Socially-Assistive Robots Using Empathy to Reduce Pain and Distress during Peripheral IV Placement in Children

Abstract

Objectives. Socially-assistive robots (SAR) have been used to reduce pain and distress in children in medical settings. Patients who perceive empathic treatment have increased satisfaction and improved outcomes. We sought to determine if an empathic SAR could be developed and used to decrease pain and fear associated with peripheral IV placement in children. Methods. We conducted a pilot study of children receiving IV placement. Participating children were randomized to interact with (1) no robot, or a commercially available 3D printed humanoid SAR robot programmed with (2) empathy or (3) distraction conditions. Children and parents completed demographic surveys, and children used an adapted validated questionnaire to rate the robot’s empathy on an 8-point Likert scale. Survey scores were compared by the t-test or chi-square test. Pain and fear were measured by self-report using the FACES and FEAR scales, and video tapes were coded using the CHEOPS and FLACC. Scores were compared using repeated measures 2-way ANOVA. This trial is registered with NCT02840942. Results. Thirty-one children with an average age of 9.6 years completed the study. For all measures, mean pain and fear scores were lowest in the empathy group immediately before and after IV placement. Children were more likely to attribute characteristics of empathy to the empathic condition (Likert score 7.24 v. 4.70; p=0.012) and to report that having the empathic vs. distraction robot made the IV hurt less (7.45 vs. 4.88; p=0.026). Conclusions. Children were able to identify SAR designed to display empathic characteristics and reported it helped with IV insertion pain and fear. Mean scores of self-reported or objective pain and fear scales were the lowest in the empathy group and the highest in the distraction condition before and after IV insertion. This result suggests empathy improves SAR functionality when used for painful medical procedures and informs future research into SAR for pain management.

Reducing negative emotions in children using social robots: systematic review

“…Children receiving a vaccination or IV-line placement were the most common target population [15,16,22,23]. The NAO robot was the most frequently used robot in the selected studies.…”

“…Four studies were conducted in the USA [18][19][20]23], two in Canada [15,21] two in Italy [14,22], one in Iran [13], and another in the Netherlands [16]. Four of the studies were Randomised Controlled Trials (RCTs) [15,19,[20][21], with the others classed as quasi-experimental [13], an observational study [14], a pilot study [23], and three explorative studies [16,18,22]. Risk of bias assessment was conducted for all studies, and the method of randomisation was examined.…”

“…Two studies used a computer or central web-based programme to assign their participants into groups [15,20]. Two studies used block randomisation, where they divided their participants into blocks, depending on age [19,23]. Three studies reported that participants were randomly assigned but did not explain which randomisation method was used [13,14,21].…”

“…Approach-Avoidance Distress Scale (BAADS) and the third using Observational Scales of Behavioural Distress-Revised (OSBD-R)[15,20,23].Beran et al used the NAO robot as a means of distraction whilst the child received an injection. NAO would instruct children to blow and purposely divert their attention to fun topics.…”

Using AI-Enhanced Social Robots to Improve Children’s Healthcare Experiences

“…Recently, several studies have explored the use of social robots in this context, specifically providing psychological interventions during needle-based procedures [2,12,27]. The results of these studies have generally been positive, showing high acceptance among the target population as well as promising initial clinical results.…”