JMIR Publications

ABSTRACT

Background:

Socially assistive robots (SARs) have demonstrated significant efficacy in pediatric hospital care for reducing procedural pain and anxiety, yet widespread clinical adoption remains limited to isolated pilot studies. This research-to-practice gap is primarily organizational and psychological, driven by healthcare professionals’ (HCPs’) uncertainty about SARs’ clinical role, technological reliability, and relational value. Existing technology acceptance frameworks, such as the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), were developed for productivity software and do not adequately capture the relational and institutional dynamics central to SAR adoption in pediatric settings.

Objective:

This study aimed to identify the psychological, relational, and institutional factors that predict pediatric HCPs’ behavioral intentions toward SAR adoption.

Methods:

A convergent parallel mixed-methods design was employed at a tertiary academic medical center in northern Taiwan. The quantitative strand administered a validated 24-item extended UTAUT2 questionnaire to 125 pediatric HCPs measuring Performance Expectancy, Effort Expectancy, Social Influence, Facilitating Conditions, Hedonic Motivation, Trust, and Behavioral Intention; multiple regression and ANOVA were the primary analyses. The qualitative strand conducted 17 semi-structured interviews with nurses and physicians, analyzed using thematic analysis. Findings were integrated through a convergent parallel joint display.

Results:

The multiple regression model explained 72.2% of variance in behavioral intention (adjusted R²=.707, F (6,118) = 50.96; P<.001). Social Influence (β=.394, P<.001) and Hedonic Motivation (β=.379, P<.001) were the co-primary predictors, followed by Performance Expectancy (β=.215, P=.003) and Trust (β=.151, P=.028); Effort Expectancy was non-significant (β=.008, P=.900). Prior SAR exposure showed a significant dose-response effect on behavioral intention and overall acceptance (P<.001). Thematic analysis yielded 6 themes and 33 categories covering emotional challenges, SAR functional roles, HCP attitudes, child-centered design, implementation considerations, and institutional decision-making. PICU staff had significantly lower Trust scores than other units (P=.011, η²=.165).

Conclusions:

Pediatric HCPs evaluate SARs primarily as relational entities and through institutional norm signals rather than purely functional criteria. Structured exposure programs and institutional accountability frameworks represent high-leverage implementation strategies, suggesting that organizational norm-targeting strategies may be more efficient than individual-level persuasion for initiating SAR adoption.