Clinical Application of a Humanoid Robot in Pediatric Cancer Interventions

The effect of social robot interventions on anxiety in children in clinical settings: a systematic review and meta-analysis

AIMS

Children in clinical settings are prone to anxiety due to developmental limitations, which hinders treatment progress. This systematic review and meta-analysis aimed to evaluate the efficacy of social robot interventions compared to routine care or alternative non-pharmacological strategies in reducing anxiety among children aged 4-12 years undergoing medical procedures in clinical settings, based on evidence from randomized controlled trials.

METHODS

The review protocol was prospectively registered in PROSPERO. Five electronic databases PubMed, Web of Science, Embase, Cochrane Library and PsycINFO were searched for randomized controlled trials (RCTs) examining the effects of SRs on children's anxiety. The search ends on 1 December 2024. A total of 10 RCTs meeting the inclusion criteria were identified, involving 877 children aged 4-12 years.

RESULTS

The meta-analysis reveals a significant reduction in anxiety levels among children who interacted with social robots in clinical settings. Subgroup analyses showed that 1) Both inpatient and outpatient children exhibited reduced anxiety levels. 2) School-age children experienced a decrease in anxiety following interventions with social robots. 3) The social robots were effective in alleviating children's anxiety using distraction techniques and psycho-educational interventions.

CONCLUSIONS

This meta-analysis is the first to summarize the effects of social robots on anxiety in children and finds an overall positive trend. It's more effective than traditional psychotherapy and has no adverse effects due to drug use. In the context of care shortages, social robots represent a significant tool for reducing anxiety among children in clinical settings and demonstrate promising potential.

Effectiveness of Technology-Based Intervention in Symptom Management in Pediatric Oncology Patients: A Systematic Review and Meta-Analysis

BACKGROUND

Technology-based interventions are increasingly integrated to improve symptom management of pediatric oncology patients. However, evidence for their effectiveness remains low across various studies characterized by different methodologies and patient populations. This study aimed to synthesize and analyze the effectiveness of technology-based intervention in symptom management in pediatric oncology patients.

METHODS

Six databases (PubMed, Web of Science, Cochrane Library, Ovid MEDLINE, CINAHL, and Scopus) were searched from January 1, 2014, to January 1, 2024. The methodological quality of the included studies was assessed using the Cochrane and JBI checklists. The PRISMA guidelines for systematic reporting were followed in this study. The search protocol has been registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42024516320).

RESULTS

Thirteen studies with 624 pediatric oncology patients were analyzed. Significant differences were found between intervention and control groups in pain (Hedge's g = -0.695, 95% CI: -0.994 to -0.396, p < 0.001), fear (Hedge's g = -0.737, 95% CI: -1.01 to -0.464, p < 0.001), anxiety, and nausea and vomiting (Hedge's g = -0.573, 95% CI: -0.912 to -0.235, p < 0.001).

CONCLUSION

The findings indicate that VR, iPad, humanoid robots, and Pain Squad reduce pain in pediatric oncology. VR, biofeedback-based VR, and iPads also alleviate fear, while all three plus humanoid robots mitigate anxiety. VR, interactive mobile apps, tablet games, text reminders, and iPads effectively decrease nausea and vomiting. More research is needed to evaluate the long-term effects of these interventions.

Effectiveness of social robots in improving psychological well-being of hospitalised children: A systematic review and meta-analysis

AIM

To evaluate the effectiveness of social robots in reducing pain, stress, and anxiety among hospitalised children.

BACKGROUND

Children are often subjected to painful medical procedures during hospitalisation, resulting in pain, stress and anxiety. This can have significant implications for a child's psychological and overall well-being. Therefore, it is essential to alleviate these emotions among hospitalised children.

METHODS

The review included studies involving hospitalised children ages 1-12 who underwent any medical procedure and received interventions involving social robots. Six databases were searched for articles published on the review topic. The search timeline was from January 2013 to January 2024. The included studies need to assess the effectiveness of the robots in improving primary outcomes such as pain, stress, distress, or anxiety levels. A meta-analysis of these variables was conducted.

RESULTS

The meta-analysis of 313 participants found that social robots had a standardised mean difference (SMD) of -0.10 (95 % CI: -0.41 to 0.22, P = 0.54) in reducing pain, indicating no significant effect. For stress and distress, with a total of 309 participants, the SMD was -0.33 (95 % CI: -0.62 to -0.03, P = 0.003), and for anxiety, including 335 participants, the SMD was -0.42 (95 % CI: -0.73 to -0.10, P = 0.09). These findings suggest that while social robots are not effective in reducing pain, however, they are effective in lowering stress and anxiety levels in hospitalised children undergoing painful medical procedures.

CONCLUSION

This review highlights the efficacy of social robots when introduced to hospitalised children who are undergoing painful medical procedures. Nurses could consider integrating social robots into patient care protocols, which would yield advantages for anxious young children and their parents, as social robots help improving the child's psychological and overall well-being during medical procedures.

How does training given to pediatric nurses about artificial intelligence and robot nurses affect their opinions and attitude levels? A quasi-experimental study

PURPOSE

This study was conducted to investigate the effect of training provided to pediatric nurses on their knowledge and attitude levels about artificial intelligence and robot nurses.

DESIGN AND METHODS

In this study, a single-group pre- and post-test quasi-experimental design was used. Data were collected from pediatric nurses working in Training and Research Hospital located in western Turkey. Forty-three pediatric nurses participated in the study. The study data were collected using the "Pediatric Nurses' Descriptive Characteristics Form", "Artificial Intelligence Knowledge Form", and "Artificial Intelligence General Attitude Scale".

RESULTS

The mean scores of the participating pediatric nurses obtained from the Artificial Intelligence Knowledge Form before, right after and one month after the training were 41.16 ± 14.95, 68.25 ± 13.57 and 69.06 ± 13.19, respectively. The mean scores they obtained from the Positive Attitudes towards Artificial Intelligence subscale of the Artificial Intelligence General Attitude Scale before and after the training were 3.43 ± 0.54 and 3.59 ± 0.60, respectively whereas the mean scores they obtained from its Negative Attitudes towards Artificial Intelligence subscale were 2.68 ± 0.67 and 2.77 ± 0.75, respectively.

CONCLUSIONS

It was determined that the training given to the pediatric nurses about artificial intelligence and robot nurses increased the nurses' knowledge levels and their artificial intelligence attitude scores, but this increase in the artificial intelligence attitude scores was not significant.

PRACTICE IMPLICATIONS

The use of artificial intelligence and robotics or advanced technology in pediatric nursing care can be fostered.

The pilot study of group robot intervention on pediatric inpatients and their caregivers, using 'new aibo'

The study on robot-assisted therapy in a pediatric field has not been applied sufficiently in clinical settings. The purpose of this pilot study is to explore the potential therapeutic effects of a group robot intervention (GRI), using dog-like social robot (SR) 'aibo' in pediatric ward. GRI by aibo was conducted for those children with chronic illness (127 in total) who are hospitalized in National Centre for Child Health and Development (NCCHD), and their caregivers (116 in total), from March to April 2018. The observer made structured behavioural observation records, based on which qualitative research on the features of their words and conducts, were carried out. As a result, first, during the GRI, about 2/3 of total expression by children were positive, while about 1/4 were negative or inappropriate. On the other hand, as seen in the 'change' group, those children who had originally responded with negative expression eventually came to express positive expression, while getting involved in a ternary relationship or participating in a session more than once. Secondly, as for the expression from the caregivers during the GRI, active expressions such as 'participation' and 'exploration' accounted for the 2/3, while 1/3 turned out to be rather placid expressions such as 'watch over' or 'encourage.'Conclusion: There has not been any precedent study on the features of words and conducts expressed by patients and their caregivers during the GRI by aibo. The outcome suggests that aibo could possibly be used as a tool for group robot-assisted therapy in the pediatric treatment setting. What is Known: • The study on robot-assisted therapy in a pediatric field has only just begun. • Though many kinds of social robot have been reportedly used so far, none has yet to be applied in clinical settings What is New: • Our study revealed the features of words and behaviour expressed by the patients and their caregivers, when dog-like social robot 'aibo' was used for a group robot intervention in the pediatric ward. • The outcome suggests that aibo could possibly be used as a tool for group robot-assisted therapy in the pediatric treatment setting.

Robotics in Clinical and Developmental Psychology

Technological advances in robotics over the last 20 years have allowed us to explore the use of robots in different healthcare contexts, in which robots can be deployed as tools for intervention and rehabilitation programs. This chapter intends to analyze, in a lifespan perspective (childhood, adulthood, and elderly age), the potentialities that the use of robots can offer in clinical practices without neglecting the robot's technical constraints and the methodological limitations of the studies. We will provide suggestions for future research and indications for the clinical application of robots according to the different pathologies and ages.

Robo Ludens

The use of games as vehicles to study human-robot interaction (HRI) has been established as a suitable solution to create more realistic and naturalistic opportunities to investigate human behavior. In particular, multiplayer games that involve at least two human players and one or more robots have raised the attention of the research community. This article proposes a scoping review to qualitatively examine the literature on the use of multiplayer games in HRI scenarios employing embodied robots aiming to find experimental patterns and common game design elements. We find that researchers have been using multiplayer games in a wide variety of applications in HRI, including training, entertainment and education, allowing robots to take different roles. Moreover, robots have included different capabilities and sensing technologies, and elements such as external screens or motion controllers were used to foster gameplay. Based on our findings, we propose a design taxonomy called Robo Ludens, which identifies HRI elements and game design fundamentals and classifies important components used in multiplayer HRI scenarios. The Robo Ludens taxonomy covers considerations from a robot-oriented perspective as well as game design aspects to provide a comprehensive list of elements that can foster gameplay and bring enjoyable experiences in HRI scenarios.

Reducing negative emotions in children using social robots: systematic review

BACKGROUND

For many children, visiting the hospital can lead to a state of increased anxiety. Social robots are being explored as a possible tool to reduce anxiety and distress in children attending a clinical or hospital environment. Social robots are designed to communicate and interact through movement, music and speech.

OBJECTIVE

This systematic review aims at assessing the current evidence on the types of social robots used and their impact on children's anxiety or distress levels when visiting the hospital for outpatient appointments or planned admissions.

METHODS

Databases such as MEDLINE, PubMed, IEEE Xplore, Web of Science, PsychINFO and Google Scholar were queried for papers published between January 2009 and August 2020 reporting the use of social robots interacting with children in hospital or clinical environments.

RESULTS

A total of 10 studies were located and included. Across these 10 studies, 7 different types of robots were used. Anxiety and distress were found to be reduced in the children who interacted with a social robot.

CONCLUSIONS

Overall, the evidence suggests that social robots hold a promising role in reducing levels of anxiety or distress in children visiting the hospital. However, research on social robots is at an early stage and requires further studies to strengthen the evidence base.

Robotic Psychology: A PRISMA Systematic Review on Social-Robot-Based Interventions in Psychological Domains

Current technological advancements have allowed robots to be successfully employed in the healthcare sector. However, the recently acquired ability of social robots to process social information and act according to it has potentially made them very well suited to support or conduct psychological interventions. The present paper carried out a systematic review of the available literature regarding social-robot-based interventions in psychological domains using preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The inclusion criteria were: (i) publication date until 2020; (ii) being an empirical study, master thesis, or project report; (iii) written in English or Italian languages (the two languages spoken by the authors); (iv) published in a scholarly peer-reviewed journal or conference proceedings, or were Ph.D. or master’s theses; and (v) assessed “social robot”-based intervention in psychological domains. Overall, the review showed that three main areas may benefit from social-robot-based interventions: social skills, mood, and wellbeing (e.g., stress and anxiety levels). Interestingly, social robots seemed to have a performance comparable to, and sometimes even better than, human operators. The main, but not exclusive, target of robot-based interventions in the psychological field was children with autism spectrum disorder (ASD). As evidence is, however, still limited and in an embryonic state, deeper investigations are needed to assess the full potential of social robots for the purposes of psychological intervention. This is relevant, considering the role that social robots could have in overcoming barriers to access psychological assessment and therapies.

Effectiveness of technology-based psychosocial interventions for child, adolescents and young adults undergoing cancer treatment: A meta-analysis of randomised controlled trials

BACKGROUND

Cancer can have various psychosocial effects on children and young adults. Technology-based psychosocial interventions are increasingly popular in paediatric oncology for psychosocial health.

OBJECTIVE

The objective of this study is to investigate the effectiveness of technology-based psychosocial interventions applied to children, adolescent and young adults undergoing cancer treatment.

METHODS

Eight electronic databases including PubMed, Cochrane Library (including Cochrane Central Register of Controlled Trials [CENTRAL]), CINAHL Plus with Full Text, PsycINFO, MEDLINE, ProQuest, Science Direct and Scopus were searched to identify eligible randomised controlled trials from 1 January 2010 up to 9 April 2021. Search results were limited to 'children, adolescent and young adults' 6-24 years undergoing cancer treatment. Randomised controlled studies in which technology-based psychosocial interventions were applied were examined. Of 4,927 articles, 12 articles met the inclusion criteria. Hedges' g effect size was computed for each study. Effect sizes and moderator variables were tested using random-effects models. This study is registered with PROSPERO, number CRD42020177787.

RESULTS

The outcomes were anger, anxiety, coping, depression, distress, quality of life and resilience. Compared with standard care, technology-based psychosocial interventions had a large effect and significantly on anger (g = -1.327, 95% CI: [-2.43, 0.22], anxiety (g = -0.89, 95%CI: [-1.34, -0.18], and depression (g = -1.05, 95% CI: [-1.65,-0.46]. Also, it was found that the duration of interventions had a significant moderator and effect size of the distress and resilience outcomes increased as the duration increased.

CONCLUSION

This meta-analysis demonstrated that technology-based psychosocial interventions served as an effective intervention as it appears to have implications reducing anger, anxiety and depression in paediatric oncology. Nevertheless, randomised controlled studies with larger samples still needed to establish evidence-based psycho-oncological interventions for paediatric oncology. Future research should develop interventions more graduated by duration.

Using social robot PLEO to enhance the well-being of hospitalised children

Hospitalisation is stressful for children. Play material is often offered for distraction and comfort. We explored how contact with social robot PLEO could positively affect a child's well-being. To this end, we performed a multiple case study on the paediatric ward of two hospitals. Child life specialists offered PLEO as a therapeutic activity to children in a personalised way for a well-being related purpose in three to five play like activity sessions during hospital visits/stay. Robot-child interaction was observed; care professionals, children and parents were interviewed. Applying direct content analysis revealed six categories of interest: interaction with PLEO, role of the adults, preferences for PLEO, PLEO as buddy, attainment of predetermined goal(s) and deployment of PLEO. Four girls and five boys, aged 4-13, had PLEO offered as a relief from stress or boredom or for physical stimulation. All but one started interacting with PLEO and showed behaviours like hugging, caring or technical exploration, promoting relaxation, activation and/or making contact. Interaction with PLEO contributed to achieving the well-being related purpose for six of them. PLEO was perceived as attractive to elicit play. Although data are limited, promising results emerge that the well-being of hospitalised children might be fostered by a personalised PLEO offer.

Comparison of Acceptance and Knowledge Transfer in Patient Information Before an MRI Exam Administered by Humanoid Robot Versus a Tablet Computer: A Randomized Controlled Study

PURPOSE

 To investigate whether a humanoid robot in a clinical radiological setting is accepted as a source of information in conversations before MRI examinations of patients. In addition, the usability and the information transfer were compared with a tablet.

METHODS

 Patients were randomly assigned to a robot or tablet group with their consent prior to MRI. The usability of both devices was compared with the extended System Usability Scale (SUS) and the information transfer with a knowledge query. Reasons for refusal were collected by a non-responder questionnaire.

RESULTS

 At the University Hospital Halle 117 patients were included for participation. There was no statistically significant difference in gender and age. Of 18 non-responders, 4 refused to participate partly because of the robot; for another 3 the reason could not be clarified. The usability according to SUS score was different with statistical significance between the groups in the mean comparison and was one step higher for the tablet on the adjective scale. There was no statistically significant difference in knowledge transfer. On average, 8.41 of 9 questions were answered correctly.

CONCLUSION

 This study is the first application, in a clinical radiological setting, of a humanoid robot interacting with patients. Tablet and robot are suitable for information transfer in the context of MRI. In comparison to studies in which the willingness to interact with a robot in the health care sector was investigated, the willingness is significantly higher in the present study. This could be explained by the fact that it was a concrete use case that was understandable to the participants and not a hypothetical scenario. Thus, potentially high acceptance for further specific areas of application of robots in radiology can be assumed. The higher level of usability perceived in the tablet group can be explained by the fact that here the interface represents a form of operation that has been established for years in all population groups. More frequent exposure to robots could also improve the response in the future.

KEY POINTS

· patients accept humanoid robots in clinical radiologic situations. · at present they can only convey information as well as an inexpensive tablet. · future systems can relieve the burden on personnel..

CITATION FORMAT

· Stoevesandt D, Jahn P, Watzke S et al. Comparison of Acceptance and Knowledge Transfer in Patient Information Before an MRI Exam Administered by Humanoid Robot Versus a Tablet Computer: A Randomized Controlled Study. Fortschr Röntgenstr 2021; 193: 947 - 954.

A Systematic Review of Robotic Rehabilitation for Cognitive Training

A large and increasing number of people around the world experience cognitive disability. Rehabilitation robotics has provided promising training and assistance approaches to mitigate cognitive deficits. In this article, we carried out a systematic review on recent developments in robot-assisted cognitive training. We included 99 articles in this work and described their applications, enabling technologies, experiments, and products. We also conducted a meta analysis on the articles that evaluated robot-assisted cognitive training protocol with primary end users (i.e., people with cognitive disability). We identified major limitations in current robotics rehabilitation for cognitive training, including the small sample size, non-standard measurement of training and uncontrollable factors. There are still multifaceted challenges in this field, including ethical issues, user-centered (or stakeholder-centered) design, the reliability, trust, and cost-effectiveness, personalization of the robot-assisted cognitive training system. Future research shall also take into consideration human-robot collaboration and social cognition to facilitate a natural human-robot interaction.

The effect of digital health technologies on managing symptoms across pediatric cancer continuum: A systematic review

Objective

Pediatric cancer patients endure multiple symptoms during treatment and also in survivorship. Digital health technologies provide an innovative way to support their symptom management. This review aimed to examine the effect of digital health technologies on managing symptoms among across pediatric cancer continuum.

Methods

A systematic literature search of six English and three Chinese electronic databases was combined with hand searching, to identify eligible research studies from database establishment to November 30, 2019. Two reviewers carried out data selection, data extraction, and quality appraisal independently. A narrative approach was taken to summarize data.

Results

Four randomized control trials, two quasi-experiments, and five one group pre-posttest designed studies, were included in the review with a total of 425 participants. The methodological quality of the studies was generally fair. Seven symptoms (anxiety, depression, pain, anger, fatigue, fear, distress) and seven digital health technologies (visual reality, website, humanoid robot, app, wearable devices, short messages and videoconference) were reported in the included studies.

Conclusions

Current evidence supports the effect of digital health technologies is generally mixed and inconclusive. There is a trend of positive effects found in the interventions that feature digital health technologies' interactive function. This review highlights the need for further investigation with rigorous research designs and the consideration of influencing factors from the symptoms, participants, and context levels to inform a better digital health implementation.

Perspectives of Child Life Specialists After Many Years of Working With a Humanoid Robot in a Pediatric Hospital: Narrative Design

Background

Child life specialists (CLSs) play an important role in supporting patients and their families during their visits to a children’s hospital. Although CLSs are equipped with considerable expertise to support families during some of the most difficult moments of their lives, we introduced an additional resource to them in the form of a humanoid robot named MEDi.

Objective

The aim of this study is to explore the experiences of CLSs using a robot to support children.

Methods

We interviewed 7 CLSs who had worked with this robot for several years. The transcribed interviews were analyzed using open and axial coding.

Results

The first main theme that emerged was the process of navigating from fear to friendship in learning to use a humanoid robot for therapeutic support. The second major theme was MEDi as a source of connection and support to children. CLSs’ perceptions of MEDi as an adaptable resource and working with the limits of MEDi constituted the last 2 themes.

Conclusions

These descriptions show how CLSs can incorporate a robot into their practice.

Trust in and Ethical Design of Carebots: The Case for Ethics of Care

The paper has two main objectives: to examine the challenges arising from the use of carebots as well as to discuss how the design of carebots can deal with these challenges. First, it notes that the use of carebots to take care of the physical and mental health of the elderly, children and the disabled as well as to serve as assistive tools and social companions encounter a few main challenges. They relate to the extent of the care robots’ ability to care for humans, potential deception by robot morphology and communications, (over)reliance on or attachment to robots, and the risks of carebot use without informed consent and potential infringements of privacy. Secondly, these challenges impinge upon issues of ethics and trust which are somewhat overlapping in terms of concept and practice. The existing ethical guidelines, standards and regulations are general in nature and lack a central ethical framework and concrete principles applicable to the care contexts. Hence, to deal with these important challenges, it is proposed in the third part of the paper that carebots be designed by taking account of Ethics of Care as the central ethical framework. It argues that the Ethics of Care offer the following advantages: (a) it provides sufficiently concrete principles and embodies values that are sensitive and applicable to the design of carebots and the contexts of caring practices; (b) it coheres with the tenets of Principlism and select ethical theories (utilitarianism, deontology and virtue ethics); and (c) it is closely associated with the preservation and maintenance of trust.

Social robots as treatment agents: Pilot randomized controlled trial to deliver a behavior change intervention

Social robots are increasingly demonstrating effectiveness as low-intensity behavior change agents. Key targets for these behavioral interventions include daily lifestyle behaviors with significant health consequences, such as the consumption of high-calorie foods and drinks ('snacks'). A pilot randomized controlled trial using a stepped-wedge design was conducted to determine the efficacy of a motivational intervention by an autonomous robot, to help reduce high-calorie snacks. Twenty-six adults were randomized to receive Immediate or 4-week Delayed treatment, with assessments at Baseline and Weeks 4 and 8. The treatment comprised motivation enhancement and self-management training using mental imagery (Functional Imagery Training). A significant condition by time effect for snack episode reduction was obtained, F(2, 32.06) = 4.30, p = .022. The Immediate condition significantly reduced snacking between Baseline and Week 4 (d = -1.06), while the Delayed condition did not (d = -0.08). Immediate participants maintained their improvement between Weeks 4 and 8 (d = -0.18), and Delayed participants then showed a significant fall (d = -1.42). Overall, 'Immediate' participants decreased their snack episodes by 54% and 'Delayed' decreased by 62% from Baseline to Week 8, and an average weight reduction of 4.4 kg was seen across over the first 2 weeks of treatment. Four weeks after starting the intervention, both conditions had significant increases in perceived confidence to control snack intake for time duration, specific scenarios and emotional states (d = 0.61 to 1.42). Working alliance was significantly correlated with reduced snack episodes. The pilot's results appear to suggest that the robot-delivered intervention may be as effective as a human clinician delivering a similar intervention. The robot-delivered pilot achieved similar snack episode reduction in the first four weeks (FIT-R, 55%) when compared with the human-delivered version by a trained clinician (FIT-H, 49%). Overall, the results provide preliminary evidence for an autonomous social robot to deliver a low-intensity treatment on dietary intake without the need for human intervention. Future trials should extend the deployment of the robot-delivered intervention protocol to other low-intensity behavioral outcomes.

Quick, Single-Frequency Dielectric Characterization of Blood Samples of Pediatric Cancer Patients by a Cylindrical Capacitor: Pilot Study

In this paper, as an application in biometrics, the electrical capacitance of normal and cancerous blood samples is experimentally determined in order to test the null hypothesis that the electrical capacitance of the two samples differs. The samples taken from healthy donors and patients diagnosed with different types of hematologic cancer are examined by a cylindrical capacitor with blood as its dielectric. The capacitance of these samples is measured at room temperature and a single frequency of 120 Hz, well below the frequency where β -dispersion starts, using a simple LCR meter device. The measurements indicate that the capacitance of the blood increases under applied electric field for a short period of time and asymptotically reaches its steady-state value. The measured values for the healthy group agreed with previous data in the literature. By the use of the unpaired two-tailed T-test, it is found that cancerous blood has higher values of capacitance when compared to normal samples ( p < 0.05 ). The reasons that might lead to such alterations are discussed from a biological perspective. Moreover, based on correlation calculations, a strong negative association is observed between blood capacitance and red blood cell (RBC) count in each group. Furthermore, sensitivity (SE) and specificity (SP) analysis demonstrates that for a threshold value between 15 and 17 for the capacitance value, both SE and SP are 100%. These preliminary findings on capacitance values may pave the way for the development of inexpensive and easy-to-use diagnosis tools for hematologic cancers at medical facilities and for in-home use, especially for children.

Social robots to support children's well-being under medical treatment: A systematic state-of-the-art review

Hospitalization is a stressful experience for children. Socially assistive robots (SARs), designed to interact with humans, might be a means to mitigate a child's stress and support its well-being. A systematic state-of-the-art review was performed to inventorize the use of SARs in hospital to support children's well-being and what the effects are. We searched five databases (Cinahl, Medline, Embase, PsycInfo, IEEE), combining terms for 'distress', 'relaxation' and 'well-being' with terms for social robot and child, and did an additional hand search. Ten publications (on eight studies) out of 563 unique titles were considered relevant. Six different robots were used (one humanoid, five pet-like) for distraction during medical procedure, emotional support for dealing with a disease or support of well-being during hospital stay. Positive effects on the children were noted, such as experiencing distraction and engagement, and less stress or pain, more relaxation, smiling and openness or better communication. On a psychiatric ward some youngsters felt unsafe with the robot. The outcomes suggest that SARs may have a potentially positive influence on a child's well-being. Further research is needed to determine the effect of using SARs and how to integrate the use in the working routines of health personnel.

Conversational Interfaces for Health: Bibliometric Analysis of Grants, Publications, and Patents

BACKGROUND

Conversational interfaces (CIs) in different modalities have been developed for health purposes, such as health behavioral intervention, patient self-management, and clinical decision support. Despite growing research evidence supporting CIs' potential, CI-related research is still in its infancy. There is a lack of systematic investigation that goes beyond publication review and presents the state of the art from perspectives of funding agencies, academia, and industry by incorporating CI-related public funding and patent activities.

OBJECTIVE

This study aimed to use data systematically extracted from multiple sources (ie, grant, publication, and patent databases) to investigate the development, research, and fund application of health-related CIs and associated stakeholders (ie, countries, organizations, and collaborators).

METHODS

A multifaceted search query was executed to retrieve records from 9 databases. Bibliometric analysis, social network analysis, and term co-occurrence analysis were conducted on the screened records.

RESULTS

This review included 42 funded projects, 428 research publications, and 162 patents. The total dollar amount of grants awarded was US $30,297,932, of which US $13,513,473 was awarded by US funding agencies and US $16,784,459 was funded by the Europe Commission. The top 3 funding agencies in the United States were the National Science Foundation, National Institutes of Health, and Agency for Healthcare Research and Quality. Boston Medical Center was awarded the largest combined grant size (US $2,246,437) for 4 projects. The authors of the publications were from 58 countries and 566 organizations; the top 3 most productive organizations were Northeastern University (United States), Universiti Teknologi MARA (Malaysia), and the French National Center for Scientific Research (CNRS; France). US researchers produced 114 publications. Although 82.0% (464/566) of the organizations engaged in interorganizational collaboration, 2 organizational research-collaboration clusters were observed with Northeastern University and CNRS as the central nodes. About 112 organizations from the United States and China filed 87.7% patents. IBM filed most patents (N=17). Only 5 patents were co-owned by different organizations, and there was no across-country collaboration on patenting activity. The terms patient, child, elderly, and robot were frequently discussed in the 3 record types. The terms related to mental and chronic issues were discussed mainly in grants and publications. The terms regarding multimodal interactions were widely mentioned as users' communication modes with CIs in the identified records.

CONCLUSIONS

Our findings provided an overview of the countries, organizations, and topic terms in funded projects, as well as the authorship, collaboration, content, and related information of research publications and patents. There is a lack of broad cross-sector partnerships among grant agencies, academia, and industry, particularly in the United States. Our results suggest a need to improve collaboration among public and private sectors and health care organizations in research and patent activities.

Psychosocial Health Interventions by Social Robots: Systematic Review of Randomized Controlled Trials

Background

Social robots that can communicate and interact with people offer exciting opportunities for improved health care access and outcomes. However, evidence from randomized controlled trials (RCTs) on health or well-being outcomes has not yet been clearly synthesized across all health domains where social robots have been tested.

Objective

This study aimed to undertake a systematic review examining current evidence from RCTs on the effects of psychosocial interventions by social robots on health or well-being.

Methods

Medline, PsycInfo, ScienceDirect, Scopus, and Engineering Village searches across all years in the English language were conducted and supplemented by forward and backward searches. The included papers reported RCTs that assessed changes in health or well-being from interactions with a social robot across at least 2 measurement occasions.

Results

Out of 408 extracted records, 27 trials met the inclusion criteria: 6 in child health or well-being, 9 in children with autism spectrum disorder, and 12 with older adults. No trials on adolescents, young adults, or other problem areas were identified, and no studies had interventions where robots spontaneously modified verbal responses based on speech by participants. Most trials were small (total N=5 to 415; median=34), only 6 (22%) reported any follow-up outcomes (2 to 12 weeks; median=3.5) and a single-blind assessment was reported in 8 (31%). More recent trials tended to have greater methodological quality. All papers reported some positive outcomes from robotic interventions, although most trials had some measures that showed no difference or favored alternate treatments.

Conclusions

Controlled research on social robots is at an early stage, as is the current range of their applications to health care. Research on social robot interventions in clinical and health settings needs to transition from exploratory investigations to include large-scale controlled trials with sophisticated methodology, to increase confidence in their efficacy.

Effectiveness of technology-based educational interventions on the empowerment related outcomes of children and young adults with cancer: A quantitative systematic review

AIM

To determine the effectiveness of technological-based educational interventions on the empowerment-related outcomes of children and young adults with cancer.

DESIGN

Quantitative systematic review.

DATA SOURCES

Six electronic databases, including PubMed, Cochrane Library, EMBASE, CINAHL, Scopus, and PsycINFO, were searched to identify eligible randomized controlled trials from each database's point of inception to December 2017. Grey literature was also searched from ProQuest and MedNar.

REVIEW METHODS

A narrative summary of the results was undertaken owing to the small number of eligible studies and high heterogeneity across the studies.

RESULTS

Five studies were included in the review. Five empowerment-related outcomes under the domain "patient states" were identified at differing time points of 3-month postintervention, immediate postintervention, and during treatment: (a) self-efficacy; (b) cancer knowledge; (c) health locus of control; (d) emotional well-being; and (e) quality of life. At 3-month postintervention, health locus of control was found to be significant in two studies and self-efficacy and cancer knowledge were found to be significant in one study. No difference in quality of life was found. At immediate postintervention, a beneficial indication was observed. During treatment, no statistical significance was found regarding the effectiveness of a technological-based cognitive behavioural package.

CONCLUSION

Weak evidences led to inconclusive findings on the effectiveness of technological-based educational interventions on the empowerment-related outcomes of children and young adults with cancer. Future research will benefit from well-designed clinical trials that use a common outcome measurement to provide more information regarding the effectiveness of such interventions.

Can social robots help children in healthcare contexts? A scoping review

OBJECTIVE

To review research on social robots to help children in healthcare contexts in order to describe the current state of the literature and explore future directions for research and practice.

DESIGN

Scoping review.

DATA SOURCES

Engineering Village, IEEE Xplore, Medline, PsycINFO and Scopus databases were searched up until 10 July 2017. Only publications written in English were considered. Identified publications were initially screened by title and abstract, and the full texts of remaining publications were then subsequently screened.

ELIGIBILITY CRITERIA

Publications were included if they were journal articles, conference proceedings or conference proceedings published as monographs that described the conceptualisation, development, testing or evaluation of social robots for use with children with any mental or physical health condition or disability. Publications on autism exclusively, robots for use with children without identified health conditions, physically assistive or mechanical robots, non-physical hardware robots and surgical robots were excluded.

RESULTS

Seventy-three publications were included in the review, of which 50 included user studies with a range of samples. Most were feasibility studies with small sample sizes, suggesting that the robots were generally accepted. At least 26 different robots were used, with many of these still in development. The most commonly used robot was NAO. The evidence quality was low, with only one randomised controlled trial and a limited number of experimental designs.

CONCLUSIONS

Social robots hold significant promise and potential to help children in healthcare contexts, but higher quality research is required with experimental designs and larger sample sizes.

Design Performance Characteristics of a Social Robot Companion “Arash” for Pediatric Hospitals

This paper presents the design process and construction of a mobile social robot companion “Arash” for educational and therapeutic intervention for children with chronic diseases; one which is based on their interests and needs. This study concentrates on children with cancer who suffer from physical pain caused by both the disease and its treatment. Moreover, cancer treatment causes emotional distress, which can reduce the efficiency of medications. Using social robots to interact with ill children in a hospital environment could decrease their distress, thereby improving the efficiency of the treatment. Arash is a 15 degrees-of-freedom cost effective humanoid mobile robot companion, designed and developed to interact with children ages 4 to 12 years old. The robot has five physical subsystems: head, arms, torso, waist, and the mobile-base. Based on the robot requirements and specifications, appropriate measures were generated and thoroughly evaluated. An important and novel concept is the robots appearance, selected based on a survey taken from 50 children with chronic diseases at three pediatric hospitals in the city of Tehran. Based on these criteria and needs, Arash was designed, constructed, modified, and developed to operate in pediatric hospital environments.

Arash: A social robot buddy to support children with cancer in a hospital environment

This article presents the thorough design procedure, specifications, and performance of a mobile social robot friend Arash for educational and therapeutic involvement of children with cancer based on their interests and needs. Our research focuses on employing Arash in a pediatric hospital environment to entertain, assist, and educate children with cancer who suffer from physical pain caused by both the disease and its treatment process. Since cancer treatment causes emotional distress, which can reduce the efficiency of medications, using social robots to interact with children with cancer in a hospital environment could decrease this distress, thereby improving the effectiveness of their treatment. Arash is a 15 degree-of-freedom low-cost humanoid mobile robot buddy, carefully designed with appropriate measures and developed to interact with children ages 5–12 years old. The robot has five physical subsystems: the head, arms, torso, waist, and mobile-platform. The robot’s final appearance is a significant novel concept; since it was selected based on a survey taken from 50 children with chronic diseases at three pediatric hospitals in Tehran, Iran. Founded on these measures and desires, Arash was designed, built, improved, and enhanced to operate successfully in pediatric cancer hospitals. Two experiments were devised to evaluate the children’s level of acceptance and involvement with the robot, assess their feelings about it, and measure how much the robot was similar to the favored conceptual sketch. Both experiments were conducted in the form of storytelling and appearance/performance evaluations. The obtained results confirm high engagement and interest of pediatric cancer patients with the constructed robot.