Determinants of implementation: Embedding pet robots in nursing homes for dementia care

Abstract

Background Pet robots are a type of social robots that have been used to benefit the psychosocial health of people living with dementia, particularly in nursing home settings. Despite the body of literature that have been conducted to evaluate their impacts, research to understand how pet robots can be translated from research into real‐world practice have been largely overlooked. This study seeks to address this knowledge gap by exploring the multilevel barriers and facilitators to implementing two pet robots for dementia care in nursing homes. Methods We conducted a descriptive qualitative study, conceptualised and guided using the Consolidated Framework of Implementation Research (CFIR), which consists of 39 constructs within five domains salient to implementation. Maximum variation sampling was used to identify and recruit healthcare professionals and organisational leaders from nursing homes. Individual, semi‐structured interviews were conducted with each participants face‐to‐face or over Zoom. Data was transcribed and analysed using Framework Analysis, supported by the NVivo12 qualitative data management software. Results A total of 22 participants from eight nursing homes were included in this study, of which 9 had seen or used a pet robot with residents with dementia. Barriers and facilitators were mapped to constructs from all five CFIR domains: 1) intervention characteristics, 2) outer setting, 3) inner setting, 4) characteristics of individuals and 5) process. Facilitators include the realisticness and familiarity of pet robots, identification of residents’ needs that can be met (or were met) using a pet robot, compatibility with prevailing regulatory guidelines and organisational care process, intrinsic desires to improve residents’ quality of life, and buy‐in from stakeholders. Barriers include a lack of customisability of pet robots to suit residents’ abilities and preferences, doubts about long‐term use, prohibitive costs, lack of external funding, lack of resources and knowledge, infection prevention mandates, and conflicting views on the anthropomorphisation of pet robots. Discussion Overall, this study highlights an incongruence between the characteristics of pet robots, organisational considerations (such as available resources), and external contextual factors. These findings have practical utility in informing the development of implementation strategies to guide the translation of pet robots from research into real‐world practice.