Use of a Social Robot (LOVOT) for Persons With Dementia:Exploratory Study

BACKGROUND: Approximately 50 million people worldwide are living with dementia. Social robots have been developed and tested to determine whether they improve the quality of life for persons with dementia. A new mobile social robot called LOVOT has artificial intelligence and sensor technologies built in. LOVOT, which is manufactured in Japan, has not yet been tested for use by persons with dementia. OBJECTIVE: This study aimed to explore how the social robot LOVOT interacts with persons with dementia and how health care professionals experience working with LOVOT in their interaction with persons with dementia. METHODS: The study was carried out at 3 nursing homes in Denmark, all with specialized units for persons with dementia. The interaction between the persons with dementia and LOVOT was tested in both individual sessions for 4 weeks and group sessions for 12 weeks. A total of 42 persons were included in the study, of which 12 were allocated to the individual sessions. A triangulation of data collection techniques was used: the World Health Organization-5 questionnaire, face scale, participant observation, and semistructured focus group interviews with health care professionals (n=3). RESULTS: There were no clinically significant changes in the well-being of the persons with dementia followed in the individual or group interaction sessions over time. The results from the face scale showed that in both the individual and group sessions, persons with dementia tended to express more positive facial expressions after the sessions. Findings on how persons with dementia experienced their interaction with LOVOT can be stated in terms of the following themes: LOVOT opens up communication and interaction; provides entertainment; creates a breathing space; is accepted and creates joy; induces feelings of care; can create an overstimulation of feelings; is not accepted; is perceived as an animal; is perceived as being nondemanding; and prevents touch deprivation. Findings regarding the health care professionals’ experiences using LOVOT were as follows: the artificial behavior seems natural; and it is a communication tool that can stimulate, create feelings of security, and open up communication. Our findings indicate that the social robot is a tool that can be used in interactions with persons with dementia. CONCLUSIONS: The LOVOT robot is the next generation of social robots with advanced artificial intelligence. The vast majority of persons with dementia accepted the social robot LOVOT. LOVOT had positive effects, opened up communication, and facilitated interpersonal interaction. Although LOVOT did not create noticeable effects on social well-being, it gave individual persons a respite from everyday life. Some residents were overstimulated by emotions after interacting with LOVOT. Health care professionals accepted the social robot and view LOVOT as a new tool in the work with persons with dementia

Patient-Reported Outcomes From Patients With Heart Failure Participating in the Future Patient Telerehabilitation Program:Data From the Intervention Arm of a Randomized Controlled Trial

BackgroundMore than 37 million people worldwide have been diagnosed with heart failure, which is a growing burden on the health sector. Cardiac rehabilitation aims to improve patients’ recovery, functional capacity, psychosocial well-being, and health-related quality of life. However, cardiac rehabilitation programs have poor compliance and adherence. Telerehabilitation may be a solution to overcome some of these challenges to cardiac rehabilitation by making it more individualized. As part of the Future Patient Telerehabilitation program, a digital toolbox aimed at enabling patients with heart failure to monitor and evaluate their own current status has been developed and tested using data from a patient-reported outcome questionnaire that the patient filled in every alternate week for 1 year. ObjectiveThe aim of this study is to evaluate the changes in quality of life and well-being among patients with heart failure, who are participants in the Future Patient Telerehabilitation program over the course of 1 year. MethodsIn total, 140 patients were enrolled in the Future Patient Telerehabilitation program and randomized into either the telerehabilitation group (n=70) or the control group (n=70). Of the 70 patients in the telerehabilitation group, 56 (80.0%) answered the patient-reported outcome questionnaire and completed the program, and these 56 patients comprised the study population. The patient-reported outcomes consisted of three components: (1) questions regarding the patients’ sleep patterns assessed using the Spiegel Sleep Questionnaire; (2) measurements of physical limitations, symptoms, self-efficacy, social interaction, and quality of life assessed using the Kansas City Cardiomyopathy Questionnaire in 10 dimensions; and (3) 5 additional questions regarding psychological well-being that were developed by the research group. ResultsThe changes in scores during 1 year of the study were examined using 1-sample Wilcoxon signed-rank tests. There were significant differences in the scores for most of the slopes of the scores from the dimensions of the Kansas City Cardiomyopathy Questionnaire (P<.05). ConclusionsThere was a significant increase in clinical and social well-being and quality of life during the 1-year period of participating in a telerehabilitation program. These results suggest that patient-reported outcome questionnaires may be used as a tool for patients in a telerehabilitation program that can both monitor and guide patients in mastering their own symptoms. Trial RegistrationClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT0338891

Increased motivation for and use of digital services in heart failure patients participating in a telerehabilitation program:a randomized controlled trial

BACKGROUND: eHealth literacy (eHL) may be an important factor in the adoption of telerehabilitation. However, little is known about how telerehabilitation affects patients’ eHL. The current study evaluated changes over time in eHL for heart failure (HF) patients in a telerehabilitation program (the Future Patient Program) compared to a traditional rehabilitation program. METHODS: As part of a randomized controlled trial comparing telerehabilitation with traditional rehabilitation, 137 HF patients completed the eHealth Literacy Questionnaire (eHLQ) at 6 and 12 months of their respective rehabilitation programs. RESULTS: At 6 months, the telerehabilitation group indicated higher levels of ‘using technology to process health information’ and ‘motivated to engage with digital services’. This difference was consistent over time, and we found no other differences between groups or over time with regard to eHL. CONCLUSIONS: Providing a digital toolbox for processing health information to HF patients may aid in increasing their eHL, motivation, and ability to engage with digital services in HF patients. Especially, if the technology is designed to support patient needs in terms of the educational content of the program. Preferably technology should be provided early on in the rehabilitation process to ensure optimal outcome. TRIAL REGISTRATION: The study was registered in ClinicalTrials.gov (NCT03388918)

Checklist for transferability of multidisciplinary evaluations of telemedicine

INTRODUCTION: Emerging opportunities for the use of new technologies leads to an increasing need for timely and qualified input for decision-making in hospitals and the health care sector. Health Technology Assessment (HTA) is a useful tool for decision-makers to assess the effects of introducing a new technology. Full HTA evaluations are, however, resource and time consuming due to the methodological demands of multiple scientific fields. Thus, it is necessary to be able to transfer results between settings, with some kind of adjustment to local prerequisites, in order to limit the number of assessments needed and to accommodate the need for timely information on the effects of telemedicine applications. AIMS AND OBJECTIVES: The overall aim of this project is to develop a checklist for the transferability of results from HTAs of telemedicine. Based on comparisons of the empirical data from three RCTs on the effects of telemedicine for COPD patients, a study will be carried out indicating which variables on organisational and other aspects to consider in order to extrapolate results to other settings. METHODS: The common outcome measures from the three RCTs will be compared in two different ways in order to explore the differences between the local settings: Individual patient data (IPD) from the three trials will be combined in an IPD meta analysis, and the explanation for variance will be explored through multiple regressions with the outcome as dependent variable and possible effect modifiers as independent variables. Quantitative summary measures, i.e. odds ratios will be combined in meta analysis and in cases of heterogeneity, a random effects model will be used and the heterogeneity will be explored through meta regressions. Also, possible intracluster correlations will be explored through multilevel regression analyses. RESULTS: The fact that the study includes data from three settings permits quantitative analyses of the impact of organisational aspects on treatment effects. An operationalization of organisational aspects identifies independent variables for the regression analyses i.e. hospital size, staffs’ attitude and knowledge on IT, level of education among staff, communication among staff etc. The dependent variables are the primary and secondary outcomes of the RCTs, i.e. number of readmissions, patients’ quality of life, use of resources etc. Independent variables explaining the variance in between-country-results or between-strata-results with predefined strata (e.g. based on age, income, use of telemedicine service) being defined through the organisational analysis. These analyses will result in identification of how much variance in the common results is explained by which independent variable. This will provide a picture of which variables are necessary and in what form they should be presented (dichotomous, numerical or categorical), if they should be extrapolated to another setting. CONCLUSIONS: This study will result in a checklist for transferability of results of telemedicine evaluations that can serve as a guide for what to present in articles for others to be able to implement similar interventions and know what to expect in terms of results without reproducing a costly HTA