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An aging global population and preference for aging-in-place pose the opportunity for home-based robots to assist older adults with their daily routines. However, there is limited research into the experiences of older adults using robots in their own homes. In this descriptive qualitative feasibility study, older self-supporting and community-dwelling adults with various age-related health needs used Bomy, a dailycare robot in their homes for up to one week. The study explored the usefulness of the robot and participants' perceptions and experiences of using it. Bomy reminded them of daily activities and delivered cognitive stimulation games. Semi-structured in-person interviews were conducted, and data were analyzed thematically. Findings revealed an acceptance toward robots and the value of assistive dailycare robots. Participants perceived Bomy as a companion and made suggestions for improvement, including resolving technical issues associated with long-term use. Future functions should be personalizable, to accommodate each user's health needs and could also include smoke detection and reading aloud functions. Dailycare robots show promising potential in elderly care, especially in providing reminders for medication, health and wellbeing. This study highlights the importance of co-design and testing robotics in the environments for which they have been developed. Widespread implementation of Bomy might be feasible in the future, with some further adjustments.

Background and Aim: Loneliness is a common problem in older adults and contributes to poor health. This scoping review aimed to synthesize and report evidence on the effectiveness of interventions using social robots or computer agents to reduce loneliness in older adults and to explore intervention strategies., Methods: The review adhered to the Arksey and O'Malley process for conducting scoping reviews. The SCOPUS, PUBMED, Web of Science, EMBASE, CINAHL, PsycINFO, ACM Digital Library and IEEE Xplore databases were searched in November, 2020. A two-step selection process identified eligible research. Information was extracted from papers and entered into an Excel coding sheet and summarised. Quality assessments were conducted using the Mixed Methods Appraisal Tool., Results: Twenty-nine studies were included, of which most were of moderate to high quality. Eighteen were observational and 11 were experimental. Twenty-four used robots, four used computer agents and one study used both. The majority of results showed that robots or computer agents positively impacted at least one loneliness outcome measure. Some unintended negative consequences on social outcomes were reported, such as sadness when the robot was removed. Overall, the interventions helped to combat loneliness by acting as a direct companion (69%), a catalyst for social interaction (41%), facilitating remote communication with others (10%) and reminding users of upcoming social engagements (3%)., Conclusion: Evidence to date suggests that robots can help combat loneliness in older adults, but there is insufficient research on computer agents. Common strategies for reducing loneliness include direct companionship and enabling social interactions. Future research could investigate other strategies used in human interventions (eg, addressing maladaptive social cognition and improving social skills), and the effects of design features on efficacy. It is recommended that more robust experimental and mixed methods research be conducted, using a combination of validated self-report, observational, and interview measures of loneliness., Competing Interests: Elizabeth Broadbent authored/co-authored five studies included in the review. However, Elizabeth did not conduct the quality assessments, so potential conflicts of interest were mitigated. Soul Machines Ltd (a company that makes digital humans) employs Kate Loveys as an intern and contracts Elizabeth Broadbent as a consultant. The authors report no other conflicts of interest in this work., (© 2021 Gasteiger et al.)

Background: For robots to be effectively used in health applications, they need to display appropriate social behaviors. A fundamental requirement in all social interactions is the ability to engage, maintain, and demonstrate attention. Attentional behaviors include leaning forward, self-disclosure, and changes in voice pitch., Objective: This study aimed to examine the effect of robot attentional behaviors on user perceptions and behaviors in a simulated health care interaction., Methods: A parallel randomized controlled trial with a 1:1:1:1 allocation ratio was conducted. We randomized participants to 1 of 4 experimental conditions before engaging in a scripted face-to-face interaction with a fully automated medical receptionist robot. Experimental conditions included a self-disclosure condition, voice pitch change condition, forward lean condition, and neutral condition. Participants completed paper-based postinteraction measures relating to engagement, perceived robot attention, and perceived robot empathy. We video recorded interactions and coded for participant attentional behaviors., Results: A total of 181 participants were recruited from the University of Auckland. Participants who interacted with the robot in the forward lean and self-disclosure conditions found the robot to be significantly more stimulating than those who interacted with the robot in the voice pitch or neutral conditions (P=.03). Participants in the forward lean, self-disclosure, and neutral conditions found the robot to be significantly more interesting than those in the voice pitch condition (P<.001). Participants in the forward lean and self-disclosure conditions spent significantly more time looking at the robot than participants in the neutral condition (P<.001). Significantly, more participants in the self-disclosure condition laughed during the interaction (P=.01), whereas significantly more participants in the forward lean condition leant toward the robot during the interaction (P<.001)., Conclusions: The use of self-disclosure and forward lean by a health care robot can increase human engagement and attentional behaviors. Voice pitch changes did not increase attention or engagement. The small effects with regard to participant perceptions are potentially because of the limitations in self-report measures or a lack of comparison for most participants who had never interacted with a robot before. Further research could explore the use of self-disclosure and forward lean using a within-subjects design and in real health care settings., (©Deborah L Johanson, Ho Seok Ahn, Bruce A MacDonald, Byeong Kyu Ahn, JongYoon Lim, Euijun Hwang, Craig J Sutherland, Elizabeth Broadbent. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 04.10.2019.)

Objectives: This research is part of an international project to design and test a home-based healthcare robot to help older adults with mild cognitive impairment (MCI) or early dementia. The aim was to investigate the perceived usefulness of different daily-care activities for the robot, developed from previous research on needs., Design: Qualitative descriptive analysis using semistructured interviews. Two studies were conducted. In the first study, participants watched videos of a prototype robot performing daily-care activities; in the second study, participants interacted with the robot itself., Setting: Interviews were conducted at a university and a retirement village., Participants: In study 1, participants were nine experts in aged care and nine older adults living in an aged care facility. In study 2, participants were 10 experts in aged care., Results: The themes that emerged included aspects of the robot's interactions, potential benefits, the appearance, actions and humanness of the robot, ways to improve its functionality and technical issues. Overall, the activities were perceived as useful, especially the reminders and safety checks, with possible benefits of companionship, reassurance and reduced caregiver burden. Suggestions included personalising the robot to each individual, simplifying the language and adding more activities. Technical issues still need to be fixed., Conclusion: This study adds to knowledge about healthcare robots for people with MCI by developing and testing a new robot with daily-care activities including safety checks. The robot was seen to be potentially useful but needs to be tested with people with MCI., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Socially assistive robots are being developed for patients to help manage chronic health conditions such as chronic obstructive pulmonary disease (COPD). Adherence to medication and availability of rehabilitation are suboptimal in this patient group, which increases the risk of hospitalization., Objective: This pilot study aimed to investigate the effectiveness of a robot delivering telehealth care to increase adherence to medication and home rehabilitation, improve quality of life, and reduce hospital readmission compared with a standard care control group., Methods: At discharge from hospital for a COPD admission, 60 patients were randomized to receive a robot at home for 4 months or to a control group. Number of hospitalization days for respiratory admissions over the 4-month study period was the primary outcome. Medication adherence, frequency of rehabilitation exercise, and quality of life were also assessed. Implementation interviews as well as benefit-cost analysis were conducted., Results: Intention-to-treat and per protocol analyses showed no significant differences in the number of respiratory-related hospitalizations between groups. The intervention group was more adherent to their long-acting inhalers (mean number of prescribed puffs taken per day=48.5%) than the control group (mean 29.5%, P=.03, d=0.68) assessed via electronic recording. Self-reported adherence was also higher in the intervention group after controlling for covariates (P=.04). The intervention group increased their rehabilitation exercise frequency compared with the control group (mean difference -4.53, 95% CI -7.16 to -1.92). There were no significant differences in quality of life. Of the 25 patients who had the robot, 19 had favorable attitudes., Conclusions: This pilot study suggests that a homecare robot can improve adherence to medication and increase exercise. Further research is needed with a larger sample size to further investigate effects on hospitalizations after improvements are made to the robots. The robots could be especially useful for patients struggling with adherence., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12615000259549; http://www.anzctr.org.au (Archived by WebCite at  http://www.webcitation.org/6whIjptLS)., (©Elizabeth Broadbent, Jeff Garrett, Nicola Jepsen, Vickie Li Ogilvie, Ho Seok Ahn, Hayley Robinson, Kathryn Peri, Ngaire Kerse, Paul Rouse, Avinesh Pillai, Bruce MacDonald. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.02.2018.)

Objectives: This scoping study is the first step of a multiphase, international project aimed at designing a homecare robot that can provide functional support, track physical and psychological well-being, and deliver therapeutic intervention specifically for individuals with mild cognitive impairment., Design: Observational requirements gathering study., Participants and Settings: Semistructured interviews were conducted with 3 participant groups: (1) individuals with memory challenges, mild cognitive impairment (MCI), or mild dementia (patients; n = 9); (2) carers of those with MCI or dementia (carers; n = 8); and (3) those with expertise in MCI or dementia research, clinical care, or management (experts; n = 16). Interviews took place at the university, at dementia care facilities or other workplaces, at participant's homes, or via skype (experts only)., Measurements: Semistructured interviews were conducted, transcribed, and reviewed., Results: Several key themes were identified within the 4 topics of: (1) daily challenges, (2) safety and security, (3) monitoring health and well-being, and (4) therapeutic intervention., Conclusions: A homecare robot could provide both practical and therapeutic benefit for the mildly cognitively impaired with 2 broad programs providing routine and reassurance; and tracking health and well-being. The next phase of the project aims to program homecare robots with scenarios developed from these results, integrate components from project partners, and then test the feasibility, utility, and acceptability of the homecare robot., (Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Objectives: To investigate the affective, social, behavioral, and physiological effects of the companion robot Paro for people with dementia in both a day care center and a home setting., Design: A pilot block randomized controlled trial over 12 weeks. Participants were randomized to the intervention (Paro) or control condition (standard care)., Setting: Two dementia day care centers and participants' homes in Auckland, New Zealand., Participants: Thirty dyads (consisting of a care recipient with dementia and their caregiver) took part in this study. All care recipients attended dementia day care centers at Selwyn Foundation and had a formal diagnosis of dementia., Intervention: Thirty-minute unstructured group sessions with Paro at the day care center were run 2 to 3 times a week for 6 weeks. Participants also had Paro at home for 6 weeks., Measurements: At the day care centers, observations of the care recipients' behavior, affect, and social responses were recorded using a time sampling method. Observations of interactions with Paro for participants in the intervention were also recorded. Blood pressure and salivary cortisol were collected from care recipients before and after sessions at day care. In the home setting, level of cognition, depressive symptoms, neuropsychiatric symptoms, behavioral agitation, and blood pressure were measured at baseline, 6 weeks, and 12 weeks. Hair cortisol measures were collected at baseline and at 6 weeks., Results: Observations showed that Paro significantly improved facial expressions (affect) and communication with staff (social interaction) at the day care centers. Subanalyses showed that care recipients with less cognitive impairment responded significantly better to Paro. There were no significant differences in care recipient dementia symptoms, nor physiological measures between the intervention and control group., Conclusion: Paro shows promise in enhancing affective and social outcomes for certain individuals with dementia in a community context. Larger randomized controlled trials in community settings, with longer time frames, are needed to further specify the contexts and characteristics for which Paro is most beneficial., (Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

In movies, robots are often extremely humanlike. Although these robots are not yet reality, robots are currently being used in healthcare, education, and business. Robots provide benefits such as relieving loneliness and enabling communication. Engineers are trying to build robots that look and behave like humans and thus need comprehensive knowledge not only of technology but also of human cognition, emotion, and behavior. This need is driving engineers to study human behavior toward other humans and toward robots, leading to greater understanding of how humans think, feel, and behave in these contexts, including our tendencies for mindless social behaviors, anthropomorphism, uncanny feelings toward robots, and the formation of emotional attachments. However, in considering the increased use of robots, many people have concerns about deception, privacy, job loss, safety, and the loss of human relationships. Human-robot interaction is a fascinating field and one in which psychologists have much to contribute, both to the development of robots and to the study of human behavior.

Aim: We recently reported that a companion robot reduced residents' loneliness in a randomised controlled trial at an aged-care facility. This report aims to provide additional, previously unpublished data about how the sessions were run, residents' interactions with the robot and staff perspectives., Methods: Observations were conducted focusing on engagement, how residents treated the robot and if the robot acted as a social catalyst. In addition, 16 residents and 21 staff were asked open-ended questions at the end of the study about the sessions and the robot., Results: Observations indicated that some residents engaged on an emotional level with Paro, and Paro was treated as both an agent and an artificial object. Interviews revealed that residents enjoyed sharing, interacting with and talking about Paro., Conclusion: This study supports other research showing Paro has psychosocial benefits and provides a guide for those wishing to use Paro in a group setting in aged care., (© 2015 AJA Inc.)

Aim: This study investigated whether multiple health-care robots could have any benefits or cause any problems in an aged care facility., Method: Fifty-three residents and 53 staff participated in a non-randomised controlled trial over 12 weeks. Six robots provided entertainment, communication and health-monitoring functions in staff rooms and activity lounges. These settings were compared to control settings without robots., Results: There were no significant differences between groups in resident or staff outcomes, except a significant increase in job satisfaction in the control group only. The intervention group perceived the robots had more agency and experience than the control group did. Perceived agency of the robots decreased over time in both groups. Overall, we received very mixed responses with positive, neutral and negative comments., Conclusions: The robots had no major benefits or problems. Future research could give robots stronger operational roles, use more specific outcome measures, and perform cost-benefit analyses., (© 2015 AJA Inc.)

Aims: To investigate whether robots could reduce resident sleeping and stimulate activity in the lounges of an older persons' care facility., Methods: Non-randomised controlled trial over a 12-week period. The intervention involved situating robots in low-level and high-dependency ward lounges and a comparison with similar lounges without robots. A time sampling observation method was utilised to observe resident behaviour, including sleep and activities over periods of time, to compare interactions in robot and no robot lounges., Results: The use of robots was modest; overall 13% of residents in robot lounges used the robot. Utilisation was higher in the low-level care lounges; on average, 23% used the robot, whereas in high-level care lounges, the television being on was the strongest predictor of sleep., Conclusion: This study found that having robots in lounges was mostly a positive experience. The amount of time residents slept during the day was significantly less in low-level care lounges that had a robot., (© 2015 AJA Inc.)

Aim: To investigate the effects of interacting with the companion robot, Paro, on blood pressure and heart rate of older people in a residential care facility., Methods: This study used a repeated measures design. Twenty-one residents in rest home and hospital level care had their blood pressure taken three times; before, during and after interacting with the seal robot., Results: Four residents who did not interact with the robot were excluded from the final analysis (final n = 17). The final analysis found that systolic and diastolic blood pressure changed significantly over time as did heart rate. Planned comparisons revealed that systolic and diastolic blood pressure decreased significantly from baseline to when residents had Paro (systolic, P = 0.048; diastolic, P = 0.05). Diastolic blood pressure increased significantly after Paro was withdrawn (P = 0.03)., Conclusion: Interacting with Paro has a physiological effect on cardiovascular measures, which is similar to findings with live animals., (© 2013 ACOTA.)

Objectives: To investigate the psychosocial effects of the companion robot, Paro, in a rest home/hospital setting in comparison to a control group., Design: Randomized controlled trial. Residents were randomized to the robot intervention group or a control group that attended normal activities instead of Paro sessions. Sessions took place twice a week for an hour over 12 weeks. Over the trial period, observations were conducted of residents' social behavior when interacting as a group with the robot. As a comparison, observations were also conducted of all the residents during general activities when the resident dog was or was not present., Setting: A residential care facility in Auckland, New Zealand., Participants: Forty residents in hospital and rest home care., Measurements: Residents completed a baseline measure assessing cognitive status, loneliness, depression, and quality of life. At follow-up, residents completed a questionnaire assessing loneliness, depression, and quality of life. During observations, behavior was noted and collated for instances of talking and stroking the dog/robot., Results: In comparison with the control group, residents who interacted with the robot had significant decreases in loneliness over the period of the trial. Both the resident dog and the seal robot made an impact on the social environment in comparison to when neither was present. Residents talked to and touched the robot significantly more than the resident dog. A greater number of residents were involved in discussion about the robot in comparison with the resident dog and conversation about the robot occurred more., Conclusion: Paro is a positive addition to this environment and has benefits for older people in nursing home care. Paro may be able to address some of the unmet needs of older people that a resident animal may not, particularly relating to loneliness., (Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.)

It is important for robot designers to know how to make robots that interact effectively with humans. One key dimension is robot appearance and in particular how humanlike the robot should be. Uncanny Valley theory suggests that robots look uncanny when their appearance approaches, but is not absolutely, human. An underlying mechanism may be that appearance affects users' perceptions of the robot's personality and mind. This study aimed to investigate how robot facial appearance affected perceptions of the robot's mind, personality and eeriness. A repeated measures experiment was conducted. 30 participants (14 females and 16 males, mean age 22.5 years) interacted with a Peoplebot healthcare robot under three conditions in a randomized order: the robot had either a humanlike face, silver face, or no-face on its display screen. Each time, the robot assisted the participant to take his/her blood pressure. Participants rated the robot's mind, personality, and eeriness in each condition. The robot with the humanlike face display was most preferred, rated as having most mind, being most humanlike, alive, sociable and amiable. The robot with the silver face display was least preferred, rated most eerie, moderate in mind, humanlikeness and amiability. The robot with the no-face display was rated least sociable and amiable. There was no difference in blood pressure readings between the robots with different face displays. Higher ratings of eeriness were related to impressions of the robot with the humanlike face display being less amiable, less sociable and less trustworthy. These results suggest that the more humanlike a healthcare robot's face display is, the more people attribute mind and positive personality characteristics to it. Eeriness was related to negative impressions of the robot's personality. Designers should be aware that the face on a robot's display screen can affect both the perceived mind and personality of the robot.

Objectives: To investigate the suitability of a new eldercare robot (Guide) for people with dementia and their caregivers compared with one that has been successfully used before (Paro), and to generate suggestions for improved robot enhanced dementia care., Design: Cross-sectional study. A researcher demonstrated both robots in a random order to each staff member alone, or to each resident together with his/her relative(s). The researcher encouraged the participants to interact with each robot and asked staff and relatives a series of open ended questions about each robot., Setting: A secure dementia residential facility in Auckland, New Zealand., Participants: Ten people with dementia and 11 of their relatives, and five staff members., Measurements: Each robot interaction was video-taped and coded for the number of times the resident looked at, smiled, touched, and talked to and about each robot, as well as relative interactions with the resident. Qualitative analysis was used to code the open ended questions., Results: Residents smiled, touched and talked to Paro significantly more than Guide. Paro was found to be more acceptable to family members, staff, and residents, although many acknowledged that Guide had the potential to be useful if adapted for this population in terms of ergonomics and simplification., Conclusion: Healthcare robots in dementia settings have to be simple and easy to use as well as stimulating and entertaining. This research highlights how eldercare robots may be adapted to have the best effects in dementia settings. It is concluded that Paro's sounds could be modified to be more acceptable to this population. The ergonomic design of Guide could be reviewed and the software application could be simplified and targeted to people with dementia., (Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.)

Aim: This study investigated the attitudes and preferences of staff, residents and relatives of residents in a retirement village towards a health-care robot., Methods: Focus groups were conducted with residents, managers and caregivers, and questionnaires were collected from 32 residents, 30 staff and 27 relatives of residents., Results: The most popular robot tasks were detection of falls and calling for help, lifting, and monitoring location. Robot functionality was more important than appearance. Concerns included the loss of jobs and personal care, while perceived benefits included allowing staff to spend quality time with residents, and helping residents with self-care. Residents showed a more positive attitude towards robots than both staff and relatives., Conclusions: These results provide an initial guide for the tasks and appearance appropriate for a robot to provide assistance in aged care facilities and highlight concerns., (© 2011 The Authors. Australasian Journal on Ageing © 2011 ACOTA.)

Objective: The use of robots in healthcare is a new concept. The public's perception and acceptance is not well understood. The objective was to investigate the perceptions and emotions toward the utilization of healthcare robots among individuals over 40 years of age, investigate factors contributing to acceptance, and evaluate differences in blood pressure checks taken by a robot and a medical student., Materials and Methods: Fifty-seven (n = 57) adults aged over 40 years and recruited from local general practitioner or gerontology group lists participated in two cross-sectional studies. The first was an open-ended questionnaire assessing perceptions of robots. In the second study, participants had their blood pressure taken by a medical student and by a robot. Patient comfort with each encounter, perceived accuracy of each measurement, and the quality of the patient interaction were studied in each case. Readings were compared by independent t-tests and regression analyses were conducted to predict quality ratings., Results: Participants' perceptions about robots were influenced by their prior exposure to robots in literature or entertainment media. Participants saw many benefits and applications for healthcare robots, including simple medical procedures and physical assistance, but had some concerns about reliability, safety, and the loss of personal care. Blood pressure readings did not differ between the medical student and robot, but participants felt more comfortable with the medical student and saw the robot as less accurate. Although age and sex were not significant predictors, individuals who held more positive initial attitudes and emotions toward robots rated the robot interaction more favorably., Conclusions: Many people see robots as having benefits and applications in healthcare but some have concerns. Individual attitudes and emotions regarding robots in general are likely to influence future acceptance of their introduction into healthcare processes.