<p>Management of acute pain in dementia: a feasibility study of a robot-assisted intervention</p>

Abstract

Background: The management of pain is particularly challenging in patients with moderate to severe dementia owing to the loss of communication ability or underlying causes such as behavioral symptoms. It is often associated with health care professionals’ frustration and feeling of helplessness. The present study determined a framework and examined the feasibility of an innovative intervention using the PARO ® robot for the management of acute pain in dementia. Method: A mixed-methods research design combining qualitative (five focus groups) and quantitative (questionnaire survey) approaches was used to define the intervention framework. We recruited 57 health care professionals from various medical and paramedical specialties (eg, nursing auxiliaries, nurses, physicians, psychologists) and with expertise in gerontology. The feasibility of the intervention was subsequently assessed with 12 patients suffering from dementia in painful situations to validate the procedure. Results: Four main issues have been addressed: 1) the identification of a core group of painful situations associated with care (washing, dressing/change, transfer/mobilization), currently considered as inefficiently managed; 2) the selection of an appropriate assessment methodology including criteria and tools for pain evaluation; 3) the definition of health professionals' training needs and organizational requirements for their implementation; and 4) the perceived usefulness of a robot-assisted intervention for the management of pain in dementia in daily practice. The feasibility study showed that the predefined intervention framework was applicable and acceptable for the majority of professionals and patients. Conclusion: A consistent and feasible intervention framework for the management of painful situations associated with care in dementia using the PARO robot was defined. Understanding of professionals’ needs, opinions and perceived obstacles regarding the intervention was a useful step in the preparation of the forthcoming clinical trial.

Predicted Influences of Artificial Intelligence on the Domains of Nursing: Scoping Review

“…Emerging AIHTs discussed in the literature included robots (eg, socially assistive robots [SARs], humanoid robots, and mobility robots), predictive analytics, clinical decision support systems (CDSSs), smart homes, and virtual health care assistant chatbots. It was found that nurses are already using robots in their clinical practice, across multiple patient populations, for various tasks, such as to assist with exercise sessions for older adults or rehabilitation patients [ 27 , 28 ]; to serve as a distraction tool for pain management [ 29 - 31 ]; and to facilitate conversation and rapport, conduct interviews, and deliver patient education [ 27 , 33 , 34 , 36 - 39 , 41 , 42 ].…”

How people with dementia perceive a therapeutic robot called PARO in relation to their pain and mood: A qualitative study

“…Several studies have indicated that robotic pets have the potential to evoke previous memories of pets (Coghlan et al, 2018;Moyle et al, 2016b) and both care staff and family also mentioned the benefits of PARO for reminiscence (Birks et al, 2016;Moyle, Bramble, Jones, & Murfield, 2017a), especially in one-on-one sessions (Moyle et al, 2016b). Demange et al (2019) also found that PARO could be used as a distraction stimulus of pain during the care of people with dementia, such as bathing, skin care and dressing change. There are also correlations between the modulation of mood and pain perception; therefore, improved mood could also possibly modulate the relief of pain.…”

“…Although PARO may have the potential effect to reduce paediatric pain (Okita, 2013), pain in cancer patients (Eskander, Tewari, Osann, & Shibata, 2013) and pain medications in people with dementia (Petersen, Houston, Qin, Tague, & Studley, 2017), few studies have focused on the effect of PARO on pain management in people with dementia. One recent feasibility study indicated that PARO could potentially reduce acute pain associated with care procedures in patients with dementia measured by health professionals using the ALGOPLUS scale (Demange, Pino, Kerhervé, Rigaud, & Cantegreil-Kallen, 2019).…”

Nursing procedures for advanced dementia: Traditional techniques versus autonomous robotic applications (Review)

“…In the study performed by Demange et al ( 14 ), it was demonstrated that the PARO ® robot (Intelligent System Co.) was helpful in supporting the treatment of acute pain in 12 patients with dementia. The PARO ® robot is a pet robot in the shape of a baby harp seal designed for psychological care in geriatric patients.…”

“…It was previously successfully used to accompany the treatment of certain behavioural disorders, reducing loneliness, stress levels and improving communication and/or social behaviours in elderly patients with dementia. A total of 92% of the patients revealed a positive attitude toward the PARO robot, regardless of the type of painful situation ( 14 ).…”