Older adults' experiences and perceptions of living with Bomy, an assistive dailycare robot: a qualitative study

When a notification at the right time is not enough: the reminding process for socially assistive robots in institutional care

Reminding is often identified as a central function of socially assistive robots in the healthcare sector. The robotic reminders are supposed to help people with memory impairments to remember to take their medicine, to drink and eat, or to attend appointments. Such standalone reminding technologies can, however, be too demanding for people with memory injuries. In a co-creation process, we developed an individual reminder robot together with a person with traumatic brain injury and her care personnel. During this process, we learned that while current research describe reminding as a prototypical task for socially assistive robots, there is no clear definition of what constitutes a reminder nor that it is based on complex sequences of interactions that evolve over time and space, across different actions, actors and technologies. Based on our data from the co-creation process and the first deployment, we argue for a shift towards a sequential and socially distributed character of reminding. Understanding socially assistive robots as rehabilitative tools for people with memory impairment, they need to be reconsidered as interconnected elements in institutional care practices instead of isolated events for the remindee.

Acceptance of a robotic system for nursing care: a cross-sectional survey with professional nurses, care recipients and relatives

BACKGROUND

The end-users' acceptance is a core concept in the development, implementation and evaluation of new systems like robotic systems in daily nursing practice. So far, studies have shown various findings concerning the acceptance of systems that are intended to assist people with support or care needs. Not much has been reported on the acceptance of robots that provide direct physical assistance to nurses in bedside care. Therefore, this study aimed to investigate the acceptance along with ethical implications of the prototype of an assistive robotic arm aiming to support nurses in bedside care, from the perspective of nurses, care recipients and their relatives.

METHODS

A cross-sectional survey design was applied at an early stage in the technological development of the system. Professional nurses, care recipients and relatives were recruited from a university hospital and a nursing home in Germany. The questionnaire was handed out following either a video or a live demonstration of the lab prototype and a subsequent one-to-one follow-up discussion. Data analysis was performed descriptively.

RESULTS

A total of 67 participants took part in the study. The rejection of specified ethical concerns across all the respondents was 77%. For items related to both perceived usefulness and intention to use, 75% of ratings across all the respondents were positive. In the follow-up discussions, the participants showed interest and openness toward the prototype, although there were varying opinions on aspects such as size, appearance, velocity, and potential impact on workload.

CONCLUSIONS

Regarding the current state of development, the acceptance among the participants was high, and ethical concerns were relatively minor. Moving forward, it would be beneficial to explore the acceptance in further developmental stages of the system, particularly when the usability is tested.

Identifying Preferred Appearance and Functional Requirements of Aged Care Robots Among Older Chinese Immigrants: Cross-Sectional Study

Background

Older Chinese immigrants constitute the largest older Asian ethnic population in New Zealand. Aging in a foreign land can be complex, presenting increasing challenges for gerontology scholars, practitioners, and policy makers. Older Chinese immigrants are more susceptible to experiencing loneliness and social isolation compared to native older people, primarily due to language, transportation, and cultural barriers. These factors subsequently impact their physical and mental health. With advancements in robotic technology, aged care robots are being applied to support older people with their daily living needs. However, studies on using robots with older immigrants living in the community are sparse. Their preferences for the appearance and function of aged care robots are unclear, which impacts the acceptance and usability of robots, highlighting the need for a user-centered design approach.

Objective

This study aims to explore older Chinese immigrants' needs and preferences toward the appearance and function of aged care robots and to examine their relationships with the demographic characteristics of participants.

Methods

A cross-sectional design was used in this study, which was undertaken between March and May 2020. A total of 103 participants completed a web-based survey.

Results

The average age of participants was 68.7 (SD 5.5) years. The results suggest that 41.7% (n=43) of the 103 participants preferred a humanlike adult appearance, while 32% (n=33) suggested an animallike appearance. These participants reported higher scores in both rigorousness and friendliness compared to others who preferred different robot appearances. Participants expressed a greater preference for the functions of housework assistance (n=86, 83.5%), language translation (n=79, 76.7%), health monitoring (n=78, 75.7%), facial expressions (n=77, 74.8%), news reading (n=66, 64.1%), and security monitoring (n=65, 63.1%). These preferences were found to be significantly associated with marital status, financial status, and duration of immigration.

Conclusions

To support immigrant populations to age well in a foreign country and address the growing shortage of health and social professionals, it is important to develop reliable robotic technology services that are tailored based on the needs and preferences of individuals. We collected and compared the perspectives of immigrant and nonimmigrant participants on using robots to support aging in place. The results on users' needs and preferences inform robotic technology services, indicating a need to prioritize older Chinese immigrants' preference toward aged care robots that perform housework assistance, language translation, and health and safety monitoring, and robots with humanlike features.

Application of Artificial Intelligence in Geriatric Care: Bibliometric Analysis

BACKGROUND

Artificial intelligence (AI) can improve the health and well-being of older adults and has the potential to assist and improve nursing care. In recent years, research in this area has been increasing. Therefore, it is necessary to understand the status of development and main research hotspots and identify the main contributors and their relationships in the application of AI in geriatric care via bibliometric analysis.

OBJECTIVE

Using bibliometric analysis, this study aims to examine the current research hotspots and collaborative networks in the application of AI in geriatric care over the past 23 years.

METHODS

The Web of Science Core Collection database was used as a source. All publications from inception to August 2022 were downloaded. The external characteristics of the publications were summarized through HistCite and the Web of Science. Keywords and collaborative networks were analyzed using VOSviewers and Citespace.

RESULTS

We obtained a total of 230 publications. The works originated in 499 institutions in 39 countries, were published in 124 journals, and were written by 1216 authors. Publications increased sharply from 2014 to 2022, accounting for 90.87% (209/230) of all publications. The United States and the International Journal of Social Robotics had the highest number of publications on this topic. The 1216 authors were divided into 5 main clusters. Among the 230 publications, 4 clusters were modeled, including Alzheimer disease, aged care, acceptance, and the surveillance and treatment of diseases. Machine learning, deep learning, and rehabilitation had also become recent research hotspots.

CONCLUSIONS

Research on the application of AI in geriatric care has developed rapidly. The development of research and cooperation among countries/regions and institutions are limited. In the future, strengthening the cooperation and communication between different countries/regions and institutions may further drive this field's development. This study provides researchers with the information necessary to understand the current state, collaborative networks, and main research hotspots of the field. In addition, our results suggest a series of recommendations for future research.

Exploring the Presence of Humanoid Social Robots at Home and Capturing Human-Robot Interactions with Older Adults: Experiences from Four Case Studies

BACKGROUND

Social robots have the potential to bring benefits to aged care. However, it is uncertain whether placing these robots in older people's home is acceptable and whether human-robot interactions would occur or not.

METHODS

Four case studies were conducted to understand the experiences of older adults and family caregivers when humanoid social robot Ka Ka was placed in homes for two weeks.

RESULTS

Four older adults and three family caregivers were involved. Older adults interacted with the social robot Ka Ka every day during the study period. 'Talking to Ka Ka', 'listening to music', 'using the calendar reminder', and 'listening to the weather report' were the most commonly used features. Qualitative data reported the strengths of Ka Ka, such as providing emotional support to older adults living alone, diversifying their daily activities, and enhancing family relationships. The voice from Ka Ka (female, soft, and pleasing to the ear) was considered as 'bringing a pleasant feeling' to older adults.

CONCLUSIONS

In order to support aging-in-place and fill the gaps of the intensified shortage of health and social manpower, it is of prime importance to develop reliable and age-friendly AI-based robotic services that meet the needs and preferences of older adults and caregivers.

Nursing and human-computer interaction in healthcare robots for older people: An integrative review

Objectives

This study examined the published works related to healthcare robotics for older people using the attributes of health, nursing, and the human-computer interaction framework.

Design

An integrative literature review.

Methods

A search strategy captured 55 eligible articles from databases (CINAHL, Embase, IEEE Xplore, and PubMed) and hand-searching approaches. Bibliometric and content analyses grounded on the health and nursing attributes and human-computer interaction framework were performed using MAXQDA. Finally, results were verified using critical friend feedback by a second reviewer.

Results

Most articles were from multiple authorship, published in non-nursing journals, and originating from developed economies. They primarily focused on applying healthcare robots in practice settings, physical health, and communication tasks. Using the human-computer interaction framework, it was found that older adults frequently served as the primary users while nurses, healthcare providers, and researchers functioned as secondary users and operators. Research articles focused on the usability, functionality, and acceptability of robotic systems. At the same time, theoretical papers explored the frameworks and the value of empathy and emotion in robots, human-computer interaction and nursing models and theories supporting healthcare practice, and gerontechnology. Current robotic systems are less anthropomorphic, operated through real-time direct and supervisory inputs, and mainly equipped with visual and auditory sensors and actuators with limited capability in performing health assessments.

Conclusion

Results communicate the need for technological competency among nurses, advancements in increasing healthcare robot humanness, and the importance of conscientious efforts from an interdisciplinary research team in improving robotic system usability and utility for the care of older adults.

A Scoping Review of the Literature On Prosodic Elements Related to Emotional Speech in Human-Robot Interaction

Background

Sentiment expression and detection are crucial for effective and empathetic human-robot interaction. Previous work in this field often focuses on non-verbal emotion expression, such as facial expressions and gestures. Less is known about which specific prosodic speech elements are required in human-robot interaction. Our research question was: what prosodic elements are related to emotional speech in human-computer/robot interaction?

Methods

The scoping review was conducted in alignment with the Arksey and O’Malley methods. Literature was identified from the SCOPUS, IEEE Xplore, ACM Digital Library and PsycINFO databases in May 2021. After screening and de-duplication, data were extracted into an Excel coding sheet and summarised.

Results

Thirteen papers, published from 2012 to 2020 were included in the review. The most commonly used prosodic elements were tone/pitch (n = 8), loudness/volume (n = 6) speech speed (n = 4) and pauses (n = 3). Non-linguistic vocalisations (n = 1) were less frequently used. The prosodic elements were generally effective in helping to convey or detect emotion, but were less effective for negative sentiment (e.g., anger, fear, frustration, sadness and disgust).

Discussion

Future research should explore the effectiveness of commonly used prosodic elements (tone, loudness, speed and pauses) in emotional speech, using larger sample sizes and real-life interaction scenarios. The success of prosody in conveying negative sentiment to humans may be improved with additional non-verbal cues (e.g., coloured light or motion). More research is needed to determine how these may be combined with prosody and which combination is most effective in human-robot affective interaction.

Extended Interviews with Stroke Patients Over a Long-Term Rehabilitation Using Human–Robot or Human–Computer Interactions

Socially assistive robots (SARs) have been proposed to assist post-stroke patients in performing their exercise during their rehabilitation process, with the trust in the robot identified as an important factor in human–robot interaction. In the current study, we aimed to identify and characterize factors that influence post-stroke patients’ trust in a robot-operated and a computer-operated rehabilitation platform during and after a long-term experience with the platform. We conducted 29 interviews with 16 stroke patients who underwent a long-term rehabilitation process, assisted by either a SAR or a computer interface. The intervention lasted 5–7 weeks per patient, for a total of 229 sessions over 18 months. By using a qualitative research method—extended interviews “in the wild” with stroke patients, over a long-term rehabilitation process—our study reveals users’ perspectives regarding factors affecting trust in the SAR or in the computer interface during their rehabilitation process. The results support the assertion that SARs have an added value in the rehabilitative care of stroke patients; It appears that personal characteristics, such as age and gender, have an effect on the users’ acceptance of a non-human operator as a practice assistant. Our findings support the notion that SARs augment rehabilitative therapies beyond a standard computer; Importantly, patients appreciated different aspects of the non-human operator in the two groups: In the SAR group, users preferred its functional performance over its anthropomorphized social skills; In the Computer group, users highlighted its contribution to the training of their memory skills.

Technology Acceptance in Socially Assistive Robots: Scoping Review of Models, Measurement, and Influencing Factors

Objectives

We summarized technology acceptance and the influencing factors of elderly people toward socially assistive robots (SARs).

Methods

A scoping review whereby a literature search was conducted in Embase, Cochrane, Scopus, PubMed, and Web of Science databases (2006-2021) to retrieve studies. No restrictions on study methodology were imposed.

Results

Out of the 1187 retrieved papers, 35 studies were finally included in the study. The articles covered various aspects, including general attitudes towards using SARs, technology acceptance theory models, and factors associated with technology acceptance. Twelve studies reported a positive attitude towards SARs. Three explicit theoretical frameworks were reported. Studies involving the elderly reported three themes that influence attitudes towards SARs: individual characteristics, concerns/problems regarding robots, and social factors.

Conclusions

This review elucidates on the suitability of theory-based framework as applied to acceptance of SARs. We found that research on technology acceptance with regard to SARs is still in the developmental stages, and further studies of assessment tools for SARs are required. It is also essential to consider the factors that influence the acceptance of SARs by older people to ensure that they meet the end goal requirements of the user.

Robot-Delivered Cognitive Stimulation Games for Older Adults

Cognitive stimulation games delivered on robots may be able to improve cognitive functioning and delay decline in older adults. However, little is known about older adults’ in-depth opinions of robot-delivered games, as current research primarily focuses on technical development and one-off use. This article explores the usability, acceptability, and perceptions of community-dwelling older adults towards cognitive games delivered on a robot that incorporated movable interactive blocks. Semi-structured interviews were conducted with participants at the end of a 12-week cognitive stimulation games intervention delivered entirely on robots. Participants were 10 older adults purposively sampled from two retirement villages. A framework analysis approach was used to code data to predefined themes related to technology acceptance (perceived benefits, satisfaction, and preference), and usability (effectiveness, efficiency, and satisfaction). Results indicated that cognitive games delivered on a robot may be a valuable addition to existing cognitive stimulation activities. The robot was considered easy to use and useful in improving cognitive functioning. Future developments should incorporate interactive gaming tools, the use of social anthropomorphic robots, contrasting colour schemes to accommodate macular degeneration, and cultural-specific imagery and language. This will help cater to the preferences and age-related health needs of older adults, to ultimately enhance usability and acceptability.

Deploying social robots in museum settings: A quasi-systematic review exploring purpose and acceptability

Social robots are increasingly used within public spaces, including museum settings. This quasi-systematic review identifies and synthesizes the evidence on social robots that have recently been deployed in museum settings. It specifically focuses on their intended purpose, their acceptability and factors important for successful human–robot interaction in this setting. Four databases (PsycINFO, SCOPUS, ACM Digital Library and IEEE Xplore) were systematically searched to retrieve literature published within the last 10 years on human–robot interaction studies with social robots deployed in museum settings. Due to the heterogeneous nature of the studies, qualitative and quantitative findings were summarized. A total of 604 items were identified, of which 12 were included in the review. Robots in 11 studies were physical and 1 was an embodied conversational agent presented as a virtual robot. In 75% of the studies ( n = 9), the purpose of the robots was to act as museum guides, while in 17% ( n = 2) they entertained visitors and in 8% ( n = 1) the robot taught visitors in a museum outreach programme. Overall, many of the robots were found to be acceptable for use within museum settings. Three main themes for successful social human–robot interaction were evident across the findings: (1) facial expressions, (2) movement and (3) communication and speech. There is a great opportunity for social robots to be deployed within museum settings, as guides, educators, entertainers or a combination thereof. State-of-the-art methods have led to the development of museum robots that are more capable of social interaction; however, more work is required to develop speech capabilities that work in the ‘wild’. Future work should combine the factors that have been identified within this review to improve human–robot interaction.

Companion robots for older adults: Rodgers' evolutionary concept analysis approach

This study aims to analyze the concept of companion robots for older adults from the perspective of nursing. This study employed a concept analysis. The literature from July 2011 to June 2021 was sought from databases using specific keywords. Any quantitative or qualitative study published in English or Korean focusing on companion robots for older adults was included in the study. Rodgers' evolutionary concept analysis was used to clarify the antecedents, attributes, and consequences. Seventy-five eligible articles were studied. The findings were categorized into antecedents, attributes, and consequences. Companion robot antecedents were classified into individual factors, attitude toward robots, and caregiver and social factors. The defining attributes included human-robot interaction, function, features, structure, cost, and management of the robot being a companion. Consequences were categorized into user, caregiver, and health related. Companion robots are designed to enhance well-being, quality of life, and independence by providing service and companionship and assisting daily life. This mainly includes cognitive and social support, mobility support, relaxation, health monitoring, and self-care support through human-robot interaction. The attributes, antecedents, and consequences of companion robots identified in this study can inform future decision making and interventions by caregivers for aging in place.

Socially Assistive Robots Helping Older Adults through the Pandemic and Life after COVID-19

The COVID-19 pandemic has critically impacted the health and safety of the population of the world, especially the health and well-being of older adults. Socially assistive robots (SARs) have been used to help to mitigate the effects of the pandemic including loneliness and isolation, and to alleviate the workload of both formal and informal caregivers. This paper presents the first extensive survey and discussion on just how socially assistive robots have specifically helped this population, as well as the overall impact on health and the acceptance of such robots during the pandemic. The goal of this review is to answer research questions with respect to which SARs were used during the pandemic and what specific tasks they were used for, and what the enablers and barriers were to the implementation of SARs during the pandemic. We will also discuss lessons learned from their use to inform future SAR design and applications, and increase their usefulness and adoption in a post-pandemic world. More research is still needed to investigate and appreciate the user experience of older adults with SARs during the pandemic, and we aim to provide a roadmap for researchers and stakeholders.