Barriers and facilitators to the implementation of social robots for older adults and people with dementia: a scoping review

Abstract

Background Psychosocial issues, such as social isolation and loneliness among older adults and people with dementia, continue to pose challenges with a rapidly aging population worldwide. Social robots are a rapidly emerging field of technology, developed to help address the psychosocial needs of this population. Although studies have reported positive findings regarding their psychosocial benefits, their implementation in real-world practice remains a challenge. Nevertheless, little is known about the factors affecting their implementation. The purpose of this review is to provide a systematic overview of the barriers and facilitators affecting the implementation of social robots for older adults and people with dementia. Method The Arksey and O’Malley approach with methodological enhancement by Levac et al. was used to guide the conduct of this review. Seven electronic databases were searched. In addition, hand searching and backward citation tracing was conducted. Three independent reviewers were involved in the screening and data charting process. Findings were synthesised and categorised into the five domains outlined in the Consolidated Framework of Implementation Research (CFIR). Results A total of 53 studies were included in the final review. Most of the included studies were based in participants’ homes and in care facilities. Barriers and facilitators were mapped onto 18 constructs in the five domains of the CFIR. The most frequently cited barriers were mapped to the constructs within the domain of “Intervention characteristics”, where issues such as the complexity of using the technology and technical obstacles impeded implementation. Most facilitators were mapped onto the domain “Patient needs and resources”. Overall, existing research are disproportionately focused on the internal validity (i.e. characteristics) of social robots, and there is significantly less research investigating their external validity, such as organisational or wider contextual factors that can affect their implementation in real-world practice. Conclusion This review has identified and synthesised the breadth of evidence on the barriers and facilitators to the implementation of social robots for older adults and people with dementia. Future research should pay more attention to investigating the contextual factors, using an implementation framework, to identify barriers and facilitators to guide the implementation of social robots.

Companion robots for older adults: Rodgers’ evolutionary concept analysis approach

“…The findings suggest that the use of robots allows older adults to maintain their independence by improving health management and reducing social isolation and loneliness, thereby significantly contributing to improving their quality of life or well-being [ 3 , 8 , 15 , 31 , 32 , 56 , 62 – 67 ]. Companion robots have been widely used in addressing social isolation—a phenomenon older adults experience more than younger people because of the increased possibility of health problems and life-changing events [ 2 , 62 – 64 , 68 , 69 ]. Companion robots can establish a direct relationship with the robot and enhance social contact between the users and the staff and family, thereby improving social functioning, mood, and participation [ 6 , 18 , 32 , 50 , 66 ].…”

“…Studies reported several concerns regarding robots in general. For instance, the complexity of using the robots and technical obstacles impede implementation in the real world [ 49 , 69 ]. Older adults might fear the inability to handle the malfunctioning and rusting of the robot [ 20 ].…”

“…In some cases, people soon lose interest in the non-living robot and its limited behavioral repertoire [ 53 ]. The benefits of robots for society and empowerment of older people must be contrasted against possible ethical concerns in the field around issues, such as deceit, infantilization, increased feeling of objectification or anxiety, loss of control and dignity, loss of privacy and personal freedom as well as reduced human contact and accountability [ 3 , 14 , 45 , 49 , 59 , 60 , 69 , 75 ]. 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 [ 3 , 31 , 41 , 42 ].…”

“…Despite the importance and high priority of interaction between users and companion robots [ 46 ], studies revealed challenges concerning facial or voice recognition, technical or usability issues (e.g., navigation failure, noise level, power consumption, and disconnecting), and the practicalities and modularity in real-life settings [ 3 , 5 , 23 , 25 , 31 , 63 , 64 , 69 ]. Some studies showed that the robot was considered more like a toy than a supportive device for independent living because of a lack of technological robustness and slow performance [ 72 ].…”

“…Further, existing research focuses on the internal validity of robots. There is significantly less research investigating their external validity, such as organizational or wider contextual factors affecting their implementation in real-world practice [ 69 ]. More research is required to confirm the usefulness of real-world applications in older adults’ residences.…”