JMIR Publications

ABSTRACT

Background:

Hospitalization poses significant psychosocial challenges for children, including anxiety, emotional distress, and disruption of daily routines. While animal-assisted therapy has shown benefits, practical barriers such as infection control concerns and inconsistent availability limit its implementation in pediatric wards. Social robots have emerged as a promising alternative, but evidence for their psychosocial impact in pediatric settings remains limited. LOVOT is a companion robot designed for emotional engagement through warmth, softness, and non-verbal interaction; however, no studies have examined its effects in pediatric healthcare.

Objective:

This exploratory study aimed to assess the perceived impact of LOVOT on hospitalized children, their caregivers, and healthcare staff in a pediatric ward.

Methods:

This prospective observational study was conducted in a pediatric ward at Hyogo Prefectural Amagasaki General Medical Center, Japan, from May 2024 to March 2025. Two LOVOT units were permanently installed in the playroom for free interaction. Caregivers (n=110) and healthcare staff (n=32) completed post-introduction questionnaires with retrospective ratings of perceived change using 5-point Likert scales (1=much worse to 5=much better, with 3=no change as baseline). Free-text responses (n=91) were analyzed using automated emotion classification. One-sample t-tests or Wilcoxon signed-rank tests compared ratings against baseline, with false discovery rate (FDR) correction for multiple comparisons.

Results:

All 10 caregiver-rated and 11 of 12 staff-rated outcomes showed significant perceived improvement (FDR P<.05). Mean ratings ranged from 3.25 to 4.62 on the 5-point scale (baseline 3=no change). The largest perceived improvements were reported for children's enjoyment of hospital life (mean 4.47, SD 0.62), adaptation to hospital life (mean 4.10-4.28), and stress/anxiety reduction (mean 4.17-4.19). One-sample effect sizes ranged from medium to very large (Cohen d: 0.53-2.67); however, because these were calculated against a fixed neutral baseline rather than a control group, they should be interpreted cautiously. Ratings from caregivers and staff showed strong agreement on 4 of 5 matched items. Notably, no detectable increase in staff workload was observed (mean 3.09, P=.37), supporting implementation feasibility. Qualitative analysis revealed predominantly positive responses, with joy as the dominant emotion (mean probability 88.7%, 95% CI 86.8%-90.6%).

Conclusions:

This study provides preliminary evidence that a companion robot (LOVOT) may positively impact hospitalized children, caregivers, and healthcare staff across multiple psychosocial outcomes without a detectable increase in staff workload. The low response rate and reliance on retrospective self-report limit generalizability and causal inference; however, convergent findings across stakeholder perspectives justify further investigation through controlled trials. Companion robots represent a feasible, low-burden adjunct to psychosocial care in pediatric settings.