Using PARO, a robotic seal, to support people living with dementia: ‘what works’ in inpatient dementia care settings?

Emily Shoesmith, Chris Clarke, Grace McPherson, Elena Ratschen
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Abstract

Introduction: The robotic seal PARO has received increased attention as a new technology to support people living with dementia in terms of emotional and physiological outcomes. However, little research has been conducted to improve understanding of how and why PARO may work within inpatient dementia care. We investigate for whom PARO works best in this setting, and why PARO may work. Methods: Informed by principles from realist methodology, qualitative interviews were conducted with healthcare professionals, participants with dementia and their relatives to explore experiences related to the delivery and receipt of an intervention using PARO in an inpatient dementia ward in the United Kingdom (UK). Observations of PARO intervention sessions were conducted to gain further insight into provision and implementation of sessions using PARO in ‘real time’. Data were analysed using thematic analysis, and using the process of configuration mapping, we constructed a visualisation of our findings framed within the Intervention-Context-Actor-Mechanisms-Outcomes (ICAMO) model. Results: The visualisation of our findings framed within the ICAMO model suggests that PARO may result in positive outcomes within inpatient dementia care due to a range of potential mechanisms, including enhancement of social interactions, developing a sense of attachment, evoking emotive memories, physical interaction, and perceiving the robotic animal as a live being. For these mechanisms to be activated, the sessions should be structured but participant-led, and be delivered as needed in a one-to-one setting by a skilled facilitator. Conclusion: Using PARO in an inpatient dementia care context appeared promising and well-received in this small observational study. This study explicitly considers the context and mechanisms of using PARO within inpatient dementia care settings, presenting findings in a structured visualisation framed within the ICAMO model and offering a theoretical basis for future intervention research.
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使用机器人海豹 PARO 为痴呆症患者提供支持:在痴呆症住院护理环境中 "什么有效"?
简介作为一种在情感和生理方面为痴呆症患者提供支持的新技术,机器人海豹 PARO 已受到越来越多的关注。然而,关于 PARO 如何以及为何能在痴呆症住院护理中发挥作用的研究却很少。我们研究了 PARO 在这种情况下对哪些人最有效,以及 PARO 为何有效。方法:在现实主义方法论原则的指导下,我们对医护人员、痴呆症患者及其亲属进行了定性访谈,以探讨在英国(UK)的痴呆症住院病房中使用 PARO 提供和接受干预的相关经验。此外,还对 PARO 干预疗程进行了观察,以进一步了解 "实时 "使用 PARO 提供和实施疗程的情况。我们使用主题分析法对数据进行了分析,并通过配置图的绘制过程,在 "干预-背景-角色-机制-结果"(ICAMO)模型的框架内构建了可视化的研究结果。结果:根据 ICAMO 模型对我们的研究结果进行的可视化分析表明,PARO 可通过一系列潜在机制,包括加强社会互动、培养依恋感、唤起情感记忆、肢体互动以及将机器人动物视为活物等,在痴呆症住院护理中产生积极的效果。要激活这些机制,课程应该是结构化的,但由参与者主导,并由熟练的主持人根据需要在一对一的环境中进行。结论在这项小型观察研究中,在痴呆症住院患者护理中使用 PARO 似乎很有前景,而且很受欢迎。本研究明确考虑了在痴呆症住院患者护理环境中使用 PARO 的背景和机制,在 ICAMO 模型的框架内以结构化可视化的方式展示了研究结果,并为未来的干预研究提供了理论基础。
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