Maschine statt Mensch: Robotik in der Pflege Sabina De Geest, Professor of Nursing Science BGS Tagung Basel, October 27, 2017 Version 26.10.17 4 TH Industrial revolution - Digitalisation - Robotics Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 2 1
BAZ, 01.02.2015 Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 4 2
Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 5 GDI 2017 3
PR2. Courtesy of Willow TUG from Aethon https://www.youtube.com/watch?v=rhmezl7izgi http://www.aethon.com/ 4
http://pulse.embs.org/january-2015/the-robot-will-see-you-now-telepresence/ 5
Bevölkerungsentwicklung, Gesundheitsversorgungs- und Personalbedarf 2020 50% 40% 30% 20% Referenzszenario Hospitalisationsdauer Gesundheitszustand 10% 0% -10% 0-19 J.. 20-64 J.. 65+ J. Spitalaufenthaltstage AP-Heimaufenthaltstage Spitexdienste Vollzeit Äquivalente Alternatives Szenario Hospitalisationsdauer +/- Gesundheitszustand +/- Bevölkerung Pflegebedarf Stellenbedarf OBSAN, 2009a 6
Why an interest for robotics in nursing care? Growth in robotics is expected due to workforce shortages, a growing elder population, and a call for higher quality care not subject to human limitations Areas of projected robotic growth include also the use of robots as direct care providers. Robots are expected to become part of our (professional) daily life http://nursingworld.org/mainmenucategories/anamarketplace/anaperiodicals/oji N/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Emerging-Technology.html Kachouie et al. Int. J of Human-Computer Interaction 2014; 30: 369-393 Two categories of robots in nursing Rehabilitation robots - focus on physical assistive technological features - not communicative e.g. smart wheelchairs, artifical limbs Assistive social robots I. Service robots: support basic tasks of independent living (e.g. eating, bathing, mobility, navigation, II. monitoring, safety) Companion robots: aim to enhance the health and psychological well being of the elderly Kachouie et al. Int. J of Human-Computer Interaction 2014; 30: 369-393 7
Real life examples of robotics in nursing Video 1.17 www.youtube.com/watch?v=59a-rxsxstm Video 5:15 http://www.youtube.com/watch?v=abpotvlzh2u Vote Would you be open to be assisted by a robot when you would need nursing care? YES NO Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 16 8
Vote Would you be open to be assisted by a robot when being in a hospital or in a nursing home? YES NO Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 17 Vote Would you be open to be assisted by a robot at home if this would help you to delay/avoid a nursing home admission? YES NO Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 18 9
Scientific evidence? 107 robots identified 6 robots in concept phase 95 in development phase 6 commercially available Support in 4 activity domains: mobility, self care, interpersonal interaction and relationships, and other activities Bedaf et al. Assistive Technology, 27:2, 88-100, DOI: 10.1080/10400435.2014.97891 Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 20 10
Capabilities of robots for older people Assistance Monitoring Companionship Robinson H, MacDonald B, Broadbent E.: The role of healthcare robots for older people at home: A Review. Int. J. of Social Robotics 2014, 6; 575-591. 11
Mental service robot Paro is fitted with sensors beneath its fur and whiskers and it responds to petting by opening and closing its eyes and moving its flippers. Paro is used to provide comfort and reduce stress in nursing home residents. Character Giving Model of KANSEI Robot Based on the Tendency of User s Treatment for Personalization KANSEI robot. Interacting with human. Robots designed for human-robot interaction are expected to have the ability of communicating with human smoothly. Surprise Anger Sadness Disgust Happy Fear Horoki Ogasawara and Shobei Kato Intelligent Interactive Multimedia: Systems and Services Smart Innovation, System and Technologies Volume 14, 2012, pp 117-127 12
Where have evaluation Where studies been performed? * ** * * * Kachouie et al. Int. J of Human-Computer Interaction 2014; 30: 369-393 The effects of socially assistive robots (SAR) on the elderly Summary of Nearly all studies report positive effects in elderly Outcomes care Positive emotions Improvement in feeling and mood, improvement in emotional state, feeling good experience, decrease in stress level, increase in laughter, elderly become calmer, increase in sense of security and joy of life, richer expressions Engagement Relationships Meaning Achievement Other effects Evocative experience, increase in activities, ease to externalize elderly internal emotions, increase activity during occupational therapy, motivating physical activity, more active movements Increase in social interactions and activities, increase in social networks and ties, positive social effects, decrease in loneliness, encourage and smooth the communication, attachment to robot, facilitate the establishment of friendly relationship Decrease in depression Sense of achievement in winning one-to-one or group games Positive psychological effect, improvement in cortical neurons, positive reaction of vital organs to stress, decrease in CgA, improvement in abilities, decrease in physical disruptive behavior Kachouie and overall et al. agitation, Int. J of Human-Computer improvement in personalization Interaction of care 2014; 30: 13
Issues to be addressed (1) 1. Cultural background patients need to be taken into consideration, i.e. values & preferences 2. User-centered design - Involve all stakeholders (i.e. elderly, family, nurses, other caregivers) The importance of a user centered design in developing (e-)health technology Slide courtesy Fabienne Dobbels KU Leuven 14
Issues to be addressed (2) 1. Cultural background patients need to be taken into consideration, i.e. values & preferences 2. User-centered design - Involve all stakeholders (i.e. elderly, family, nurses, other caregivers) 3. Evaluation of usability 4. Long-term effects? 5. Person centered care? 6. Legal aspects? 7. Ethical aspects? Ethical issues 1. Non-maleficence, Beneficence, Autonomy & Justice 2. What about the pro s and cons of a particular solution? Would we even be considering this if the person was not elderly or if they did not have dementia? If this is the case what does it say about our view of the person with a disability or impairment? Are we failing to take into account their strengths or their wishes for example? What would I want for myself in this situation? What might the views be of everyone involved about the proposed action and the consequences of doing or not doing it? e.g. Do we agree about the level of risk (actual and perceived)? Is everyone involved aware of the pros and cons of this technology on the person and their carers? The ethical use of assistive technology http://www.atdementia.org.uk assessed May 20, 2015 15
What are the implications for nursing education (1)? - Learning how to optimally use robotics in nursing care - Reflecting on implications for nursing competencies in using/collaborating with robots - Interprofessional education: robots part of team approach? Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 31 What are the implications for nursing education (2)? - New nursing roles University of Virginia Commonwealth, USA Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 32 16
More rigourous research and evaluation is needed!! http://ec.europa.eu/digital-agenda/en/news/slides-and-video-icthealth-and-ageing-well-horizon-2020-health-info-day http://ec.europa.eu/digital-agenda/en/news/slides-and-video-icthealth-and-ageing-well-horizon-2020-health-info-day 17
http://ec.europa.eu/digital-agenda/en/news/slides-and-video-icthealth-and-ageing-well-horizon-2020-health-info-day FP7 research projects examples Companionable (IP) Integrated Cognitive Assistive & Domestic Robotic Systems for Ability net/ & Security http://companionable. SRS Multi-Role Shadow Robotic System for Independent Living http://srs-project.eu/ MobiServ An integrated Intelligent Home Environment for the Provision of Health Nutrition and Mobility Services in the Elderly http://www.mobiserv.info/ ACCOMPANY Acceptable robotics COMPanions for AgeiNg Years http://accompanyproject.eu DOMEO Domestic Robot for elderly assistance www.aal-domeo.eu 18
Journal of Nursing Scholarship Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 37 Contemporary Nurse, 2017 Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 38 19
Conclusions Current graying of population and health care personnel shortages drive investment and innovation in view of robotics in nursing Robots will be part of our daily (professional) life in the future Rehabilitation robots & Assistive social robots Many projects underway for developing and testing of robots yet with limited end-user involvement Nursing needs to be part of this development and proactively reflect and plan what role of robots in nursing might be Legal and ethical dimensions need also to be addressed Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 39 it should have one!!!! Titel Vortrag, Autor, DD.MM.YY Universität Basel, Department Public Health PFLEGEWISSENSCHAFT 40 20
Vielen Dank für Ihre Aufmerksamkeit. sabina.degeest@unibas.ch 21