[Robotic systems for care at home: A scoping review]

Assistive robotic systems in nursing care: a scoping review

BACKGROUND

The use of assistive robotic systems in care is intended to relieve nursing staff. Differentiated and literature-based findings on current application possibilities, technological developments and empirical findings are necessary to enable a goal-oriented and participatory development of assistive robotic systems of care. The aim of this review was to identify assistive robotic systems and their areas of application in nursing settings. Furthermore, an overview of existing social and nursing science findings from the research field of assistive robotic systems will be described.

METHODS

A systematic literature search was performed based on the JBI scoping review methodology. During the period from May to August 2020, the databases MEDLINE via PubMed, CINAHL, Cochrane Library, Web of Science, and IEEE Xplore Digital Library were searched. In order to reflect current developments and evidence in the present literature work, a supplementary search with these same requirements was conducted in January 2022.

RESULTS

The 47 included publications are divided into 15 studies, 23 technical articles and nine opinion-based articles (text-opinion). A total of 39 different assistive robotic systems were identified. There were 55% in the testing phase and 29% of the systems in the development phase. Assistive robotic systems can be divided into six fields of application: Information and patient data processing, assistance with activities of daily living, fetch and bring activities, telepresence and communication, monitoring, safety and navigation, and complex assistance systems. The description of the study findings is divided into "integration of technology and impact on practice" and "attitude and acceptance of elderly people towards assistive robotic systems".

CONCLUSION

The results of the research show that the use of assistive robotic systems in care mainly take place in the context of development and testing phases. In addition to usability and acceptance issues, implementation factors must be integrated into theory-driven research projects.

Study protocol for the implementation and evaluation of a digital-robotic-based intervention for nurses and patients in a hospital: a quantitative and qualitative triangulation based on the Medical Research Council (MRC) framework for developing and evaluating complex interventions

BACKGROUND

Nurses spend part of their working time on non-nursing tasks. Unnecessary walking distances and the assumption of service activities and other non-care-related tasks take up a lot of space, which reduces the time for direct patient care and demonstrably increases the dissatisfaction of the persons involved. The REsPonSe project aims to relieve nursing staff by using a smartphone app for communication in combination with an autonomous service robot to reduce walking distances and service activities. The technical systems are tested on a nuclear medicine ward and are intended to reduce the radiation exposure of the staff. The aim of this study is to test and evaluate the use and intervention of the technical systems, the acceptance of the users and the change in the utilisation of the nursing service. In addition to findings on usability and manageability, effects on nursing practice, as well as facilitating and inhibiting contextual factors for implementation, will be identified.

METHODS

The Medical Research Council (MRC) Framework for Developing and Evaluating for Complex Interventions was chosen as the theoretical basis. The data collection in the Feasibility and Evaluation phase is a triangulation of quantitative and qualitative methods. Standardised observations are planned to collect data on non-care activities and walking distances, and a survey of utilisation by use of a questionnaire based on the NASA TLX. Qualitative individual interviews with patients and group discussions with nursing staff will be conducted. Statements on the subjective experiences, as well as the evaluation of the use of the digital-robotic system in the clinical setting, will be collected. The descriptive evaluation of the usage and retrieval data will provide information on duration, time, requests, and reduced contact times, as well as error and fault messages.

DISCUSSION

The evaluation study will make it possible to represent a variety of perspectives from different interest groups. The results should contribute to the definition of implementation and evaluation criteria and facilitate the integration of digital-robotic assistance systems in nursing acute inpatient settings.

TRIAL REGISTRATION

The trial was registered with the German Clinical Trials Register (DRKS) on 16.02.2022: DRKS00028127.

[Identification of measures conducive to learning for the introduction of digital and assistive technologies (DAT) in processes of nursing care: a qualitative study]

Background

Digital, assistive technologies (DAT) are finding their way into care processes. There are no concepts for introducing nursing professionals DAT in a structured manner. A structured concept makes sense for a sustainable implementation of DAT. This paper suggests a guideline to train nurses in dealing with DAT.

Aim

The work addresses the question of how nursing professionals experience and evaluate a structured approach of sensitization, qualification and testing with respect to DAT. This is also intended to assess the extent to which a transformative learning approach changes the willingness of nurses to use DAT.

Method

In a long-term inpatient facility, nurses have been made aware of DAT and instructed in its use. The nurses were trained in using two robotic systems and a passive exoskeleton. The experience and perception of the structural design of the educational approach were surveyed through interviews. Evaluation took place by qualitative content analysis according to Kuckartz.

Results

All 5 nurses surveyed had completed 3 years of training in nursing care. 2 of the interviewees perform tasks in the management of the care unit. All interviewee rated the structured approach positively. The approach increases the interest to think about an integration of DAT. It turns out that the accuracy of fit of DAT to care-related problems as well as the necessity to make DAT available by employers are crucial prerequisites for DAT integration into practice.

Conclusion

A structured concept can sustainably increase the willingness of nurses to use DAT. Poor implementation of DAT is based on a lack of knowledge and concepts for education and training. The reflection that has been initiated enables DAT to be checked for specific care problems.

Humanoid socially assistive robots in dementia care: a qualitative study about expectations of caregivers and dementia trainers

OBJECTIVE

To examine the expectations of informal caregivers, nurses, and dementia trainers regarding the support of (physical and psychosocial) human needs by humanoid social assistive robots (SARs) in dementia care.

METHODS

A qualitative study was conducted with 11 homogeneous focus groups of informal caregivers, nurses and dementia trainers providing dementia care at home, in adult daycare centers, or in nursing homes. A qualitative content analysis was performed using a concept- and data-driven coding frame.

RESULTS

Focus group discussions with 52 individuals were held. Participants reported mostly positive expectations and stated that SARs could offer potential support in all components of human needs, especially in avoiding danger (e.g. recognise danger, organise help), communication/contact with others (e.g. enable telephone calls, provide company), daily activities (e.g. remind of appointments, household obligations), recreational activities (e.g. provide music), eating/drinking (e.g. help cook), and mobility/body posture (e.g. give reminders/instructions for physical exercise). Participants also mentioned some negative expectations in all human needs, predominantly in communication/contact with others (e.g. loss of interpersonal interaction) and avoiding danger (e.g. scepticism regarding emergencies).

CONCLUSION

Participants stated that SARs had great potential to provide assistance in dementia care, especially by reminding, motivating/encouraging and instructing people with dementia. Informal caregivers and nurses also considered them as useful supportive devices for themselves. However, participants also mentioned negative expectations, especially in communication/contact with others and avoiding danger. These findings demonstrate the support caregivers and dementia trainers expect from humanoid SARs and may contribute to their optimisation for dementia care.

Implementation of robotic devices in nursing care. Barriers and facilitators: an integrative review

BACKGROUND

Robots in healthcare are gaining increasing attention; however, their implementation is challenging due to the complexity of both interventions themselves and the contexts in which they are implemented. The objective of this integrative review is to identify barriers to and facilitators of the implementation of robotic systems in nursing.

METHODS

Articles published from 2002 to 2019 reporting on projects to implement robotic devices in nursing care were searched on Medline (via PubMed), CINAHL and databases on funded research projects (Community Research and Development Information Services and Technische Informationsbibliothek) and in journals for robotic research in November 2017 and July 2019 for an update. No restrictions regarding study designs were imposed. All included articles underwent quality assessments with design-specific critical appraisal tools. Barriers to and facilitators of implementation were classified using the Context and Implementation of Complex Interventions framework.

RESULTS

After removing all duplicates, the search revealed 11 204 studies, of which 17 met the inclusion criteria and were included in the synthesis. The majority of the studies dealt with the implementation of robots designed to support individuals, either living at home or in nursing homes (n=11). The studies were conducted in Europe, the USA and New Zealand and were carried out in nursing homes, individual living environments, hospital units and laboratories. The quality of reporting and quality of evidence were low in most studies. The most frequently reported barriers were in socioeconomic and ethical domains and were within the implementation outcomes domain. The most frequently reported facilitators were related to the sociocultural context, implementation process and implementation strategies.

DISCUSSION

This review identified barriers to and facilitators of the implementation of robotic devices in nursing within different dimensions. The results serve as a basis for the development of suitable implementation strategies to reduce potential barriers and promote the integration of elements to facilitate implementation.

PROSPERO REGISTRATION NUMBER

CRD42018073486.

Effects of a Humanoid Socially Assistive Robot Versus Tablet Training on Psychosocial and Physical Outcomes of Persons With Dementia: Protocol for a Mixed Methods Study

Background

New technologies, like socially assistive robots (SARs), may have the potential to support caregivers at home. Still, the evidence for people with dementia in home care is unclear because a lot of studies are performed in a laboratory or institutional setting, and mainly use robots in prototype stages.

Objective

This study aims to explore the effects of the refined, commercially-available, humanoid SAR Pepper combined with a tablet PC–based dementia training program (Coach Pepper) versus an exclusively tablet PC–based dementia training program on psychosocial and physical outcomes of people with dementia living at home, including caregivers and dementia trainers. We hypothesize that Coach Pepper has a more positive effect on the primary outcome motivation (stable or decreased apathy) of people with dementia.

Methods

A mixed methods study will be performed, including a randomized controlled, parallel, 2-arm study with a complementary qualitative part. This sample includes 40 PWD living at home and 40 relatives, each complemented with five professional caregivers and dementia trainers. The intervention group will receive Coach Pepper (a SAR connected with a tablet PC–based dementia training program), and the control group will receive exclusively tablet PC–based training without the SAR. The duration of the intervention will be three weeks per household. Data will be collected at baseline and during and after the intervention by standardized questionnaires, sensor data of the robot, and tablet PC, as well as semistructured interviews, focus groups, and observation.

Results

To date, no results are available for this study protocol. The study intervention started in May 2019 and will end in Spring 2020.

Conclusions

The intervention of this study can be seen as a nonpharmacological intervention, including cognitive and physical training by a robot. This study will help to further refine SAR for the specific needs of people with dementia living at home.

International Registered Report Identifier (IRRID)

DERR1-10.2196/14927

Receptiveness Of GPs In The South Of Saxony-Anhalt, Germany To Obtaining Training On Technical Assistance Systems For Caregiving: A Cross-Sectional Study

Background

Challenges to general practitioners (GPs) as family doctors in Germany are growing because of the demographic situation. Technical assistance systems can improve the care for patients provided by GPs and care personnel to preserve autonomy. GPs are key persons in the health care team to recommend and facilitate access to technical solutions to influence their implementation into their patients’ homes.

Aim

Explore the general receptiveness of GPs in Germany regarding state-of-the-art and modern assistive technology, as well as their experiences, attitudes and expectations and their training demands.

Methods

A cross-sectional survey was conducted among GPs in Germany with a self-developed questionnaire sent by mail.

Results

Response rate was 34% (n=194). As expected computers and smartphones are widely used. Data glasses, digital pens and virtual reality and others are often “unknown”. Experience with assistive technology was gained with emergency call systems, smart calendars and tablet dispensers. Self-reported receptiveness to use innovative technology is high but knowledge is low. The majority reported lack of access to training and support. The receptiveness for advanced education about technical solutions is high. In free-text response, some communicated their worries about the replacement of human interaction with technology.

Conclusion

The survey showed an overall high receptiveness about assistance technology to GPs and strong demands for education and support. Education for GPs need greater efforts to master the process transforming the digital health care provision.

[Counselling approaches to assistive technologies in nursing care for people with dementia - A focus group study with informal carers]

Counselling approaches to assistive technologies in nursing care for people with dementia - A focus group study with informal carers Abstract. Background: Assistive technologies may support caregiving relatives of people with dementia. Presently, counselling and training courses are lacking as well as concrete considerations for didactic and methodical implementation.

AIM

To convey the perspectives of caring relatives on the development of knowledge and competences in assistive technologies.

METHODS

Six interview-guided focus groups with 46 caring relatives of people with dementia were conducted. For analysis the documentary method was applied.

RESULTS

Assistive technologies currently do not seem to play a role in care-relevant information and counselling structures. The early development of competences as part of a guided support process is explicitly requested by caregiving relatives. The respondents favoured to try out assistive technologies, e. g. by moderated test possibilities.

CONCLUSION

The interviewed caregiving relatives consider the existing approaches to get access to assistive technologies as inadequate. Access to knowledge and competence development of caregiving relatives must be more clearly integrated into the design of the care process. Counselling formats focusing on experience, reflection and usage of assistive technologies might be the didactic basis of structured competence achievement for sustainable integration of useful technologies in daily nursing care.