Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-21T08:15:01.554Z Has data issue: false hasContentIssue false
  • English
  • Français

A social robot intervention on depression, loneliness, and quality of life for Taiwanese older adults in long-term care

Published online by Cambridge University Press:  14 April 2020

Shu-Chuan Chen Open the ORCID record for Shu-Chuan Chen [Opens in a new window] ,
Wendy Moyle Open the ORCID record for Wendy Moyle [Opens in a new window] ,
Cindy Jones  and
Helen Petsky
Shu-Chuan Chen*
Affiliation:
School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan R.O.C.
Wendy Moyle
Affiliation:
Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
Cindy Jones
Affiliation:
Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia Faculty of Health Sciences & Medicine, Bond University, Robina, Queensland, Australia
Helen Petsky
Affiliation:
School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
*
Correspondence should be addressed to: Shu-Chuan Chen, School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, 170 Kessels Road, Nathan, Mount Gravatt, Queensland4111, Australia. Phone: +61 7 3735 7682. Email: [email protected].
Get access

Abstract

Objectives:

To investigate the effect of a social robot intervention on depression, loneliness, and quality of life of older adults in long-term care (LTC) and to explore participants’ experiences and perceptions after the intervention.

Design:

A mixed-methods approach consisting of a single group, before and after quasi-experimental design, and individual interview.

Participants:

Twenty older adults with depression from four LTC facilities in Taiwan were recruited.

Intervention:

Each participant participated in 8 weeks of observation and 8 weeks of intervention. In the observation stage, participants received usual care or activities without any research intervention. In the intervention stage, each participant was given a Paro (Personal Assistive RobOt) to keep for 24 hours, 7 days a week.

Measurements:

The Geriatric Depression Scale, the UCLA Loneliness Scale Version 3, and the World Health Organization Quality of Life Questionnaire for older adults were administered at four time points. Individual qualitative interviews with thematic analysis followed.

Results:

A repeated multivariate analysis of variance and Friedmanʼs test showed no significant changes during the observation stage between T1 and T2 for depression and quality of life (p >.5). For the intervention stage, statistically significant changes in decreasing depression and loneliness and improving quality of life over time were identified. Three themes emerged from the interviews: (i) humanizing Paro through referring to personal experiences and engagement; (ii) increased social interaction with other people; and (iii) companionship resulting in improved mental well-being.

Conclusions:

There were significant improvements in mental well-being in using Paro. Further research may help us to understand the advantages of using a Paro intervention as depression therapy.

Keywords

social robotParoolder adultsdepressionlonelinesswell-beingpsychosocial intervention
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 8: Issue Theme: Technology for Brain Health and Artificial Wisdom , August 2020 , pp. 981 - 991
Copyright
© International Psychogeriatric Association 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). Washington, DC: American Psychiatric Pub.Google Scholar
Barua, A., Ghosh, M. K., Kar, N. and Basilio, M. A. (2011). Prevalence of depressive disorders in the elderly. Annals of Saudi Medicine, 31, 620–624. doi: 10.4103/0256-4947.87100.CrossRefGoogle ScholarPubMed
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101. doi: 10.1191/1478088706qp063oa.CrossRefGoogle Scholar
Chang, S.-H. and Yang, M.-S. (1999). The relationship between the elderly loneliness and its factors of personal attributions, perceived health status and social support. Kaohsiung Journal Medical Science, 15, 337–347.Google Scholar
Chau, R., Kissane, D. W. and Davison, T. E. (2019a). Risk factors for depression in long-term care: a prospective observational cohort study. Clinical Gerontologist, 1–14. doi: 10.1080/07317115.2019.1635548.Google ScholarPubMed
Chau, R., Kissane, D. W. and Davison, T. E. (2019b). Risk factors for depression in long-term care: a systematic review. Clinical Gerontologist, 42, 224–237. doi: 10.1080/07317115.2018.1490371.CrossRefGoogle ScholarPubMed
Chen, S.-C., Jones, C. and Moyle, W. (2018). Social robots for depression in older adults: a systematic review. Journal of Nursing Scholarship, 50, 612–622. doi: 10.1111/jnu.12423.Google ScholarPubMed
Dow, B., Lin, X., Tinney, J., Haralambous, B. and Ames, D. (2011). Depression in older people living in residential homes. International Psychogeriatrics, 23, 681–699. doi: 10.1017/S1041610211000494.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Friedman, B., Heisel, M. J. and Delavan, R. L. (2005). Psychometric properties of the 15-item geriatric depression scale in functionally impaired, cognitively intact, community-dwelling elderly primary care patients. Journal of the American Geriatrics Society, 53, 1570–1576. doi: 10.1111/j.1532-5415.2005.53461.x.CrossRefGoogle ScholarPubMed
Greenberg, S. A. (2007). Why use the GDS: SF instead of other tools? American Journal of Nursing, 107. doi: 10.1097/01.NAJ.0000292198.14195.10.CrossRefGoogle Scholar
Gupta, S. K. (2011). Intention-to-treat concept: a review. Perspectives in Clinical Research, 2, 109–112. doi: 10.4103/2229-3485.83221.CrossRefGoogle ScholarPubMed
Hoover, D. R.et al. (2010). Depression in the first year of stay for elderly long-term nursing home residents in the U.S.A. International Psychogeriatrics, 22, 1161–1171. doi: 10.1017/S1041610210000578.CrossRefGoogle Scholar
Hung, L.et al. (2019). The benefits of and barriers to using a social robot PARO in care settings: a scoping review. BMC Geriatrics, 19, 232. doi: 10.1186/s12877-019-1244-6.Google ScholarPubMed
Jøranson, N., Pedersen, I., Rokstad, A. M. and Ihlebaek, C. (2015). Effects on symptoms of agitation and depression in persons with dementia participating in robot-assisted activity: a cluster-randomized controlled trial. Journal of the American Medical Directors Association, 16, 867–873. doi: 10.1016/j.jamda.2015.05.002.CrossRefGoogle ScholarPubMed
Jøranson, N., Pedersen, I., Rokstad, A. M. and Ihlebaek, C. (2016). Change in quality of life in older people with dementia participating in paro-activity: a cluster-randomized controlled trial. Journal of Advanced Nursing, 72, 3020–3033. doi: 10.1111/jan.13076.Google ScholarPubMed
Lane, G. W.et al. (2016). Effectiveness of a social robot, “Paro,” in a VA long-term care setting. Psychological Services, 13, 292–299. doi: 10.1037/ser0000080.Google Scholar
Lee, H.-C. B., Chiu, H. F. K., Kwok, W. Y., Leung, C. M., Kwong, P. K. and Chung, D. W. S. (1993). Chinese elderly and the GDS short form: a preliminary study. Clinical Gerontologist, 14, 27–62. doi: 10.1300/J018v14n02_04.Google Scholar
Liang, A.et al. (2017). A pilot randomized trial of a companion robot for people with dementia living in the community. Journal of the American Medical Directors Association, 18, 871–878. doi: 10.1016/j.jamda.2017.05.019.Google ScholarPubMed
Liu, C.-Y., Lu, C.-H., Yu, S. and Yang, Y.-Y. (1998). Correlations between scores on chinese versions of long and short forms of the geriatric depression scale among elderly chinese. Psychological Reports, 82, 211–214. doi: 10.2466/pr0.1998.82.1.211.Google ScholarPubMed
Liu, L. J., Gou, Z. G. and Zuo, J. N. (2016). Social support mediates loneliness and depression in elderly people. Journal of Health Psychology, 21, 750–758. doi: 10.1177/1359105314536941.CrossRefGoogle ScholarPubMed
Liu, R.et al. (2013). The Chinese version of the World Health Organization Quality of Life instrument-Older Adults module (WHOQOL-OLD): Psychometric evaluation. Health and Quality of Life Outcomes, 11, 156. doi: 10.1186/1477-7525-11-156.Google ScholarPubMed
Lou, M. F., Dai, Y. T., Huang, G. S. and Yu, P. J. (2007). Identifying the most efficient items from the Mini-Mental State Examination for cognitive function assessment in older Taiwanese patients. Journal of Clinical Nursing, 16, 502–508. doi: 10.1111/j.1365-2702.2005.01551.x.CrossRefGoogle ScholarPubMed
Luppa, M.et al. (2012). Age- and gender-specific prevalence of depression in latest-life – systematic review and meta-analysis. Journal of Affective Disorders, 136, 212–221. doi: http://doi.org/10.1016/j.jad.2010.11.033.CrossRefGoogle ScholarPubMed
Marioni, R. E., Chatfield, M., Brayne, C. and Matthews, F. E. (2011). The reliability of assigning individuals to cognitive states using the mini mental-state examination: a population-based prospective cohort study. BMC Medical Research Methodology, 11, 127. doi: 10.1186/1471-2288-11-127.CrossRefGoogle ScholarPubMed
Moyle, W. (2019). The promise of technology in the future of dementia care. Nature Reviews Neurology, 15, 353–359. doi: 10.1038/s41582-019-0188-y.CrossRefGoogle ScholarPubMed
Moyle, W., Bramble, M., Jones, C. and Murfield, J. (2018). Care staff perceptions of a social robot called paro and a look-alike plush toy: a descriptive qualitative approach. Aging & Mental Health, 22, 330–335. doi: 10.1080/13607863.2016.1262820.CrossRefGoogle Scholar
Moyle, W.et al. (2013). Exploring the effect of companion robots on emotional expression in older adults with dementia: a pilot randomized controlled trial. Journal of Gerontological Nursing, 39, 46–53. doi: 10.3928/00989134-20130313-03.Google ScholarPubMed
Moyle, W.et al. (2017). Use of a robotic seal as a therapeutic tool to improve dementia symptoms: a cluster-randomized controlled trial. Journal of the American Medical Directors Association, 18, 766–773. doi: 10.1016/j.jamda.2017.03.018.CrossRefGoogle ScholarPubMed
Novick, D., Montgomery, W., Bertsch, J., Peng, X. M., Brugnoli, R. and Haro, J. M. (2015). Impact of painful physical symptoms on depression outcomes in elderly Asian patients. International Psychogeriatrics, 27, 305–312. doi: 10.1017/s1041610214002142.CrossRefGoogle Scholar
Nyqvist, F., Cattan, M., Andersson, L., Forsman, A. K. and Gustafson, Y. (2013). Social capital and loneliness among the very old living at home and in institutional settings: a comparative study. Journal of Aging and Health, 25, 1013–1035. doi: 10.1177/0898264313497508.CrossRefGoogle ScholarPubMed
Petersen, S., Houston, S., Qin, H., Tague, C. and Studley, J. (2017). The utilization of robotic pets in dementia care. Journal of Alzheimerʼs Disease, 55, 569–574. doi: 10.3233/jad-160703.Google ScholarPubMed
Power, M., Quinn, K., Schmidt, S., Group, W.-O., Grp, W.-O. and Group, W.-O. (2005). Development of the WHOQOL-Old Module. Quality of Life Research, 14, 2197–2214. doi: 10.1007/s11136-005-7380-9.CrossRefGoogle ScholarPubMed
Prieto-Flores, M.-E., Forjaz, M. J., Fernandez-Mayoralas, G., Rojo-Perez, F. and Martinez-Martin, P. (2011). Factors associated with loneliness of noninstitutionalized and institutionalized older adults. Journal of Aging and Health, 23, 177–194. doi: 10.1177/0898264310382658.CrossRefGoogle ScholarPubMed
Pu, L., Moyle, W., Jones, C. and Todorovic, M. (2018). The effectiveness of social robots for older adults: a systematic review and meta-analysis of randomized controlled studies. Gerontologist, e37–e51. doi: 10.1093/geront/gny046.Google Scholar
Robert, L. (2017). The growing problem of humanizing robots. International Robotics & Automation Journal, 3, 247–248. doi: 10.15406/iratj.2017.03.00043.Google Scholar
Robinson, H., MacDonald, B. and Broadbent, E. (2015). Physiological effects of a companion robot on blood pressure of older people in residential care facility: a pilot study. Australasian Journal on Ageing, 34, 27–32. doi: 10.1111/ajag.12099CrossRefGoogle ScholarPubMed
Robinson, H., Macdonald, B., Kerse, N. and Broadbent, E. (2013). The psychosocial effects of a companion robot: a randomized controlled trial. Journal of the American Medical Directors Association, 14, 661–667. doi: 10.1016/j.jamda.2013.02.007Google ScholarPubMed
Russell, D. W. (1996). UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure. Journal of Personality Assessment, 66, 20–40. doi: 10.1207/s15327752jpa6601_2.CrossRefGoogle ScholarPubMed
Sciutti, A., Mara, M., Tagliasco, V. and Sandini, G. (2018). Humanizing human-robot interaction: on the importance of mutual understanding. IEEE Technology and Society Magazine, 37, 22–29. doi: 10.1109/MTS.2018.2795095.Google Scholar
Seitz, D., Purandare, N. and Conn, D. (2010). Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review. International Psychogeriatrics, 22, 1025–1039. doi: 10.1017/S1041610210000608.CrossRefGoogle ScholarPubMed
Shibata, T., Kawaguchi, Y. and Wada, K. (2012). Investigation on people living with seal robot at home. International Journal of Social Robotics, 4, 53–63. doi: 10.1007/s12369-011-0111-1.Google Scholar
Shibata, T. and Wada, K. (2011). Robot therapy: a new approach for mental healthcare of the elderly – a mini-review. Gerontology, 57, 378–386. doi: 10.1159/000319015.Google ScholarPubMed
Simning, A. and Simons, K. V. (2017). Treatment of depression in nursing home residents without significant cognitive impairment: a systematic review. International Psychogeriatrics, 29, 209–226. doi: 10.1017/S1041610216001733.Google ScholarPubMed
Soler, M. V.et al. (2015). Social robots in advanced dementia. Frontiers in Aging Neuroscience, 7, 133. doi: 10.3389/fnagi.2015.00133.Google Scholar
Takayanagi, K., Kirita, T. and Shibata, T. (2014). Comparison of verbal and emotional responses of elderly people with mild/moderate dementia and those with severe dementia in responses to seal robot, PARO. Frontiers in Aging Neuroscience, 6, 257. doi: 10.3389/fnhum.2014.00257.CrossRefGoogle ScholarPubMed
THE WHOQOL GROUP (1998). Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment. Psychological medicine, 28, 551–558. doi: 10.1017/S0033291798006667.CrossRefGoogle Scholar
Thodberg, K.et al. (2016). Therapeutic effects of dog visits in nursing homes for the elderly. Psychogeriatrics, 16, 289–297. doi: 10.1111/psyg.12159.Google ScholarPubMed
Viscogliosi, G.et al. (2013). Depressive symptoms in older people with metabolic syndrome: is there a relationship with inflammation? International Journal of Geriatric Psychiatry, 28, 242–247. doi: 10.1002/gps.3817.Google Scholar
Wade, D. T. and Collin, C. (1988). The Barthel ADL Index: a standard measure of physical disability? International Disability Studies, 10, 64–67. doi: 10.3109/09638288809164105.Google ScholarPubMed
Yang, L.et al. (2015). The effects of psychological stress on depression. Current Neuropharmacology, 13, 494–504. doi: 10.2174/1570159X1304150831150507.CrossRefGoogle ScholarPubMed
Yao, G. and Chien, C. C. (2013). Validation of the WHOQOL-OLD in Taiwan. Value in Health, 16, A598–A598. doi: 10.1016/j.jval.2013.08.1683.CrossRefGoogle Scholar
Yeh, T., Liao, I., Yang, Y., HC, K., CJ, C. and FH, L. (1995). Geriatric depression scale (Taiwanese and Manderin Translation). Clinical Gerontologist, 15, 58–60.Google Scholar
Yesavage, J. and Sheikh, J. (1986). 9/Geriatric Depression Scale (GDS). Clinical Gerontologist, 5, 165–173. doi: 10.1300/J018v05n01_09.Google Scholar
Zhang, M.et al. (1990). The prevalence of dementia and Alzheimerʼs disease in Shanghai, China: impact of age, gender and education. Annals of Neurology, 27, 428–437. doi: 10.1002/ana.410270412.CrossRefGoogle Scholar