Caring robots are here to help

Introducing Transcultural Robotic Nursin

Embedding ethics in the design of culturally competent socially assistive robots

Research focusing on the development of socially assistive robots (SARs) that will promote the health, well-being and quality of life of older persons and of their caregivers has been growing in recent years. This growth has prompted a great deal of ethical reflection on the future of SARs in care, but there is an increasing awareness of the divide that often separates the settings in which ethics research and debate take place from those where technological innovation is practiced. Different frameworks have been proposed to handle the ethical dimension of technology from within the design and development process, including Value Sensitive Design (VSD). VSD has been defined as a theoretically grounded approach to the design of technology that accounts for human values in a principled and comprehensive manner throughout the design process. Inspired in part by VSD, we have developed a process geared towards embedding ethics at the core of CARESSES, an international multidisciplinary project that aims to design the first culturally competent SAR for the care of older adults. Here we describe that process, including how we utilized qualitative thematic analysis to extract key ethical concepts from relevant ethical guidelines (Alzheimer Europe's Guidelines and Position on the Ethical Use of Assistive Technologies for/by People with Dementia), and how we applied those concepts to the scenarios that describe how the CARESSES robot will interact with individuals belonging to different cultures and provide the grounding for its cultural competence. This straightforward approach highlights the ethical implications of the robot’s behavior during the design process and thus it enables researchers to identify and engage with ethical problems proactively, rather than restrict ethics to retrospective assessments. With suitable modifications, it may be usefully applied in other research projects involving SARs

Encoding guidelines for a culturally competent robot for elderly care

The functionalities and behaviours of socially assistive robots for the care of older people are usually defined by the robot’s designers with limited room for runtime adaptation to meet the preferences, expectations and needs of the assisted person. However, adaptation plays a crucial role for the robot’s acceptability and ultimately for its effectiveness. Culture, which deeply influences a person’s preferences and habits, can be viewed as an invaluable “enabling technology” to achieve such level of adaptation. This paper discusses how guidelines describing culturally competent assistive behaviours can be encoded in a robot to effectively tune its actions, gestures and words. The proposed system is implemented on a Pepper robot and tested with an Indian persona, whose habits and preferences the robot discovers and adapts to at runtime

Towards a national strategy for the provision of spiritual care during major health disasters: a qualitative study

Background Spirituality is beneficial to health. Evidence around the benefits of Spiritual care (SC) is advancing, and training is becoming part of healthcare professional development. As the COVID-19 crisis showed, during major health disasters (MHDs), the demand for SC grows exponentially, while the burden of care and focus on preserving life often hamper its provision. Nonetheless, existing health emergency strategic frameworks lack preparedness for the provision of SC. Aim The aim of this study was to identify the components for a National Strategy (NS) for the provision of SC during MHDs. Methods Descriptive, cross-sectional, qualitative phenomenological design based on individual, semi-structured e-interviews with nursing managers and National Health Service/volunteer chaplains based in England. Thematic analysis of 25 e-interview data was performed based on a dialogic collaborative process. Results and Discussion Eleven themes were identified as components of the proposed NS. From these components, specific recommendations for practical actions are provided. An integrated framework approach and smart investments in resources, staff training and technologies should be led by the paradigm of culturally competent and compassionate care. Conclusion The need to have strategic frameworks, both national and local, that better equip a country healthcare sector to prevent, face, and recover from MHDs is paramount. Catering for the spiritual needs of the affected population should be a key aspect of any health emergency strategy to ensure the preservation of quality care

Using smartwatches to observe changes in activity during recovery from critical illness following COVID-19:a 1 year multi-centre observational study

BACKGROUND: As a sequela of the COVID-19 pandemic, a large cohort of critical illness survivors have had to recover in the context of ongoing societal restrictions. OBJECTIVE: We aimed to use smartwatches (Fitbit Charge 3; Fitbit LLC) to assess changes in the step counts and heart rates of critical care survivors following hospital admission with COVID-19, use these devices within a remote multidisciplinary team (MDT) setting to support patient recovery, and report on our experiences with this. METHODS: We conducted a prospective, multicenter observational trial in 8 UK critical care units. A total of 50 participants with moderate or severe lung injury resulting from confirmed COVID-19 were recruited at discharge from critical care and given a smartwatch (Fitbit Charge 3) between April and June 2020. The data collected included step counts and daily resting heart rates. A subgroup of the overall cohort at one site—the MDT site (n=19)—had their smartwatch data used to inform a regular MDT meeting. A patient feedback questionnaire and direct feedback from the MDT were used to report our experience. Participants who did not upload smartwatch data were excluded from analysis. RESULTS: Of the 50 participants recruited, 35 (70%) used and uploaded data from their smartwatch during the 1-year period. At the MDT site, 74% (14/19) of smartwatch users uploaded smartwatch data, whereas 68% (21/31) of smartwatch users at the control sites uploaded smartwatch data. For the overall cohort, we recorded an increase in mean step count from 4359 (SD 3488) steps per day in the first month following discharge to 7914 (SD 4146) steps per day at 1 year (P=.003). The mean resting heart rate decreased from 79 (SD 7) beats per minute in the first month to 69 (SD 4) beats per minute at 1 year following discharge (P<.001). The MDT subgroup’s mean step count increased more than that of the control group (176% increase vs 42% increase, respectively; +5474 steps vs +2181 steps, respectively; P=.04) over 1 year. Further, 71% (10/14) of smartwatch users at the MDT site and 48% (10/21) of those at the control sites strongly agreed that their Fitbit motivated them to recover, and 86% (12/14) and 48% (10/21), respectively, strongly agreed that they aimed to increase their activity levels over time. CONCLUSIONS: This is the first study to use smartwatch data to report on the 1-year recovery of patients who survived a COVID-19 critical illness. This is also the first study to report on smartwatch use within a post–critical care MDT. Future work could explore the role of smartwatches as part of a randomized controlled trial to assess clinical and economic effectiveness. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.12968/ijtr.2020.010