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Tan XR, Wilson IM, Tay PKC, Win PPS, Song CF, Wee SL. Mapping of technological strategies for reducing social isolation in homebound older adults: A scoping review. Arch Gerontol Geriatr 2024; 125:105478. [PMID: 38776697 DOI: 10.1016/j.archger.2024.105478] [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: 11/23/2023] [Revised: 04/18/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Homebound older adults (HOAs) are particularly vulnerable to social isolation and loneliness, which engender a poorer physical and mental health, and greater cognitive decline. The purpose of this review is to map the literature to identify potential technological strategies that reduce social isolation in HOAs, and to understand facilitators and barriers for adoption and implementation. METHODS Six databases including PubMed (MEDLINE), Google Scholar, Cochrane Database, EBSCOHost, National Library ProQuest, Web of Science, and the Journal of Medical Internet Research were searched for relevant articles. Peer-reviewed literature published in English from Jan 2014 to Feb 2024 that employed technological strategies applicable to HOAs and assessed social isolation or connectedness as an outcome measure were included. RESULTS 107 studies were reviewed and classified into different technological categories based on their functions and features. A social technology framework encompassing delivery, hardware, software, content, training, and support was conceptualized with core characteristics identified from the reviewed technological strategies. Cost and complexity of technology, and resource commitment were identified as barriers while user-friendliness, content curation and a supportive ecosystem may facilitate the adoption of a technological strategy to address social isolation in HOAs. CONCLUSION There is a need for early and concerted effort to identify HOAs, provide technology training, and empower them to tap on the digital world to complement and/or supplement social interactions. Development of cost-effective and rapid-to-implement technology is vital for HOAs who are at highest risk to social isolation.
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Affiliation(s)
- Xiang Ren Tan
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ingrid M Wilson
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Latrobe University, Melbourne, Australia
| | - Peter Kay Chai Tay
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Phoo Pyae Sone Win
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Cai Feng Song
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Shiou-Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Geriatric Education and Research Institute, Singapore
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Duffner LA, Janssen N, Deckers K, Schroyen S, de Vugt ME, Köhler S, Adam S, Verhey FRJ, Veenstra MY. Facing the Next "Geriatric Giant"-A Systematic Literature Review and Meta-Analysis of Interventions Tackling Loneliness and Social Isolation Among Older Adults. J Am Med Dir Assoc 2024; 25:105110. [PMID: 38945174 DOI: 10.1016/j.jamda.2024.105110] [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: 10/02/2023] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVES Loneliness and social isolation are associated with adverse health outcomes, especially within the older adult population, underlining the need for effective interventions. This systematic review and meta-analysis aims to summarize all available evidence regarding the effectiveness of interventions for loneliness and social isolation, to map out their working mechanisms, and to give implications for policy and practice. DESIGN Systematic literature review and meta-analysis. SETTING AND PARTICIPANTS Older adults (≥65 years). METHODS A systematic search was conducted in MEDLINE, PsycINFO, and CINAHL for studies quantitively or qualitatively assessing effects of interventions for loneliness and social isolation in older adults, following predefined selection criteria. Risk of bias as well as small study effects were assessed and, wherever appropriate, information about effect sizes of individual studies pooled using random-effects meta-analyses. Sources for between-study heterogeneity were explored using meta-regression. RESULTS Of n = 2223 identified articles, n = 67 were eventually included for narrative synthesis. Significant intervention effects were reported for a proportion of studies (55.9% and 50.0% for loneliness and social isolation, respectively) and 57.6% of studies including a follow-up measure (n = 29) reported sustained intervention effects. Meta-analysis of n = 27 studies, representing n = 1756 participants, suggested a medium overall effect of loneliness interventions (d = -0.47; 95% CI, -0.62 to -0.32). Between-study heterogeneity was substantial and could not be explained by differences in study design, year of publication, outcome measures, intervention length, participant demographics, setting, baseline level of loneliness, or geographic location. However, non-technology-based interventions reported larger effect sizes on average (Δd = -0.35; 95% CI, -0.66 to -0.04; P = .029) and were more often significant. Qualitative assessment of potential intervention mechanisms resulted in 3 clusters of effective components: "promoting social contact," "transferring knowledge and skills," and "addressing social cognition". CONCLUSIONS AND IMPLICATIONS Interventions for loneliness and social isolation can generally be effective, although some unexplained between-study heterogeneity remains. Further research is needed regarding the applicability of interventions across different settings and countries, also considering their cost-effectiveness.
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Affiliation(s)
- Lukas A Duffner
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Niels Janssen
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Kay Deckers
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sarah Schroyen
- Psychology of Aging Unit (UPsySen), Faculty of Psychology, University of Liege, Liege, Belgium
| | - Marjolein E de Vugt
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Stéphane Adam
- Psychology of Aging Unit (UPsySen), Faculty of Psychology, University of Liege, Liege, Belgium
| | - Frans R J Verhey
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Marja Y Veenstra
- Alzheimer Centrum Limburg, Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Tan CK, Lou VWQ, Cheng CYM, He PC, Khoo VEJ. Improving the Social Well-Being of Single Older Adults Using the LOVOT Social Robot: Qualitative Phenomenological Study. JMIR Hum Factors 2024; 11:e56669. [PMID: 39178408 PMCID: PMC11380060 DOI: 10.2196/56669] [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: 02/01/2024] [Revised: 06/01/2024] [Accepted: 07/29/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND This study examined the social well-being of single older adults through the companionship of a social robot, LOVOT (Love+Robot; Groove X). It is designed as a companion for older adults, providing love and affection through verbal and physical interaction. We investigated older adults' perceptions of the technology and how they benefitted from interacting with LOVOT, to guide the future development of social robots. OBJECTIVE This study aimed to use a phenomenological research design to understand the participants' experiences of companionship provided by the social robot. Our research focused on (1) examining the social well-being of single older adults through the companionship of social robots and (2) understanding the perceptions of single older adults when interacting with social robots. Given the prevalence of technology use to support aging, understanding single older adults' social well-being and their perceptions of social robots is essential to guide future research on and design of social robots. METHODS A total of 5 single women, aged 60 to 75 years, participated in the study. The participants interacted independently with the robot for a week in their own homes and then participated in a poststudy interview to share their experiences. RESULTS In total, 4 main themes emerged from the participants' interactions with LOVOT, such as caring for a social robot, comforting presence of the social robot, meaningful connections with the social robot, and preference for LOVOT over pets. CONCLUSIONS The results indicate that single older adults can obtain psychosocial support by interacting with LOVOT. LOVOT is easily accepted as a companion and makes single older adults feel like they have a greater sense of purpose and someone to connect with. This study suggests that social robots can provide companionship to older adults who live alone. Social robots can help alleviate loneliness by allowing single older adults to form social connections with robots as companions. These findings are particularly important given the rapid aging of the population and the increasing number of single-person households in Singapore.
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Affiliation(s)
- Cheng Kian Tan
- S R Nathan School of Human Development, Singapore University of Social Sciences, Singapore, Singapore
| | - Vivian W Q Lou
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China (Hong Kong)
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Clio Yuen Man Cheng
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China (Hong Kong)
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Phoebe Chu He
- Department of Economics, The University of Chicago, Chicago, IL, United States
| | - Veronica Eng Joo Khoo
- S R Nathan School of Human Development, Singapore University of Social Sciences, Singapore, Singapore
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MacNeil M, Hirslund E, Baiocco-Romano L, Kuspinar A, Stolee P. A scoping review of the use of intelligent assistive technologies in rehabilitation practice with older adults. Disabil Rehabil Assist Technol 2024; 19:1817-1848. [PMID: 37498115 DOI: 10.1080/17483107.2023.2239277] [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: 09/01/2022] [Revised: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE There is growing interest in intelligent assistive technologies (IATs) in the rehabilitation and support of older adults, however, the factors contributing to or preventing their use in practice are not well understood. This study aimed to develop an overview of current knowledge on barriers and facilitators to the use of smart technologies in rehabilitative practice with older adults. MATERIALS AND METHODS We undertook a scoping review following guidelines proposed by Arksey and O'Malley (2005) and Levac et al. (2010). A computerised literature search was conducted using the Scopus and Ovid databases, yielding 7995 citations. Of these, 94 studies met inclusion criteria. Analysis of extracted data identified themes which were explored in semi-structured interviews with a purposefully selected sample of seven clinical rehabilitation practitioners (three physical therapists, two occupational therapists, and two speech-language pathologists). RESULTS Barriers and facilitators to using these technologies were associated with accessibility, reported effectiveness, usability, patient-centred considerations, and staff considerations. CONCLUSIONS Collaborative efforts of policy-makers, researchers, manufacturers, rehabilitation professionals, and older persons are needed to improve the design of technologies, develop appropriate funding and reimbursement strategies, and minimise barriers to their appropriate use to support independence and quality of life. Any strategies to improve upon barriers to prescribing smart technologies for older people should leverage the expertise of rehabilitation professionals operating at the interface between older people; their health/mobility; their families; and technology-based solutions.
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Affiliation(s)
- Maggie MacNeil
- School of Nursing, McMaster University, Hamilton, Canada
| | - Emily Hirslund
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | | | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Lu J, Ren E, Guo X, Zhou Z, Wang Y, Zhang N. The role of pet attachment in alleviating the negative effects of loneliness on a health-promoting lifestyle: An empirical study based on threshold effects for pet owners. Int J Older People Nurs 2023; 18:e12554. [PMID: 37461157 DOI: 10.1111/opn.12554] [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: 10/18/2021] [Revised: 05/22/2023] [Accepted: 06/05/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND A health-promoting lifestyle is acknowledged as a 'positive ageing' strategy for older people. The inevitable decline in their social networks may lead to loneliness and subsequently damage their health-promoting lifestyle. Therefore, pet owning has become a popular way for them to alleviate loneliness. However, the attachment resulting from pet ownership may either facilitate or impede older people's ability to counteract the negative effect of loneliness on health-promoting lifestyles, and this effect may only be observed when pet owners have limited human confidants. OBJECTIVES To identify the role of pet attachment in alleviating the negative impact of loneliness on a health-promoting lifestyle and its supplementary role in the deficiency of social relationships by analysing the correlation mechanism between pet attachment, loneliness and a health-promoting lifestyle. METHODS Self-report questionnaires were sent to 879 older people (aged ≥60) with pets in China by using a multistage stratified random sampling method. Cross-sectional threshold regression models were established to analyse the nonlinear effects of loneliness on a health-promoting lifestyle and the different threshold effects among different social relationship levels. RESULTS A single threshold value (0.444) was drawn to determine the action mode of pet attachment on the negative relationship between loneliness and a health-promoting lifestyle. When the level of pet attachment exceeded 0.444, the inhibition of loneliness on a health-promoting lifestyle decreased significantly. Additionally, this threshold effect was evident among older people at different levels of social relationships. CONCLUSIONS The negative effect of loneliness on a health-promoting lifestyle is alleviated by the single threshold effect of pet attachment. Pet-owner relationships can compensate for a lack of social relationships to some extent and alleviate both an individual's loneliness and its negative effect on a health-promoting lifestyle. IMPLICATIONS FOR PRACTICE To alleviate loneliness and promote healthy ageing in older people who lack social relationships, the tailored pet intervention strategies that prioritize 'one health' at the animal-ecosystem interface that consider their different individual levels of social relationship should be developed.
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Affiliation(s)
- Jiao Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Erxing Ren
- School of Management, Shanxi Medical University, Taiyuan, China
| | - Xinyu Guo
- School of Management, Shanxi Medical University, Taiyuan, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Yuan Wang
- School of Management, Shanxi Medical University, Taiyuan, China
| | - Na Zhang
- School of Management, Shanxi Medical University, Taiyuan, China
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Li S, Milligan K, Blythe P, Zhang Y, Edwards S, Palmarini N, Corner L, Ji Y, Zhang F, Namdeo A. Exploring the role of human-following robots in supporting the mobility and wellbeing of older people. Sci Rep 2023; 13:6512. [PMID: 37081106 PMCID: PMC10119299 DOI: 10.1038/s41598-023-33837-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/19/2023] [Indexed: 04/22/2023] Open
Abstract
With the ever-pressing challenges of societal ageing, robotic technologies for older people are increasingly portrayed as a solution for better independent living for longer. However, the application of human-following robots for elderly citizens has not yet been considered, and any prospective benefits offered by the technology for active ageing have previously been overlooked. This qualitative research aimed to explore older people's needs and requirements towards the human-following robot through the reflexive thematic analysis of semi-structured interview data from 17 independent older adults, supported by a video-based demonstration of the robot. The results indicate that older people believed that human-following robot has the potential to provide social benefits to an independent older adult by encouraging walking trips and prompting social interaction with others in the community. Practical limitations and cost of the robot are barriers to adoption at present. The findings indicate that there is potential for human-following robots to support active ageing, through increasing opportunities for the social participation of an older adult, but further development of the robot is needed for this potential to be realised.
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Affiliation(s)
- Shuo Li
- School of Engineering, Newcastle University, Cassie Building, Claremont Road, Newcastle Upon Tyne, NE1 7RU, UK.
| | - Kirsty Milligan
- School of Engineering, Newcastle University, Cassie Building, Claremont Road, Newcastle Upon Tyne, NE1 7RU, UK
| | - Phil Blythe
- School of Engineering, Newcastle University, Cassie Building, Claremont Road, Newcastle Upon Tyne, NE1 7RU, UK
| | - Yanghanzi Zhang
- School of Engineering, Newcastle University, Cassie Building, Claremont Road, Newcastle Upon Tyne, NE1 7RU, UK
| | - Simon Edwards
- School of Engineering, Newcastle University, Cassie Building, Claremont Road, Newcastle Upon Tyne, NE1 7RU, UK
| | - Nic Palmarini
- UK's National Innovation Centre for Ageing, The Catalyst, 3 Science Square, Newcastle Upon Tyne, NE4 5TG, UK
| | - Lynne Corner
- UK's National Innovation Centre for Ageing, The Catalyst, 3 Science Square, Newcastle Upon Tyne, NE4 5TG, UK
| | - Yanjie Ji
- Jiangsu Key Laboratory of Urban ITS, Jiangsu Province Collaborative Innovation Centre of Modern Urban Traffic Technologies, School of Transportation, Southeast University, Southeast University Road 2, Nanjing, 211189, China
| | - Fan Zhang
- Jiangsu Key Laboratory of Urban ITS, Jiangsu Province Collaborative Innovation Centre of Modern Urban Traffic Technologies, School of Transportation, Southeast University, Southeast University Road 2, Nanjing, 211189, China
| | - Anil Namdeo
- Department of Geography and Environmental Sciences, Northumbria University, Ellison Place, Newcastle Upon Tyne, NE1 8ST, UK
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Harris-Gersten ML, Davagnino JM, Alcorn ER, Hastings SN. Usability and Acceptability of Social Robot Pets Among Community-Dwelling Veterans Living With Dementia and Their Caregivers. Am J Alzheimers Dis Other Demen 2023; 38:15333175231200973. [PMID: 37688378 PMCID: PMC10624055 DOI: 10.1177/15333175231200973] [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] [Indexed: 09/10/2023]
Abstract
Social robot pets promote engagement and psychosocial well-being among older adults, yet little is known about their use among community-dwelling Veterans living with dementia. This programmatic evaluation used a within subjects, pre-post design to examine the usability (frequency of use, frequency of caregiver reminders) and acceptability (benefit, satisfaction) of social robot pets among Veterans with dementia (N = 20). An intervention usability and acceptability tool was completed by telephone with family caregivers 3 months after delivery of the pet to the home. Overall, 80% of Veterans used the pet often or daily, while 7 caregivers provided reminders for the Veteran to use the pet. Caregivers indicated that Veterans experienced benefit with the pet, as well themselves. Regarding satisfaction, 89% reported they would recommend a social robot pet to others. Research is needed to expand generalizability, evaluate effects on outcomes, and enhance implementation of social robot pets among Veteran families with dementia.
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Affiliation(s)
- Melissa L. Harris-Gersten
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA
- School of Nursing, Duke University, Durham, NC, USA
- Clinical and Translational Science Institute’s National Clinician Scholars Program, Duke University, Durham, NC, USA
| | - Judith M. Davagnino
- Geriatric Research, Education, and Clinical Center-Caring for Older Adults and Caregivers at Home Program, Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Edwin R. Alcorn
- Geriatric Research, Education, and Clinical Center-Caring for Older Adults and Caregivers at Home Program, Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - S. Nicole Hastings
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA
- School of Medicine, Duke University, Durham, NC, USA
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Ekoh PC, Okolie TJ, Nnadi FB, Oyinlola O, Walsh CA. Understanding the impact of digital technology on the well-being of older immigrants and refugees: A scoping review. Digit Health 2023; 9:20552076231194947. [PMID: 38321989 PMCID: PMC10846041 DOI: 10.1177/20552076231194947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/28/2023] [Indexed: 02/08/2024] Open
Abstract
Background The fast-paced development of digital technologies in the areas of social media, pet robots, smart homes, and artificial intelligence, among others, profoundly influence the daily lives of older adults. Digital technology can improve the well-being and quality of life of older adults, older immigrants and refugees who suffer migration-associated stress, loneliness, health and psychosocial challenges. Aims The aim of this scoping review is to map out extant empirical literature that has examined the implication of digital technology among older refugees and immigrants. Methods Using a1 five-stage framework, we conducted a scoping review of peer-reviewed empirical studies published in English with no time restrictions. We searched nine databases for the reviews, and abstracts were reviewed using Rayyan QCRi(c) before the full-text review. The comprehensive database search yielded 4134 articles, of which 15 met the inclusion criteria. Results The results of the review suggest that digital technology is essential to the well-being, quality of life of older immigrants and refugees, especially for maintaining and building new social support networks, navigating opportunities, coping with migration-induced stress through e-leisure, and staying connected to their culture. The literature also revealed poor utilisation of digital technologies amongst older immigrants and refugees, suggesting barriers to access. Conclusion The study concluded by highlighting the need for more research and interventions that focus on multiple strategies, including education for increased access to and utilisation of digital technology to ensure that more older migrants can benefit from the advantages of digital technology in a safe way.
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Affiliation(s)
- Prince Chiagozie Ekoh
- Faculty of Social Work, University of Calgary, 2500 University Drive NW Calgary, Alberta, Canada
- Department of Social Work, University of Nigeria, Enugu, Nigeria
| | - Tochukwu Jonathan Okolie
- Department of Social Work, University of Nigeria, Enugu, Nigeria
- Department of Sociology and Gerontology, Miami University, Oxford, USA
| | | | - Oluwagbemiga Oyinlola
- School of Social Work, McGill University, Montréal, QC, Canada
- Medical Social Services Department, University College Hospital, Ibadan, Oyo, Nigeria
| | - Christine A Walsh
- Faculty of Social Work, University of Calgary, 2500 University Drive NW Calgary, Alberta, Canada
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Ma B, Yang J, Wong FKY, Wong AKC, Ma T, Meng J, Zhao Y, Wang Y, Lu Q. Artificial intelligence in elderly healthcare: A scoping review. Ageing Res Rev 2023; 83:101808. [PMID: 36427766 DOI: 10.1016/j.arr.2022.101808] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/26/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022]
Abstract
The ageing population has led to a surge in the adoption of artificial intelligence (AI) technologies in elderly healthcare worldwide. However, in the advancement of AI technologies, there is currently a lack of clarity about the types and roles of AI technologies in elderly healthcare. This scoping review aimed to provide a comprehensive overview of AI technologies in elderly healthcare by exploring the types of AI technologies employed, and identifying their roles in elderly healthcare based on existing studies. A total of 10 databases were searched for this review, from January 1 2000 to July 31 2022. Based on the inclusion criteria, 105 studies were included. The AI devices utilized in elderly healthcare were summarised as robots, exoskeleton devices, intelligent homes, AI-enabled health smart applications and wearables, voice-activated devices, and virtual reality. Five roles of AI technologies were identified: rehabilitation therapists, emotional supporters, social facilitators, supervisors, and cognitive promoters. Results showed that the impact of AI technologies on elderly healthcare is promising and that AI technologies are capable of satisfying the unmet care needs of older adults and demonstrating great potential in its further development in this area. More well-designed randomised controlled trials are needed in the future to validate the roles of AI technologies in elderly healthcare.
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Affiliation(s)
- Bingxin Ma
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Jin Yang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | | | | | - Tingting Ma
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Jianan Meng
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China.
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China; School of Integrative Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China; National Institute of Health Data Science at Peking University, Beijing, China.
| | - Qi Lu
- School of Nursing, Tianjin Medical University, Tianjin, China.
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Leung AYM, Zhao IY, Lin S, Lau TK. Exploring the Presence of Humanoid Social Robots at Home and Capturing Human-Robot Interactions with Older Adults: Experiences from Four Case Studies. Healthcare (Basel) 2022; 11:healthcare11010039. [PMID: 36611499 PMCID: PMC9818881 DOI: 10.3390/healthcare11010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
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.
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Affiliation(s)
- Angela Y. M. Leung
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Research Institute of Smart Aging (RISA), The Hong Kong Polytechnic University, Hong Kong 999077, China
- Correspondence: ; Tel.: +852-2766-5587
| | - Ivy Y. Zhao
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Research Institute of Smart Aging (RISA), The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Shuanglan Lin
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Terence K. Lau
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Research Institute of Smart Aging (RISA), The Hong Kong Polytechnic University, Hong Kong 999077, China
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Støre SJ, Tillfors M, Wästlund E, Angelhoff C, Andersson G, Norell‐Clarke A. The effects of a sleep robot intervention on sleep, depression and anxiety in adults with insomnia—A randomized waitlist‐controlled trial. J Sleep Res 2022; 32:e13758. [PMID: 36285420 DOI: 10.1111/jsr.13758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/01/2022] [Accepted: 09/24/2022] [Indexed: 11/29/2022]
Abstract
The study objective was to assess if a 3-week intervention with the Somnox sleep robot had effects on symptoms of insomnia, somatic arousal, and/or concurrent symptoms of depression and anxiety in adults with insomnia, compared with a waitlist-control group. The participants (n = 44) were randomized to a 3-week intervention with the sleep robot (n = 22), or to a waitlist-control group (n = 22). The primary outcome measure was the Insomnia Severity Index administered at baseline, mid-intervention, post-intervention and at 1-month follow-up. Secondary outcome measures were the Pre-Sleep Arousal Scale, and the Hospital Anxiety and Depression Scale. Additionally, sleep-onset latency, wake time after sleep onset, total sleep time and sleep efficiency were measured the week prior to and the last week of the intervention, both subjectively with the Consensus Sleep Diary and objectively with wrist actigraphy. Mixed-effects models were used to analyse data. The effect of the sleep robot on the participants' insomnia severity was not statistically significant. The differences between the intervention group and the control group on the measures of arousal, anxiety and depression were also not statistically significant, and neither were the sleep diary and actigraphy variables. In conclusion, a 3-week intervention with daily at-home use of the robot was not found to be an effective method to relieve the symptom burden in adults with insomnia.
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Affiliation(s)
- Siri Jakobsson Støre
- Department of Social and Psychological Studies Karlstad University Karlstad Sweden
| | - Maria Tillfors
- Department of Social and Psychological Studies Karlstad University Karlstad Sweden
| | - Erik Wästlund
- Department of Social and Psychological Studies Karlstad University Karlstad Sweden
| | - Charlotte Angelhoff
- Crown Princess Victoria's Child and Youth Hospital and Department of Biomedical and Clinical Sciences (BKV) Linköping University Linköping Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden
- Department of Clinical Neuroscience Karolinska Institute Stockholm Sweden
| | - Annika Norell‐Clarke
- Department of Social and Psychological Studies Karlstad University Karlstad Sweden
- Faculty of Health Sciences Kristianstad University Kristianstad Sweden
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12
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Chiu C, Lo Y, Ho M, Montayre J, Zhao I. Association between loneliness and acceptance of using robots and pets as companions among older Chinese immigrants during the COVID-19 pandemic. Australas J Ageing 2022; 41:414-423. [PMID: 35438833 PMCID: PMC9111400 DOI: 10.1111/ajag.13075] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/19/2022] [Accepted: 03/27/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine loneliness experienced by middle-aged and older Chinese immigrants and its association with accepting technology as a companion (apps, Internet and robots) versus owning pets, when social distancing measures were implemented in New Zealand during the first COVID-19 outbreak. METHODS This study conducted a community-based cross-sectional survey. Chinese immigrants who were 45-87 years old (n = 173) were invited to answer an online survey in the Chinese language, collecting demographic data, responses to the 6-item De Jong Gierveld Loneliness Scale and experiences in using technology and pet ownership. Descriptive analyses and inferential statistics tests were utilised in the data analysis. RESULTS A moderate level of overall loneliness with a mean score of 3.68 (SD 1.84), ranging from 0 to 6, was reported by participants. Emotional and social loneliness ranged from 0 to 3 with mean scores of 1.69 (SD 0.98) and 1.99 (SD 1.24), respectively. Self-reported health, financial status, English language abilities, transportation and experiences of using the Internet and apps were significantly related to experiencing loneliness. Loneliness had a weak association with acceptance of robots and pets, but 67.8% and 58.3% of participants who felt lonely, accepted companionship of robots and pets, respectively. CONCLUSIONS The level of loneliness among older and middle-aged immigrants increased during the COVID-19 pandemic. Further evidence of the specific dimensions of loneliness and the utility of technology to alleviate loneliness among immigrant groups is needed. Interventions tailored for older people with specific cultural requirements to address loneliness are needed.
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Affiliation(s)
- Ching‐Ju Chiu
- Institute of GerontologyCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Yi‐Hsuan Lo
- Department of StatisticsCollege of ManagementNational Cheng Kung UniversityTainanTaiwan
| | - Mu‐Hsing Ho
- School of NursingLKS Faculty of MedicineThe University of Hong KongPokfulamHong Kong SAR
| | - Jed Montayre
- School of Nursing and MidwiferyWestern Sydney UniversitySydneyNew South WalesAustralia
| | - Ivy Yan Zhao
- WHO Collaborating Centre for Community Health ServicesSchool of NursingThe Hong Kong Polytechnic UniversityHung HomHong Kong SAR
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13
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Pollak C, Wexler SS, Drury L. Effect of a Robotic Pet on Social and Physical Frailty in Community-Dwelling Older Adults: A Randomized Controlled Trial. Res Gerontol Nurs 2022; 15:229-237. [PMID: 36113009 DOI: 10.3928/19404921-20220830-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current randomized controlled trial investigated the effect of a robotic pet on social and physical frailty in community-dwelling older adults. The intervention group (n = 107) received a robotic pet and the control group (n = 113) received usual care following hospital discharge. Social and physical frailty were measured using the Questionnaire to Define Social Frailty Status and the FRAIL questionnaire. Cognitive function and depression were assessed using the Short Portable Mental Status Questionnaire and Geriatric Depression Scale, respectively. Continuous outcomes were compared between groups using t tests or Wilcoxon rank sum tests, as appropriate. Categorical outcomes were compared between groups using chi-square tests or Fisher's exact tests, as appropriate. Main findings showed the robotic pet positively impacted cognitive status in participants who reported they enjoyed engaging with their pet. This finding supported the theoretical premise of the current study that greater engagement with the robotic pet would yield greater improvement in study outcomes. [Research in Gerontological Nursing, 15(5), 229-237.].
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14
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Bradwell H, Edwards KJ, Winnington R, Thill S, Allgar V, Jones RB. Exploring the effect of implementing affordable socially assistive pet robots in eight care homes before and during the COVID-19 pandemic: a stratified cluster randomised controlled trial and mixed-method study. JMIR Aging 2022; 5:e38864. [PMID: 35830959 PMCID: PMC9407160 DOI: 10.2196/38864] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/10/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Robot pets may assist in the challenges of supporting an aging population with growing dementia prevalence. Prior work has focused on the impacts of the robot seal Paro on older adult well-being, but recent studies have suggested the good acceptability and implementation feasibility of more affordable devices (Joy for All [JfA] cats and dogs). Objective We aimed to address the limited effectiveness research on JfA devices. Methods We conducted an 8-month, stratified, cluster randomized controlled trial in 8 care homes in Cornwall, United Kingdom. Over 4 months, 4 care homes each received 2 JfA devices (1 cat and 1 dog; intervention group), and 4 homes received care as usual (control group). Psychometrics were collected before and after the intervention to compare the change from baseline to follow-up between the groups. In the final 4 months, all 8 care homes received devices, but only qualitative data were collected owing to COVID-19 and reduced capacity. The primary outcome was neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI] Nursing Home version). Care provider burden was a secondary outcome (occupational disruptiveness NPI subscale), alongside the Challenging Behavior scale, the Holden communication scale, the Campaign to End Loneliness questionnaire, and medication use. Qualitative data were collected through care staff observation calendars and end-of-study interviews to understand use, experience, and impact. We also collected demographic data and assessed dementia severity. In total, 253 residents had robot interaction opportunities, and 83 were consented for direct data collection. Results There was a significant difference in the total change from baseline to follow-up between the intervention and control groups for NPI (P<.001) and occupational disruptiveness (P=.03). Neuropsychiatric symptoms increased in the control group and decreased in the intervention group. No significant difference was seen for communication issues or challenging behavior. For NPI subdomains, there were significant differences from baseline to follow-up in delusions (P=.03), depression (P=.01), anxiety (P=.001), elation (P=.02), and apathy (P=.009), all of which decreased in the intervention group and increased slightly in the control group. The summative impact results suggested that most residents (46/54, 85%) who interacted with robots experienced a positive impact. Those who interacted had significantly higher dementia severity scores (P=.001). The qualitative results suggested good adoption, acceptability, and suitability for subjectively lonely individuals and lack of a novelty effect through sustained use, and demonstrated that the reasons for use were entertainment, anxiety, and agitation. Conclusions Affordable robot pets hold potential for improving the well-being of care home residents and people with dementia, including reducing neuropsychiatric symptoms and occupational disruptiveness. This work suggests no novelty effect and contributes toward understanding robot pet suitability. Moreover, interactions were more common among residents with more moderate/severe dementia and those subjectively lonely. Trial Registration ClinicalTrials.gov NCT04168463; https://www.clinicaltrials.gov/ct2/show/NCT04168463
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Affiliation(s)
- Hannah Bradwell
- Centre for Health Technology, University of Plymouth, University of PlymouthDrake Circus, Plymouth, GB
| | - Katie J Edwards
- Centre for Health Technology, University of Plymouth, University of PlymouthDrake Circus, Plymouth, GB
| | - Rhona Winnington
- Auckland University of Technology, 90 Akoranga Drive, Auckland, NZ
| | - Serge Thill
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University, Nijmegen, NL
| | - Victoria Allgar
- Centre for Health Technology, University of Plymouth, University of PlymouthDrake Circus, Plymouth, GB
| | - Ray B Jones
- Centre for Health Technology, University of Plymouth, University of PlymouthDrake Circus, Plymouth, GB
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15
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The Use of Robotic Pets by Community-Dwelling Older Adults: A Scoping Review. Int J Soc Robot 2022. [DOI: 10.1007/s12369-022-00892-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Aho K. "We're protecting them to death"-A Heideggerian interpretation of loneliness among older adults in long-term care facilities during COVID-19: Contact details. PHENOMENOLOGY AND THE COGNITIVE SCIENCES 2022; 22:1-14. [PMID: 35250413 PMCID: PMC8881943 DOI: 10.1007/s11097-022-09803-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
In this paper, I draw on Heidegger's phenomenology of "moods" (Stimmungen) to interpret loneliness as a diffused and atmospheric feeling-state that often undergirds the lives of older adults, shaping the ways in which they are attuned to and make sense of the world. I focus specifically on residents in long-term care facilities to show how the social isolation and lockdown measures of the COVID-19 pandemic dramatically intensified the mood. The aim is to shed light on how profound and totalizing the experience has been for residents. Making use of Heidegger's account of the affective "collapse" or "breakdown" (Zusammenbruch) of meaning, I argue that when older adults are functionally locked in their rooms for months at a time and cut off from the orienting routines and rhythms of the relational world, the result is a crumbling of the fundamental meaning-structures that constitute subjectivity. The global sense of abandonment and disconnection strips away the possibility for self-understanding, and residents are often left confused and abandoned to an existence that has been drained of meaning and significance.
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Affiliation(s)
- Kevin Aho
- Florida Gulf Coast University, 33965 Fort Myers, FL USA
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17
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Designing Man's New Best Friend: Enhancing Human-Robot Dog Interaction through Dog-Like Framing and Appearance. SENSORS 2022; 22:s22031287. [PMID: 35162032 PMCID: PMC8839789 DOI: 10.3390/s22031287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/28/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023]
Abstract
To understand how to improve interactions with dog-like robots, we evaluated the importance of “dog-like” framing and physical appearance on interaction, hypothesizing multiple interactive benefits of each. We assessed whether framing Aibo as a puppy (i.e., in need of development) versus simply a robot would result in more positive responses and interactions. We also predicted that adding fur to Aibo would make it appear more dog-like, likable, and interactive. Twenty-nine participants engaged with Aibo in a 2 × 2 (framing × appearance) design by issuing commands to the robot. Aibo and participant behaviors were monitored per second, and evaluated via an analysis of commands issued, an analysis of command blocks (i.e., chains of commands), and using a T-pattern analysis of participant behavior. Participants were more likely to issue the “Come Here” command than other types of commands. When framed as a puppy, participants used Aibo’s dog name more often, praised it more, and exhibited more unique, interactive, and complex behavior with Aibo. Participants exhibited the most smiling and laughing behaviors with Aibo framed as a puppy without fur. Across conditions, after interacting with Aibo, participants felt Aibo was more trustworthy, intelligent, warm, and connected than at their initial meeting. This study shows the benefits of introducing a socially robotic agent with a particular frame and importance on realism (i.e., introducing the robot dog as a puppy) for more interactive engagement.
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18
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Site A, Lohan ES, Jolanki O, Valkama O, Hernandez RR, Latikka R, Alekseeva D, Vasudevan S, Afolaranmi S, Ometov A, Oksanen A, Martinez Lastra J, Nurmi J, Fernandez FN. Managing Perceived Loneliness and Social-Isolation Levels for Older Adults: A Survey with Focus on Wearables-Based Solutions. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22031108. [PMID: 35161852 PMCID: PMC8839843 DOI: 10.3390/s22031108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 05/02/2023]
Abstract
As an inevitable process, the number of older adults is increasing in many countries worldwide. Two of the main problems that society is being confronted with more and more, in this respect, are the inter-related aspects of feelings of loneliness and social isolation among older adults. In particular, the ongoing COVID-19 crisis and its associated restrictions have exacerbated the loneliness and social-isolation problems. This paper is first and foremost a comprehensive survey of loneliness monitoring and management solutions, from the multidisciplinary perspective of technology, gerontology, socio-psychology, and urban built environment. In addition, our paper also investigates machine learning-based technological solutions with wearable-sensor data, suitable to measure, monitor, manage, and/or diminish the levels of loneliness and social isolation, when one also considers the constraints and characteristics coming from social science, gerontology, and architecture/urban built environments points of view. Compared to the existing state of the art, our work is unique from the cross-disciplinary point of view, because our authors' team combines the expertise from four distinct domains, i.e., gerontology, social psychology, architecture, and wireless technology in addressing the two inter-related problems of loneliness and social isolation in older adults. This work combines a cross-disciplinary survey of the literature in the four aforementioned domains with a proposed wearable-based technological solution, introduced first as a generic framework and, then, exemplified through a simple proof of concept with dummy data. As the main findings, we provide a comprehensive view on challenges and solutions in utilizing various technologies, particularly those carried by users, also known as wearables, to measure, manage, and/or diminish the social isolation and the perceived loneliness among older adults. In addition, we also summarize the identified solutions which can be used for measuring and monitoring various loneliness- and social isolation-related metrics, and we present and validate, through a simple proof-of-concept mechanism, an approach based on machine learning for predicting and estimating loneliness levels. Open research issues in this field are also discussed.
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Affiliation(s)
- Aditi Site
- Faculty of Information Technology and Communication Sciences, Tampere University, 33720 Tampere, Finland; (D.A.); (A.O.); (J.N.)
- Correspondence: (A.S.); (E.S.L.)
| | - Elena Simona Lohan
- Faculty of Information Technology and Communication Sciences, Tampere University, 33720 Tampere, Finland; (D.A.); (A.O.); (J.N.)
- Correspondence: (A.S.); (E.S.L.)
| | - Outi Jolanki
- Faculty of Social Sciences, Tampere University, 33720 Tampere, Finland; (O.J.); (O.V.); (R.L.); (A.O.)
| | - Outi Valkama
- Faculty of Social Sciences, Tampere University, 33720 Tampere, Finland; (O.J.); (O.V.); (R.L.); (A.O.)
| | - Rosana Rubio Hernandez
- Faculty of Built Environment, Tampere University, 33720 Tampere, Finland; (R.R.H.); (F.N.F.)
| | - Rita Latikka
- Faculty of Social Sciences, Tampere University, 33720 Tampere, Finland; (O.J.); (O.V.); (R.L.); (A.O.)
| | - Daria Alekseeva
- Faculty of Information Technology and Communication Sciences, Tampere University, 33720 Tampere, Finland; (D.A.); (A.O.); (J.N.)
| | - Saigopal Vasudevan
- Faculty of Engineering and Natural Sciences, Tampere University, 33720 Tampere, Finland; (S.V.); (S.A.); (J.M.L.)
| | - Samuel Afolaranmi
- Faculty of Engineering and Natural Sciences, Tampere University, 33720 Tampere, Finland; (S.V.); (S.A.); (J.M.L.)
| | - Aleksandr Ometov
- Faculty of Information Technology and Communication Sciences, Tampere University, 33720 Tampere, Finland; (D.A.); (A.O.); (J.N.)
| | - Atte Oksanen
- Faculty of Social Sciences, Tampere University, 33720 Tampere, Finland; (O.J.); (O.V.); (R.L.); (A.O.)
| | - Jose Martinez Lastra
- Faculty of Engineering and Natural Sciences, Tampere University, 33720 Tampere, Finland; (S.V.); (S.A.); (J.M.L.)
| | - Jari Nurmi
- Faculty of Information Technology and Communication Sciences, Tampere University, 33720 Tampere, Finland; (D.A.); (A.O.); (J.N.)
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19
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Robinson F, Nejat G. An analysis of design recommendations for socially assistive robot helpers for effective human-robot interactions in senior care. J Rehabil Assist Technol Eng 2022; 9:20556683221101389. [PMID: 35733614 PMCID: PMC9208044 DOI: 10.1177/20556683221101389] [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: 01/29/2022] [Accepted: 04/26/2022] [Indexed: 11/15/2022] Open
Abstract
As the global population ages, there is an increase in demand for assistive technologies that can alleviate the stresses on healthcare systems. The growing field of socially assistive robotics (SARs) offers unique solutions that are interactive, engaging, and adaptable to different users’ needs. Crucial to having positive human-robot interaction (HRI) experiences in senior care settings is the overall design of the robot, considering the unique challenges and opportunities that come with novice users. This paper presents a novel study that explores the effect of SAR design on HRI in senior care through a results-oriented analysis of the literature. We provide key design recommendations to ensure inclusion for a diverse set of users. Open challenges of considering user preferences during design, creating adaptive behaviors, and developing intelligent autonomy are discussed in detail. SAR features of appearance and interaction mode along with SAR frameworks for perception and intelligence are explored to evaluate individual developments using metrics such as trust, acceptance, and intent to use. Drawing from a diverse set of features, SAR frameworks, and HRI studies, the discussion highlights robot characteristics of greatest influence in promoting wellbeing and aging-in-place of older adults and generates design recommendations that are important for future development.
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Affiliation(s)
- Fraser Robinson
- Autonomous Systems and Biomechatronics Laboratory (ASBLab), Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
| | - Goldie Nejat
- Autonomous Systems and Biomechatronics Laboratory (ASBLab), Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, Toronto, ON, Canada
- Baycrest Health Sciences, Rotman Research Institute, Toronto, ON, Canada
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20
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Lavin P, Lesage M, Monroe E, Kanevsky M, Gruber J, Cinalioglu K, Rej S, Sekhon H. Humanoid robot intervention vs. treatment as usual for loneliness in long-term care homes: Study protocol for a pilot randomized controlled trial. Front Psychiatry 2022; 13:1003881. [PMID: 36339874 PMCID: PMC9633865 DOI: 10.3389/fpsyt.2022.1003881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Loneliness affects up to 42% of long-term care residents and is associated with poor health outcomes. Humanoid robot interventions hold promise for reducing loneliness and decreasing barriers to social interaction in long-term care settings, such as the current COVID-19 safety measures in many countries, limited mobility, and poor health. We present a protocol describing an assessor-blinded randomized controlled trial comparing the effects of a humanoid robot intervention to treatment as usual, on loneliness and mental health outcomes in long-term care residents. METHODS Seventy-four (n = 74) older adults experiencing loneliness in 3 long-term care homes will be randomized 1:1 to an 8-week, twice a week social intervention with the Grace humanoid robot vs. a treatment as usual active control. We will assess change (baseline to week 8) in (1) loneliness (primary outcome), (2) depression severity, and (3) stress (secondary outcomes), as well as (4) other exploratory outcomes: anxiety, quality of life and reduction in acute healthcare utilization. We will also assess the feasibility and acceptability of the intervention using qualitative methods. DISCUSSION The proposed study will assess the effects of a social robot on loneliness and other mental health outcomes, as well as the feasibility of the intervention in older adults living in long-term care settings. TRIAL REGISTRATION NCT05423899.
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Affiliation(s)
- Paola Lavin
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada
| | - Myriam Lesage
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada
| | - Edward Monroe
- Awakening Health Limited, Hong Kong, Hong Kong SAR, China
| | - Michael Kanevsky
- CONNECTIN-TeleEmpathy™, Village Medical Center™, Global Health University™, Montréal, QC, Canada
| | - Johanna Gruber
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada
| | - Karin Cinalioglu
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada
| | - Soham Rej
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, Jewish General Hospital, McGill University, Montréal, QC, Canada
| | - Harmehr Sekhon
- Department of Psychiatry, GeriPARTy Research Group, Jewish General Hospital, Montréal, QC, Canada.,Department of Psychiatry, McLean Hospital and Harvard Medical School, Cambridge, MA, United States
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21
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Latikka R, Rubio-Hernández R, Lohan ES, Rantala J, Nieto Fernández F, Laitinen A, Oksanen A. Older Adults' Loneliness, Social Isolation, and Physical Information and Communication Technology in the Era of Ambient Assisted Living: A Systematic Literature Review. J Med Internet Res 2021; 23:e28022. [PMID: 34967760 PMCID: PMC8759023 DOI: 10.2196/28022] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/30/2021] [Accepted: 11/08/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Loneliness and social isolation can have severe effects on human health and well-being. Partial solutions to combat these circumstances in demographically aging societies have been sought from the field of information and communication technology (ICT). OBJECTIVE This systematic literature review investigates the research conducted on older adults' loneliness and social isolation, and physical ICTs, namely robots, wearables, and smart homes, in the era of ambient assisted living (AAL). The aim is to gain insight into how technology can help overcome loneliness and social isolation other than by fostering social communication with people and what the main open-ended challenges according to the reviewed studies are. METHODS The data were collected from 7 bibliographic databases. A preliminary search resulted in 1271 entries that were screened based on predefined inclusion criteria. The characteristics of the selected studies were coded, and the results were summarized to answer our research questions. RESULTS The final data set consisted of 23 empirical studies. We found out that ICT solutions such as smart homes can help detect and predict loneliness and social isolation, and technologies such as robotic pets and some other social robots can help alleviate loneliness to some extent. The main open-ended challenges across studies relate to the need for more robust study samples and study designs. Further, the reviewed studies report technology- and topic-specific open-ended challenges. CONCLUSIONS Technology can help assess older adults' loneliness and social isolation, and alleviate loneliness without direct interaction with other people. The results are highly relevant in the COVID-19 era, where various social restrictions have been introduced all over the world, and the amount of research literature in this regard has increased recently.
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Affiliation(s)
- Rita Latikka
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | | | - Elena Simona Lohan
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Juho Rantala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | | | - Arto Laitinen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Atte Oksanen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
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22
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Kim J, Kim S, Kim S, Lee E, Heo Y, Hwang CY, Choi YY, Kong HJ, Ryu H, Lee H. Companion robots for older adults: Rodgers' evolutionary concept analysis approach. INTEL SERV ROBOT 2021; 14:729-739. [PMID: 34804242 PMCID: PMC8593639 DOI: 10.1007/s11370-021-00394-3] [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: 02/16/2021] [Accepted: 10/15/2021] [Indexed: 12/30/2022]
Abstract
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.
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Affiliation(s)
- Jeongeun Kim
- Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Sukwha Kim
- Department of Reconstructive Plastic Surgery, Medical Big Data Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seongheui Kim
- College of Fine Arts, Seoul National University, Seoul, Republic of Korea
| | - Euehun Lee
- Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Yoonjeong Heo
- College of Music, Seoul National University, Seoul, Republic of Korea
| | - Cheol-Yong Hwang
- College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Yun-Young Choi
- College of Humanities, Seoul National University, Seoul, Republic of Korea
| | - Hyoun-Joong Kong
- Transdisciplinary Department of Medicine and Advanced Technology (TDMAT), Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeongju Ryu
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyeongsuk Lee
- College of Nursing, Gachon University, Seoul, Republic of Korea
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Huang H, Chen Z, Cao S, Xiao M, Xie L, Zhao Q. Adoption Intention and Factors Influencing the Use of Gerontechnology in Chinese Community-Dwelling Older Adults: A Mixed-Methods Study. Front Public Health 2021; 9:687048. [PMID: 34604153 PMCID: PMC8484701 DOI: 10.3389/fpubh.2021.687048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To explore the Chinese community-dwelling intention of older adults to adopt gerontechnology and its influencing factors. Design: A mixed-methods sequential explanatory design with an inductive approach was employed. In phase 1, a self-made questionnaire was administered from August 2018 to December 2019. Multifactor logistic regression was used to analyze the adoption intention and factors influencing the use of gerontechnology. In phase 2, participants completed a semistructured interview to explore the adoption intention of a specific form of gerontechnology, Smart Aged Care Platform, from May to July 2020. Setting: Twelve communities in three districts of Chongqing, China. Participants: Community-dwelling older adults were included. Results: A total of 1,180 older adults completed the quantitative study; two-thirds of them (68.7%) showed adoption intention toward gerontechnology. Nineteen participants (10 users and nine nonusers) completed the qualitative study and four themes were explored. Through a summarized understanding of the qualitative and quantitative data, a conceptual model of influencing factors, namely, predictive, enabling, and need factors, was constructed. Conclusions: This study reveals that most Chinese community-dwelling older adults welcome the emergence of new technologies. However, there was a significant difference in the adoption intention of gerontechnology in Chinese community-dwelling older adults based on their sociodemographic and psychographic characteristics. Our findings extend previous technology acceptance models and theories and contribute to the existing resource base.
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Affiliation(s)
- Huanhuan Huang
- First Clinical College, Chongqing Medical University, Chongqing, China.,Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiyu Chen
- First Clinical College, Chongqing Medical University, Chongqing, China.,Department of Orthopedic, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Songmei Cao
- First Clinical College, Chongqing Medical University, Chongqing, China.,Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liling Xie
- Department of Nursing, The First Branch of First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Barriers and facilitators to the implementation of social robots for older adults and people with dementia: a scoping review. BMC Geriatr 2021; 21:351. [PMID: 34107876 PMCID: PMC8191065 DOI: 10.1186/s12877-021-02277-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/10/2021] [Indexed: 11/12/2022] Open
Abstract
Background Psychosocial issues, such as social isolation and loneliness among older adults and people with dementia, continue to pose challenges with a rapidly aging population worldwide. Social robots are a rapidly emerging field of technology, developed to help address the psychosocial needs of this population. Although studies have reported positive findings regarding their psychosocial benefits, their implementation in real-world practice remains a challenge. Nevertheless, little is known about the factors affecting their implementation. The purpose of this review is to provide a systematic overview of the barriers and facilitators affecting the implementation of social robots for older adults and people with dementia. Method The Arksey and O’Malley approach with methodological enhancement by Levac et al. was used to guide the conduct of this review. Seven electronic databases were searched. In addition, hand searching and backward citation tracing was conducted. Three independent reviewers were involved in the screening and data charting process. Findings were synthesised and categorised into the five domains outlined in the Consolidated Framework of Implementation Research (CFIR). Results A total of 53 studies were included in the final review. Most of the included studies were based in participants’ homes and in care facilities. Barriers and facilitators were mapped onto 18 constructs in the five domains of the CFIR. The most frequently cited barriers were mapped to the constructs within the domain of “Intervention characteristics”, where issues such as the complexity of using the technology and technical obstacles impeded implementation. Most facilitators were mapped onto the domain “Patient needs and resources”. Overall, existing research are disproportionately focused on the internal validity (i.e. characteristics) of social robots, and there is significantly less research investigating their external validity, such as organisational or wider contextual factors that can affect their implementation in real-world practice. Conclusion This review has identified and synthesised the breadth of evidence on the barriers and facilitators to the implementation of social robots for older adults and people with dementia. Future research should pay more attention to investigating the contextual factors, using an implementation framework, to identify barriers and facilitators to guide the implementation of social robots. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02277-9.
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Gasteiger N, Loveys K, Law M, Broadbent E. Friends from the Future: A Scoping Review of Research into Robots and Computer Agents to Combat Loneliness in Older People. Clin Interv Aging 2021; 16:941-971. [PMID: 34079242 PMCID: PMC8163580 DOI: 10.2147/cia.s282709] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/08/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIM Loneliness is a common problem in older adults and contributes to poor health. This scoping review aimed to synthesize and report evidence on the effectiveness of interventions using social robots or computer agents to reduce loneliness in older adults and to explore intervention strategies. METHODS The review adhered to the Arksey and O'Malley process for conducting scoping reviews. The SCOPUS, PUBMED, Web of Science, EMBASE, CINAHL, PsycINFO, ACM Digital Library and IEEE Xplore databases were searched in November, 2020. A two-step selection process identified eligible research. Information was extracted from papers and entered into an Excel coding sheet and summarised. Quality assessments were conducted using the Mixed Methods Appraisal Tool. RESULTS Twenty-nine studies were included, of which most were of moderate to high quality. Eighteen were observational and 11 were experimental. Twenty-four used robots, four used computer agents and one study used both. The majority of results showed that robots or computer agents positively impacted at least one loneliness outcome measure. Some unintended negative consequences on social outcomes were reported, such as sadness when the robot was removed. Overall, the interventions helped to combat loneliness by acting as a direct companion (69%), a catalyst for social interaction (41%), facilitating remote communication with others (10%) and reminding users of upcoming social engagements (3%). CONCLUSION Evidence to date suggests that robots can help combat loneliness in older adults, but there is insufficient research on computer agents. Common strategies for reducing loneliness include direct companionship and enabling social interactions. Future research could investigate other strategies used in human interventions (eg, addressing maladaptive social cognition and improving social skills), and the effects of design features on efficacy. It is recommended that more robust experimental and mixed methods research be conducted, using a combination of validated self-report, observational, and interview measures of loneliness.
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Affiliation(s)
- Norina Gasteiger
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
- School of Health Sciences, The University of Manchester, Manchester, UK
| | - Kate Loveys
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Mikaela Law
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Elizabeth Broadbent
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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Kim ES, Tkatch R, Martin D, MacLeod S, Sandy L, Yeh C. Resilient Aging: Psychological Well-Being and Social Well-Being as Targets for the Promotion of Healthy Aging. Gerontol Geriatr Med 2021; 7:23337214211002951. [PMID: 33816707 PMCID: PMC7995285 DOI: 10.1177/23337214211002951] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 12/27/2022] Open
Abstract
Population aging is one of the most important social trends of the 21st century and in the United States, the number of people aged ≥65 is projected to increase by nearly 50% in the next 15 years. Most biomedical and public health efforts have focused on reducing harmful risk factors when targeting chronic disease—an approach that has contributed greatly to prevention and treatment programs. However, evidence suggests that the number of years lost to disability is increasing and historic gains we have made in life expectancy are eroding, and even reversing in some groups. As our society ages and grapples with these issues, expanding the focus to include resilience, as well as psychosocial assets in our prevention and treatment programs might help inform the multidisciplinary response effort we need. Here we synthesize research evaluating associations between different dimensions of psychological well-being (e.g., purpose in life, optimism, life satisfaction) and social well-being (e.g., structural, functional, quality) with chronic conditions. We also evaluate evidence around three biopsychosocial pathways hypothesized to underlie these associations. These factors are meaningful, measurable, and potentially modifiable; thus, further pursuing this line of inquiry might unveil innovative paths to enhancing the health of our rapidly aging society.
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Affiliation(s)
- Eric S Kim
- University of British Columbia, Vancouver, Canada
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Koh WQ, Ang FXH, Casey D. Impacts of Low-cost Robotic Pets for Older Adults and People With Dementia: Scoping Review. JMIR Rehabil Assist Technol 2021; 8:e25340. [PMID: 33497349 PMCID: PMC8082946 DOI: 10.2196/25340] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/12/2020] [Accepted: 01/04/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Older adults and people with dementia are particularly vulnerable to social isolation. Social robots, including robotic pets, are promising technological interventions that can benefit the psychosocial health of older adults and people with dementia. However, issues such as high costs can lead to a lack of equal access and concerns about infection control. Although there are previous reviews on the use of robotic pets for older adults and people with dementia, none have included or had a focus on low-cost and familiarly and realistically designed pet robots. OBJECTIVE The aim of this review is to synthesize evidence on the delivery and impact of low-cost, familiarly and realistically designed interactive robotic pets for older adults and people with dementia. METHODS The Arksey and O'Malley framework was used to guide this review. First, the research question was identified. Second, searches were conducted on five electronic databases and Google Scholar. Studies were selected using a two-phase screening process, where two reviewers independently screened and extracted data using a standardized data extraction form. Finally, the results were discussed, categorized, and presented narratively. RESULTS A total of 9 studies were included in the review. Positive impacts related to several psychosocial domains, including mood and affect, communication and social interaction, companionship, and other well-being outcomes. Issues and concerns associated with its use included misperceptions of the robotic pets as a live animal, ethical issues of attachment, negative reactions by users, and other pragmatic concerns such as hygiene and cost. CONCLUSIONS Overall, the findings resonate with previous studies that investigated the effectiveness of other social robots, demonstrating the promise of these low-cost robotic pets in addressing the psychosocial needs of older adults and people with dementia. The affordability of these robotic pets appeared to influence the practicalities of real-world use, such as intervention delivery and infection control, which are especially relevant in light of COVID-19. Moving forward, studies should also consider comparing the effects of these low-cost robots with other robotic pets.
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Affiliation(s)
- Wei Qi Koh
- National University of Ireland Galway, Galway, Ireland
| | | | - Dympna Casey
- National University of Ireland Galway, Galway, Ireland
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Acceptance and Influencing Factors of Social Virtual Reality in the Urban Elderly. SUSTAINABILITY 2020. [DOI: 10.3390/su12229345] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In the stage of aging society and population aging, the social needs of the elderly are widely discussed by researchers. Especially driven by the demand of tele-medical treatment and tele-rehabilitation therapy, it is vital for the elderly to integrate into virtual communities by combining social virtual reality (VR) with different medical services and entertainment needs. In addition, affected by the COVID-19 epidemic, it is more difficult for people to have face-to-face contacts. With more remote consultation, entertainment and virtual social connectivity, the application of social VR is more urgent and valuable. However, there is little discussion on the acceptability and influencing factors of social VR among the elderly at present. Therefore, in order to get further data, we used (1) early stage semi-structured interviews and then (2) Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaires for investigation. One hundred fourteen elderly people aged 60–89 living in the metropolitan area of Taipei were taken as the subjects. To help them understand the situation and state of using social VR, these elderly people were asked to use a head-mounted display (HMD) to experience social VR games. The preliminary results showed that the elderly had obvious preference for entertainment (32.4%) and medical treatment (31.3%). The interview showed that this was related to the physiological condition or medical needs of the age range. In order to further understand how social VR would affect the social life of the elderly, we proposed the further demand structure of UTAUT Model based on the interview of both experts and the elderly. The model structures include (1) Performance Expectancy, (2) Perceived Enjoyment, (3) Social Influence, (4) User Attitude, (5) Behavioral Intention, and so on. These structures were applied to conduct interviews and questionnaires to find out the influence extent and relevance of the elderly on different structural needs, and suggestions were given accordingly. The results of the above interviews showed that (1) the elderly thought that the functions of entertaining and interacting of social VR could increase their social opportunities, and also meet medical needs (teleconference, cognitive decline, etc.), (2) the closeness of social relations (between family members, friends, doctors, and places), and also affect the relevance of Perceived Enjoyment (β = 0.77, p = 0.000 < 0.05). The results of these phenomena and interviews showed the interplay between the demand structures and their special relevance. They also indicated that as to social VR technologies, various demands and functional issues of the elderly need to be considered, and these demands would appear in the subtle usage, and different social VR interfaces and functions would emerge based on their special living ways and physical and psychological demands.
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