Formal caregivers' perceptions and experiences of using pet robots for persons living with dementia in long-term care: A meta-ethnography

Exploring the perceptions and experiences of caregivers with the application of socially assistive robots in dementia care: A systematic review of qualitative studies

BACKGROUND

The use of socially assistive robots in dementia care is growing, aimed at improving patient well-being and alleviating caregiver burden. Refining the utilisation of robotic assistance in individuals with dementia is critical, drawing on feedback and insights from caregivers. While numerous qualitative studies have examined how caregivers view and interact with socially assistive robots, a comprehensive synthesis of these insights is missing. This study seeks to integrate existing research on caregiver perceptions and experiences regarding socially assistive robots, offering guidance for applying and developing such technology in dementia care.

METHODS

A computerised search of the Cochrane Library, PubMed, Embase, CINAHL, Web of Science Core Collection, CNKI, Wanfang, Vip and SinoMed was conducted to identify relevant qualitative studies. The search covered the period from establishing each database until July 2024. The Joanna Briggs Institute criteria for qualitative research were utilised to evaluate the quality of the studies, and a thematic synthesis approach was employed to integrate the findings.

RESULTS

A total of 15 studies were included, yielding four new integrated findings: (1) mixed attitudes of caregivers towards socially assistive robots, (2) perceived benefits of using socially assistive robots in people with dementia from caregivers, (3) realistic barriers in applying socially assistive robots for dementia care, and (4) future expectations for socially assistive robots from caregivers. Most caregivers actively embrace socially assistive robots, while a minority express concerns and doubts. These devices have significantly improved the psychological and physical conditions of people with dementia, concurrently reducing the burden for caregivers. However, the current models of these robots still exhibit several shortcomings and technical limitations, and caregivers maintain high expectations for their improvement.

CONCLUSION

During the implementation of socially assistive robots, the requirements and intentions of people with dementia and their caregivers must be addressed. This involves conducting essential knowledge dissemination and relevant educational activities to enhance user acceptance of these robotic assistants. Simultaneously, efforts should be made to improve the functionality and design aesthetics of these robots, refine the social support system and further enhance the quality of care for people with dementia while alleviating caregiver burden.

REGISTRATION

PROSPERO CRD42024511500.

TWEETABLE ABSTRACT

Socially assistive robots improve the well-being of people with dementia.

A Scoping Review on Long-Term Care Workers' Perceptions of Robot-Assisted Care for Older Adults in Long-Term Care Facilities

AIMS

To synthesise the current research on long-term care workers' perceptions (i.e., attitudes, concerns, and expected functions) of robot-assisted care and their perceived effects of different types of robot-assisted care for older adults in long-term care facilities.

DESIGN

Scoping review.

DATA SOURCES

A search was conducted in July 2024 using five databases. Articles published between 2010 and 2024 on the perceptions and/or perceived effects of robot-assisted care for older adults among frontline long-term care workers in long-term care facilities were identified. Additionally, the reference lists of the included articles were manually searched.

METHODS

A five-step framework that guided the development of research questions, screening of studies, and synthesis and presentation of data was adopted. Two authors independently screened and analysed the identified articles. Conflicts were resolved through joint-discussions.

RESULTS

Forty-one articles were included in the review. Data were narratively synthesised into three categories: expected function of care robots, perceived effects of robot-assisted care, and attitudes and concerns regarding robot-assisted care. Subcategories were identified and presented in tabular form.

CONCLUSION

This review shows the physical, psychological, social, and practical benefits and limitations of different types of robot-assisted care. It also contributes to understanding long-term care workers' attitudes, concerns, and expectations regarding the function of robot-assisted care.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Having a priori discussion with long-term care workers about their expectations regarding using robot-assisted care is needed. Improvements in the design and in the digital literacy of the workers are also necessary.

IMPACT

This review provides an overview of the perceptions and perceived effects of different types of robot-assisted care among care workers in long-term care facilities. The findings provide practical implications and highlight areas in need of further studies.

REPORTING METHOD

Scoping Review (PRISMA-ScR) checklist.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Utilisation of robots in nursing practice: an umbrella review

BACKGROUND

The provision of nursing care across the globe is confronted with a range of challenges, including the surge in the older persons population which amplifies the reliance on nursing services and exacerbates the shortage of nurses worldwide. A possible solution could be the broader implementation of robotics in nursing practice. Therefore, this umbrella review aimed to assess and synthesise systematically reviewed evidence on the utilisation of robots in nursing practice.

METHODS

An extensive search of nine relevant databases was conducted for research syntheses. We included reviews that reported the experiences of nurses, perceived benefits and challenges of using robots in nursing practice in all care settings and published between the years 2012 and 2022. A supplementary search was conducted in October 2024 using the same criteria. Quality appraisal, data extraction and syntheses were carried out according to Joanna Brigg's Institute's guidelines for undertaking umbrella reviews. The protocol of this umbrella review was registered on PROSPERO prior to the commencement of the review (Registration ID CRD42022361835).

RESULTS

Thirteen reviews (representing 558 studies) were included following the quality appraisal. The evidence was summarised in narrative form with supporting quotes from the reviews. The findings were grouped into categories, which were further categorised into three main synthesised findings: 'Documented experiences of nurses in using robots', 'perceived benefits of using robots' and 'perceived challenges of using robots'. To the best of our knowledge, this is the first umbrella review that synthesised evidence on the experiences and perceptions of nurses regarding the use of robots. This umbrella review has limitations as it is not the primary source of evidence, relying on the quality of the included reviews and studies.

CONCLUSIONS

Evidence shows that there is a perception that robots can support nurses in their work. However, there is not enough experiential evidence from nurses who work with robots in practice to support this. There are also perceived challenges that are of concern to nurses, particularly in relation to liability, ethical dilemmas and patient safety. The authors have no competing interests to declare in the conduct of this review.

Digital technologies in nursing: An umbrella review

BACKGROUND

Digital technologies promise to reduce nurses' workload and increase quality of care. However, considering the plethora of single and review studies published to date, maintaining a comprehensive overview of digital technologies' impact on nursing and effectively utilizing available evidence is challenging.

OBJECTIVE

This review aims (i) to map published reviews on digital nursing technologies, based on their aims and the specific technologies investigated, to synthesize evidence on how these technologies' uses is associated with (ii) nurses' work-related and organizational factors, professional behavior, and health and work safety and (iii) ethically relevant outcomes for people in need of care.

DESIGN

Preregistered overview of reviews (PROSPERO-ID: CRD42023389751).

SETTING(S)

We searched for systematic reviews in eight databases, five key journals, and reference lists of included reviews published in English until May 21, 2024.

METHODS

We used the AMSTAR 2 checklist to assess the methodological quality of included reviews reporting associations with nursing outcomes. The extracted data were analyzed by their frequency and narratively synthesized.

RESULTS

We identified 213 reviews on digital technologies' uses in the nursing sector. Most of these focused on information and communication technologies. The most frequently reported research objectives encompass technology usage and/or general experiences with it and technology-related consequences for care recipients. Regarding work-related and organizational factors, beneficial impacts were found for the execution of nursing tasks, information management and job control. Depending on the technology type, reviews reported mixed effects for documentation activities, communication/collaboration and mainly negative effects on nurses' workload. Concerning occupational safety and health-related and further nurse outcomes, reviews reported mostly positive effects on nurses' job satisfaction and professional competence. Adverse effects related to mental and physical strain, such as increased frustration, fatigue, and burnout. Regarding ethically relevant outcomes, robotic and telecare technologies had the most reported findings. Most evidence concerned effects on the principles of beneficence/non-maleficence and respect for autonomy.

CONCLUSIONS

Digital nursing technologies' legitimacy hinges on their impact on patient outcomes and nurses' work, safety, and health. This review identifies a diverse array of these technologies, with both positive and negative effects. However, due to narrative limitations, meta-analysis was impractical. Future research should quantitatively assess the effects of various digital nursing technologies on work, safety, health, and ethical outcomes.

TWEETABLE ABSTRACT

Research on digital tech in nursing lacks focus on key work factors, occupational health and ethical outcomes. #NursingTech #ResearchGaps.

Barriers and facilitators to participation in electronic health interventions in older adults with cognitive impairment: an umbrella review

BACKGROUND

Research increasingly supports the role of electronic health technology in improving cognitive function. However, individuals with mild cognitive impairment or dementia often show low compliance with electronic health technology. To understand the barriers and facilitators for this group, this study was conducted.

METHODS

This study used the Joanna Briggs Institute (JBI) umbrella review method, searching relevant English articles in PubMed, Embase, Cochrane, Scopus, MEDLINE, Web of Science, and CINAHL from inception to May 2023. Two researchers independently selected articles based on predefined criteria, assessed study quality using Meta-QAT and A Measurement Tool to Assess Systematic Reviews (AMSTAR), and determined confidence in the evidence using GRADE-CERQual. The Unified Theory of Acceptance and Use of Technology (UTAUT) model was employed to analyze factors related to electronic health technology, and Behavior Change Techniques (BCTs) were used to develop implementation strategies.

RESULTS

This study included 21 reviews, covering 535 primary studies, identifying 13 factors. The three most impactful factors on engagement were Perceived Behavioral Control, Relative Advantage, and Social Factors. Six implementation strategies were formulated based on BCT: enhancing targeted approaches, adapting to existing contexts, involving care organizations, accommodating family involvement, accessing virtual community resources, and recognizing patient variability.

CONCLUSIONS

This umbrella review underscores the need for a multi-level stakeholder approach and a holistic perspective in developing targeted implementation strategies. Using the UTAUT framework, key influential factors have been identified, offering valuable insights for future interventions and enhancing participation in electronic health interventions.

REGISTRATION

This study was registered with the PROSPERO (CRD42023429410).

The Effect of Social Robots on Depression and Loneliness for Older Residents in Long-Term Care Facilities: A Meta-Analysis of Randomized Controlled Trials

OBJECTIVES

Depression and loneliness are challenges facing older residents living in long-term care facilities. Social robots might be a solution as nonpharmacologic interventions. The purpose of this study was to explore the effects of concrete forms of social robots on depression and loneliness in older residents in long-term care facilities by a systematic review and meta-analysis of randomized controlled trials.

DESIGN

This is a systematic review and meta-analysis.

SETTING AND PARTICIPANTS

Older residents in long-term care facilities.

METHODS

Six electronic databases of PubMed, Embase, Scopus, Web of Science, MEDLINE, and CINAHL plus were searched in August 2023. Random effect models of meta-analyses, subgroup analyses, and meta-regressions were performed for statistical analyses.

RESULTS

After evaluation, 8 studies were selected for both qualitative and quantitative synthesis. Social robot interventions had significant positive effects on decreasing depression and loneliness with large effect sizes. Group-based robot activities had a better effect on improving depression than individual-based robot activities. Longer durations of interventions produced significantly more improvement in depression.

CONCLUSION AND IMPLICATION

Social robots with physical manifestation provide the opportunity for older adults' social engagement and interactions with robots and others. Social robot interventions are recommended for older residents in long-term care facilities to promote psychosocial well-being in daily care routines.

Strategies for implementing pet robots in care homes and nursing homes for residents with dementia: protocol for a modified Delphi study

Background

Pet robots are a type of technology-based innovation that have shown positive psychosocial benefits for people with dementia in residential facilities, such as improving mood and social interaction and reducing agitation. Nevertheless, little is known about how pet robots can be implemented in care homes and nursing homes for dementia care in real-world practice. The objectives of this study are to (1) identify contextualised implementation strategies for implementing pet robots into care homes and nursing homes for dementia care and (2) achieve consensus on the most relevant strategies.

Method

This study is informed by a preceding scoping review and qualitative study, which used the Consolidated Framework of Implementation Research (CFIR) to identify multi-level determinants of implementation (i.e. barriers and facilitators). We will use the CFIR-ERIC matching tool to identify relevant implementation strategies from the Expert Recommendations for Implementing Change (ERIC) taxonomy to address these determinants. Data from the scoping review and qualitative study will be used to contextualise the generic ERIC strategies for our setting. After that, a group of key stakeholders will be consulted to further contextualise and refine these strategies. Next, a two-round modified Delphi process will be conducted. Fifty-four international expert participants including healthcare professionals and organisational leaders from care homes and nursing homes and academic researchers will be recruited through purposive sampling. During the first Delphi round, participants will be invited to rate the relevance of each implementation strategy on a 9-point Likert scale and provide comments or suggestions. Descriptive statistics will be used to identify whether consensus has been obtained. Inductive qualitative content analysis will be used to analyse and summarise textual responses for any new statements suggested by participants. Statements that do not reach consensus and new statements suggested in round 1 will be taken to the next round, which will follow the same rating process.

Discussion

This study will identify strategies for implementing pet robots in care homes and nursing homes for residents with dementia, which will have practical utility for clinicians, organisations and researchers. It will also demonstrate the practical application (and adaptation) of the CFIR-ERIC tool to identify and contextualise ERIC strategies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43058-022-00308-z.