behavioural characteristics of pets. OBJECTIVE To bring together the evidence of the experiences of staff, residents and family members of interacting with robopets and the effects of robopets on the health and well-being of older people living in care homes. DESIGN Systematic review of qualitative and quantitative research. DATA SOURCES We searched 13 electronic databases from inception to July 2018 and undertook forward and backward citation chasing. METHODS Eligible studies reported the views and experiences of robopets from residents, family members and staff (qualitative studies using recognised methods of qualitative data collection and analysis) and the effects of robopets on the health and well-being of care home residents (randomised controlled trials, randomised crossover trials and cluster randomised trials). Study selection was undertaken independently by two reviewers. We used the Wallace criteria and the Cochrane Risk of Bias tool to assess the quality of the evidence. We developed a logic model with stakeholders and used this as a framework to guide data extraction and synthesis. Where appropriate, we used meta-analysis to combine effect estimates from quantitative studies. RESULTS Nineteen studies (10 qualitative, 2 mixed methods and 7 randomised trials) met the inclusion criteria. Interactions with robopets were described as having a positive impact on aspects of well-being including loneliness, depression and quality of life by residents and staff, although there was no corresponding statistically significant evidence from meta-analysis for these outcomes. Meta-analysis showed evidence of a reduction in agitation with the robopet "Paro" compared to control (-0.32 [95% CI -0.61 to -0.04, p = 0.03]). Not everyone had a positive experience of robopets. CONCLUSIONS Engagement with robopets appears to have beneficial effects on the health and well-being of older adults living in care homes, but not all chose to engage. Whether the benefits can be sustained are yet to be investigated. IMPLICATIONS FOR PRACTICE Robopets have the potential to benefit people living in care homes, through increasing engagement and interaction. With the robopet acting as a catalyst, this engagement and interaction may afford comfort and help reduce agitation and loneliness.
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Affiliation(s)
- Rebecca Abbott
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| | - Noreen Orr
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| | - Paige McGill
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Rebecca Whear
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| | - Alison Bethel
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| | - Ruth Garside
- European Centre for Environment and Human HealthUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Ken Stein
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
| | - Jo Thompson‐Coon
- Evidence Synthesis Team, NIHR CLAHRC South West Peninsula (PenCLAHRC), College of Medicine and HealthUniversity of ExeterExeterUK
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Hung L, Liu C, Woldum E, Au-Yeung A, Berndt A, Wallsworth C, Horne N, Gregorio M, Mann J, Chaudhury H. The benefits of and barriers to using a social robot PARO in care settings: a scoping review. BMC Geriatr 2019; 19:232. [PMID: 31443636 PMCID: PMC6708202 DOI: 10.1186/s12877-019-1244-6] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 08/11/2019] [Indexed: 02/06/2023] Open
Abstract
Background Given the complexity of providing dementia care in hospitals, integrating technology into practice is a high challenge and an important opportunity. Although there are a growing demand and interest in using social robots in a variety of care settings to support dementia care, little is known about the impacts of the robotics and their application in care settings, i.e., what worked, in which situations, and how. Methods Scientific databases and Google Scholar were searched to identify publications published since 2000. The inclusion criteria consisted of older people with dementia, care setting, and social robot PARO. Results A total of 29 papers were included in the review. Content analysis identified 3 key benefits of and 3 barriers to the use of PARO. Main benefits include: reducing negative emotion and behavioral symptoms, improving social engagement, and promoting positive mood and quality of care experience. Key barriers are: cost and workload, infection concerns, and stigma and ethical issues. This review reveals 3 research gaps: (a) the users’ needs and experiences remain unexplored, (b) few studies investigate the process of how to use the robot effectively to meet clinical needs, and (c) theory should be used to guide implementation. Conclusions Most interventions conducted have been primarily researcher-focused. Future research should pay more attention to the clinical needs of the patient population and develop strategies to overcome barriers to the adoption of PARO in order to maximize patient benefits. Electronic supplementary material The online version of this article (10.1186/s12877-019-1244-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lillian Hung
- Gerontology Research Centre, Simon Fraser University, Room 2818, 2800-515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada. .,University of British Columbia, Vancouver, Canada.
| | - Cindy Liu
- University of British Columbia, Vancouver, Canada
| | - Evan Woldum
- University of British Columbia, Vancouver, Canada
| | | | - Annette Berndt
- Community Engagement Advocacy Network at Vancouver Coastal Health, Vancouver, Canada
| | - Christine Wallsworth
- Community Engagement Advocacy Network at Vancouver Coastal Health, Vancouver, Canada
| | - Neil Horne
- Community Engagement Advocacy Network at Vancouver Coastal Health, Vancouver, Canada
| | - Mario Gregorio
- Community Engagement Advocacy Network at Vancouver Coastal Health, Vancouver, Canada
| | - Jim Mann
- Community Engagement Advocacy Network at Vancouver Coastal Health, Vancouver, Canada
| | - Habib Chaudhury
- Gerontology Research Centre, Simon Fraser University, Room 2818, 2800-515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada
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Krick T, Huter K, Domhoff D, Schmidt A, Rothgang H, Wolf-Ostermann K. Digital technology and nursing care: a scoping review on acceptance, effectiveness and efficiency studies of informal and formal care technologies. BMC Health Serv Res 2019; 19:400. [PMID: 31221133 PMCID: PMC6585079 DOI: 10.1186/s12913-019-4238-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 06/10/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The existence, usage and benefits of digital technologies in nursing care are relevant topics in the light of the current discussion on technologies as possible solutions to problems such as the shortage of skilled workers and the increasing demand for long-term care. A lack of good empirical overviews of existing technologies in the present literature prompted us to conduct this review. Its purpose was to map the field of digital technologies for informal and formal care that have already been explored in terms of acceptance, effectiveness and efficiency (AEE), and to show the scope of the used methods, target settings, target groups and fields of support. METHODS A systematic literature search was conducted using Medline, Scopus, CINAHL, Cochrane Library, ACM Digital Library, IEEE Xplore, the Collection of Computer Science Bibliographies, GeroLit and CareLit. In addition, project websites were manually screened for relevant publications. RESULTS Seven hundred fifteen papers were included in the review. Effectiveness studies have been most frequently performed for ICT, robots and sensors. Acceptance studies often focussed on ICT, robots and EHR/EMR. Efficiency studies were generally rare. Many studies were found to have a low level of evidence. Experimental designs with small numbers and without control groups were the most common methods used to evaluate acceptance and effectiveness. Study designs with high evidence levels were most commonly found for ICT, robots and e-learning. Technologies evaluated for informal caregivers and children or indicated for formal care at home or in cross-sectoral care were rare. CONCLUSION We recommend producing high-quality evaluations on existing digital technologies for AEE in real-life settings rather than systematic reviews with low-quality studies. More focus should be placed on research into efficiency. Future research should be devoted to a closer examination of the applied AEE evaluation methods. Policymakers should provide funding to enable large-scale, long-term evaluations of technologies in the practice of care, filling the research gaps for technologies, target settings and target groups identified in this review.
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Affiliation(s)
- Tobias Krick
- SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 3, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
| | - Kai Huter
- SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 3, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
| | - Dominik Domhoff
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
| | - Annika Schmidt
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
| | - Heinz Rothgang
- SOCIUM Research Center on Inequality and Social Policy, University of Bremen, Mary-Somerville-Straße 3, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
| | - Karin Wolf-Ostermann
- Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany
- High-profile Area of Health Sciences, University of Bremen, Bremen, Germany
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Dodds P, Martyn K, Brown M. Infection prevention and control challenges of using a therapeutic robot. Nurs Older People 2019; 30:34-40. [PMID: 29569863 DOI: 10.7748/nop.2018.e994] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2018] [Indexed: 11/09/2022]
Abstract
This work was part of a National Institute for Health Research participatory action research and practice development study, which focused on the use of a therapeutic, robotic baby seal (PARO, for personal assistive robot) in everyday practice in a single-site dementia unit in Sussex. From the beginning of January 2017 until the end of September 2017, the cleaning and cleanliness of PARO was monitored through a service audit process that focused on the cleaning, amount of use and testing of contamination of PARO being used in everyday clinical practice with individuals and in group sessions. Its use and cleaning followed protocols developed by the study team, which incorporated hand hygiene and standard precaution policies. Its cleanliness was determined using an adenosine triphosphate (ATP) luminometer, with a benchmark of 50 relative light units (RLU). A reading of ATP below 50RLU is the level of cleanliness recommended for social areas in hospital settings. Throughout the study period, monitoring showed that all swab zones on PARO were within the benchmark of the 50RLU threshold for cleanliness. PARO has an emerging evidence base as a useful therapeutic device. However, introducing such devices into clinical practice may encounter barriers or concerns from an infection prevention and control (IPC) perspective. This study of PARO in clinical practice aims to address the IPC concerns raised and offers cleaning and testing protocols and results.
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63
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Robinson NL, Cottier TV, Kavanagh DJ. Psychosocial Health Interventions by Social Robots: Systematic Review of Randomized Controlled Trials. J Med Internet Res 2019; 21:e13203. [PMID: 31094357 PMCID: PMC6533873 DOI: 10.2196/13203] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/22/2019] [Accepted: 04/09/2019] [Indexed: 01/06/2023] Open
Abstract
Background Social robots that can communicate and interact with people offer exciting opportunities for improved health care access and outcomes. However, evidence from randomized controlled trials (RCTs) on health or well-being outcomes has not yet been clearly synthesized across all health domains where social robots have been tested. Objective This study aimed to undertake a systematic review examining current evidence from RCTs on the effects of psychosocial interventions by social robots on health or well-being. Methods Medline, PsycInfo, ScienceDirect, Scopus, and Engineering Village searches across all years in the English language were conducted and supplemented by forward and backward searches. The included papers reported RCTs that assessed changes in health or well-being from interactions with a social robot across at least 2 measurement occasions. Results Out of 408 extracted records, 27 trials met the inclusion criteria: 6 in child health or well-being, 9 in children with autism spectrum disorder, and 12 with older adults. No trials on adolescents, young adults, or other problem areas were identified, and no studies had interventions where robots spontaneously modified verbal responses based on speech by participants. Most trials were small (total N=5 to 415; median=34), only 6 (22%) reported any follow-up outcomes (2 to 12 weeks; median=3.5) and a single-blind assessment was reported in 8 (31%). More recent trials tended to have greater methodological quality. All papers reported some positive outcomes from robotic interventions, although most trials had some measures that showed no difference or favored alternate treatments. Conclusions Controlled research on social robots is at an early stage, as is the current range of their applications to health care. Research on social robot interventions in clinical and health settings needs to transition from exploratory investigations to include large-scale controlled trials with sophisticated methodology, to increase confidence in their efficacy.
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Affiliation(s)
- Nicole Lee Robinson
- Australian Centre for Robotic Vision, Brisbane, Australia.,Queensland University of Technology, Brisbane, Australia
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Pu L, Moyle W, Jones C, Todorovic M. The Effectiveness of Social Robots for Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. THE GERONTOLOGIST 2019; 59:e37-e51. [PMID: 29897445 DOI: 10.1093/geront/gny046] [Citation(s) in RCA: 166] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives Social robots may promote the health of older adults by increasing their perceived emotional support and social interaction. This review aims to summarize the effectiveness of social robots on outcomes (psychological, physiological, quality of life, or medications) of older adults from randomized controlled trials (RCTs). Research Design and Methods A mixed-method systematic review of RCTs meeting the study inclusion criteria was undertaken. Eight databases were electronically searched up to September 2017. Participants' characteristics, intervention features, and outcome data were retrieved. The mean difference and standardized mean difference with 95% confidence intervals (CI) were synthesized to pool the effect size. Results A total of 13 articles from 11 RCTs were identified from 2,204 articles, of which 9 studies were included in the meta-analysis. Risk of bias was relatively high in allocation concealment and blinding. Social robots appeared to have positive impacts on agitation, anxiety, and quality of life for older adults but no statistical significance was found in the meta-analysis. However, results from a narrative review indicated that social robot interactions could improve engagement, interaction, and stress indicators, as well as reduce loneliness and the use of medications for older adults. Discussion and Implications Social robots appear to have the potential to improve the well-being of older adults, but conclusions are limited due to the lack of high-quality studies. More RCTs are recommended with larger sample sizes and rigorous study designs.
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Affiliation(s)
- Lihui Pu
- School of Nursing and Midwifery, Nathan Campus, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Wendy Moyle
- School of Nursing and Midwifery, Nathan Campus, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Cindy Jones
- School of Nursing and Midwifery, Nathan Campus, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Michael Todorovic
- School of Nursing and Midwifery, Nathan Campus, Griffith University, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Ford Ii JH, Dodds D, Hyland J, Potteiger M. Evaluating the Impact of Music & Memory's Personalized Music and Tablet Engagement Program in Wisconsin Assisted Living Communities: Pilot Study. JMIR Aging 2019; 2:e11599. [PMID: 31518259 PMCID: PMC6716484 DOI: 10.2196/11599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/15/2018] [Accepted: 01/08/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Individuals with Alzheimer disease or related dementia represent a significant and growing segment of the older adult (aged 65 years and above) population. In addition to physical health concerns, including comorbid medical conditions, these individuals often exhibit behavioral and psychological symptoms of dementia (BPSD). The presence of BPSD in long-term care residential facilities can disrupt resident's care and impact staff. Nonpharmacological interventions such as personalized music and tablet engagement maintain cognitive function, improve quality of life (QOL), and mitigate BPSD for older adults with dementia. Evidence of the impact of such interventions in assisted living communities (ALCs) is needed for widespread adoption and sustainment of these technologies. OBJECTIVE The aim of this study was to assess the impact of Music & Memory's personalized music and tablet engagement (PMATE) program on QOL, agitation, and medication use for residents living in 6 Wisconsin ALCs. METHODS The data collected were on the utilization of iPods and iPads by the residents. Residents' outcomes were assessed using the Pittsburgh Agitation Scale, the Quality of Life in Late Stage Dementia scale, and self-reported medication use. A mixed-methods approach was utilized to examine the impact of the PMATE program on these outcomes. Descriptive statistics were calculated. A paired t test explored changes in residents' QOL. A 1-way analysis of variance was utilized to examine changes in resident's agitation and QOL based on the resident's utilization of the PMATE program. Qualitative interviews were conducted with the individuals responsible for PMATE implementation in the ALC. Residents excluded from the analysis were those who passed away, were discharged, or refused to participate. RESULTS A total of 5 apps, based on average times used by residents, were identified. In all, 4 of the 5 apps were rated as being useful to promote residents' engagement. PMATE utilization was not associated with changes in the residents' agitation levels or antipsychotic medication use over time. Over a 3-month period, the change in residents' QOL was significant (P=.047), and the differences across ALCs were also significant (F25=3.76, P=.02). High utilizers of the PMATE program (>2500 min over 3 months) showed greater improvements in QOL as compared with low utilizers (a change of -5.90 points vs an increase of 0.43 points). The difference was significant (P=.03). Similar significant findings were found between the high- and midutilizers. CONCLUSIONS The study is one of the first to explore the impact of Music & Memory's PMATE program on residents living in ALCs. Findings suggest that higher utilization over time improves residents' QOL. However, a more comprehensive study with improved data collection efforts across multiple ALCs is needed to confirm these preliminary findings.
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Affiliation(s)
- James H Ford Ii
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Julie Hyland
- Wisconsin Department of Health Servicess, Madison, WI, United States
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Leng M, Liu P, Zhang P, Hu M, Zhou H, Li G, Yin H, Chen L. Pet robot intervention for people with dementia: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res 2019; 271:516-525. [PMID: 30553098 DOI: 10.1016/j.psychres.2018.12.032] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 01/29/2023]
Abstract
This study aims to systematically evaluate the efficacy of Pet robot intervention (PRI) for people with dementia. Two waves of electronic searches of the PubMed, EMBASE, Web of Science, Cochrane library, IEEE Digital Library and PsycINFO databases were conducted. In total, eight articles from six randomized controlled trials (RCTs) met the eligibility criteria and were included in this systematic review. The results of the meta-analysis showed a statistically significant decrease in behavioral and psychological symptoms of dementia (BPSD), especially agitation and depression, in people with dementia who were treated with PRI. Both individual and group format PRI significantly ameliorated BPSD. However, there were no significant improvements in cognitive function or quality of life. The results of the meta-analysis suggest that PRI may be suitable as a treatment option for BPSD in people with dementia and should be considered as a useful tool in clinical practice.
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Affiliation(s)
- Minmin Leng
- School of Nursing, Jilin University, Changchun, China
| | - Peng Liu
- School of Mechanical Science and Engineering, Jilin University, Changchun, China
| | - Ping Zhang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Mingyue Hu
- School of Nursing, Jilin University, Changchun, China
| | - Haiyan Zhou
- The First Hospital of Jilin University, Changchun, China
| | - Guichen Li
- School of Nursing, Jilin University, Changchun, China
| | - Huiru Yin
- School of Nursing, Jilin University, Changchun, China
| | - Li Chen
- School of Nursing, Jilin University, Changchun, China; Department of Pharmacology, college of Basic Medical sciences, Jilin University, Changchun, China.
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Health Outcomes of Deprescribing Interventions Among Older Residents in Nursing Homes: A Systematic Review and Meta-analysis. J Am Med Dir Assoc 2018; 20:362-372.e11. [PMID: 30581126 DOI: 10.1016/j.jamda.2018.10.026] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 08/21/2018] [Accepted: 10/20/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Deprescribing is effective in addressing concerns relating to polypharmacy in residents of nursing homes. However, the clinical outcomes of deprescribing interventions among residents in nursing homes are not well understood. We evaluated the impact of deprescribing interventions by health care professionals on clinical outcomes among the older residents in nursing homes. DESIGN Systematic review and meta-analysis of randomized controlled trials. CINAHL, International Pharmaceutical Abstracts, MEDLINE, EMBASE, and Cochrane Library were searched from inception until September 2017; manual searches of reference lists of systematic reviews identified in the electronic search; and online trial registries for unpublished, ongoing, or planned trials. (PROSPERO CRD42016050028). SETTING AND PARTICIPANTS Randomized controlled trials in a nursing home setting that included participants of at least 60 years of age. MEASURES Falls, all-cause mortality, hospitalization, and potentially inappropriate medication were assessed in the meta-analysis. RESULTS A total of 41 randomized clinical studies (18,408 residents) that examined deprescribing (defined as either medication discontinuation, substitution, or reduction) in nursing were identified. Deprescribing interventions significantly reduced the number of residents with potentially inappropriate medications by 59% (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.19-0.89). In subgroup analysis, medication review-directed deprescribing interventions reduced all-cause mortality by 26% (OR 0.74, 95% CI 0.65-0.84), as well as the number of fallers by 24% (OR 0.76, 95% CI 0.62-0.93). CONCLUSIONS Compared to other deprescribing interventions, medication review-directed deprescribing had significant benefits on older residents in nursing homes. Further research is required to elicit other clinical benefits of medication review-directed deprescribing practice.
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Chiberska D. The use of robotic animals in dementia care: challenges and ethical dilemmas. ACTA ACUST UNITED AC 2018. [DOI: 10.7748/mhp.2018.e1342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Góngora Alonso S, Hamrioui S, de la Torre Díez I, Motta Cruz E, López-Coronado M, Franco M. Social Robots for People with Aging and Dementia: A Systematic Review of Literature. Telemed J E Health 2018; 25:533-540. [PMID: 30136901 DOI: 10.1089/tmj.2018.0051] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Social robots are currently a form of assistive technology for the elderly, healthy, or with cognitive impairment, helping to maintain their independence and improve their well-being. Objective: The main aim of this article is to present a review of the existing research in the literature, referring to the use of social robots for people with dementia and/or aging. Methods: Academic databases that were used to perform the searches are IEEE Xplore, PubMed, Science Direct, and Google Scholar, taking into account as date of publication the last 10 years, from 2007 to the present. Several search criteria were established such as "robot" AND "dementia," "robot" AND "cognitive impairment," "robot" AND "social" AND "aging," and so on., selecting the articles of greatest interest regarding the use of social robots in elderly people with or without dementia. Results: This search found a total of 96 articles on social robots in healthy people and with dementia, of which 38 have been identified as relevant work. Many of the articles show the acceptance of older people toward social robots. Conclusion: From the review of the research articles analyzed, it can be said that use of social robots in elderly people without cognitive impairment and with dementia, help in a positive way to work independently in basic activities and mobility, provide security, and reduce stress.
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Affiliation(s)
- Susel Góngora Alonso
- 1 Department of Signal Theory and Communications, and Telematics Engineering, University of Valladolid, Valladolid, Spain
| | - Sofiane Hamrioui
- 2 Department of Telecommunication and Networks, Bretagne Loire and Nantes Universities, Polytech Nantes, France
| | - Isabel de la Torre Díez
- 1 Department of Signal Theory and Communications, and Telematics Engineering, University of Valladolid, Valladolid, Spain
| | - Eduardo Motta Cruz
- 2 Department of Telecommunication and Networks, Bretagne Loire and Nantes Universities, Polytech Nantes, France
| | - Miguel López-Coronado
- 1 Department of Signal Theory and Communications, and Telematics Engineering, University of Valladolid, Valladolid, Spain
| | - Manuel Franco
- 3 Psychiatry Service, Hospital Zamora, Zamora, Spain
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Demange M, Lenoir H, Pino M, Cantegreil-Kallen I, Rigaud AS, Cristancho-Lacroix V. Improving well-being in patients with major neurodegenerative disorders: differential efficacy of brief social robot-based intervention for 3 neuropsychiatric profiles. Clin Interv Aging 2018; 13:1303-1311. [PMID: 30057445 PMCID: PMC6057554 DOI: 10.2147/cia.s152561] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Behavioral and psychological symptoms of dementia (BPSD) affect patients’ daily life and subjective well-being. International recommendations stress nonpharmacological interventions as first-line treatment. While newer psychosocial initiatives adapted to geriatric populations based on social robot therapy have emerged, to our knowledge, no studies on differential efficacy depending on BPSD profiles have been conducted yet. Objectives This pilot study examined the impact of short exposure to a social robot (Paro®) on the subjective emotional well-being of patients with major neurocognitive disorder as well as its impact on differential effects for 3 BPSD profiles. Methods Seventeen patients with major NCD with apathy (n=6), depression (n=7), and agitation (n=4) were recruited. The intervention was composed of four 15-minute individual sessions. Exposure occurred without the simultaneous presence of a health care provider. A pre–post assessment of emotional well-being was conducted with the International Positive and Negative Affect Schedule Short-Form, which measures positive and negative affectivity. Results Overall findings showed a significant increase of positive affectivity (p=0.02). Subgroup analysis demonstrated that agitated patients reduced negative affectivity significantly more than depressed patients (p=0.03). Results also confirmed users’ overall acceptability of the robot. Conclusion These findings support the usefulness of brief interactive sessions with the Paro robot for elderly patients with major NCD. These preliminary results encourage further research focused on brief interventions using social robotics, as well as on their specific benefits depending on the behavioral typology of patients with neurocognitive disorders.
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Affiliation(s)
- Manon Demange
- Department of Geriatrics, Broca Hospital, Greater Paris University Hospitals (APHP), Paris, France, .,Research Team 4468, Paris Descartes University, Paris, France,
| | - Hermine Lenoir
- Department of Geriatrics, Broca Hospital, Greater Paris University Hospitals (APHP), Paris, France, .,Research Team 4468, Paris Descartes University, Paris, France,
| | - Maribel Pino
- Department of Geriatrics, Broca Hospital, Greater Paris University Hospitals (APHP), Paris, France, .,Research Team 4468, Paris Descartes University, Paris, France,
| | - Inge Cantegreil-Kallen
- Department of Geriatrics, Broca Hospital, Greater Paris University Hospitals (APHP), Paris, France, .,Research Team 4468, Paris Descartes University, Paris, France,
| | - Anne Sophie Rigaud
- Department of Geriatrics, Broca Hospital, Greater Paris University Hospitals (APHP), Paris, France, .,Research Team 4468, Paris Descartes University, Paris, France,
| | - Victoria Cristancho-Lacroix
- Department of Geriatrics, Broca Hospital, Greater Paris University Hospitals (APHP), Paris, France, .,Research Team 4468, Paris Descartes University, Paris, France,
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Jones C, Moyle W, Murfield J, Draper B, Shum D, Beattie E, Thalib L. Does Cognitive Impairment and Agitation in Dementia Influence Intervention Effectiveness? Findings From a Cluster-Randomized-Controlled Trial With the Therapeutic Robot, PARO. J Am Med Dir Assoc 2018; 19:623-626. [PMID: 29656838 DOI: 10.1016/j.jamda.2018.02.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 02/27/2018] [Accepted: 02/28/2018] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To explore whether severity of cognitive impairment and agitation of older people with dementia predict outcomes in engagement, mood states, and agitation after a 10-week intervention with the robotic seal, PARO. DESIGN Data from the PARO intervention-arm of a cluster-randomized controlled trial was used, which involved individual, nonfacilitated, 15-minute sessions with PARO 3 afternoons per week for 10 weeks. SAMPLE AND PARTICIPANTS One hundred thirty-eight residents-aged ≥60 years, with dementia-from 9 long-term care facilities. MEASURES A series of stepwise multiple linear regressions were conducted. Dependent variables were participants' levels of engagement, mood states, and agitation at week 10 [assessed by video observation and Cohen Mansfield Agitation Inventory-Short Form (CMAI-SF)]. Predictor variables were baseline levels of cognitive impairment [assessed by Rowland Universal Dementia Assessment Scale (RUDAS)] and agitation (CMAI-SF). RESULTS Five models were produced. The strongest finding was that participants with more severe agitation at baseline had higher levels of agitation at week 10 (R2 = .82, P < .001). Predictors of positive response were less significant. Low levels of agitation at baseline predicted greater positive behavioral engagement with PARO (R2 = .054, P = .009) and fewer observed instances of agitation (R2 = .033, P = .045) at week 10, whereas greater visual engagement was predicted by both lower levels of agitation and cognitive impairment (R2 = .082, P = .006). Less severe cognitive impairment predicted greater pleasure at week 10 (R2 = .067, P = .004). CONCLUSIONS/IMPLICATIONS Participants with severe agitation had poor response to PARO. Lower levels of agitation and higher cognitive functioning were associated with better responses. In clinical practice, we recommend PARO should be restricted to people with low-moderate severity of agitation. Further research is needed to determine the optimal participant characteristics for response to PARO.
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Affiliation(s)
- Cindy Jones
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia.
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - Jenny Murfield
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - Brian Draper
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - David Shum
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Applied Psychology, Mt Gravatt Campus, Griffith University, Brisbane, Queensland, Australia; Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Elizabeth Beattie
- School of Nursing, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - Lukman Thalib
- Department of Public Health, College of Health Sciences, Qatar University, Qatar
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Moyle W, Jones C, Murfield J, Thalib L, Beattie E, Shum D, O’Dwyer S, Mervin MC, Draper B. Effect of a robotic seal on the motor activity and sleep patterns of older people with dementia, as measured by wearable technology: A cluster-randomised controlled trial. Maturitas 2018; 110:10-17. [DOI: 10.1016/j.maturitas.2018.01.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 01/11/2018] [Accepted: 01/12/2018] [Indexed: 10/18/2022]
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Moyle W, Bramble M, Jones C, Murfield J. Care staff perceptions of a social robot called Paro and a look-alike Plush Toy: a descriptive qualitative approach. Aging Ment Health 2018; 22:330-335. [PMID: 27967207 DOI: 10.1080/13607863.2016.1262820] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Social robots such as Paro, a therapeutic companion robot, have recently been introduced into dementia care as a means to reduce behavioural and psychological symptoms of dementia. The purpose of this study was to explore care staff perceptions of Paro and a look-alike non-robotic animal, including benefits and limitations in dementia care. METHODS The study assumed a descriptive qualitative approach, nested within a large cluster-randomised controlled trial. We interviewed a subsample of 20 facility care staff, from nine long-term care facilities in Southeast Queensland, Australia. Thematic analysis of the data, which was inductive and data-driven, was undertaken with the assistance of the qualitative software, ATLAS.ti®. RESULTS The findings refer to four categories: increasing excitement for Paro and decreasing enthusiasm for Plush Toy; value and function of Paro; opportunities for engagement; and alternatives vs. robustness. CONCLUSION Staff caring for people with dementia preferred Paro compared to a look-alike Plush Toy. Staff identified that Paro had the potential to improve quality of life for people with dementia, whereas the Plush Toy had limitations when compared to Paro. However, participants expressed concern that the cost of Paro could reduce opportunities for use within aged care.
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Affiliation(s)
- Wendy Moyle
- a Menzies Health Institute Queensland , Griffith University , Brisbane , Australia.,b School of Nursing and Midwifery, Nathan Campus , Griffith University , Brisbane , Australia
| | - Marguerite Bramble
- c School of Health Sciences , University of Tasmania , Sydney , Australia
| | - Cindy Jones
- a Menzies Health Institute Queensland , Griffith University , Brisbane , Australia.,b School of Nursing and Midwifery, Nathan Campus , Griffith University , Brisbane , Australia
| | - Jenny Murfield
- a Menzies Health Institute Queensland , Griffith University , Brisbane , Australia.,b School of Nursing and Midwifery, Nathan Campus , Griffith University , Brisbane , Australia
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Abdi J, Al-Hindawi A, Ng T, Vizcaychipi MP. Scoping review on the use of socially assistive robot technology in elderly care. BMJ Open 2018; 8:e018815. [PMID: 29440212 PMCID: PMC5829664 DOI: 10.1136/bmjopen-2017-018815] [Citation(s) in RCA: 158] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/10/2017] [Accepted: 12/13/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE With an elderly population that is set to more than double by 2050 worldwide, there will be an increased demand for elderly care. This poses several impediments in the delivery of high-quality health and social care. Socially assistive robot (SAR) technology could assume new roles in health and social care to meet this higher demand. This review qualitatively examines the literature on the use of SAR in elderly care and aims to establish the roles this technology may play in the future. DESIGN Scoping review. DATA SOURCES Search of CINAHL, Cochrane Library, Embase, MEDLINE, PsychINFO and Scopus databases was conducted, complemented with a free search using Google Scholar and reference harvesting. All publications went through a selection process, which involved sequentially reviewing the title, abstract and full text of the publication. No limitations regarding date of publication were imposed, and only English publications were taken into account. The main search was conducted in March 2016, and the latest search was conducted in September 2017. ELIGIBILITY CRITERIA The inclusion criteria consist of elderly participants, any elderly healthcare facility, humanoid and pet robots and all social interaction types with the robot. Exclusions were acceptability studies, technical reports of robots and publications surrounding physically or surgically assistive robots. RESULTS In total, 61 final publications were included in the review, describing 33 studies and including 1574 participants and 11 robots. 28 of the 33 papers report positive findings. Five roles of SAR were identified: affective therapy, cognitive training, social facilitator, companionship and physiological therapy. CONCLUSIONS Although many positive outcomes were reported, a large proportion of the studies have methodological issues, which limit the utility of the results. Nonetheless, the reported value of SAR in elderly care does warrant further investigation. Future studies should endeavour to validate the roles demonstrated in this review. SYSTEMATIC REVIEW REGISTRATION NIHR 58672.
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Affiliation(s)
- Jordan Abdi
- Department of Medicine, Imperial College London, London, UK
| | - Ahmed Al-Hindawi
- Magill Department of Anaesthesia, Intensive Care Medicine and Pain Management, Chelsea and Westminster Hospital, London, UK
| | - Tiffany Ng
- Magill Department of Anaesthesia, Intensive Care Medicine and Pain Management, Chelsea and Westminster Hospital, London, UK
| | - Marcela P Vizcaychipi
- Magill Department of Anaesthesia, Intensive Care Medicine and Pain Management, Chelsea and Westminster Hospital, London, UK
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Moyle W, Jones CJ, Murfield JE, Thalib L, Beattie ERA, Shum DKH, O'Dwyer ST, Mervin MC, Draper BM. Use of a Robotic Seal as a Therapeutic Tool to Improve Dementia Symptoms: A Cluster-Randomized Controlled Trial. J Am Med Dir Assoc 2017; 18:766-773. [PMID: 28780395 DOI: 10.1016/j.jamda.2017.03.018] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 03/28/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To test the effects of individual, nonfacilitated sessions with PARO (version 9), when compared against a look-alike plush toy and usual care, on the emotional and behavioral symptoms of dementia for people living in long-term care facilities. DESIGN Parallel, 3-group, cluster-randomized controlled trial conducted between June 14, 2014, and May 16, 2015. SETTING Twenty-eight long-term care facilities operated by 20 care organizations located in South-East Queensland, Australia. PARTICIPANTS Four hundred fifteen participants aged ≥60 years, with a documented diagnosis of dementia. INTERVENTION Stratified by private/not-for-profit status and randomized using a computer-generated sequence, 9 facilities were randomized to the PARO group (individual, nonfacilitated, 15-minute sessions 3 times per week for 10 weeks); 10 to plush toy (same, but given PARO with robotic features disabled); and 9 to usual care. Treatment allocation was masked to assessors. MEASUREMENTS Primary outcomes were changes in levels of engagement, mood states, and agitation after a 10-week intervention, assessed by coded video observations (baseline, weeks 1, 5, 10, and 15) and Cohen-Mansfield Agitation Inventory-Short Form (baseline, weeks 10 and 15). Analyses followed intention-to-treat, using repeated measures mixed effects models. Australian New Zealand Clinical Trials Registry (ACTRN12614000508673). RESULTS Video data showed that participants in the PARO group were more verbally [3.61, 95% confidence interval (CI): 6.40-0.81, P = .011] and visually engaged (13.06, 95% CI: 17.05-9.06, P < .0001) than participants in plush toy. Both PARO (-3.09, 95% CI: -0.45 to -5.72, P = .022) and plush toy (-3.58, 95% CI: -1.26 to -5.91, P = .002) had significantly greater reduced neutral affect compared with usual care, whilst PARO was more effective than usual care in improving pleasure (1.12, 95% CI: 1.94-0.29, P = .008). Videos showed that PARO was more effective than usual care in improving agitation (3.33, 95% CI: 5.79-0.86, P = .008). When measured using the CMAI-SF, there was no difference between groups. CONCLUSIONS Although more effective than usual care in improving mood states and agitation, PARO was only more effective than a plush toy in encouraging engagement.
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Affiliation(s)
- Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia.
| | - Cindy J Jones
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - Jenny E Murfield
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Nursing and Midwifery, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - Lukman Thalib
- Department of Public Health, College of Health Sciences, Qatar University, Qatar
| | - Elizabeth R A Beattie
- School of Nursing, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - David K H Shum
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; School of Applied Psychology, Mt Gravatt Campus, Griffith University, Brisbane, Queensland, Australia
| | - Siobhan T O'Dwyer
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; Medical School, University of Exeter, Exeter, United Kingdom
| | - M Cindy Mervin
- Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Queensland, Australia; Center for Applied Health Economics, School of Medicine, Nathan Campus, Griffith University, Nathan, Brisbane, Queensland, Australia
| | - Brian M Draper
- School of Psychiatry, University of New South Wales, Sydney, Australia
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A Pilot Randomized Trial of a Companion Robot for People With Dementia Living in the Community. J Am Med Dir Assoc 2017; 18:871-878. [PMID: 28668664 DOI: 10.1016/j.jamda.2017.05.019] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 05/15/2017] [Accepted: 05/18/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To investigate the affective, social, behavioral, and physiological effects of the companion robot Paro for people with dementia in both a day care center and a home setting. DESIGN A pilot block randomized controlled trial over 12 weeks. Participants were randomized to the intervention (Paro) or control condition (standard care). SETTING Two dementia day care centers and participants' homes in Auckland, New Zealand. PARTICIPANTS Thirty dyads (consisting of a care recipient with dementia and their caregiver) took part in this study. All care recipients attended dementia day care centers at Selwyn Foundation and had a formal diagnosis of dementia. INTERVENTION Thirty-minute unstructured group sessions with Paro at the day care center were run 2 to 3 times a week for 6 weeks. Participants also had Paro at home for 6 weeks. MEASUREMENTS At the day care centers, observations of the care recipients' behavior, affect, and social responses were recorded using a time sampling method. Observations of interactions with Paro for participants in the intervention were also recorded. Blood pressure and salivary cortisol were collected from care recipients before and after sessions at day care. In the home setting, level of cognition, depressive symptoms, neuropsychiatric symptoms, behavioral agitation, and blood pressure were measured at baseline, 6 weeks, and 12 weeks. Hair cortisol measures were collected at baseline and at 6 weeks. RESULTS Observations showed that Paro significantly improved facial expressions (affect) and communication with staff (social interaction) at the day care centers. Subanalyses showed that care recipients with less cognitive impairment responded significantly better to Paro. There were no significant differences in care recipient dementia symptoms, nor physiological measures between the intervention and control group. CONCLUSION Paro shows promise in enhancing affective and social outcomes for certain individuals with dementia in a community context. Larger randomized controlled trials in community settings, with longer time frames, are needed to further specify the contexts and characteristics for which Paro is most beneficial.
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Strøm BS, Engedal K, Benth JS, Grov EK. Effect of the Sonas Programme on Communication in People with Dementia: A Randomized Controlled Trial. Dement Geriatr Cogn Dis Extra 2017; 7:122-135. [PMID: 28553314 PMCID: PMC5425769 DOI: 10.1159/000468147] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 02/20/2017] [Indexed: 11/19/2022] Open
Abstract
Background Strategies to improve communication in people with dementia are warranted. We examined the effect of the Sonas programme on communication ability in persons with moderate to severe dementia. Methods A 24-week 3-armed (Sonas, reading, and control group) randomized controlled trial including 120 nursing home residents with dementia was conducted; 105 completed the follow-up assessments. The main outcome was change in communication abilities measured by the Holden Communication Scale (HCS). Results We found no overall significant effect of the Sonas programme with regard to communication ability as measured by the HCS. However, an effect between the Sonas group and the reading group and between the Sonas group and the control group from T0 to T1 and T2 was found, as well as a significant improvement in communication in the Sonas group. Among people with severe dementia, the Sonas group scored significantly better on the HCS compared to the reading group after 12 weeks, but not after 24 weeks. Conclusion This study failed to document an overall effect of the Sonas programme on communication; however, the findings indicate that the Sonas programme has a significant effect on communication among those with severe dementia.
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Affiliation(s)
| | - Knut Engedal
- Norwegian Advisory Unit for Aging and Health, Vestfold Hospital HF, Tønsberg, Norway.,Department of Geriatrics, Oslo University Hospital, Oslo, Norway
| | | | - Ellen-Karine Grov
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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