Evaluating levels of automation with different feedback modes in an assistive robotic table clearing task for eldercare.

This paper focuses on how the autonomy level of an assistive robot that offers support for older adults in a daily task and its feedback affect the interaction. Identifying the level of automation (LOA) that prioritizes older adults' preferences while avoiding passiveness and sedentariness is challenging. The feedback mode should match the cognitive and perceptual capabilities of older adults and the LOA. We characterized three LOAs and paired them with two modes of feedback in a human-robot collaborative task. Twenty-seven older adults participated in evaluating the LOA-feedback variations in a mixed experimental design, utilizing an experimental setup of an assistive robot in a table clearing task. The quality of the interaction was evaluated with objective and subjective measures. The combination of high LOA with voice feedback improved the overall interaction when compared to other LOA and feedback combinations. This study emphasizes the importance of appropriate coupling of LOA and feedback for successful interaction of the older adults with an assistive robot.

An Evaluation of a Clinic-Based Low Vision Device Lending Library.

As the efficacy of low vision service provision is facilitated by clients' access to and proper use of low vision devices, the objective of this study was to evaluate an outpatient clinic-based low vision device lending library program and the functional and psychosocial impact that device use had upon clients. Twenty individuals borrowed portable video magnifiers during the study period. Line items from the Revised-Self-Report Assessment of Functional Visual Performance and the Reading Behavior Inventory were analyzed before and after device loan at two months. The Psychosocial Impact of Assistive Devices Scale-10 and a semi-structured interview were also completed at two months. Reported improvements in reading performance and satisfaction levels on the Reading Behavior Inventory were significant (p<.001). The Revised-Self-Report Assessment of Functional Visual Performance indicated improved independence in reading medications, bills and labels. Higher scores in happiness, independence, sense of control and adaptability on the Psychosocial Impact of Assistive Devices Scale-10 indicated device retention at two months. Qualitative themes included improved independence, time needed to acclimate to the device, personal appraisal impacting motivation and challenges specific to low vision. This article provides occupational therapists a model to facilitate access, person-device fit and successful use of low vision devices to promote therapy outcomes.

Psychometric properties of the psychosocial impact of assistive devices scale (PIADS): A systematic review.

The Psychosocial Impact of Assistive Devices Scale (PIADS) is commonly used to assess the psychosocial effects of an assistive device. Given its growing use, an appraisal of the evidence regarding its psychometric properties is required. We conduct a systematic review using validated critical appraisal scales to analyze both the quality and content of the evidence on the psychometric properties of the PIADS. PubMed/Medline, Embase, and CINAHL were systematically searched for identification of studies. Two independent reviewers appraised the retrieved studies using MacDermid and COSMIN-RoB checklists, and extracted data regarding the psychometric measurements reported. MacDermid scores showed that 8 out of 11 studies were, at least, of good methodological quality. COSMIN-RoB scores ranged from inadequate to very good. Except criterion and construct validity, which have presented a moderate level of evidence, the other psychometric properties assessed have demonstrated a high level of evidence. Cross-cultural validity, measurement error, and responsiveness have not been studied. Few studies have yet evaluated the psychometric properties of the PIADS. However, the quality of the evidence that they provide is mostly adequate. Therefore, this review supports the use of the PIADS, which has overall good psychometric properties.

A Care Robot with Ethical Sensing System for Older Adults at Home.

Many studies have explored emotional and mental services that robots can provide for older adults, such as offering them daily conversation, news, music, or health information. However, the ethical issues raised by using sensors for frail older adults to monitor their daily movements or their medication intake, for instance, are still being discussed. In this study, we develop an older adult-guided, caregiver-monitored robot, Dori, which can detect and recognize movement by sensing human poses in accordance with two factors from the human-centered artificial intelligence (HCAI) framework. To design the care robot's services based on sensing movement during daily activities, we conducted focus group interviews with two groups-caregivers and medical staff-on the topic of care robot services not for patients but for prefrail and frail elderly individuals living at home. Based on their responses, we derived the focal service areas of cognitive support, emotional support, physical activity support, medication management, and caregiver management. We also found the two groups differed in their ethical judgments in the areas of dignity, autonomy, controllability, and privacy for services utilizing sensing by care robots. Therefore, the pose recognition technology adopted in the present work uses only joint coordinate information extracted from camera images and thus is advantageous for protecting human dignity and personal information.

Eliciting a User's Preferences by the Self-Disclosure of Socially Assistive Robots in Local Households of Older Adults to Facilitate Verbal Human-Robot Interaction.

To realize a society in which older adults can live independently in their homes and familiar environments for as long as possible, their lives can be supported by providing appropriate technology. In this case, a new intervention for older people using socially assistive robots (SARs) is proposed; however, previous research has demonstrated that individual differences exist in the use and response to SAR interventions, and it has also been reported that SARs are not used by users in some cases. Therefore, in this study, we developed a self-disclosure function to promote continuous interaction with robots, using a Japanese corpus and self-disclosure items. In this study, we defined the specific requirements and functions of self-disclosure in SARs and developed ten non-arbitrary speech scripts from the field of social psychology using a Japanese corpus and self-disclosure items. To evaluate the effect of self-disclosure in SARs, an SAR was introduced to each household for 20 days, with the consent of seven community-dwelling older adults. Based on the recorded voice interaction data, we analyzed how the number, total time, and quality of verbal interactions changed with the SAR's self-disclosure. Furthermore, we conducted group interviews with the participants and received positive comments regarding the robot's self-disclosure. Some participants considered the specific personality of the SAR by accumulating its behavioral characteristics. As a consequence, these results indicate that the robot's self-disclosure feature is effective in significantly increasing the quantity and quality of verbal interactions with older adults.

Older adults' experiences and perceptions of living with Bomy, an assistive dailycare robot: a qualitative study.

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.

Comprehensible instructions from assistive robots for older adults with or without cognitive impairment.

The purpose of this study was to reveal comprehensible instructions from an assistive robot for older adults, across cognitive levels and characteristics. Participants included 19 older adults with or without cognitive impairment. We administered cognitive tests assessing all major domains (e.g., memory and attention). Participants were required to listen to robot instructions carefully, and perform three activities of daily living (e.g., taking medicine) with three different types of instructions. In instruction pattern 1 (IP1), the robot informed seniors of the task in one sentence, while in instruction patterns 2 and 3 (IP2 and IP3), the steps of each activity were split into two and three sentences, respectively. Participants with lower cognitive level showed lower task performance with IP1, whereas almost all participants completed tasks with IP2 and IP3. Cognitive domains such as working memory significantly affected task performances. Participants with lower attention made mistakes in taking their medicine. The results imply that step-by-step instructions should be used for older people with lower levels of cognitive function, especially working memory, and repeated instructions may be required for lower attention. Types of instruction should be selected depending on cognitive characteristics.

Reduced care burden and improved quality of life in African American family caregivers: Positive impact of personalized assistive technology.

BACKGROUND: African Americans living with dementia are considered less likely to seek formal institutionalized elder care and more likely to be managed in the home by family-member caregivers. Assistive technologies (the use of smart visual devices like tablets and phones) can be used effectively to guide memory-impaired individuals with a sequence of pictures showing steps to complete activities of daily living, e.g., bathing, toileting, dressing. Assistive technology so far has not been generally embraced in African American communities. OBJECTIVES: Determine, if African American family caregivers, given the opportunity, would embrace the use of assistive technology and if they would perceive its use beneficial. METHODS: We assessed a group of eight family caregivers' overall care-burden scores, and their user-satisfaction scores after using assistive technology for three months. RESULTS: We found significant reduction in caregiver burden, positive changes in behavior and emotion scores, and high ratings on user satisfaction. CONCLUSIONS: The findings reported here comprise the first systematic study of the use of assistive technology by caregivers in an underserved population. They set the stage for exploring meaningful strategies and variables that will better engage underserved populations to take advantage of assistive technologies available in healthcare.

Transcending human frailties with technological enhancements and replacements: Transhumanist perspective in nursing and healthcare.

As human beings age, they become weak, fragile, and feeble. It is a slowly progressing yet complex syndrome in which old age or some disabilities are not prerequisites; neither does loss of human parts lead to frailty among the physically fit older persons. This paper aims to describe the influences of transhumanist perspectives on human-technology enhancements and replacements in the transcendence of human frailties, including those of older persons, in which technology is projected to deliver solutions toward transcending these frailties. Through technologies including genetic screening and other technological manipulations, intelligent machines and augmented humans improve, maintain, and remedy human-linked susceptibilities. Furthermore, other technologies replace parts fabricated through inorganic-mechanical processes such as 3D-printing. Advancing technologies are reaching the summit of technological sophistication contributing to the transhumanist views of being human in a technological world. Technologies enhance the transcendence of human frailties as essential expressions of the symbiosis between human beings and technology in a transcendental world.

Reflections and future directions for psychological science in Prosthetics and Orthotics International.

In the inaugural edition of Prosthetics and Orthotics International in 1977, Dr Sidney Fishman identified the Psychological Sciences as one of six indispensable areas of skill and knowledge in professional prosthetic-orthotic practice. Since then, there have been substantial changes and developments in the complexity and capabilities of assistive technologies, greater emphasis on understanding the relationships between people and enabling technologies, growing recognition of the importance of the contexts and environments that support their use, and changes in both health care services and the professional development of prosthetists and orthotists. The aim of this narrative review is to reflect on the role of Prosthetics and Orthotics International in shaping the evolving understanding of psychology in prosthetics and orthotics. There remains considerable potential and opportunity for the development and application of psychology in addressing the challenges of disability globally. However, a broad interpretation and application of the principles of rehabilitation psychology are needed if we are to meaningfully incorporate psychological science into the knowledge that informs prosthetic and orthotic practice.

Effectiveness of internet-based guided self-help for binge-eating disorder and characteristics of completers versus noncompleters.

OBJECTIVE: Binge-eating disorder (BED) is characterized by recurrent episodes of binge eating, accompanied by a lack of control and feelings of shame. Online intervention is a promising, accessible treatment approach for BED. In the current study, we compared completers with noncompleters in a 10-session guided internet-based treatment program (iBED) based on cognitive behavioral therapy. METHODS: Adults (N = 75) with mild to moderate BED participated in iBED with weekly written support from psychologists. Participants were compared on the Eating Disorder Examination Questionnaire (EDE-Q), diagnostic criteria for BED (BED-Q), major depression inventory (MDI), quality of life (EQ-5D-5L), body mass index (BMI) and sociodemographic variables. RESULTS: Minor differences were observed between completers and noncompleters on depression. No differences were found in BED-symptoms, BMI, and sociodemographic variables. Participants who completed treatment showed large reductions in eating disorder pathology. DISCUSSION: More research is needed to determine risk factors for attrition or treatment outcome in internet-based interventions for BED. It is suggested that iBED is an efficient intervention for BED. However, more studies of internet-interventions are needed.

Age-Related Differences in the Uncanny Valley Effect.

BACKGROUND: Due to declining birthrates and an increasing aging population, shortage of the caregiving labor force has become a global issue. Among various efforts toward the solution, introducing robotic products for assistance could provide an effective way to help older adults in their daily lives. As previous studies have indicated that older adults' acceptance of robots is lower than that of younger adults, enhancing older adults' acceptance of robots is imperative. Because older adults' first impressions based on a robot's appearance might affect their acceptance of the robot, we investigated the uncanny valley effect (UVE) here. The UVE refers to the phenomenon that people rate robots more positively as robots become more humanlike, but only up to a certain point; as robots approach a near-perfect similarity to human appearance, likeability drops and forms the uncanny valley. Nevertheless, evidence for the UVE came mainly from younger adults. OBJECTIVE: The present study aimed to examine whether the UVE varies across different age groups and whether a robot's appearance would affect participants' acceptance of the robot's service or companionship. METHODS: An online questionnaire study was conducted with 255 participants, including younger (n = 77, age 18-39 years), middle-aged (n = 87, age 40-59 years), and older (n = 91, age 60-87 years) adults. Participants were asked to view each picture in a set selected from a total of 83 robot pictures and evaluate their impressions of each robot and the intention of use regarding robot function as a service provider or a companion. RESULTS: The UVE was found in younger and middle-aged adults; however, older adults did not show the UVE. Older adults preferred humanlike over non-humanlike robots, regardless of robot function. CONCLUSION: The design of assistive robots should take the UVE into consideration by customizing robot appearance based on the age group of the intended user.

Lack of time and dependence on significant others: Occupational therapists´ experiences of prescribing time assistive technology for persons with dementia.

Background: There is lack of knowledge on how occupational therapists (OTs) assess daily time management (DTM) for persons with dementia (PwDs) and on which aspects affect prescription of time assistive technology (AT).Aim: To explore OTs' experiences of assessing the need for and prescribing time AT for PwDs.Material and methods: Focus group interviews with OTs that prescribe time AT for PwDs analyzed via qualitative content analysis.Results: A main category and four categories were identified. The categories illustrated a complex and time-consuming prescription process, which was facilitated if the PwD was supported by a significant other (SO). Support from a SO was especially important during implementation and follow-up. OTs had to take individual responsibility for staying informed about time AT. Organizational limitations and time constraints were barriers for OTs striving to work according to national prescription guidelines.Conclusions and significance: High demands are made on SO's participation during the prescription process. PwDs with no support from SOs are at risk not receiving or fully benefitting from time AT. To avoid inequalities, specific forms of support need to be developed and targeted at PwDs without SOs to ensure that they have sufficient opportunities to access and use time AT.

Home-dwelling persons with dementia's perception on care support: Qualitative study.

BACKGROUND: Over the last years, there has been a growth in care solutions aiming to support home-dwelling persons with dementia. Assistive technology and voluntarism have emerged as supplements to traditional homecare and daycare centers. However, patient participation is often lacking in decision-making processes, undermining ethical principles and basic human rights. RESEARCH OBJECTIVE: This study explores the perceptions of persons with dementia toward assistive technology, volunteer support, homecare services, and daycare centers. RESEARCH DESIGN: A hermeneutical approach was chosen for this study, using a semi-structured interview guide to allow for interviews in the form of open conversations. PARTICIPANTS AND RESEARCH CONTEXT: Twelve home-dwelling persons with dementia participated in the study. The participants were recruited through municipal daycare centers. ETHICAL CONSIDERATIONS: Interviews were facilitated within a safe environment, carefully conducted to safeguard the participants' integrity. The Regional Committee for Medical and Health Research Ethics, Western Norway (Project number 2016/1630) approved the study. FINDINGS: The participants shared a well of reflections on experience and attitudes toward the aspects explored. They described assistive technology as possibly beneficial, but pointed to several non-beneficial side effects. Likewise, they were hesitant toward volunteer support, depending on how this might fit their individual preferences. Homecare services were perceived as a necessary means of care, its benefits ascribed to a variety of aspects. Similarly, the participants' assessments of daycare centers relied on specific aspects, with high individual variety. DISCUSSION AND CONCLUSION: The study indicates that the margins between whether these specific care interventions were perceived as supportive or infringing may be small and details may have great effect on the persons' everyday life. This indicates that patient participation in decision-making processes for this group is-in addition to be a judicial and ethical requirement-crucial to ensure adequate care and support.

Enablers and barriers to the implementation of socially assistive humanoid robots in health and social care: a systematic review.

OBJECTIVES: Socially assistive humanoid robots are considered a promising technology to tackle the challenges in health and social care posed by the growth of the ageing population. The purpose of our study was to explore the current evidence on barriers and enablers for the implementation of humanoid robots in health and social care. DESIGN: Systematic review of studies entailing hands-on interactions with a humanoid robot. SETTING: From April 2018 to June 2018, databases were searched using a combination of the same search terms for articles published during the last decade. Data collection was conducted by using the Rayyan software, a standardised predefined grid, and a risk of bias and a quality assessment tool. PARTICIPANTS: Post-experimental data were collected and analysed for a total of 420 participants. Participants comprised: older adults (n=307) aged ≥60 years, with no or some degree of age-related cognitive impairment, residing either in residential care facilities or at their home; care home staff (n=106); and informal caregivers (n=7). PRIMARY OUTCOMES: Identification of enablers and barriers to the implementation of socially assistive humanoid robots in health and social care, and consequent insights and impact. Future developments to inform further research. RESULTS: Twelve studies met the eligibility criteria and were included. None of the selected studies had an experimental design; hence overall quality was low, with high risks of biases. Several studies had no comparator, no baseline, small samples, and self-reported measures only. Within this limited evidence base, the enablers found were enjoyment, usability, personalisation and familiarisation. Barriers were related to technical problems, to the robots' limited capabilities and the negative preconceptions towards the use of robots in healthcare. Factors which produced mixed results were the robot's human-like attributes, previous experience with technology and views of formal and informal carers. CONCLUSIONS: The available evidence related to implementation factors of socially assistive humanoid robots for older adults is limited, mainly focusing on aspects at individual level, and exploring acceptance of this technology. Investigation of elements linked to the environment, organisation, societal and cultural milieu, policy and legal framework is necessary. PROSPERO REGISTRATION NUMBER: CRD42018092866.

Attitudes faced by young adults using assistive technology as depicted through photovoice.

Purpose: To explore how the attitudinal environment influences the participation experiences of young adults with disabilities who use assistive technology.Methods: In this qualitative study, twenty young adults using assistive technology completed individual interviews before and after engaging in a photovoice process. Ten of the participants then took part in a focus group. Data were analyzed inductively using a thematic analysis approach.Results: Analysis yielded three primary themes "seen and treated as different, assumptions made and impatience". A fourth theme emerged through focus group discussion "photos as a means of consciousness-raising". Findings suggest that young adults with disabilities who use assistive technology regularly encounter negative societal attitudes that hinder participation. The photovoice process promoted consciousness-raising at the individual, interpersonal and societal level for the participants.Conclusion: Many young adults with disabilities use assistive technology to facilitate participation in everyday activities. However, the usefulness of assistive technology is susceptible to the environment in which it is used. Further actions are needed toward resolving this challenging participation barrier; these actions should draw on the perspectives and creativity of young adult assistive technology users.IMPLICATIONS FOR REHABILITATIONYoung adults with disabilities who use assistive technology describe how other people's negative attitudes can make it challenging to participate in their important activities.Participants took photographs that represented the negative attitudes they face on a daily basis and saw their photos as a way to raise awareness of the negative attitudes.This research highlights the importance of addressing negative attitudes toward people using assistive technology: young adults with disabilities have expertise and creative ideas about how to do this, so their voices should guide future research projects.

The Ethics of Socially Assistive Robots in Aged Care. A Focus Group Study With Older Adults in Flanders, Belgium.

OBJECTIVES: Socially assistive robots (SARs) need to be studied from older adults' perspective, given their predicted future ubiquity in aged-care settings. Current ethical discourses on SARs in aged care are uninformed by primary stakeholders' ethical perceptions. This study reports on what community-dwelling older adults in Flanders, Belgium, perceive as ethical issues of SARs in aged care. METHODS: Constructivist grounded theory guided the study of 9 focus groups of 59 community-dwelling older adults (70+ years) in Flanders, Belgium. An open-ended topic guide and a modified Alice Cares documentary focused discussions. The Qualitative Analysis Guide of Leuven (QUAGOL) guided data analysis. RESULTS: Data revealed older adults' multidimensional perceptions on the ethics of SARs which were structured along three sections: (a) SARs as components of a techno-societal evolution, (b) SARs' embeddedness in aged-care dynamics, (c) SARs as embodiments of ethical considerations. DISCUSSION: Perceptions sociohistorically contextualize the ethics of SAR use by older adults' views on societal, organizational, and relational contexts in which aged care takes place. These contexts need to inform the ethical criteria for the design, development, and use of SARs. Focusing on older adults' ethical perceptions creates "normativity in place," viewing participants as moral subjects.

Motivators and barriers to using information and communication technology in everyday life following stroke: a qualitative and video observation study.

Purpose: Information and communication technology devices have become a ubiquitous part of everyday life and a primary means of communication. The aim of this study was to describe the experience of information and communication technology and to explore the barriers and motivators to its use following stroke.Materials and methods: This observational study used semi-structured individual interviews and video observation of information and communication technology device use with six people, four men, and two women age 60-82 years with upper limb disability following stroke. They were analyzed using thematic analysis.Results: Three themes were identified that relate to barriers: (i) Sensory and motor impairments; (ii) Limited vision and impaired speech; and (iii) Device-specific limitations. Six themes were identified as motivators: (i) Connect with others; (ii) Provide safety; (iii) Facilitate reintegration; (iv) Reinforce technology adoption; (v) Leisure activities; and (vi) Contribute to the rehabilitation process.Conclusion: All participants used some form of information and communication technology daily to promote safety, enable daily activities, and social interaction, and to a lesser extent engage in leisure and rehabilitation activities. Barriers to information and communication technology use were primarily related to stroke related impairments and device-specific requirements, which limited use, particularly of smartphones. These barriers should be addressed to facilitate the use of information and communication technology devices.Implications for rehabilitationThis research suggests that;People with stroke are highly motivated to use information and communication technology devices in daily activitiesStroke-specific and age-related impairments limit the use and functionality of information and communication technology devices for people with strokeInformation and communication technology devices do not appear to be promoted or used in the rehabilitation or as assistive technologies.

Feasibility study by a single-blind randomized controlled trial of self-management of mobility with a gait-speed feedback device by older persons at risk for falling.

This single-blind randomized pilot study explored feasibility and safety of a self-management fall prevention program, hypothesizing that older persons can comply with this program, while it does not result in more (injurious) falls, or a decrease in mental wellbeing as an adverse effect of being focused on falls prevention. Eighty-six persons, community-dwelling or home for the aged (mean age 80.3 years [SD: 6.3], 56 women (65.1%)) participated. The intervention group measured their gait speed by using the Mobility Feedback Device (MFD) weekly for 6 months. The control group was monitored for the outcomes without an intervention. Change scores involving health perception and mental wellbeing (Medical Outcomes Study 20-item short form (MOS-20)) were compared between groups. Feasibility was assessed by drop-out rate and compliance to measure gait speed. Safety was assessed by fall incidence during follow-up. MOS-20 decreased significantly in the control group (p = 0.024) but remained stable in the intervention group. Drop-out rate was low (9.3%), and compliance was good. Fall incidence was the same for both groups (p = 0.155). The self-management fall prevention program is feasible and safe in a community-dwelling and home for the aged population, making it worthwhile to further explore self-management fall-prevention studies.

The psychosocial impact of assistive device scale: Italian validation in a cohort of nonambulant people with neuromotor disorders.

The importance of adaptive seating system on body structure and function is widely accepted, but its impact on psychosocial aspects needs more consideration by health professionals. This article describes the Italian validation of the Psychosocial Impact of Assistive Device Scale (IT-PIADS) for non-ambulant people with neuromotor disorders.Once agreement has been given by the original authors, the scale was translated and adapted to the Italian culture. The IT-PIADS was administered to different wheelchairs users with heterogeneous diagnosis. The internal consistency and test-retest reliability were examined. Its concurrent validity was evaluated with the Italian version of the WheelCon-M-SF.The IT-PIADS was administered to 87 subjects. Cronbach's α was 0.92 (p < 0.05), and the test-retest reliability (ICC) for competence, adaptability and self-esteem subscales were 0.96, 0.90, 0.93, respectively. The Pearson correlation coefficient of the IT-PIADS with the WheelCon-M-I-SF scores showed significant data for competence and adaptability subscales.Psychosocial perception on assistive devices can be reliably measure. The IT-PIADS showed good psychometric properties and it is possible to confirm its validity for clinical and research purposes. Nevertheless, before using this measure with greater confidence, further psychometric properties tests of the IT-PIADS are recommended.