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Karami V, Yaffe MJ, Gore G, Moon AJ, Abbasgholizadeh Rahimi S. Socially Assistive Robots for patients with Alzheimer's Disease: A scoping review. Arch Gerontol Geriatr 2024; 123:105409. [PMID: 38565072 DOI: 10.1016/j.archger.2024.105409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The most common form of dementia, Alzheimer's Disease (AD), is challenging for both those affected as well as for their care providers, and caregivers. Socially assistive robots (SARs) offer promising supportive care to assist in the complex management associated with AD. OBJECTIVES To conduct a scoping review of published articles that proposed, discussed, developed or tested SAR for interacting with AD patients. METHODS We performed a scoping review informed by the methodological framework of Arksey and O'Malley and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist for reporting the results. At the identification stage, an information specialist performed a comprehensive search of 8 electronic databases from the date of inception until January 2022 in eight bibliographic databases. The inclusion criteria were all populations who recive or provide care for AD, all interventions using SAR for AD and our outcomes of inteerst were any outcome related to AD patients or care providers or caregivers. All study types published in the English language were included. RESULTS After deduplication, 1251 articles were screened. Titles and abstracts screening resulted to 252 articles. Full-text review retained 125 included articles, with 72 focusing on daily life support, 46 on cognitive therapy, and 7 on cognitive assessment. CONCLUSION We conducted a comprehensive scoping review emphasizing on the interaction of SAR with AD patients, with a specific focus on daily life support, cognitive assessment, and cognitive therapy. We discussed our findings' pertinence relative to specific populations, interventions, and outcomes of human-SAR interaction on users and identified current knowledge gaps in SARs for AD patients.
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Affiliation(s)
- Vania Karami
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Mila - Quebec AI Institute, Montreal, Canada
| | - Mark J Yaffe
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada; St. Mary's Hospital Center, Montreal, Canada
| | - Genevieve Gore
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Canada
| | - AJung Moon
- Department of Electrical & Computer Engineering, Faculty of Engineering, McGill University, Montreal, Canada
| | - Samira Abbasgholizadeh Rahimi
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Mila - Quebec AI Institute, Montreal, Canada; Faculty of Dental Medicine and Oral Health Sciences.
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Haltaufderheide J, Lucht A, Strünck C, Vollmann J. Increasing efficiency and well-being? a systematic review of the empirical claims of the double-benefit argument in socially assistive devices. BMC Med Ethics 2023; 24:106. [PMID: 38037080 PMCID: PMC10687833 DOI: 10.1186/s12910-023-00984-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 11/17/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Socially assistive devices (care robots, companions, smart screen assistants) have been advocated as a promising tool in elderly care in Western healthcare systems. Ethical debates indicate various challenges. One of the most prevalent arguments in the debate is the double-benefit argument claiming that socially assistive devices may not only provide benefits for autonomy and well-being of their users but might also be more efficient than other caring practices and might help to mitigate scarce resources in healthcare. Against this background, we used a subset of comparative empirical studies from a comprehensive systematic review on effects and perceptions of human-machine interaction with socially assistive devices to gather and appraise all available evidence supporting this argument from the empirical side. METHODS Electronic databases and additional sources were queried using a comprehensive search strategy which generated 9851 records. Studies were screened independently by two authors. Methodological quality of studies was assessed. For 39 reports using a comparative study design, a narrative synthesis was performed. RESULTS The data shows positive evidential support to claim that some socially assistive devices (Paro) might be able to contribute to the well-being and autonomy of their users. However, results also indicate that these positive findings may be heavily dependent on the context of use and the population. In addition, we found evidence that socially assistive devices can have negative effects on certain populations. Evidence regarding the claim of efficiency is scarce. Existing results indicate that socially assistive devices can be more effective than standard of care but are far less effective than plush toys or placebo devices. DISCUSSION We suggest using the double-benefit argument with great caution as it is not supported by the currently available evidence. The occurrence of potentially negative effects of socially assistive devices requires more research and indicates a more complex ethical calculus than suggested by the double-benefit argument.
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Affiliation(s)
- Joschka Haltaufderheide
- Medical Ethics with a Focus on Digitization, Joint Faculty for Health Sciences Brandenburg, University of Potsdam, Am Mühlenberg 9, 14476, Potsdam, Germany.
- Institute for Medical Ethics and History of Medicine, Ruhr-University Bochum, Bochum, Germany.
| | - Annika Lucht
- Institute for Medical Ethics and History of Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Christoph Strünck
- School of Life Sciences, University of Siegen, Siegen, Germany
- Institute of Gerontology at Technical University Dortmund, Dortmund, Germany
| | - Jochen Vollmann
- Institute for Medical Ethics and History of Medicine, Ruhr-University Bochum, Bochum, Germany
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Noh D, Shim MS. Effectiveness of Robot Interventions for Cognitive and Psychological Outcomes among Older Adults with Cognitive Impairment: A Meta-Analysis. Healthcare (Basel) 2023; 11:2341. [PMID: 37628538 PMCID: PMC10454070 DOI: 10.3390/healthcare11162341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
This review was performed to evaluate the effects of robot interventions on cognitive and psychological outcomes among older adults with cognitive impairment. Three databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) were searched for studies published in English between January 2015 and August 2021. We included studies that involved older adults with cognitive impairment, interventions using robots, outcome measures related to cognitive and psychological status, and randomized controlled trials. Ten studies included in the systematic review, and nine studies derived from these ten articles were included in the meta-analyses. The meta-analyses revealed that robot interventions significantly decreased anxiety and agitation but exerted no significant effects on cognitive function, neuropsychiatric symptoms, and quality of life. The subgroup analyses according to robot types revealed that pet-type robot interventions reduced anxiety and agitation. In addition, subgroup analysis according to the intervention format of robot interventions found that individual intervention was effective for improving agitation, but a group-based intervention was effective for improving depression. We suggest using robot interventions to improve psychological outcomes such as anxiety and agitation; however, further research is needed to determine whether robot interventions affect symptoms such as cognitive function, neuropsychiatric symptoms, and quality of life.
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Affiliation(s)
- Dabok Noh
- College of Nursing, Eulji University, Seongnam 13135, Republic of Korea;
| | - Mi-So Shim
- College of Nursing, Keimyung University, Daegu 42601, Republic of Korea
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Goda A, Shimura T, Murata S, Kodama T, Nakano H, Ohsugi H. Effects of Robot-Assisted Activity Using a Communication Robot on Neurological Activity in Older Adults with and without Cognitive Decline. J Clin Med 2023; 12:4818. [PMID: 37510933 PMCID: PMC10381845 DOI: 10.3390/jcm12144818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Robot-assisted activity (RAA) using a communication robot (RAA-CR) has been proposed as a tool for alleviating behavioral and psychological symptoms accompanying dementia (BPSD) in patients with cognitive decline. This study aimed to clarify the effects of differences in cognitive function among older adults on changes in active brain areas induced by RAA-CR. Twenty-nine older adults were divided into a cognitive decline group (n = 11) and a control group (n = 18). The participants individually received a 5-minute RAA session, and their resting EEG activity was measured before and after the session. Brain spatial analysis was performed on recorded EEG data using standardized low-resolution brain electromagnetic tomography. In addition, statistical comparisons of neural activity in the brain were made before and after RAA-CR and between the cognitively impaired and control groups. These results suggest that RAA-CR stimulates neural activity in the region centered on the posterior cingulate gyrus and precuneus in cognitively healthy older adults but does not significantly alter brain neural activity in cognitively impaired older adults. Therefore, modifications to the implementation methods may be necessary to effectively implement RAA-CR in cognitively impaired individuals.
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Affiliation(s)
- Akio Goda
- Department of Physical Therapy, Faculty of Health and Medical Sciences, Hokuriku University, 1-1 Taiyogaoka, Kanazawa 920-1180, Japan
| | - Takaki Shimura
- BME Research Laboratory, Sosei Ltd., Hamamatsu 432-8002, Japan
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Takayuki Kodama
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Hironori Ohsugi
- Department of Physical Therapy, Faculty of Social Work Studies, Josai International University, Togane 283-8555, Japan
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Bevilacqua R, Maranesi E, Felici E, Margaritini A, Amabili G, Barbarossa F, Bonfigli AR, Pelliccioni G, Paciaroni L. Social robotics to support older people with dementia: a study protocol with Paro seal robot in an Italian Alzheimer's day center. Front Public Health 2023; 11:1141460. [PMID: 37415712 PMCID: PMC10321520 DOI: 10.3389/fpubh.2023.1141460] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction The aging of the population and the high incidence of those over 80 lead to an inevitable increase in chronic degenerative diseases, such as dementia, resulting in increased morbidity and disability. Treatment of people with dementia involves both pharmacological and non-pharmacological interventions. In particular, robot-assisted therapy is a potentially useful treatment for dementia as it has the advantage of improving mood, encouraging social interaction and communication. The overall objective of the study is to evaluate the improvement in patient-perceived quality of life following the use of the Paro robot integrated with usual care in the older people with dementia. Methods and analysis For this study, 20 patients with dementia are recruited and divided into Experimental Group (EG) and Control Group (CG). Twenty-four session of intervention are conducted, divided into 2 sessions per week, for 12 weeks. The therapy sessions last 20 min. The Experimental Group will receive a social robotic intervention with Paro combined with usual care; the Control Group will receive only the traditional therapy, consisting of cognitive stimulation (reality orientation therapy, cognitive training) and occupational activities (painting workshops, cooking workshops, garden therapy, music therapy, etc.). Paro is a seal-shaped robot designed to have a calming effect and elicit emotional responses in patients in hospitals, nursing homes, and retirement homes. Assessment will be performed at the baseline, at the end of intervention and 3 months after the end of intervention. During these phases, several scales will be administered to the patients, such as Quality of Life-Alzheimer's Disease, Addenbrooke's Cognitive Examination, the Rating Anxiety In Dementia scale and the Cornell Scale for Depression in Dementia, Quebec User Evaluation of Satisfaction, Neuropsychiatric Inventory, the Technology Acceptance Model. Discussions The final goals of the present study are to evaluate the improvement in patient-perceived quality of life following the use of the Paro robot integrated with usual care in the older people with dementia. Ethics and dissemination The study was approved by the Ethic Committee of the Istituto Nazionale Ricovero e Cura Anziani, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS INRCA) during the session of 12 April 2022. It was recorded in ClinicalTrials.gov on 23 November 2022 on the number NCT05626205. The study findings will be used for publication in peer-reviewed scientific journals and presentations in scientific meetings.
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Affiliation(s)
| | | | - Elisa Felici
- Scientific Direction, IRCCS INRCA, Ancona, Italy
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Bradley L, Shanker S, Murphy J, Fenge LA, Heward M. Effectiveness of digital technologies to engage and support the wellbeing of people with dementia and family carers at home and in care homes: A scoping review. DEMENTIA 2023:14713012231178445. [PMID: 37235791 DOI: 10.1177/14713012231178445] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Use of digital technologies to support meaningful engagement of people with dementia and carers increased during the COVID-19 pandemic. The purpose of this scoping review was to determine the effectiveness of digital technologies in supporting the engagement and wellbeing of people with dementia and family carers at home and in care homes. Studies published in peer reviewed literature were identified across four databases (CINAHL, Medline, PUBMED, PsychINFO). Sixteen studies met the inclusion criteria. Findings indicate that digital technologies can potentially support the wellbeing of people with dementia and family carers, although only a few studies had measured impact on wellbeing, as many were reporting on technology at proof-of-concept stage rather than commercially ready products. Moreover, current studies lacked meaningful involvement of people with dementia, family carers, and care professionals in the design of the technology. Future research should bring together people with dementia, family carers, care professionals and designers to coproduce digital technologies with researchers and evaluate them using robust methodologies. Codesign should start early in the intervention development phase and continue until implementation. There is a need for real world applications that nurture social relationships by focusing on how digital technologies can support more personalised, adaptive forms of care. Developing the evidence base to identify what makes digital technologies effective in supporting the wellbeing of people with dementia is crucial. Future interventions should therefore consider the needs and preferences of people with dementia, their families, and professional carers, as well as the suitability and sensitivity of wellbeing outcome measures.
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Affiliation(s)
- Lyndsey Bradley
- Ageing and Dementia Research Centre, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Shanti Shanker
- Ageing and Dementia Research Centre, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Jane Murphy
- Ageing and Dementia Research Centre, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Lee-Ann Fenge
- Centre for Seldom Heard Voices, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Michelle Heward
- Ageing and Dementia Research Centre, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
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Alemi Y, Loughman B, Uriyo M. Distributed Caregiving for Cognitively Impaired Individuals: A Case Report. Cureus 2023; 15:e34677. [PMID: 36909032 PMCID: PMC9994040 DOI: 10.7759/cureus.34677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/09/2023] Open
Abstract
Many caregivers of people with cognitive impairment spend a significant amount of their time helping patients with instrumental daily functions. Distributed caregiving is an innovative model designed to reduce an individual caregiver's time burden and increase the likelihood of continued independent living for the patient. Echo Show and Google Home platforms were used to enable the participation of remote family members in caregiving, specifically the socialization and entertainment of a person with cognitive impairment. Caregiver interviews, review of medical records, and case study analysis were used to measure caregiver burden, after distributing some components of caregiving to distant family members with human-in-the-loop artificial intelligence. This case explores the use of Alexa, Echo Show, and other commercial technologies in the management of a patient with cognitive impairment. The human-in-the-loop system introduced in this case study is a creative, accessible, low-cost, and sustainable way to potentially reduce caregiver burden and improve patient outcomes with targeted intervention. Targeted distributed caregiving reduced time spent in caregiving, reduced caregiver guilt and frustration, improved patient's compliance with requests for behavior changes (e.g., voiding before leaving the house), and improved the relationship between the caregiver and the person with cognitive impairment. This case study demonstrates how distributed caregiving, including human-in-the-loop artificial intelligence, can lead to better use of technology in reducing the social isolation of persons with cognitive impairment and in reducing caregiver burden.
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Affiliation(s)
- Yara Alemi
- Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | | | - Maria Uriyo
- Health Administration and Policy, George Mason University, Fairfax, USA
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Sun FC, Lin LC, Chang SC, Li HC, Cheng CH, Huang LY. Reliability and Validity of a Chinese Version of the Cohen–Mansfield Agitation Inventory-Short Form in Assessing Agitated Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159410. [PMID: 35954767 PMCID: PMC9368134 DOI: 10.3390/ijerph19159410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/20/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022]
Abstract
Background: Patients with dementia often present agitated behaviors. The Cohen–Mansfield Agitation Inventory-short form (CMAI-SF) is one of the most widely used instruments to evaluate agitated behaviors that affect patients’ quality of life and impose burden on caregivers. However, there is no simplified Chinese version of the CMAI-SF (C-CMAI-SF) in clinical settings. Purpose: This study aimed to develop a Chinese version of the C-CMAI-SF and examine its validity and reliability. Methods: This cross-sectional study included three phases. In Phase I, the original CMAI-SF was translated to Chinese. In Phase II, experts were invited to examine the content validity index (CVI). Phase III was conducted to test the validity and reliability of the C-CMAI-SF. Results: The scale showed good validity and reliability with a scale-level CVI of 0.89, Cronbach’s alpha (measure of internal consistency) of 0.874, and test–retest correlation coefficient of 0.902 (for 257 individuals). Using factor analysis, three factors were identified. Regarding concurrent validity, the C-CMAI-SF score was correlated with the Neuropsychiatric Inventory (agitation aggression subscale) and the Cornell Scale for Depression in Dementia (agitation subscale). Conclusions: The study demonstrated that the C-CMAI-SF is a valid and reliable instrument for evaluating agitated behaviors in people with dementia. Relevance to clinical practice: The C-CMAI-SF is an easy and quick tool used to identify and evaluate agitated behaviors in busy clinical settings.
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Affiliation(s)
- Feng-Ching Sun
- Department of Nursing, Kaohsiung Municipal United Hospital, Kaohsiung 80457, Taiwan; (F.-C.S.); (L.-Y.H.)
- College of Nursing, Fooyin University, Kaohsiung 83102, Taiwan
| | - Li-Chan Lin
- College of Nursing, Asia University, Taichung 41354, Taiwan;
| | - Shu-Chen Chang
- Department of Nursing, Changhua Christian Hospital, Changhua 50006, Taiwan;
- College of Nursing and Health Sciences, Da-Yeh University, Changhua 515006, Taiwan
| | - Hui-Chi Li
- College of Nursing, Asia University, Taichung 41354, Taiwan;
- Correspondence:
| | - Chia-Hsin Cheng
- Department of Nursing, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Ling-Ya Huang
- Department of Nursing, Kaohsiung Municipal United Hospital, Kaohsiung 80457, Taiwan; (F.-C.S.); (L.-Y.H.)
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Nadeau JM, Tan SY. Considerations for intensive treatment programs among youth with medical and behavioral health concerns. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2022.2106986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Sim Yin Tan
- Rogers Behavioral Health, Outpatient Services, Tampa, FL, USA
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Yu C, Sommerlad A, Sakure L, Livingston G. Socially assistive robots for people with dementia: Systematic review and meta-analysis of feasibility, acceptability and the effect on cognition, neuropsychiatric symptoms and quality of life. Ageing Res Rev 2022; 78:101633. [PMID: 35462001 DOI: 10.1016/j.arr.2022.101633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 04/05/2022] [Accepted: 04/14/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND There is increasing interest in using robots to support dementia care but little consensus on the evidence for their use. The aim of the study is to review evidence about feasibility, acceptability and clinical effectiveness of socially assistive robots used for people with dementia. METHOD We conducted a systematic review and meta-analysis. We searched MEDLINE, EMBASE, PsychINFO, CINHAL, IEEE Xplore Digital Library, and EI Engineering Village from inception to 04 - 02-2022 - included primary studies assessing feasibility, acceptability, or effectiveness of socially assistive robots for people with dementia. Two independent reviewers screened studies for eligibility, and assessed quality. Narrative synthesis prioritized higher quality studies, and random-effect meta-analyses compared robots with usual care (UC) or active control (AC) immediately after the intervention (short-term; ST) or long-term (LT) on cognition, neuropsychiatric symptoms, and quality of life. FINDINGS 66 studies and four categories of robots were eligible: Companion robots (Pet and humanoid companion robots), telepresence communication robots, homecare assistive robots and multifunctional robots. PARO (companion robot seal) was feasible and acceptable but limited by its weight, cost, and sound. On meta-analysis, PARO had no ST or LT compared to UC or AC over 5-12 weeks on agitation (ST vs UC, 4 trials, 153 participants: pooled standardized mean difference (SMD) 0.25; - 0.57 to 0.06; LT vs UC; 2 trials, 77 participants, SMD = -0.24; - 0.94, 0.46), cognition (ST vs UC, 3 trials, 128 participants: SMD= 0.03; -0.32, 0.38), overall neuropsychiatric symptoms (ST vs UC, 3 trials, 169 participants: SMD= -0.01; -0.32, 0.29; ST vs AC, 2 trials, 145 participants: SMD =0.02, -0.71, 0.85), apathy (ST vs AC, 2 trials, 81 participants: SMD= 0.14; 0.29, 0.58), depression (ST vs UC, 4 trials, 181 participants; SMD= 0.08; -0.52, 0.69; LT vs UC: 2 trials, 77 participants: SMD =0.01; -0.75, 0.77), anxiety (ST vs UC: 2 trials, 104 participants, SMD= 0.24; -0.85, 1.33) and quality of life (ST vs UC, 2 trials, 127 participants: SMD=-0.05; -0.52, 0.42; ST vs AC: 2 trials, 159 participants, SMD =-0.36, -0.76, 0.05). Robotic animals, humanoid companion robots, telepresence robots and multifunctional robots were feasible and acceptable. However, humanoid companion robots have speech recognition problems, and telepresence robots and multifunctional robots were often difficult to use. There was mixed evidence about the feasibility of homecare robots. There was little evidence on any of these robots' effectiveness. CONCLUSION Although robots were generally feasible and acceptable, there is no clear evidence that people with dementia derive benefit from robots for cognition, neuropsychiatric symptoms, or quality of life. We recommend that future research should use high quality designs to establish evidence of effectiveness.
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Guemghar I, Pires de Oliveira Padilha P, Abdel-Baki A, Jutras-Aswad D, Paquette J, Pomey MP. Social Robot Interventions in Mental Health Care and Their Outcomes, Barriers, and Facilitators: Scoping Review. JMIR Ment Health 2022; 9:e36094. [PMID: 35438639 PMCID: PMC9066335 DOI: 10.2196/36094] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The use of social robots as innovative therapeutic tools has been increasingly explored in recent years in an effort to address the growing need for alternative intervention modalities in mental health care. OBJECTIVE The aim of this scoping review was to identify and describe social robot interventions in mental health facilities and to highlight their outcomes as well as the barriers and facilitators to their implementation. METHODS A scoping review of the literature published since 2015 was conducted using the Arksey and O'Malley's framework. The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and PsycINFO databases were searched, and 2239 papers were retrieved. The papers included were primary empirical studies published in peer-reviewed literature. Eligible studies were set in mental health facilities and they included participants with a known mental health disorder. The methodological quality of the included papers was also assessed using the Mixed Methods Appraisal Tool. RESULTS A total of 30 papers met the eligibility criteria for this review. Studies involved participants with dementia, cognitive impairment, schizophrenia, depression, autism spectrum disorder, attention-deficit hyperactivity disorder, and an intellectual disability. The outcomes studied included engagement, social interaction, emotional state, agitation, behavior, and quality of life. CONCLUSIONS The methodological weaknesses of the studies conducted this far and the lack of diversity in the conditions studied limit the generalizability of the results. However, despite the presence of certain barriers to their implementation (eg, technical problems, unsuitable environment, staff resistance), social robot interventions generally show positive effects on patients with mental health disorders. Studies of stronger methodological quality are needed to further understand the benefits and the place of social robots in mental health care.
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Affiliation(s)
- Imane Guemghar
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
| | | | - Amal Abdel-Baki
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département de Psychiatrie et d'Addictologie, Université de Montréal, Montreal, QC, Canada
| | - Didier Jutras-Aswad
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département de Psychiatrie et d'Addictologie, Université de Montréal, Montreal, QC, Canada
| | - Jesseca Paquette
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Marie-Pascale Pomey
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre d'Excellence pour le Partenariat avec les Patients et le Public, Montreal, QC, Canada
- Département de Gestion, Évaluation et Politique de Santé, École de Santé Publique de l'Université de Montréal, Montreal, QC, Canada
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Dada S, van der Walt C, May AA, Murray J. Intelligent assistive technology devices for persons with dementia: A scoping review. Assist Technol 2022:1-14. [PMID: 34644248 DOI: 10.1080/10400435.2021.1992540] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Assistive technology (AT) with context-aware computing and artificial intelligence capabilities can be applied to address cognitive and communication impairments experienced by persons with dementia (PwD). This paper aims to provide an overview of current literature regarding some characteristics of intelligent assistive technology devices (IATDs) for cognitive and communicative impairments of PwD. It also aims to identify the areas of impairment addressed by these IATDs.A multi-faceted systematic search strategy yielded records. Predefined criteria were applied for inclusion and data extraction. Thereafter data was thematically analysed and synthesised. This review demonstrates that almost all of the research involving IATDs has focused on cognitive impairments of PwD and has not yet evolved past the conceptual or prototype stages of development. Summaries of commercially available IATDs for PwD and relevant prototypes are provided at the end of this review.This research concluded that IATDs for PwD targeting cognition and communication problems primarily focus on social robots, and that they address cognitive impairments of attention, affect, and social-pragmatic communicative impairments. Future research endeavours concerning AT for PwD should explore collaboration between computer engineering and health practitioners to address the identified gaps. This may contribute to the available information for evidence-based decision making for PwD.
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Affiliation(s)
- Shakila Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria
| | | | - Adele A May
- Centre for Augmentative and Alternative Communication, University of Pretoria
| | - Janice Murray
- Centre for Augmentative and Alternative Communication, University of Pretoria
- Manchester Metropolitan University
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Exploring Factors Associated With Successful Nonpharmacological Interventions for People With Dementia. Dement Neurocogn Disord 2022; 21:1-16. [PMID: 35154336 PMCID: PMC8811205 DOI: 10.12779/dnd.2022.21.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/27/2022] Open
Abstract
Background and purpose Methods Results Conclusions
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14
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Riches S, Azevedo L, Vora A, Kaleva I, Taylor L, Guan P, Jeyarajaguru P, McIntosh H, Petrou C, Pisani S, Hammond N. Therapeutic engagement in robot-assisted psychological interventions: A systematic review. Clin Psychol Psychother 2021; 29:857-873. [PMID: 34823273 DOI: 10.1002/cpp.2696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/21/2021] [Accepted: 11/17/2021] [Indexed: 01/06/2023]
Abstract
PURPOSE Therapeutic engagement is a key component of psychological interventions. Robot-assisted psychological interventions appear to have therapeutic benefits for service users that are challenging to engage. However, engagement with robots in robot-assisted psychological interventions is not well understood. The aim of this systematic review is to evaluate the quality of therapeutic engagement in robot-assisted psychological interventions (PROSPERO: 122437). METHODS Scopus, Web of Science, PsycInfo and Medline were searched until 15 January 2021 for studies which quantitatively evaluated therapeutic engagement in robot-assisted psychological interventions. The Effective Public Health Practice Project (EPHPP) quality assessment tool was used to assess methodological dimensions of studies. RESULTS 3647 studies were identified through database searching. Thirty studies (N = 1462), published between 2004 and 2020, and from 14 countries, were included. Robots were typically toy animals or humanoids and were used to provide support and improve wellbeing through social interaction. Studies primarily tested robots on older adults with dementia and children with autism and indicated positive therapeutic engagement. Twelve studies included a control group. EPHPP ratings were 'strong' (N = 1), 'moderate' (N = 10) and 'weak' (N = 19). CONCLUSIONS Therapeutic engagement between service users and robots is generally positive. Methodological limitations of studies, such as small sample sizes, and lack of control groups and longitudinal data, mean that the field is in early stages of its development and conclusions should be drawn with caution. There are important practical and ethical implications for policymakers to consider, such as responsible clinical practice and how service users may understand the therapeutic relationship with robots.
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Affiliation(s)
- Simon Riches
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,South London and Maudsley, NHS Foundation Trust, London, UK
| | - Lisa Azevedo
- South London and Maudsley, NHS Foundation Trust, London, UK.,King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Alkesh Vora
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Ina Kaleva
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Lawson Taylor
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Peipei Guan
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Priyanga Jeyarajaguru
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Harley McIntosh
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Constantina Petrou
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Sara Pisani
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Neil Hammond
- South London and Maudsley, NHS Foundation Trust, London, UK
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15
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Ong YC, Tang A, Tam W. Effectiveness of robot therapy in the management of behavioural and psychological symptoms for individuals with dementia: A systematic review and meta-analysis. J Psychiatr Res 2021; 140:381-394. [PMID: 34144442 DOI: 10.1016/j.jpsychires.2021.05.077] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 05/13/2021] [Accepted: 05/29/2021] [Indexed: 12/17/2022]
Abstract
Robot therapy presents a promising alternative in dementia care. However, its effectiveness has not been verified comprehensively. This systematic review and meta-analysis aim at evaluating the effectiveness of robot therapy in the management of behavioural and psychological symptoms for individuals with dementia. Studies assessing the effectiveness of robot therapy were identified using 10 academic research databases: CENTRAL, CINAHL, CNKI, The Cochrane Library, Embase, IEEE Xplore, MEDLINE, PubMed, Scopus, and ProQuest Dissertations & Theses. Additional references were identified from the reference lists of included studies and relevant reviews. Data extraction and risk of bias assessment were conducted independently by two review authors. Meta-analyses and subgroup analyses were performed and the heterogeneity of studies was examined. 18 published articles from 14 studies involving a total of 1256 participants were included. Participants with robot therapy had a significant decrease in agitation (SMD -0.38, 95% CI -0.66, -0.09; p = 0.01) and a significant increase in social interaction (SMD 0.49, 95% CI 0.01, 0.97; p = 0.04) while effects for depression, anxiety, cognitive status, and quality of life were not statistically significant. Results from this review show that robot therapy can effectively reduce agitation and increase social interactions for individuals with dementia. Future clinical practice should consider the potential of robot therapy as an option to be implemented into current dementia programmes. Further large-scale trials are required for the thorough investigation of different intervention formats and robot types, while considering potential confounding factors.
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Affiliation(s)
- Yoke Chin Ong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Arthur Tang
- Department of Software, Sungkyunkwan University, Suwon, Republic of Korea.
| | - Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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16
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Inoue K, Wada K, Shibata T. Exploring the applicability of the robotic seal PARO to support caring for older persons with dementia within the home context. Palliat Care Soc Pract 2021; 15:26323524211030285. [PMID: 34350398 PMCID: PMC8287345 DOI: 10.1177/26323524211030285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/16/2021] [Indexed: 11/18/2022] Open
Abstract
Objective: To (1) examine the potentiality of using the robot PARO to mediate care
provided by the family and (2) identify problems when utilizing PARO in the
home context. Methods: Family members of 7 households were asked to use PARO for at least three
times per week, over 1 to 3 months. Research data, including standardized
assessments, interviews, and observations, were collected at initial and
subsequent monthly visits. Collected data were analyzed through descriptive
statistics and inductive thematic content analysis. Results: Out of the seven participants, five responded positively to PARO, thereby
achieving their goals of improving activity engagement, relaxation, a
respite from supervision, and improved mood. A positive initial interaction
with PARO showed continued interest to it. Participants were observed to
communicate with caregivers and relate to PARO. Discussion: The application of PARO at home is possibly influenced by the persons’
initial level of interest toward PARO. It is crucial to perform careful
observation and assessment before deciding to use PARO within the home
context to support the life of older persons with dementia.
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Affiliation(s)
- Kaoru Inoue
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Kazuyoshi Wada
- Graduate School of Systems Design, Tokyo Metropolitan University, Tokyo, Japan
| | - Takanori Shibata
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
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17
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Kulpa E, Rahman AT, Vahia IV. Approaches to assessing the impact of robotics in geriatric mental health care: a scoping review. Int Rev Psychiatry 2021; 33:424-434. [PMID: 33475445 DOI: 10.1080/09540261.2020.1839391] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The goals of this scoping literature review are to (1) aggregate the current research involving socially assistive robots in the setting of geriatric psychiatry and (2) examine the outcome measures used in these studies and determine where the gaps and needs are. In light of the global COVID-19 pandemic, the geriatric psychiatric population in particular is vulnerable to both the physical and mental toll COVID-19 may cause. Recently, socially assistive robots have gained attention for their ability to aid in the care of the geriatric psychiatry population and are being explored as a realistic way to deliver certain elements of psychiatric care that have the potential to be safe even in the setting of COVID-19. The results of this review indicate that robots are in the early stages of clinical applicability, they display usability for a range of psychiatric indications, and their impact on clinical care is notable. We project that in the next few years, robotic applications will be tailored to address clinical outcomes with a greater degree of precision and efficacy.
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Affiliation(s)
- Emily Kulpa
- Mountain Area Health Education Center, Asheville, NC, USA
| | | | - Ipsit V Vahia
- McLean Hospital, Belmont, MA, USA.,Harvard Medical School, Boston, MA, USA
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18
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Lu LC, Lan SH, Hsieh YP, Lin LY, Lan SJ, Chen JC. Effectiveness of Companion Robot Care for Dementia: A Systematic Review and Meta-Analysis. Innov Aging 2021; 5:igab013. [PMID: 34316517 PMCID: PMC8304164 DOI: 10.1093/geroni/igab013] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Indexed: 12/04/2022] Open
Abstract
Background and Objectives Dementia and central nervous system degeneration are common problems in aging societies with regard to the number of people affected and total medical expenses. Socially assistive robotic technology has gradually matured; currently, most scholars believe it can be used as companions in long-term care facilities and to work as caregivers alongside staff to improve the social interaction and mental state of older adults and patients with dementia. Therefore, this study measured the effect of the duration of exposure to socially assistive robots in older adults with dementia. Research Design and Methods Seven databases were searched up to February 2019 through the consultation of appropriate Internet sites and the use of criteria lists recommended by relevant experts. Randomized controlled trials comparing socially assistive robot use with a control group in older adults with dementia and using at least one of the primary outcomes of agitation, depression, and quality of life were included. Results Thirteen randomized controlled trials were identified from 873 articles, 7 of which were included in the meta-analysis. The pooled effect estimate from 3 trials with 214 participants revealed that the pet-type robot improved patients’ agitation level, with a standardized mean difference of −0.37 (95% CI: −0.64 to −0.10, p < .01) and no heterogeneity (I2 = 0%). The results also revealed that length of each session and pet-type robot exposure time per week were associated with reduced depression levels (β = −0.06, Q = 21.213, df = 1, p < .001 and β = −0.019, Q = 7.532, df = 1, p < .01, respectively). However, the results for quality of life were nonsignificant. Discussion and Implications Pet-type robot systems seem to be a potential activity in long-term care facilities for dementia care. Further research is warranted to establish a comprehensive intervention plan related to the use of pet-type robots.
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Affiliation(s)
- Li-Chin Lu
- School of Management, Putian University, China.,Department of Information Management, National Yunlin University of Science and Technology, Douliou, Taiwan
| | - Shao-Huan Lan
- School of Pharmaceutical Sciences and Medical Technology, Putian University, China
| | - Yen-Ping Hsieh
- Department of Long-Term Care, National Quemoy University, Jinning, Taiwan
| | - Long-Yau Lin
- Department of Obstetrics and Gynecology, Chung-Shan Medical University Hospital, Taichung, Taiwan
| | - Shou-Jen Lan
- Department of Post-Baccalaureate Veterinary Medicine, Asia University, Taichung, Taiwan
| | - Jong-Chen Chen
- Department of Information Management, National Yunlin University of Science and Technology, Douliou, Taiwan
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19
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Hirt J, Ballhausen N, Hering A, Kliegel M, Beer T, Meyer G. Social Robot Interventions for People with Dementia: A Systematic Review on Effects and Quality of Reporting. J Alzheimers Dis 2020; 79:773-792. [PMID: 33361589 PMCID: PMC7902949 DOI: 10.3233/jad-200347] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Using non-pharmacological interventions is a current approach in dementia care to manage responsive behaviors, to maintain functional capacity, and to reduce emotional stress. Novel technologies such as social robot interventions might be useful to engage people with dementia in activities and interactions as well as to improve their cognitive, emotional, and physical status. Objective: Assessing the effects and the quality of reporting of social robot interventions for people with dementia. Methods: In our systematic review, we included quasi-experimental and experimental studies published in English, French, or German, irrespective of publication year. Searching CINAHL, Cochrane Library, MEDLINE, PsycINFO, and Web of Science Core Collection was supplemented by citation tracking and free web searching. To assess the methodological quality of included studies, we used tools provided by the Joanna Briggs Institute. To assess the reporting of the interventions, we applied CReDECI 2 and TIDieR. Results: We identified sixteen studies published between 2012 and 2018, including two to 415 participants with mostly non-defined type of dementia. Eight studies had an experimental design. The predominant robot types were pet robots (i.e., PARO). Most studies addressed behavioral, emotion-related, and functional outcomes with beneficial, non-beneficial, and mixed results. Predominantly, cognitive outcomes were not improved. Overall, studies were of moderate methodological quality. Conclusion: Heterogeneous populations, intervention characteristics, and measured outcomes make it difficult to generalize the results with regard to clinical practice. The impact of social robot interventions on behavioral, emotion-related, and functional outcomes should therefore be assessed considering the severity of dementia and intervention characteristics.
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Affiliation(s)
- Julian Hirt
- Center for Dementia Care, Institute of Applied Nursing Sciences, Department of Health, University of Applied Sciences FHS St. Gallen, St. Gallen, Switzerland.,International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Nicola Ballhausen
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands.,Center for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Geneva, Switzerland
| | - Alexandra Hering
- Center for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Geneva, Switzerland.,Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Matthias Kliegel
- Center for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Geneva, Switzerland.,Department of Psychology, University of Geneva, Geneva, Switzerland.,Swiss National Center of Competences in Research LIVES -Overcoming vulnerability, Life-Course Perspectives, Lausanne and Geneva, Switzerland
| | - Thomas Beer
- Center for Dementia Care, Institute of Applied Nursing Sciences, Department of Health, University of Applied Sciences FHS St. Gallen, St. Gallen, Switzerland
| | - Gabriele Meyer
- International Graduate Academy, Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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20
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Buchanan C, Howitt ML, Wilson R, Booth RG, Risling T, Bamford M. Predicted Influences of Artificial Intelligence on the Domains of Nursing: Scoping Review. JMIR Nurs 2020; 3:e23939. [PMID: 34406963 PMCID: PMC8373374 DOI: 10.2196/23939] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Artificial intelligence (AI) is set to transform the health system, yet little research to date has explored its influence on nurses-the largest group of health professionals. Furthermore, there has been little discussion on how AI will influence the experience of person-centered compassionate care for patients, families, and caregivers. OBJECTIVE This review aims to summarize the extant literature on the emerging trends in health technologies powered by AI and their implications on the following domains of nursing: administration, clinical practice, policy, and research. This review summarizes the findings from 3 research questions, examining how these emerging trends might influence the roles and functions of nurses and compassionate nursing care over the next 10 years and beyond. METHODS Using an established scoping review methodology, MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central, Education Resources Information Center, Scopus, Web of Science, and ProQuest databases were searched. In addition to the electronic database searches, a targeted website search was performed to access relevant gray literature. Abstracts and full-text studies were independently screened by 2 reviewers using prespecified inclusion and exclusion criteria. Included articles focused on nursing and digital health technologies that incorporate AI. Data were charted using structured forms and narratively summarized. RESULTS A total of 131 articles were retrieved from the scoping review for the 3 research questions that were the focus of this manuscript (118 from database sources and 13 from targeted websites). Emerging AI technologies discussed in the review included predictive analytics, smart homes, virtual health care assistants, and robots. The results indicated that AI has already begun to influence nursing roles, workflows, and the nurse-patient relationship. In general, robots are not viewed as replacements for nurses. There is a consensus that health technologies powered by AI may have the potential to enhance nursing practice. Consequently, nurses must proactively define how person-centered compassionate care will be preserved in the age of AI. CONCLUSIONS Nurses have a shared responsibility to influence decisions related to the integration of AI into the health system and to ensure that this change is introduced in a way that is ethical and aligns with core nursing values such as compassionate care. Furthermore, nurses must advocate for patient and nursing involvement in all aspects of the design, implementation, and evaluation of these technologies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/17490.
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Affiliation(s)
| | | | - Rita Wilson
- Registered Nurses' Association of Ontario, Toronto, ON, Canada
| | - Richard G Booth
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Tracie Risling
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Megan Bamford
- Registered Nurses' Association of Ontario, Toronto, ON, Canada
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21
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Goda A, Shimura T, Murata S, Kodama T, Nakano H, Ohsugi H. Psychological and Neurophysiological Effects of Robot Assisted Activity in Elderly People With Cognitive Decline. Gerontol Geriatr Med 2020; 6:2333721420969601. [PMID: 33241078 PMCID: PMC7675859 DOI: 10.1177/2333721420969601] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 01/10/2023] Open
Abstract
Robot-assisted activity (RAA) is a non-pharmacological therapy used to treat
behavioral and psychological symptoms of dementia. This study investigated the
immediate effects of RAA on psychological and neurophysiological indices.
Twenty-eight elderly people were assigned to the cognitive decline group
(n = 11) or control group (n = 17) based
on their Mini-Mental State Examination scores. After 5-min RAA sessions that
involved patients interacting with a communication robot, patient emotions and
mood states were measured, and resting-state EEG activity and salivary cortisol
were assessed before and after RAA. We found that compared with those in the
control group, participants in the cognitive decline group did not enjoy RAA
using the communication robot. This was corroborated by EEG findings indicating
decreased relaxation immediately after RAA exposure. These results suggested
that participants with cognitive decline had difficulty understanding the
contents of communication with the robot. Our results indicated that elderly
people who have cognitive decline and use day-service centers are less likely to
experience the immediate benefits of RAA, including positive emotions and mental
relaxation. To conduct effective RAA for such populations, it may be useful to
select a method that is better understood and enjoyed by participants.
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Affiliation(s)
| | - Takaki Shimura
- BME Research Laboratory, Sosei Ltd, Hamamatsu, Shizuoka, Japan
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22
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Scerri A, Sammut R, Scerri C. Formal caregivers' perceptions and experiences of using pet robots for persons living with dementia in long-term care: A meta-ethnography. J Adv Nurs 2020; 77:83-97. [PMID: 33016382 DOI: 10.1111/jan.14581] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/10/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022]
Abstract
AIM To explore the formal caregivers' perceptions and experiences of using pet robots for persons living with dementia residing in long-term care settings and the factors influencing their perceptions by evaluating, integrating, and synthesizing findings from relevant international research articles using a meta-ethnography. DESIGN Noblit and Hare's interpretative meta-ethnography. DATA SOURCES Eight articles, published between 2013-2018, were identified following a systematic search of four databases (Scopus, ProQuest Central, EBSCO, and Google Scholar) between June 2019-February 2020. REVIEW METHODS Two researchers independently appraised the selected articles. Noblit and Hare's seven steps and a meta-ethnography reporting guidance were used. Reciprocal translation was used to obtain a line of argument synthesis. RESULTS Three overarching themes were identified: a beneficial tool but not for everybody, a tool that has limitations but could be overcome, and a positive experience if appropriately introduced and sustained. CONCLUSION This meta-ethnography contributes to the understanding of current potential benefits and limitations of pet robots for persons living with dementia residing in long-term settings. It also identifies several factors, as perceived by caregivers, that may influence their acceptability, adoption, and routine use in practice. IMPACT Although for the past two decades pet robots have been used as a psychosocial intervention for persons living with dementia in long-term care settings, there is a dearth of literature on the perception of formal caregivers and their experience of such interventions. While pet robots can have emotional, social, behavioural, and practical benefits, there are several technological, organizational, and contextual challenges and limitations that constrain their routine use. The solutions synthesized in this review can be of benefit to robot designers, facility managers, policy makers, and other health care professionals interested in introducing pet robots in long-term care settings.
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Affiliation(s)
- Anthony Scerri
- Department of Nursing, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Roberta Sammut
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Charles Scerri
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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23
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Zhang Z, Yu P, Chang HCR, Lau SK, Tao C, Wang N, Yin M, Deng C. Developing an ontology for representing the domain knowledge specific to non-pharmacological treatment for agitation in dementia. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12061. [PMID: 32995470 PMCID: PMC7507392 DOI: 10.1002/trc2.12061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/19/2020] [Accepted: 07/09/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION A large volume of clinical care data has been generated for managing agitation in dementia. However, the valuable information in these data has not been used effectively to generate insights for improving the quality of care. Application of artificial intelligence technologies offers us enormous opportunities to reuse these data. For health data science to achieve this, this study focuses on using ontology to coding clinical knowledge for non-pharmacological treatment of agitation in a machine-readable format. METHODS The resultant ontology-Dementia-Related Agitation Non-Pharmacological Treatment Ontology (DRANPTO)-was developed using a method adopted from the NeOn methodology. RESULTS DRANPTO consisted of 569 concepts and 48 object properties. It meets the standards for biomedical ontology. DISCUSSION DRANPTO is the first comprehensive semantic representation of non-pharmacological management for agitation in dementia in the long-term care setting. As a knowledge base, it will play a vital role to facilitate the development of intelligent systems for managing agitation in dementia.
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Affiliation(s)
- Zhenyu Zhang
- Centre for Digital Transformation School of Computing and Information Technology University of Wollongong Wollongong New South Wales Australia
| | - Ping Yu
- Centre for Digital Transformation School of Computing and Information Technology University of Wollongong Wollongong New South Wales Australia
- Illawarra Health and Medical Research Institute Wollongong New South Wales Australia
| | - Hui Chen Rita Chang
- Illawarra Health and Medical Research Institute Wollongong New South Wales Australia
- School of Nursing University of Wollongong Wollongong New South Wales Australia
| | - Sim Kim Lau
- Centre for Digital Transformation School of Computing and Information Technology University of Wollongong Wollongong New South Wales Australia
| | - Cui Tao
- School of Biomedical Informatics University of Texas Health Science Center Houston Texas USA
| | - Ning Wang
- PR China Southern Centre for Evidence Based Nursing and Midwifery Practice School of Nursing Southern Medical University Guangzhou City PR China
| | - Mengyang Yin
- Systems and Reporting Residential Care Catholic Healthcare Ltd Macquarie Park New South Wales Australia
| | - Chao Deng
- Illawarra Health and Medical Research Institute Wollongong New South Wales Australia
- School of Medicine University of Wollongong Wollongong New South Wales Australia
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24
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Ke C, Lou VWQ, Tan KCK, Wai MY, Chan LL. Changes in technology acceptance among older people with dementia: the role of social robot engagement. Int J Med Inform 2020; 141:104241. [PMID: 32739611 DOI: 10.1016/j.ijmedinf.2020.104241] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/18/2020] [Accepted: 07/25/2020] [Indexed: 02/09/2023]
Abstract
OBJECTIVE Emerging technologies such as social robots have shown to be effective in reducing loneliness and agitation for older people with dementia. However, the acceptance of technology (specifically social robots) was found to be low for older people with dementia. The current understanding of changes in technology acceptance following direct exposure is limited and lacks rigorous study design. This study examined the change in technology acceptance after a direct interaction with a humanoid social robot (Kabochan) that was deployed for long-term care facilities' residents with dementia. METHODS The technology acceptance was assessed using randomised control trials for a time frame of 32 weeks. A total of 103 residents clinically diagnosed with dementia, with a mean age of 87.2 years (SD = 7.4), were recruited from seven long-term care facilities in Hong Kong and were randomly allocated to either Kabochan-engagement group or control group. Participants in the engagement group interacted with Kabochan in an individual, non-facilitated approach. The behavioural engagement with Kabochan was observed by care workers and recorded into constructive engagement and non-engagement. Questionnaire surveys were taken placed at pre- and post-exposure with Kabochan to measure attitudes and beliefs towards technology. The questionnaire was based on previous studies on technology acceptance and included attitudes towards technology, perceived usefulness, perceived ease of use, technology self-efficacy, technology anxiety, and facilitating conditions. RESULTS Perceived ease of use was improved at week 32 for participants who interacted with Kabochan (F = 4.239, p = 0.042) with a small effect (ηp2 = 0.043) in comparison to usual care group. Results further demonstrated that the magnitude of belief changes was related to the intensity of constructive behavioural engagement. Specifically, resident-robot behavioural engagement moderately improved attitudes towards technology (F = 11.62, p < 0.001, ηp2 = 0.11) and perceived usefulness (F = 5.75, p = 0.02, ηp2 = 0.06). CONCLUSIONS The study tentatively supports that exposure to Kabochan has potential for changing perceived ease of use but not for other beliefs and attitudes towards technology among long-term care residents with dementia. Direct engagement with a humanoid social robot might be promising in improving the perceived ease of use towards technology.
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Affiliation(s)
- Chen Ke
- Sau Po Centre on Ageing, the University of Hong Kong, Hong Kong.
| | - Vivian Wei-Qun Lou
- Sau Po Centre on Ageing, the University of Hong Kong, Hong Kong; Social Work and Social Administration, the University of Hong Kong, Pok Fu Lam, Hong Kong.
| | - Kelvin Cheng-Kian Tan
- Social Work and Social Administration, the University of Hong Kong, Pok Fu Lam, Hong Kong.
| | - Man Yi Wai
- Hong Kong Sheng Kung Hui Welfare Council Ltd, Hong Kong.
| | - Lai Lok Chan
- Hong Kong Sheng Kung Hui Welfare Council Ltd, Hong Kong.
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Chen K, Lou VWQ, Tan KCK, Wai MY, Chan LL. Effects of a Humanoid Companion Robot on Dementia Symptoms and Caregiver Distress for Residents in Long-Term Care. J Am Med Dir Assoc 2020; 21:1724-1728.e3. [PMID: 32713772 DOI: 10.1016/j.jamda.2020.05.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/12/2020] [Accepted: 05/16/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To test the effects of deploying a humanoid companion robot (Kabochan) in comparison with usual care for long-term care facilities' residents with dementia. DESIGN A 2-arm, randomized controlled trial with ABAB withdrawal design, lasting 32 weeks. After an 8-week baseline period, Kabochan was introduced in a nonfacilitated, individual approach with experimental-group participants (n = 52) for 8 weeks, then removed for 8 weeks, and then reintroduced for another 8 weeks. The control group (n = 51) received the usual standardized care. SETTING AND PARTICIPANTS Seven long-term care facilities in Hong Kong. 103 residents (76% women, 87.2 ± 7.4 years) with a clinical diagnosis of dementia. MEASURES Outcome assessments occurred at 5 time points: baseline (week 1) and the end of each phase (weeks 8, 16, 24, and 32). Primary outcomes were assessed with the Neuropsychiatric Inventory Questionnaire (symptom severity and caregiver distress subscales) and the Geriatric Depression Scale; secondary outcomes were measured by the Hong Kong Montreal Cognitive Assessment 5-minute Protocol, the Modified Barthel Index for Activities of Daily Living, and the Quality of Life-Alzheimer's disease scale. RESULTS A multivariate analysis of variance indicated a statistically significant group × time interaction for neuropsychiatric-related caregiver distress at week 16 (F = 6.72, P = .011), with a moderate effect size (ηp2 = 0.06). When Kabochan was removed in the withdrawal phase (weeks 17-24), the neuropsychiatric symptoms became more severe at week 24 for the intervention group (F = 4.68, P = .003), although the effect size was small to moderate (ηp2 = 0.04). No statistical between-group differences were found in other health outcomes. CONCLUSIONS AND IMPLICATIONS The Kabochan was potentially effective at reducing short-term neuropsychiatric symptoms and relevant caregiver distress for residents with dementia. An individualized care plan with continuous monitoring is required to integrate the humanoid robot into routine dementia care.
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Affiliation(s)
- Ke Chen
- Sau Po Centre on Ageing, the University of Hong Kong, Hong Kong, China
| | - Vivian Wei-Qun Lou
- Sau Po Centre on Ageing, the University of Hong Kong, Hong Kong, China; Social Work and Social Administration, the University of Hong Kong, Pok Fu Lam, Hong Kong, China.
| | - Kelvin Cheng-Kian Tan
- Social Work and Social Administration, the University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Man-Yi Wai
- Hong Kong Sheng Kung Hui Welfare Council Ltd, Hong Kong, China
| | - Lai-Lok Chan
- Hong Kong Sheng Kung Hui Welfare Council Ltd, Hong Kong, China
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Suwa S, Tsujimura M, Kodate N, Donnelly S, Kitinoja H, Hallila J, Toivonen M, Ide H, Bergman-Kärpijoki C, Takahashi E, Ishimaru M, Shimamura A, Yu W. Exploring perceptions toward home-care robots for older people in Finland, Ireland, and Japan: A comparative questionnaire study. Arch Gerontol Geriatr 2020; 91:104178. [PMID: 32717586 DOI: 10.1016/j.archger.2020.104178] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/16/2020] [Accepted: 07/04/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To clarify potential users' perceptions toward the development and social implementation of home-care robots in Japan, Ireland, and Finland. METHODS Unsigned, self-administered questionnaires were distributed to adults aged 65 or older, family caregivers, and home-care/health and social care professionals (HSCPs). A total of 1004 responses were collected. RESULTS In Japan, many people were already familiar with robots in their daily lives. The most notable finding about their perspectives on home-care robots was related to safety. Moreover, 93.7 % of the Japanese respondents said, "If the user cannot decide whether to use a home-care robot, family members who know the user well should decide," followed by 76.4 % in Ireland and 83.1 % in Finland (p < .001). In Ireland, 81.8 % of the respondents said, "I want to help other people and society by participating in the research and development of home-care robots" (Japan: 69.9 %; Finland: 67.5 %) (p = .006). In Finland, many people had a negative impression of robots compared to the other two countries. Finland had the highest percentage (75.4 %) of respondents who said, "Health care professionals should be allowed to use secondary information collected by a home-care robot" (Japan and Ireland: 64 %) (p = .024). Moreover, Ireland and Finland emphasized the need to guarantee the entitlement to receive human care. CONCLUSIONS Devising optimal strategies for the development and social implementation of home-care robots by incorporating various perspectives while valuing human dignity will require examination of each country's characteristics with respect to history, culture, policies, and values related to robots.
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Affiliation(s)
- Sayuri Suwa
- Division of Visiting Nursing, Graduate School of Nursing, Chiba University, Chiba, Japan.
| | - Mayuko Tsujimura
- Division of Visiting Nursing, Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Naonori Kodate
- School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland
| | - Sarah Donnelly
- School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland
| | - Helli Kitinoja
- Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Jaakko Hallila
- Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Marika Toivonen
- Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Hiroo Ide
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | | | - Erika Takahashi
- Graduate School of Humanities, Chiba University, Chiba, Japan
| | - Mina Ishimaru
- Division of Community Health Nursing, Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Atsuko Shimamura
- Division of Community Health Nursing, Department of Nursing, Faculty of Health Science, Toho University, Chiba, Japan
| | - Wenwei Yu
- Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
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Vailati Riboni F, Comazzi B, Bercovitz K, Castelnuovo G, Molinari E, Pagnini F. Technologically-enhanced psychological interventions for older adults: a scoping review. BMC Geriatr 2020; 20:191. [PMID: 32498708 PMCID: PMC7271488 DOI: 10.1186/s12877-020-01594-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 05/25/2020] [Indexed: 01/12/2023] Open
Abstract
Background The world population is getting older. As life expectancy increases, traditional health care systems are facing different challenges in terms of cost reduction and high-quality service delivery capability. New ways to improve older adults’ quality of life have been explored, taking advantage of new technological solutions. Our focus is on the integration of technology in clinical treatments to facilitate or deliver psychological interventions meant to improve well-being in older adults. Our aims were to describe the main technology-based interventions supporting seniors’ quality of life or psychological well-being and to provide greater clarity to what is described in the current literature as their effects on seniors’ cognitive and psychological outcomes and healthcare policies. Methods We reviewed the scientific literature looking for studies that investigated how technology can be implemented into clinical psychology treatments for older adults. Our search was conducted using the following databases: PubMed, PsycINFO, Scopus, ISI Web of Science, and CINAHL. The search provided 350 articles, mostly (≈90%) dated after 2002. Abstract analysis narrowed the selection to 150 papers, according to their relevance and actuality as judged by a restricted group of independent researchers. Results Through a thematic analysis, we found that virtual reality (VR), robots, telemedicine, software, video games, and smartphone applications could potentially support older adults’ psychological treatment with a positive impact on healthcare systems. Conclusion Findings from the literature are encouraging, although most of these results are only preliminary.
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Affiliation(s)
- F Vailati Riboni
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
| | - B Comazzi
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,IRCCS Santa Maria Nascente, Fondazione Don Gnocchi, Milan, Italy
| | - K Bercovitz
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - G Castelnuovo
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Piancavallo, Verbania, Italy
| | - E Molinari
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Piancavallo, Verbania, Italy
| | - F Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Harvard University, Cambridge, MA, USA
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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: 21] [Impact Index Per Article: 5.3] [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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Nwosu AC, Sturgeon B, McGlinchey T, Goodwin CD, Behera A, Mason S, Stanley S, Payne TR. Robotic technology for palliative and supportive care: Strengths, weaknesses, opportunities and threats. Palliat Med 2019; 33:1106-1113. [PMID: 31250734 PMCID: PMC6691596 DOI: 10.1177/0269216319857628] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Medical robots are increasingly used for a variety of applications in healthcare. Robots have mainly been used to support surgical procedures, and for a variety of assistive uses in dementia and elderly care. To date, there has been limited debate about the potential opportunities and risks of robotics in other areas of palliative, supportive and end-of-life care. AIM The objective of this article is to examine the possible future impact of medical robotics on palliative, supportive care and end-of-life care. Specifically, we will discuss the strengths, weaknesses, opportunities and threats (SWOT) of this technology. METHODS A SWOT analysis to understand the strengths, weaknesses, opportunities and threats of robotic technology in palliative and supportive care. RESULTS The opportunities of robotics in palliative, supportive and end-of-life care include a number of assistive, therapeutic, social and educational uses. However, there are a number of technical, societal, economic and ethical factors which need to be considered to ensure meaningful use of this technology in palliative care. CONCLUSION Robotics could have a number of potential applications in palliative, supportive and end-of-life care. Future work should evaluate the health-related, economic, societal and ethical implications of using this technology. There is a need for collaborative research to establish use-cases and inform policy, to ensure the appropriate use (or non-use) of robots for people with serious illness.
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Affiliation(s)
- Amara Callistus Nwosu
- 1 Academic Palliative & End of Life Care Department, Royal Liverpool & Broadgreen University Hospitals NHS Trust, Liverpool, UK.,2 Palliative Care Institute Liverpool (PCIL), University of Liverpool, Liverpool, UK.,3 Marie Curie Hospice Liverpool, Liverpool, UK
| | - Bethany Sturgeon
- 4 Bristol Robotics Laboratory, University of Bristol, Bristol, UK
| | - Tamsin McGlinchey
- 2 Palliative Care Institute Liverpool (PCIL), University of Liverpool, Liverpool, UK
| | - Christian Dg Goodwin
- 2 Palliative Care Institute Liverpool (PCIL), University of Liverpool, Liverpool, UK.,5 US-UK Fulbright Commission, London, UK
| | - Ardhendu Behera
- 6 Department of Computer Science, Edge Hill University, Ormskirk, UK
| | - Stephen Mason
- 2 Palliative Care Institute Liverpool (PCIL), University of Liverpool, Liverpool, UK
| | | | - Terry R Payne
- 7 Department of Computer Science, University of Liverpool, Liverpool, UK
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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: 60] [Impact Index Per Article: 12.0] [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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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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34
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Cohen-Mansfield J. What Does Conducting a Clinical Study Teach You? Insights to Improve Care and Enhance Collaboration. J Am Med Dir Assoc 2019; 20:110-112. [PMID: 30691619 DOI: 10.1016/j.jamda.2018.12.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, and Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel.
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Sloane PD, Zimmerman S, Boustani M. The Unmet Promise of a Miracle Drug for Alzheimer's Disease: Implications for Practice, Policy, and Research. J Am Med Dir Assoc 2018; 19:557-559. [PMID: 29941155 DOI: 10.1016/j.jamda.2018.05.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 05/24/2018] [Accepted: 05/26/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Philip D Sloane
- Department of Family Medicine and Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Malaz Boustani
- Indiana Clinical Translational Science Institute, Center for Aging Research, and Center for Health Innovation and Implementation Science, Indiana University, Indianapolis, IN; Regenstrief Institute, Inc., Indianapolis, IN
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