Hayley Robinson

The Role of Healthcare Robots for Older People at Home: A Review

This review aimed to identify the areas of need that older people have, and the available solutions. In particular, the robotic solutions are explored and critiqued and areas for future development identified. The literature was reviewed for factors that influence admission to nursing home care, and for technological solutions to these factors. The main issues facing older people are physical decline, cognitive decline, health management, and psychosocial issues. Robots exist that may meet some of the identified issues but gaps where robots could be developed include delivering interventions to prevent physical decline occurring and robots with multiple functions, including a range of cognitive stimuli and health education. To reduce barriers to acceptance, robots designed to provide physical and healthcare assistance should have a serious appearance. On the other hand animal-like robots can address psychosocial issues and function like pets. While smart phones and computers can offer some solutions, robots may promote adherence due to a social presence. Robots are being developed to address areas of need in older people, including physical, cognitive, medical and psychosocial issues. However more focus could be placed on developing preventative interventions, multifunctional robots, greater educational content and motivational aspects of appearance and interaction style.

Suitability of Healthcare Robots for a Dementia Unit and Suggested Improvements

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 Paros 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.

Physiological effects of a companion robot on blood pressure of older people in residential care facility: A pilot study

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.

The Effects of Relaxation Before or After Skin Damage on Skin Barrier Recovery: A Preliminary Study.

Objectives Psychological interventions administered before wounding can reduce stress and improve healing. However, in many cases, it would be more practical for interventions to be delivered after wounding. This preliminary study investigated whether a brief relaxation intervention could improve healing when administered either before or after skin damage produced by tape stripping in comparison to a control group. Methods One hundred twenty-one healthy adults were randomized into one of three groups: a) relaxation prestripping group, b) relaxation poststripping group, or c) no relaxation. Participants completed measures of stress, fatigue, relaxation, and pain. Relaxation consisted of listening to 20 minutes of guided relaxation, whereas the control condition was quiet reading for 20 minutes. Skin barrier function was measured using transepidermal water loss at baseline, immediately after tape stripping and 25 minutes later. Results Relaxation either before or after tape stripping improved skin barrier recovery compared with the control group (F(2,92) = 3.58, p = .032, partial &eegr;2 = 0.074). Participants who took part in the relaxation intervention were significantly more relaxed and reported greater reductions in pain than the control group did 25 minutes after tape stripping. Perceived stress over the last month was not significantly related to healing. Conclusions This study showed that a relaxation intervention had a beneficial effect on skin barrier recovery regardless of whether the intervention was administered before or after wounding. Future research needs to replicate these findings in other wound types and in clinical settings, and investigate the biological mechanisms involved.

Benefits and problems of health-care robots in aged care settings: A comparison trial

This study investigated whether multiple health‐care robots could have any benefits or cause any problems in an aged care facility.

The effects of expressive writing before or after punch biopsy on wound healing

OBJECTIVE Recent studies have shown that written emotional disclosure (expressive writing) performed in the two weeks prior to wounding improves healing of punch biopsy wounds. In many clinical settings, it would be more practical for patients to perform this intervention after wounding. The aim of this study was to investigate whether expressive writing could speed the healing of punch biopsy wounds if writing was performed after wounds were made. METHODS One hundred and twenty-two healthy participants aged between 18 and 55years were randomly allocated to one of four groups in a 2 (intervention) by 2 (timing) design. Participants performed either expressive writing or neutral writing, either before or after receiving a 4mm punch biopsy wound. Wounds were photographed on day 10 (primary endpoint) and day 14 after the biopsy to measure epithelisation. Participants also completed questionnaires on stress and affect two weeks prior to the biopsy, on the day of biopsy and two weeks after biopsy. RESULTS There was a significant difference in healing at day 10 between groups, χ2(3, N=97)=8.84, p=0.032. A significantly greater proportion of participants who performed expressive writing before the biopsy had fully reepithelialised wounds on day 10 compared to participants who performed neutral writing either before or after wounding, with no other significant differences between groups. Amongst people who wrote expressively after wounding, those who finished writing over the first 6days were significantly more likely to be healed at 14days than those who finished writing later. There were significant differences in positive and negative affect over the healing period between the pre and post expressive writing groups. CONCLUSIONS Expressive writing can improve healing if it is performed prior to wounding. Performing expressive writing after wounding may be able to improve healing depending on the timing of writing and wound assessment. Expressive writing causes affect to worsen followed by subsequent improvement and it is important to consider this in the timing of intervention delivery. Further research with patient groups is required to determine the clinical relevance of these findings.

The effects of psychological interventions on wound healing: A systematic review of randomized trials

PURPOSE Psychological stress has been shown to delay wound healing. Several trials have investigated whether psychological interventions can improve wound healing, but to date, this evidence base has not been systematically synthesized. The objective was to conduct a systematic review of randomized controlled trials in humans investigating whether psychological interventions can enhance wound healing. METHODS A systematic review was performed using PsychINFO, CINAHL, Web of Science, and MEDLINE. The searches included all papers published in English up until September 2016. The reference lists of relevant papers were screened manually to identify further review articles or relevant studies. Nineteen studies met inclusion criteria and were included in the review. RESULTS Fifteen of nineteen studies were of high methodological quality. Six studies were conducted with acute experimentally created wounds, five studies with surgical patients, two studies with burn wounds, two studies with fracture wounds, and four studies were conducted with ulcer wounds. Post-intervention standardized mean differences (SMD) between groups across all intervention types ranged from 0.13 to 3.21, favouring improved healing, particularly for surgical patients and for relaxation interventions. However, there was some evidence for publication bias suggesting negative studies may not have been reported. Due to the heterogeneity of wound types, population types, and intervention types, it is difficult to pool effect sizes across studies. CONCLUSIONS Current evidence suggests that psychological interventions may aid wound healing. Although promising, more research is needed to assess the efficacy of each intervention on different wound types. Statement of contribution What is already known on this subject? Psychological stress negatively affects wound healing. A number of studies have investigated whether psychological interventions can improve healing. However, no systematic reviews have been conducted. What does this study add? Synthesis and review of 19 trials conducted on psychological interventions and wound healing. Most evidence supports improved healing, particularly for surgical wounds and relaxation interventions. More research is needed on different intervention types with clinical wounds and into mechanisms of action.

Randomized clinical trial of expressive writing on wound healing following bariatric surgery.

Objective: Writing emotionally about upsetting life events (expressive writing) has been shown to speed healing of punch-biopsy wounds compared to writing objectively about daily activities. We aimed to investigate whether a presurgical expressive writing intervention could improve surgical wound healing. Method: Seventy-six patients undergoing elective laparoscopic bariatric surgery were randomized either to write emotionally about traumatic life events (expressive writing) or to write objectively about how they spent their time (daily activities writing) for 20 min a day for 3 consecutive days beginning 2 weeks prior to surgery. A wound drain was inserted into a laparoscopic port site and wound fluid analyzed for proinflammatory cytokines collected over 24 hr postoperatively. Expanded polytetrafluoroethylene tubes were inserted into separate laparoscopic port sites during surgery and removed after 14 days. Tubes were analyzed for hydroxyproline deposition (the primary outcome), a major component of collagen and marker of healing. Fifty-four patients completed the study. Results: Patients who wrote about daily activities had significantly more hydroxyproline than did expressive writing patients, t(34) = −2.43, p = .020, 95% confidence interval [−4.61, −0.41], and higher tumor necrosis factor–alpha, t(29) = −2.42, p = .022, 95% confidence interval [−0.42, −0.04]. Perceived stress significantly reduced in both groups after surgery. Conclusions: Expressive writing prior to bariatric surgery was not effective at increasing hydroxyproline at the wound site 14 days after surgery. However, writing about daily activities did predict such an increase. Future research needs to replicate these findings and investigate generalizability to other surgical groups.

The role of social closeness during tape stripping to facilitate skin barrier recovery: Preliminary findings.

Objective: Social support is known to reduce the negative effects of stress on health, but there is mixed evidence for the effects of social support on wound healing. This study aimed to investigate whether undergoing a task designed to promote social closeness with a fellow participant and being paired with that person during a tape-stripping procedure could reduce stress and improve skin barrier recovery compared to going through tape stripping alone. Method: Seventy-two healthy adults were randomized to either a social closeness condition where participants completed a relationship-building task and tape stripping in pairs or a control condition where they completed tape stripping alone. Skin barrier recovery was measured using transepidermal water loss. Salivary cortisol and alpha-amylase were collected at four time points as markers of the endocrine and autonomic stress response. Results: Social closeness had a beneficial effect on skin barrier recovery compared to the control condition, t(54) = 2.86, p = .006, r = .36. Social closeness significantly reduced self-reported stress. The effects of the intervention on skin barrier recovery were moderated by self-reported stress reduction (p = .035). There were no significant differences in cortisol between groups, but alpha-amylase increased significantly more from baseline to after tape stripping in the control group compared to the intervention group. Conclusions: This is the first study to show that social closeness with a person going through a similar unfamiliar procedure can positively influence wound healing. Future research needs to replicate these findings in other wound types and in clinical settings.

How Could Companion Robots Be Useful in Rural Schools

Robots in schools are generally seen as useful for teaching students about engineering and robotics, and as teaching assistants for scientific or foreign language subjects. Robots may be particularly useful in rural schools, due to the challenges rural areas face with low student numbers, low funding, a lack of specialist teachers, and isolation. To date, no studies have specifically investigated how companion robots might be useful in rural schools. This cross-sectional study aimed to investigate student and teacher views about how two companion robots could be useful in rural educational settings. 207 students and 22 teachers participated in 30-min sessions with two popular companion robots, Paro and iRobiQ. Questionnaires were given to all participants and observer ratings were made of student interactions with the robots. Overall, the robots were well-received. The majority of participants said they would like to have the robots at their schools. Girls gave significantly more positive responses about the robots than boys, although boys were more engaged with iRobiQ than girls. Children aged 5–12 and their teachers responded the most positively. Participants wanted the robots to be more interactive, and perceived that the most useful functions were helping children with autism, comforting children in sick bay, and repeating exercises for children who need help. This study suggests that in addition to having an assistant teacher role, companion robots may have a useful comforting role. The results inform designers about which applications to develop for robots in rural schools and which age groups to develop them for.