Older Users' Acceptance of an Assistive Robot: Attitudinal Changes Following Brief Exposure

Assistive devices non-use, abandonment, or non-adherence? Toward standard terminology for assistive devices outcomes

For individuals with disabilities, failure to use prescribed assistive technology devices (ATDs) according to professional recommendations can have detrimental health consequences. The literature has employed various terms to describe this phenomenon such as nonuse, abandonment, and non-adherence to characterize this behavior, lacking clear and standardized definitions. Consistent use of a standardized language is critical for advancing research in this area. This study aims to identify and describe the concepts related to the failure to use prescribed ATDs, along with the associated contexts, and proposes a framework for standardizing terminology in this domain. A narrative literature review encompassing studies from inception to June 2023 was conducted to elucidate these concepts. Out of 1029 initially identified articles, 27 were retained for in-depth analysis. The review unveiled a significant inconsistency in the use of terms like nonuse, abandonment, noncompliance, and non-adherence. Some articles even employed these terms interchangeably without clear definitions. Only 10 of the 27 reviewed articles provided definitions for the terminology they used. This highlights the crucial need for adopting valid conceptual models to select appropriate terms. Researchers are strongly encouraged to furnish operational definitions aligned with theoretical models and relevant to their research context to advance this field consistently.

Immersive participatory design of assistive robots to support older adults

Assistive robots have the potential to support independence, enhance safety, and lower healthcare costs for older adults, as well as alleviate the demands of their care partners. However, ensuring that these robots will effectively and reliably address end-user needs in the long term requires user-specific design factors to be considered during the robot development process. To identify these design factors, we embedded Stretch, a mobile manipulator created by Hello Robot Inc., in the home of an older adult with motor impairments and his care partner for four weeks to support them with everyday activities. An occupational therapist and a robotics engineer lived with them during this period, employing an immersive participatory design approach to co-design and customise the robot with them. We highlight the benefits of this immersive participatory design experience and provide insights into robot design that can be applied broadly to other assistive technologies.

Humanoid robots for assisting people with physical disabilities in activities of daily living: a scoping review

The aim of this scoping review was to gather, summarize, and map the knowledge of peoples' experiences on humanoid robots, capable of assisting people with activities of daily living. The review was guided by the framework of Joanna Briggs Institute and PRISMA-ScR. We found 44 papers describing nine robots that could assist with a variety of tasks listed in the International Classification of Functioning, Disability, and Health. The mixed population experienced little or no anxiety toward the robots, and most accepted the robots' ability to monitor for safety reasons. Some participants disliked the robots' large size and slow movements. Most of the participants found the robots easy to use. They wanted improvements in the robots' functionality and the ability to personalize services. Several of the participants found the services interesting and useful, but not for themselves. The experiences of humanoid robotic assistance showed an insufficient level of technical readiness for assisting in physical assistance, a lack of personalization and readiness for use in home settings. The practical relevance of these findings lies in guiding future research and development toward a more individualized approach focusing on user needs and experiences to enhance the efficacy and integration of humanoid robots in health-care.

Care-receivers with physical disabilities' perceptions on having humanoid assistive robots as assistants: a qualitative study

BACKGROUND

People with physical disabilities due to disease or injury face barriers to their daily activities and participation in society. Many depend on formal or informal caregivers for assistance to live independently. However, future healthcare challenges due to demographic changes threaten access to home care and assistants. Assistive technologies, such as robots for physical assistance, can support the independence and autonomy of people with physical disabilities. This study explore Norwegian care-receivers' perceptions of using robot assistance in their homes, including preferences for tasks acceptable or unacceptable for robot assistance and the underlying reasons.

METHOD

Purposive sampling was employed to recruit 18 participants, aged between 18 and 77 years, with differences in physical function including diagnoses such as stroke, spinal cord injury, amputations, and muscular dystrophy. Qualitative data were gathered through four focus group interviews wherein participants watched videos featuring a humanoid assistive robot, EVEr3. The collected data underwent analysis using reflexive thematic analysis.

RESULTS

Three themes with associated sub-themes were constructed: (a) How a robot could assist in daily life, (b) The robot's appearance and functionality, and (c) Concerns about having a robot as an assistant. The participants welcomed the idea of a future robotic assistant in areas that may contribute to an increased feeling of independence and autonomy.

CONCLUSION

A robot assisting in activities of daily living would need to be individually customized to meet the needs of each user in terms of which tasks to assist with, how to assist in these defined tasks, and how it is controlled.

Acceptance of social assistant robots for the older adults living in the community in China

BACKGROUND

Social assistant robots (SARs) are an important part of providing high quality health and social care for older people, and are an effective measure to promote the development of smart aging. Therefore, it is important to understand the factors that influence the acceptance of assistive robots by older adults.

PURPOSE

To investigate the acceptance of SARs for older adults living in the community and explore its influencing factors.

METHODS

207 elderly was invited to answer a questionnaire after watching a SAR video and discussing it. Participants' characteristics, physical health status, general self-efficacy, personality trait and acceptance toward SARs were recorded and analyzed using multiple linear regression analysis.

RESULTS

showed that the degree of acceptance among older adults living in the community was moderate(2.55±0.86), and the acceptance rate was 51.0%. Whether to use mobile devices(smartphones, computers, robots), the experience of using mobile service devices, perceived usefulness, perceived enjoyment, perceived ease of use and attitude were the main affecting factors (P<0.05).

CONCLUSIONS

The elderly Chinese in the community have a low acceptance of SARs. The higher the perceived usefulness, perceived enjoyment and perceived ease of use, the more positive attitude to using. The elderly who has the experience of using mobile service devices have a higher acceptance of SARs.

Digital Engagement of Older Adults: Scoping Review

BACKGROUND

Digital technologies facilitate everyday life, social connectedness, aging at home, well-being, and dignified care. However, older adults are disproportionately excluded from these benefits. Equal digital opportunities, access, and meaningful engagement require an understanding of older adults' experience across different stages of the technological engagement life cycle from nonuse and initial adoption to sustained use, factors influencing their decisions, and how the experience changes over time.

OBJECTIVE

Our objectives were to identify the extent and breadth of existing literature on older adults' perspective on digital engagement and summarize the barriers to and facilitators for technological nonuse, initial adoption, and sustained digital technology engagement.

METHODS

We used the Arksey and O'Malley framework for the scoping review process. We searched MEDLINE, PsycINFO, CINAHL, Web of Science, and ACM digital library for primary studies published between 2005 and 2021. The inclusion and exclusion criteria were developed based on the Joanna Briggs Institute (participants, content, and context) framework. Studies that investigated the digital engagement experience as well as barriers to and facilitators of older adults' digital technology engagement were included. The characteristics of the study, types of digital technology, and digital engagement levels were analyzed descriptively. Content analysis was used to generate tentative elements using a congruent theme, and barriers and facilitators were mapped over the capability, opportunity, and motivation behavior change model (COM-B) and the theoretical domain framework. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews).

RESULTS

In total, 96 publications were eligible for the final charting and synthesis. Most of the studies were published over the past 5 years, investigated the initial adoption stage of digital engagement, and focused on everyday technologies. The most cited barriers and facilitators across the engagement stages from each COM-B component were capability (eg, physical and psychological changes and lack of skill), opportunity (eg, technological features, environmental context, and resources), and motivation (eg, optimism from perceived usefulness and beliefs about capability).

CONCLUSIONS

The COM-B model and theoretical domain framework provide a guide for identifying multiple and intertwined barriers and facilitators at each stage of digital engagement. There are limited studies looking into the whole spectrum of older adults' digital technology experience; in particular, studies on technological nonuse and sustained use stages are rare. Future research and practice should focus on tailored interventions accounting for the barriers to older adults' digital engagement and addressing capabilities, motivation, and opportunities; affordable, usable, and useful digital technologies, which address the changes and capability requirements of older adults and are cocreated with a value framework; and lifelong learning and empowerment to develop older adults' knowledge and skills to cope with digital technology development.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/25616.

The usability and feasibility validation of the social robot MINI in people with dementia and mild cognitive impairment; a study protocol

BACKGROUND

Social robots have demonstrated promising outcomes in terms of increasing the social health and well-being of people with dementia and mild cognitive impairment. According to the World Health Organization's Monitoring and assessing digital health interventions framework, usability and feasibility studies are crucial before implementing prototype social robots and proving their efficacy and effectiveness. This protocol paper aims to detail the plan for conducting the usability and feasibility study of the MINI robot based on evidence-based recommended methodology.

METHODS

In this study, an experimental design and a mixed method of data collection will be applied. Twenty participants aged 65 and over with dementia or mild cognitive impairment will be recruited. Eight sessions of interaction with the robot, as well as qualitative and quantitative assessments, will be accomplished. The research will take place in a laboratory. Ethical approvals have been acquired. This research will be valuable in the development of the MINI robot and its practical deployment in the actual world, as well as the methodological evidence base in the sector of social robots.

DISCUSSION

By the winter of 2022-2023, the findings of this study will be accessible for dissemination. This study will aid to improve the evidence-based methodology used to study the feasibility and usability of social robots in people with dementia and mild cognitive impairment as well as what can be learned to advance such study designs in the future.

Methodologies Used to Study the Feasibility, Usability, Efficacy, and Effectiveness of Social Robots For Elderly Adults: Scoping Review

Background

New research fields to design social robots for older people are emerging. By providing support with communication and social interaction, these robots aim to increase quality of life. Because of the decline in functioning due to cognitive impairment in older people, social robots are regarded as promising, especially for people with dementia. Although study outcomes are hopeful, the quality of studies on the effectiveness of social robots for the elderly is still low due to many methodological limitations.

Objective

We aimed to review the methodologies used thus far in studies evaluating the feasibility, usability, efficacy, and effectiveness of social robots in clinical and social settings for elderly people, including persons with dementia.

Methods

Dedicated search strings were developed. Searches in MEDLINE (PubMed), Web of Science, PsycInfo, and CINAHL were performed on August 13, 2020.

Results

In the 33 included papers, 23 different social robots were investigated for their feasibility, usability, efficacy, and effectiveness. A total of 8 (24.2%) studies included elderly persons in the community, 9 (27.3%) included long-term care facility residents, and 16 (48.5%) included people with dementia. Most of the studies had a single aim, of which 7 (21.2%) focused on efficacy and 7 (21.2%) focused on effectiveness. Moreover, forms of randomized controlled trials were the most applied designs. Feasibility and usability were often studied together in mixed methods or experimental designs and were most often studied in individual interventions. Feasibility was often assessed with the Unified Theory of the Acceptance and Use of Technology model. Efficacy and effectiveness studies used a range of psychosocial and cognitive outcome measures. However, the included studies failed to find significant improvements in quality of life, depression, and cognition.

Conclusions

This study identified several shortcomings in methodologies used to evaluate social robots, resulting in ambivalent study findings. To improve the quality of these types of studies, efficacy/effectiveness studies will benefit from appropriate randomized controlled trial designs with large sample sizes and individual intervention sessions. Experimental designs might work best for feasibility and usability studies. For each of the 3 goals (efficacy/effectiveness, feasibility, and usability) we also recommend a mixed method of data collection. Multiple interaction sessions running for at least 1 month might aid researchers in drawing significant results and prove the real long-term impact of social robots.

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.

Robots in Eldercare: How Does a Real-World Interaction with the Machine Influence the Perceptions of Older People?

(1) Background: Using autonomous social robots in selected areas of care for community-dwelling older adults is one of the promising approaches to address the problem of the widening care gap. We posed the question of whether a possibility to interact with the technology to be used had an impact on the scores given by the respondents in various domains of needs and requirements for social robots to be deployed in care for older individuals. (2) Methods: During the study, the opinions of older people (65+; n = 113; with no severe cognitive impairment) living in six social care institutions about a robot in care for older people were collected twice using the Users’ Needs, Requirements and Abilities Questionnaire (UNRAQ): after seeing a photo of the robot only and after a 90−150 min interaction with the TIAGo robot. (3) Results: Mean total scores for both assistive and social functions were higher after the interaction (p < 0.05). A positive correlation was found between opinion changes in social and assistive functions (r = 0.4842; p = 0.0000). (4) Conclusions: Preimplementation studies and assessments should include the possibility to interact with the robot to provide its future users with a clear idea of the technology and facilitate necessary customisations of the machine.

Designing Acceptable Robots for Assisting Older Adults: A Pilot Study on the Willingness to Interact

The aim of this paper was to explore the psychosocial determinants that lead to acceptability and willingness to interact with a service robot, starting with an analysis of older users' behaviors toward the Robot-Era platform, in order to provide strategies for the promotion of social assistive robotics. A mixed-method approach was used to collect information on acceptability, usability, and human-robot interaction, by analyzing nonverbal behaviors, emotional expressions, and verbal communication. The study involved 35 older adults. Twenty-two were women and thirteen were men, aged 73.8 (±6) years old. Video interaction analysis was conducted to capture the users' gestures, statements, and expressions. A coded scheme was designed on the basis of the literature in the field. Percentages of time and frequency of the selected events are reported. The statements of the users were collected and analyzed. The results of the behavioral analysis reveal a largely positive attitude, inferred from nonverbal clues and nonverbal emotional expressions. The results highlight the need to provide robotic solutions that respect the tasks they offer to the users It is necessary to give older consumers dedicated training in technological literacy to guarantee proper, long-lasting, and successful use.

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

BACKGROUND

Robots are gaining attention as a potential solution to aging.

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

The Role of Healthcare Robotics in Providing Support to Older Adults: a Socio-ecological Perspective

PURPOSE OF REVIEW

In this review, we provide an overview of how healthcare robotics can facilitate healthy aging, with an emphasis on physical, cognitive, and social supports. We next provide a synthesis of future challenges and considerations in the development and application of healthcare robots. We organize these considerations using a socio-ecological perspective and discuss considerations at the individual, care partner, community healthcare, and healthcare policy levels.

RECENT FINDINGS

Older adults are the fastest growing segment of the US population. Age-related changes and challenges can present difficulties, for older adults want to age healthily and maintain independence. Technology, specifically healthcare robots, has potential to provide health supports to older adults. These supports span widely across the physical, cognitive, and social aspects of healthy aging.

SUMMARY

Our review suggests that while healthcare robotics has potential to revolutionize the way in which older adults manage their health, there are many challenges such as clinical effectiveness, technology acceptance, health informatics, and healthcare policy and ethics. Addressing these challenges at all levels of the healthcare system will help ensure that healthcare robotics promote healthy aging and are applied safely, effectively, and reliably.

Acceptability of Robots to Assist the Elderly by Future Designers: A Case of Guangdong Ocean University Industrial Design Students

The development of robot technology provides many possibilities for the life support of the elderly. This study explored the acceptability of robots to assist the elderly from the perspective of future designers. A quantitative questionnaire (58 copies) and a qualitative one-to-one interview (10 people) were conducted to explore the attitude of future designers towards the use of robots to assist the elderly. One-sample Wilcoxon signed-rank test statistic was used to analyze the data of the questionnaire. The results show that the mean and median of 11 of the 12 dimensions of the acceptability questionnaire are greater than 3 (3 represents uncertain and neutral attitude), and 10 have statistical significance (p < 0.05). Also, the interview results show the positive attitude of future designers. The research shows that future designers hold a positive and open attitude towards the use of robots to assist the elderly. The research findings can help people understand the attitude of future designers and provide some reference for subsequent robot design and development.

Age Difference in Perceived Ease of Use, Curiosity, and Implicit Negative Attitude toward Robots

Understanding older adults’ attitudes toward robots has become increasingly important as robots have been introduced in various settings, such as retirement homes. We investigated whether there are age differences in both implicit and explicit attitudes toward robots after interacting with an assistive robot. Twenty-four younger and 24 older adults were recruited. Explicit attitudes were measured by self-reported questionnaires both before and after interacting with the robot. State curiosity toward robots was also measured as a momentary form of explicit attitude. Implicit attitude was measured via an implicit association test. Our results showed that (1) both older and younger adults had more positive explicit attitudes toward robots after interaction; (2) older adults had lower state curiosity than younger adults, however, their state curiosity would be up to the same level as younger adults when they perceived the robot with higher levels of personal association; and (3) the implicit association between robots and negative words was stronger for older adults than younger adults, suggesting that older adults had more implicit negative attitude toward robots. The results suggest that, despite older adults’ relatively more negative implicit attitude toward robots, personally relevant positive experiences could help improve their explicit attitudes toward robots.

Older Adults’ Perceptions of Supporting Factors of Trust in a Robot Care Provider

The older adult population is increasing worldwide, leading to an increased need for care providers. An insufficient number of professional caregivers will lead to a demand for robot care providers to mitigate this need. Trust is an essential element for older adults and robot care providers to work effectively. Trust is context dependent. Therefore, we need to understand what older adults would need to trust robot care providers, in this specific home-care context. This mixed methods study explored what older adults, who currently receive assistance from caregivers, perceive as supporting trust in robot care providers within four common home-care tasks: bathing, transferring, medication assistance, and household tasks. Older adults reported three main dimensions that support trust: professional skills, personal traits, and communication. Each of these had subthemes including those identified in prior human-robot trust literature such as ability, reliability, and safety. In addition, new dimensions perceived to impact trust emerged such as the robot’s benevolence, the material of the robot, and the companionability of the robot. The results from this study demonstrate that the older adult-robot care provider context has unique dimensions related to trust that should be considered when designing robots for home-care tasks.