Exploring the needs of children and caregivers to inform design of an artificial intelligence-enhanced social robot in the pediatric emergency department

Abstract

Background & Objective: Socially assistive robots (SARs) are a promising tool to manage children’s pain and distress related to medical procedures, but current options lack autonomous adaptability. The aim of this study was to understand children’s and caregivers' perceptions surrounding the use of an artificial intelligence (AI)-enhanced SAR to provide personalized procedural support to children during intravenous insertion (IVI) to inform the design of such a system following a user-centric approach. Methods: This study presents a descriptive qualitative needs assessment of children and caregivers. Data were collected via semi-structured individual interviews and focus groups. Participants were recruited from two Canadian pediatric emergency departments (EDs) between April 2021 and January 2022. Results: Eleven caregivers and 19 children completed 27 individual interviews and one focus group. Three main themes were identified: A. Experience in the clinical setting, B. Acceptance of and concerns surrounding SARs, and C. Features that support child engagement with SARs. Most participants expressed comfort with robot technology, however, concerns were raised about sharing personal information, photographing/videotaping, and the possibility of technical failure. Suggestions for feature enhancements included increasing movement to engage a child’s attention and tailoring language to developmental age. To enhance the overall ED experience, participants also identified a role for the SAR in the waiting room. Conclusion: Artificial intelligence-enhanced SARs were perceived by children and caregivers as a promising tool for distraction during IVIs and to enhance the overall ED experience. Insights collected will be used to inform the design of an AI-enhanced SAR.

Perspectives of Healthcare Providers to Inform the Design of an AI-Enhanced Social Robot in the Pediatric Emergency Department

“…Movement or animated behaviour was noted as being important by children and similarly by HCPs in our study [ 17 , 20 ]. The caregivers in our parallel study highlighted privacy concerns and trust in the robot technology, this was not mentioned by the HCPs in our study [ 23 ]. Finally, the importance of tailoring the SARs behaviour and language to the needs of each child was also reported by caregivers [ 23 ].…”

“…To our knowledge, no studies have used a co-design methodology with HCPs to inform the design and development of their SAR. However, three studies have used the co-design process with children and one with caregivers/parents—one of these studies is a parallel codesign study completed by our team with children and caregivers [ 17 , 20 , 23 ]. Similar to our findings with HCPs, most children and caregivers had a positive response to the SAR, were excited about its inclusion in the ED, and felt that pain and distress in children are important to manage [ 17 , 20 , 23 ].…”

“…However, three studies have used the co-design process with children and one with caregivers/parents—one of these studies is a parallel codesign study completed by our team with children and caregivers [ 17 , 20 , 23 ]. Similar to our findings with HCPs, most children and caregivers had a positive response to the SAR, were excited about its inclusion in the ED, and felt that pain and distress in children are important to manage [ 17 , 20 , 23 ]. In the singular study with caregivers, they reported the challenge of managing their stress in addition to their child’s—this was paralleled by the HCPs in our study who also found it challenging to manage inter-connected child and parent anxiety during the IVI [ 23 ].…”

“…HCPs felt that the proposed SAR should be equipped with a diverse range of abilities to suit children’s needs, including encouraging dialogue, positive reinforcement phrases, humour, and cognitive behavioural strategies (e.g., breathing techniques, guided imagery, and meditation). Children and caregivers from our parallel codesign study also reported the importance of these abilities [ 23 ]. HCPs also felt that the proposed SAR should allow the user (i.e., child) to choose from a selection of options for distraction.…”

“…As part of the process of developing the behaviour of this system (both the repertoire of SAR behaviours as well as guidelines regarding when one behaviour should be selected over another), this study aimed to characterize healthcare practitioners’ (HCPs) (a) experience managing children’s procedural pain and distress, both generally and during IVI procedures, as well as (b) their perspectives surrounding the integration of technology, more specifically AI and robots, within the pediatric ED setting. The perspectives of children and their caregivers on these matters are characterized in a previous work [ 23 ].…”