Acceptance and perceived usefulness of robots to assist with activities of daily living and healthcare tasks

Exoskeleton technology in nursing practice: assessing effectiveness, usability, and impact on nurses' quality of work life, a narrative review

The use of exoskeletons in nursing practice has gained attention as a potential solution to address the physical demands and risks associated with the profession. This narrative review examines the effectiveness, usability, and impact of exoskeleton technology on nurses' quality of work life. The review focuses on the reduction of physical strain and fatigue, improved posture and body mechanics, enhanced patient care, usability and acceptance factors, and the broader impact on work life. The effectiveness of exoskeletons in reducing physical strain and fatigue among nurses is supported by evidence showing decreased muscle activation and reduced forces exerted on the body. The usability and acceptance of exoskeletons are critical considerations, including device comfort and fit, ease of use and integration into workflows, user experience and training, compatibility with the work environment, and user feedback for iterative design improvements. The implementation of exoskeletons has the potential to positively impact nurses' work life by reducing work-related injuries, improving physical well-being, enhancing job satisfaction, and promoting psychological and psychosocial benefits. Additionally, the use of exoskeletons can lead to improved patient care outcomes. Challenges and future directions in the field of exoskeleton technology for nurses include cost and accessibility, adaptability to nursing specialties and tasks, long-term durability and maintenance, integration with personal protective equipment, and ethical considerations. Addressing these challenges and considering future research and development efforts are crucial for the successful integration of exoskeleton technology in nursing practice, ultimately improving nurses' quality of work life and patient care delivery.

Mixed methods usability evaluation of an assistive wearable robotic hand orthosis for people with spinal cord injury

BACKGROUND

Robotic hand orthoses (RHO) aim to provide grasp assistance for people with sensorimotor hand impairment during daily tasks. Many of such devices have been shown to bring a functional benefit to the user. However, assessing functional benefit is not sufficient to evaluate the usability of such technologies for daily life application. A comprehensive and structured evaluation of device usability not only focusing on effectiveness but also efficiency and satisfaction is required, yet often falls short in existing literature. Mixed methods evaluations, i.e., assessing a combination of quantitative and qualitative measures, allow to obtain a more holistic picture of all relevant aspects of device usability. Considering these aspects already in early development stages allows to identify design issues and generate generalizable benchmarks for future developments.

METHODS

We evaluated the short-term usability of the RELab tenoexo, a RHO for hand function assistance, in 15 users with tetraplegia after a spinal cord injury through a comprehensive mixed methods approach. We collected quantitative data using the Action Research Arm Test (ARAT), the System Usability Scale (SUS), and timed tasks such as the donning process. In addition, qualitative data were collected through semi-structured interviews and user observations, and analyzed with a thematic analysis to enhance the usability evaluation. All insights were attributed and discussed in relation to specifically defined usability attributes such as comfort, ease of use, functional benefit, and safety.

RESULTS

The RELab tenoexo provided an immediate functional benefit to the users, resulting in a mean improvement of the ARAT score by 5.8 points and peaking at 15 points improvement for one user (clinically important difference: 5.7 points). The mean SUS rating of 60.6 represents an adequate usability, however, indicating that especially the RHO donning (average task time = 295 s) was perceived as too long and cumbersome. The participants were generally very satisfied with the ergonomics (size, dimensions, fit) of the RHO. Enhancing the ease of use, specifically in donning, increasing the provided grasping force, as well as the availability of tailoring options and customization were identified as main improvement areas to promote RHO usability.

CONCLUSION

The short-term usability of the RELab tenoexo was thoroughly evaluated with a mixed methods approach, which generated valuable data to improve the RHO in future iterations. In addition, learnings that might be transferable to the evaluation and design of other RHO were generated, which have the potential to increase the daily life applicability and acceptance of similar technologies.

Robots in travel clinics: building on tourism's use of technology and robots for infection control during a pandemic

The arrival of COVID-19 impacted every aspect of life around the world. The virus, whose spread was facilitated overwhelmingly by people's close contact at home and by travelling, devastated the tourism, hospitality, and transportation industry. Economic survival depended largely on demonstrating to authorities and potential travellers the strict adherence to infection control measures. Fortunately, long before the pandemic, the industry had already employed digital technology, artificial intelligence, and service robots, not to keep the world safe, but to either bridge staff shortages or save costs, reduce waiting times, streamline administration, complete unattractive, tedious, or physical tasks, or use technology as marketing gimmicks. With COVID-19, offering social distancing and touchless service was an easy step by extending quickly what was already there. The question arose: could travellers' acceptance of technology and robots for infection control be useful in travel medicine? COVID-19 fostered the rapid and increased acceptance of touchless technology relating to all things travel. The public's expectations regarding hygiene, health and safety, and risk of infection have changed and may stay with us long after the pandemic is 'the new normal', or a new one approaches. This insight, combined with the current experience with robots in health and medicine, is useful in exploring how robots could assist travel medicine practice. However, several aspects need to be considered in terms of type of robot, tasks required, and the public's positive or negative attitudes towards robots to avoid known pitfalls. To meet the crucial infection control measures of social distancing and touch avoidance, the use of robots in travel medicine may not only be readily accepted but expected, and implications for management, practice, and research need to be considered.

On the importance of patient acceptance for medical robotic imaging

PURPOSE

Mutual acceptance is required for any human-to-human interaction. Therefore, one would assume that this also holds for robot-patient interactions. However, the medical robotic imaging field lacks research in the area of acceptance. This work, therefore, aims at analyzing the influence of robot-patient interactions on acceptance in an exemplary medical robotic imaging system.

METHODS

We designed an interactive human-robot scenario, including auditive and gestural cues, and compared this pipeline to a non-interactive scenario. Both scenarios were evaluated through a questionnaire to measure acceptance. Heart rate monitoring was also used to measure stress. The impact of the interaction was quantified in the use case of robotic ultrasound scanning of the neck.

RESULTS

We conducted the first user study on patient acceptance of robotic ultrasound. Results show that verbal interactions impacts trust more than gestural ones. Furthermore, through interaction, the robot is perceived to be friendlier. The heart rate data indicates that robot-patient interaction could reduce stress.

CONCLUSIONS

Robot-patient interactions are crucial for improving acceptance in medical robotic imaging systems. While verbal interaction is most important, the preferred interaction type and content are participant dependent. Heart rate values indicate that such interactions can also reduce stress. Overall, this initial work showed that interactions improve patient acceptance in medical robotic imaging, and other medical robot-patient systems can benefit from the design proposals to enhance acceptance in interactive scenarios.

Co-created Technological Solutions for Caregivers in Health Care: Systematic Review

BACKGROUND

Support interventions for caregivers can reduce their stress, possibly improving the quality of patients' care while reducing care costs. Technological solutions have been designed to cover their needs, but there are some challenges in making them truly functional for end users. Co-design approaches present important opportunities for engaging diverse populations to help ensure that technological solutions are inclusive and accessible.

OBJECTIVE

This study aimed to identify co-created technological solutions, as well as the process followed for their co-creation, in the field of health for caregivers.

METHODS

The literature review was conducted in the Medline, Web of Science, Scopus, Science Direct, Scielo, and IEEE Xplore databases. The inclusion criteria were studies written in English or Spanish and with a publication date until May 2021. The content had to specify that the caregivers actively participated in the co-creation process, which covered until the development phase of the technological solution (prototype). The level of evidence and the methodological quality were analyzed when possible, using the Scottish Intercollegiate Guidelines Network criteria and the Mixed Methods Appraisal Tool, version 2018, respectively.

RESULTS

In total, 410 papers were identified, and 11 met the eligibility criteria. The most predominant articles were mixed methods studies and qualitative studies. The technology used in the analyzed articles were mobile or web applications (9 studies) and specific devices such as sensors, cameras, or alarm systems (2 studies) to support the health and social aspects of caregivers and improve their education in care. The most common patient profile was older people (7 studies); 6 studies used co-creation in the requirements phase, 6 studies detailed the design phase. In 9 studies, the prototype was iteratively refined in the development phase, and the validation phase was performed in 5 of the reviewed studies.

CONCLUSIONS

This systematic review suggests that existing co-created technological solutions in the field of health for caregivers are mostly mobile or web applications to support caregivers' social health and well-being and improve their health knowledge when delivering care to patients, especially older people. As for the co-creation process, caregivers are particularly involved during development and in the design. The scarce literature found indicates that further research with higher methodological quality is needed.

Technology Acceptance Model for Exoskeletons for Rehabilitation of the Upper Limbs from Therapists' Perspectives

Over the last few years, exoskeletons have been demonstrated to be useful tools for supporting the execution of neuromotor rehabilitation sessions. However, they are still not very present in hospitals. Therapists tend to be wary of this type of technology, thus reducing its acceptability and, therefore, its everyday use in clinical practice. The work presented in this paper investigates a novel point of view that is different from that of patients, which is normally what is considered for similar analyses. Through the realization of a technology acceptance model, we investigate the factors that influence the acceptability level of exoskeletons for rehabilitation of the upper limbs from therapists' perspectives. We analyzed the data collected from a pool of 55 physiotherapists and physiatrists through the distribution of a questionnaire. Pearson's correlation and multiple linear regression were used for the analysis. The relations between the variables of interest were also investigated depending on participants' age and experience with technology. The model built from these data demonstrated that the perceived usefulness of a robotic system, in terms of time and effort savings, was the first factor influencing therapists' willingness to use it. Physiotherapists' perception of the importance of interacting with an exoskeleton when carrying out an enhanced therapy session increased if survey participants already had experience with this type of rehabilitation technology, while their distrust and the consideration of others' opinions decreased. The conclusions drawn from our analyses show that we need to invest in making this technology better known to the public-in terms of education and training-if we aim to make exoskeletons genuinely accepted and usable by therapists. In addition, integrating exoskeletons with multi-sensor feedback systems would help provide comprehensive information about the patients' condition and progress. This can help overcome the gap that a robot creates between a therapist and the patient's human body, reducing the fear that specialists have of this technology, and this can demonstrate exoskeletons' utility, thus increasing their perceived level of usefulness.

Intelligent Physical Robots in Health Care: Systematic Literature Review

BACKGROUND

Intelligent physical robots based on artificial intelligence have been argued to bring about dramatic changes in health care services. Previous research has examined the use of intelligent physical robots in the health care context from different perspectives; however, an overview of the antecedents and consequences of intelligent physical robot use in health care is lacking in the literature.

OBJECTIVE

In this paper, we aimed to provide an overview of the antecedents and consequences of intelligent physical robot use in health care and to propose potential agendas for future research through a systematic literature review.

METHODS

We conducted a systematic literature review on intelligent physical robots in the health care field following the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Literature searches were conducted in 5 databases (PubMed, Scopus, PsycINFO, Embase, and CINAHL) in May 2021, focusing on studies using intelligent physical robots for health care purposes. Subsequently, the quality of the included studies was assessed using the Mixed Methods Appraisal Tool. We performed an exploratory content analysis and synthesized the findings extracted from the included articles.

RESULTS

A total of 94 research articles were included in the review. Intelligent physical robots, including mechanoid, humanoid, android, and animalistic robots, have been used in hospitals, nursing homes, mental health care centers, laboratories, and patients' homes by both end customers and health care professionals. The antecedents for intelligent physical robot use are categorized into individual-, organization-, and robot-related factors. Intelligent physical robot use in the health care context leads to both non-health-related consequences (emotional outcomes, attitude and evaluation outcomes, and behavioral outcomes) and consequences for (physical, mental, and social) health promotion for individual users. Accordingly, an integrative framework was proposed to obtain an overview of the antecedents and consequences of intelligent physical robot use in the health care context.

CONCLUSIONS

This study contributes to the literature by summarizing current knowledge in the field of intelligent physical robot use in health care, by identifying the antecedents and the consequences of intelligent physical robot use, and by proposing potential future research agendas in the specific area based on the research findings in the literature and the identified knowledge gaps.

Evaluating levels of automation with different feedback modes in an assistive robotic table clearing task for eldercare

This paper focuses on how the autonomy level of an assistive robot that offers support for older adults in a daily task and its feedback affect the interaction. Identifying the level of automation (LOA) that prioritizes older adults' preferences while avoiding passiveness and sedentariness is challenging. The feedback mode should match the cognitive and perceptual capabilities of older adults and the LOA. We characterized three LOAs and paired them with two modes of feedback in a human-robot collaborative task. Twenty-seven older adults participated in evaluating the LOA-feedback variations in a mixed experimental design, utilizing an experimental setup of an assistive robot in a table clearing task. The quality of the interaction was evaluated with objective and subjective measures. The combination of high LOA with voice feedback improved the overall interaction when compared to other LOA and feedback combinations. This study emphasizes the importance of appropriate coupling of LOA and feedback for successful interaction of the older adults with an assistive robot.

Dances with Social Robots: A Pilot Study at Long-Term Care

Dance therapy can have significant physical, emotional and cognitive benefits for older adults. In particular, social robots can be developed to autonomously facilitate dance sessions to engage these individuals with the aim of improving quality of life. To successfully integrate and promote long-term use of social robots into long-term care homes for such recreational activities, it is important to explore both residents’ and staff’s perceptions of such robots. In this paper, we present the first pilot human–robot interaction study that investigates the overall experiences and attitudes of both residents and staff in a long-term care home for robot-facilitated dance sessions. In general, the questionnaire results from our study showed that both staff and residents had positive attitudes towards the robot-facilitated dance activity. Encouraging trends showed residents had higher ratings for statements on perceived ease of use, safety, and enjoyment than the staff. However, the staff had a statistically significantly higher rating for willingness to use the robots for dance facilitation. Some key statistical differences were also determined with respect to: (1) gender within the resident group (men had higher ratings for the robots being useful in helping facilitate recreational activities), as well as between staff and residents (resident men had higher perceived safety), and (2) prior robot experience (residents with limited prior experience had higher ratings on perceived ease of use and perceived enjoyment than staff with the same level of experience). The robot-facilitated dance activity was positively received by both older adults and staff as an activity of daily living that can enhance wellbeing while also being safe, easy to use and enjoyable.

Soft, lightweight wearable robots to support the upper limb in activities of daily living: a feasibility study on chronic stroke patients

Stroke can be a devastating condition that impairs the upper limb and reduces mobility. Wearable robots can aid impaired users by supporting performance of Activities of Daily Living (ADLs). In the past decade, soft devices have become popular due to their inherent malleable and low-weight properties that makes them generally safer and more ergonomic. In this study, we present an improved version of our previously developed gravity-compensating upper limb exosuit and introduce a novel hand exoskeleton. The latter uses 3D-printed structures that are attached to the back of the fingers which prevent undesired hyperextension of joints. We explored the feasibility of using this integrated system in a sample of 10 chronic stroke patients who performed 10 ADLs.We observed a significant reduction of 30.3 ± 3.5% (mean ± standard error), 31.2 ± 3.2% and 14.0 ± 5.1% in the mean muscular activity of the Biceps Brachii (BB), Anterior Deltoid (AD) and Extensor Digitorum Communis muscles, respectively. Additionally, we observed a reduction of 14.0 ± 11.5%, 14.7 ± 6.9% and 12.8 ± 4.4% in the coactivation of the pairs of muscles BB and Triceps Brachii (TB), BB and AD, and TB and Pectoralis Major (PM), respectively, typically associated to pathological muscular synergies, without significant degradation of healthy muscular coactivation. There was also a significant increase of elbow flexion angle (12.1±1.5°). These results further cement the potential of using lightweight wearable devices to assist impaired users.

Study protocol: a survey exploring patients' and healthcare professionals' expectations, attitudes and ethical acceptability regarding the integration of socially assistive humanoid robots in nursing

INTRODUCTION

Population ageing, the rise of chronic diseases and the emergence of new viruses are some of the factors that contribute to an increasing share of gross domestic product dedicated to health spending. COVID-19 has shown that nursing staff represents the critical part of hospitalisation. Technological developments in robotics and artificial intelligence can significantly reduce costs and lead to improvements in many hospital processes. The proposed study aims to assess expectations, attitudes and ethical acceptability regarding the integration of socially assistive humanoid robots into hospitalised care workflow from patients' and healthcare professionals' perspectives and to compare them with the results of similar studies.

METHODS/DESIGN

The study is designed as a cross-sectional survey, which will include three previously validated questionnaires, the Technology-Specific Expectation Scale (TSES), the Ethical Acceptability Scale (EAS) and the Negative Attitudes towards Robots Scale (NARS). The employees of a regional clinical centre will be asked to participate via an electronic survey and respond to TSES and EAS questionaries. Patients will respond to TSES and NARS questionaries. The survey will be conducted online.

ETHICS AND DISSEMINATION

Ethical approval for the study was obtained by the Medical Ethics Commission of the University Medical Center Maribor. Results will be published in a relevant scientific journal and communicated to participants and relevant institutions through dissemination activities and the ecosystem of the Horizon 2020 funded project HosmartAI (grant no. 101016834).

ETHICAL APPROVAL DATE

06 May 2021.

ESTIMATED START OF THE STUDY

December 2021.

No thank you to humanized robots: attitudes to care robots in elder care services

The growing older population will increase the demands on the health and welfare systems, including elder care services. One way of meeting these growing service needs is to shift from traditional care services to technologically oriented services. Robotic innovations are gradually being introduced to elder care services. The aim was to explore attitudes toward the use of care robots in elder care services - specifically focusing on situations and interaction, influence, and emotions in interaction with care robots. Data were obtained from visitors at a welfare technology fair (n = 124). The results show that the most negative attitudes concerned if the care robots were humanized and had emotions. The attitudes toward interacting with care robots in general were predominately positive. In conclusion, concrete usage scenarios in elder care services need to be detected, based both on users' needs, digital literacy and on the maturity of the technology itself.

Health Promotion, Health Literacy and Vaccine Hesitancy: The Role of Humanoid Robots

The use of humanoid robot technologies within global healthcare settings is rapidly evolving; however, the potential of robots in health promotion and health education is not established. The aim of this study was to explore the impact of a social humanoid robot on individuals' knowledge of influenza (flu) prevention and attitudes towards influenza vaccination. A multi-methods approach involving pre and post-test questions and interviews was used. The study was undertaken in a publicly funded tertiary level hospital in northern Queensland, Australia. Of the 995 participants, the majority were visitors (53.07%). The mean age of the participants was 42.25 (SD=19.54) years. Based on the three knowledge questions that were posed at the two-point interactions of participants with the humanoid robot 'Pepper', the results showed that there was a significant difference in the correct responses pre- and post-test regarding the best way to avoid getting the flu (Exact McNemar significance probability <.0001), how long the flu virus can live outside the human body (p <.0001) and the length of time for handwashing to be effective against spreading germs (p <.0001). The results also showed that there was a significant difference in attitudes associated with influenza vaccination when pre-test was compared to post-test (p=.0019). Interaction of the participants with the humanoid robot demonstrated immediate knowledge gains and attitudinal change that suggests that humanoid robots may be an important intervention for health promotion in prevention of influenza and other respiratory viruses.

An analysis of usability evaluation practices and contexts of use in wearable robotics

BACKGROUND

User-centered design approaches have gained attention over the past decade, aiming to tackle the technology acceptance issues of wearable robotic devices to assist, support or augment human capabilities. While there is a consensus that usability is key to user-centered design, dedicated usability evaluation studies are scarce and clear evaluation guidelines are missing. However, the careful consideration and integration of user needs appears to be essential to successfully develop an effective, efficient, and satisfactory human-robot interaction. It is primarily the responsibility of the developer, to ensure that this users involvement takes place throughout the design process.

METHODS

Through an online survey for developers of wearable robotics, we wanted to understand how the design and evaluation in actual daily practice compares to what is reported in literature. With a total of 31 questions, we analyzed the most common wearable robotic device applications and their technology maturity, and how these influence usability evaluation practices.

RESULTS

A total of 158 responses from a heterogeneous population were collected and analyzed. The dataset representing contexts of use for augmentation (16.5%), assistance (38.0%), therapy (39.8%), as well as few other specific applications (5.7%), allowed for an insightful analysis of the influence of technology maturity on user involvement and usability evaluation. We identified functionality, ease of use, and performance as the most evaluated usability attributes and could specify which measures are used to assess them. Also, we could underline the frequent use of qualitative measures alongside the expected high prevalence of performance-metrics. In conclusion of the analysis, we derived evaluation recommendations to foster user-centered design and usability evaluation.

CONCLUSION

This analysis might serve as state-of-the-art comparison and recommendation for usability studies in wearable robotics. We believe that by motivating for more balanced, comparable and user-oriented evaluation practices, we may support the wearable robotics field in tackling the technology acceptance limitations.

Acceptability of Socially Assistive Robots Among Cognitively Intact Older Adults: An Integrative Review

An aging population and technology are two rapidly evolving phenomena occurring simultaneously worldwide. To examine the literature on the acceptability of socially assistive robots (SAR) among cognitively intact older adults, an integrative review of the literature was performed using Whittemore and Knafl's approach. Electronic databases searched included CINAHL, PubMed, and the Cochrane Library. Review was limited to peer-reviewed articles published between 2013 and 2019, in or translated into English language, and included evaluation of the robot within a social context in older adults aged ≥60 years with intact cognition. A total of five articles were included in the review. There were 125 male and female participants in all studies, and the mean age of participants ranged from 66.3 to 77.1 years. The robots studied varied in design and functionality. Findings showed older adults who are cognitively intact find SAR easy to use and useful, suggesting acceptability of SAR. [Journal of Gerontological Nursing, 47(9), 49-54.].

Attitudes of the elderly living independently towards the use of robots to assist with activities of daily living

BACKGROUND

Robots are gaining attention as a potential solution to aging.

OBJECTIVE

The purpose of this study is to explore the attitude of robot assistance in Activities of Daily Living (ADLs) among elderly people living independently.

METHODS

The one-on-one interview, buddy robot video and questionnaire survey were used to analyze mean, median, range, and the test results of non-parametric statistical methods such as Wilcoxon sign-rank test statistic and one-sample Wilcoxon sign-rank test statistic, so as to explore the attitude of the elderly living independently towards robot-assisted ADLs and the acceptance of the use of robots in 32 ADLs.

RESULTS

The results showed that there were significant differences in the attitudes, usability and ease of use of elderly people towards robot assistance before and after watching the Buddy Robot video and they had a more positive attitude after watching the video. According to the results, the elderly was more receptive to the use of robots in activities such as "reminding to carry objects" and "reminding to take medicine", while they were less receptive to the use of robots in the group or private activities such as "playing mahjong" and "taking a bath".

CONCLUSIONS

The results showed that the elderly had a positive attitude towards the use of robot-assisted ADLs, and there were differences in the acceptance of robot-assisted ADLs. The results are helpful to understand the assistance needs and attitudes of the elderly, and provide a reference for the design of assistive robots that meet user needs, and ultimately improve the ability of the elderly to live independently at home.

Older adults' experiences with and perceptions of the use of socially assistive robots in aged care: A systematic review of quantitative evidence

BACKGROUND

Socially assistive robots (SARs) are created to meet challenges of the global increase of older adults. SARs are autonomous embodied technologies, equipped with auditory and visual faculties, enabling them to interact with users while performing assistive roles. Despite studies focusing on older adults' experiences with and perceptions of SARs, it remains unclear what these encompass.

OBJECTIVE

To gain insight into common aspects of older adults' experiences with and perceptions of SAR use in aged care, the relevant quantitative research literature was reviewed and synthesized.

METHODS

Six electronic databases were searched using detailed search strings. Applying pre-specified inclusion and exclusion criteria resulted in 23 articles to be included. Full texts were analyzed thematically, and graphs were developed to facilitate comparisons.

RESULTS

Six main themes related to older adults' experiences with and perceptions of SAR use were identified: (1) general attitudes toward SARs, (2) feelings about SARs, (3) perceived usefulness and perceived ease of use of SARs, (4) intention to use SARs, (5) tasks of SARs, (6) SARs' appearances. Ethical issues linked to SARs were barely described in the studies.

CONCLUSION

Older adults are relatively open-minded about SARs, generally feeling comfortable with at least some aspects of them, and intend to use SARs in the future, especially for physical assistive functions. Thus, SARs may meet some of older ones' needs. Although the quantitative evidence contributes to gaining insight in older adults' experiences with and perceptions of SARs, social contextualization is necessary to understand their full meaning.

Biomedical soft robots: current status and perspective

This paper reviews the current status of soft robots in biomedical field. Soft robots are made of materials that have comparable modulus of elasticity to that of biological systems. Several advantages of soft robots over rigid robots are safe human interaction, ease of adaptation with wearable electronics and simpler gripping. We review design factors of soft robots including modeling, controls, actuation, fabrication and application, as well as their limitations and future work. For modeling, we survey kinematic, multibody and numerical finite element methods. Finite element methods are better suited for the analysis of soft robots, since they can accurately model nonlinearities in geometry and materials. However, their real-time integration with controls is challenging. We categorize the controls of soft robots as model-based and model-free. Model-free controllers do not rely on an explicit analytical or numerical model of the soft robot to perform actuation. Actuation is the ability to exert a force using actuators such as shape memory alloys, fluid gels, elastomers and piezoelectrics. Nonlinear geometry and materials of soft robots restrict using conventional rigid body controls. The fabrication techniques used for soft robots differ significantly from that of rigid robots. We survey a wide range of techniques used for fabrication of soft robots from simple molding to more advanced additive manufacturing methods such as 3D printing. We discuss the applications and limitations of biomedical soft robots covering aspects such as functionality, ease of use and cost. The paper concludes with the future discoveries in the emerging field of soft robots.

Application of Reinforcement Learning to a Robotic Drinking Assistant

Meal assistant robots form a very important part of the assistive robotics sector since self-feeding is a priority activity of daily living (ADL) for people suffering from physical disabilities like tetraplegia. A quick survey of the current trends in this domain reveals that, while tremendous progress has been made in the development of assistive robots for the feeding of solid foods, the task of feeding liquids from a cup remains largely underdeveloped. Therefore, this paper describes an assistive robot that focuses specifically on the feeding of liquids from a cup using tactile feedback through force sensors with direct human–robot interaction (HRI). The main focus of this paper is the application of reinforcement learning (RL) to learn what the best robotic actions are, based on the force applied by the user. A model of the application environment is developed based on the Markov decision process and a software training procedure is designed for quick development and testing. Five of the commonly used RL algorithms are investigated, with the intention of finding the best fit for training, and the system is tested in an experimental study. The preliminary results show a high degree of acceptance by the participants. Feedback from the users indicates that the assistive robot functions intuitively and effectively.

Technological Advancements in Cerebral Palsy Rehabilitation

Smaller, smarter, more portable rehabilitation technology has the potential to improve the ability of individuals with cerebral palsy to perform activities and increase participation. Robotics and virtual reality may improve movement by maximizing exercise dose, providing feedback, and motivating users. Augmentative and alternative communication technology is facilitating communication. Robots can help with self-care and provide encouragement and instruction in rehabilitation programs. Mobile applications can provide education and resources. Conducting high-quality research to validate technological advances in our field has been a major focus of researchers and advocacy groups.

Robotic technology for palliative and supportive care: Strengths, weaknesses, opportunities and threats

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.

Acceptance and Use of Innovative Assistive Technologies among People with Cognitive Impairment and Their Caregivers: A Systematic Review

Cognitive impairments (CI), associated with the consequences of Alzheimer's disease and other dementias, are increasingly prevalent among older adults, leading to deterioration in self-care, mobility, and interpersonal relationships among them. Innovative Assistive Technologies (IAT) such as electronic reminders and surveillance systems are considered as increasingly important tools to facilitate independence among this population and their caregivers. The aim of this study is to synthesise knowledge on facilitators and barriers related to acceptance of and use of IAT among people with CI and their caregivers. This systematic review includes original papers with quantitative, qualitative, or mixed methods design. Relevant peer-reviewed articles published in English between 2007 and 2017 were retrieved in the following databases: CINAHL; PubMed; Inspec; and PsycINFO. The Mixed Method Appraisal Tool (MMAT) was used for quality assessment. We retrieved thirty studies, including in total 1655 participants from Europe, USA/Canada, Australia, and Asia, enrolled in their homes, care-residences, day-care centres, or Living Labs. Two-thirds of the studies tested technologies integrating home sensors and wearable devices for care and monitoring CI symptoms. Main facilitators for acceptance and adherence to IAT were familiarity with and motivation to use technologies, immediate perception of effectiveness (e.g., increase in safety perceptions), and low technical demands. Barriers identified included older age, low maturity of the IAT, little experience with technologies in general, lack of personalization, and support. More than 2/3 of the studies met 80% of the quality criteria of the MMAT. Low acceptance and use of IAT both independently and with caregivers remains a significant concern. More knowledge on facilitators and barriers to use of IAT among clients of health care and social services is crucial for the successful implementation of innovative programmes aiming to leverage innovative technologies for the independence of older people with CI.

Comfort and Attitudes Towards Robots Among Young, Middle-Aged, and Older Adults: A Cross-Sectional Study

PURPOSE

To explore the social impact of, comfort with, and negative attitudes towards robots among young, middle-aged, and older adults in the United States.

DESIGN

Descriptive, cross-sectional. Conducted in 2014-2015 in an urban area of the western United States using a purposive sample of adults 18 years of age or older.

METHODS

Respondents completed a survey that included the Negative Attitudes Toward Robots Scale (NARS) and two questions taken or modified from the European Commission's Autonomous System 2015 Report. Analyses were conducted to compare perceptions and demographic factors by age groups (young adults:18-44, middle-aged adults: 45-64, and older adults: >65 years old).

FINDINGS

Sample included 499 individuals (n = 322 age 18-44 years, n = 50 age 45-64 years, and n = 102 age 65-98 years). There were no significant differences between age groups for 9 of the 11 items regarding social impact of robots and comfort with robots. There were no significant differences by age groups for 9 of the 14 items in the NARS. Among those items with statistically significant differences, the mean scores indicate similar sentiments for each group.

CONCLUSIONS

Older, middle-aged, and younger adults had similar attitudes regarding the social impact of and comfort with robots; they also had similar negative attitudes towards robots. Findings dispel current perceptions that older adults are not as receptive to robots as other adults. This has implications for nurses who integrate supportive robots in their practice.

CLINICAL RELEVANCE

Nurses working in clinical and community roles can use these findings when developing and implementing robotic solutions. Understanding attitudes towards robots can support how, where, and with whom robots can be used in nursing practice.