JMIR Publications

ABSTRACT

Background:

Socially assistive robots that provide emotional support have been proven effective in dementia care. However, it remains unclear how the characteristics of healthcare and long-term care providers, as well as differences across clinical settings, influence perceptions of effectiveness and the real-world implementation.

Objective:

To examine, from an exploratory perspective, the factors influencing the perceived effectiveness of the seal-like robot “Paro”—such as the attributes of healthcare and long-term care professionals and the facility environment—and to identify practical insights for more effectively utilizing Paro.

Methods:

A survey using a convergent parallel mixed-methods study design targeting 162 healthcare and long-term care professionals employed at Japanese medical institutions and long-term care facilities. A questionnaire comprised 20 items on core symptoms, Behavioral and Psychological Symptoms of Dementia (BPSD), caregiver burden, and the purpose of Paro introduction. We analyzed the quantitative data using multiple regression analysis, correspondence analysis, and other methods. Qualitative data from open-ended responses were analyzed using reflexive thematic analysis with researcher triangulation.

Results:

The results of the multiple regression analysis suggested that, even after adjusting for participants' attributes (differences in perspective based on gender and occupation) and facility type, “continuous use for three years or more” remains a significant factor in reducing caregiving burden (B=0.598, P=.043). Correspondence analysis revealed a dichotomy in Paro's role, depending on the environment and professional role: the “medical/acute care model,” which focuses on managing delirium and sedation in hospitals, and the “daily living model,” which addresses wandering and the desire to return home in long-term care facilities. This polarization was already evident from the initial stages of implementation, with medical staff clearly focused on “treatment” and care staff on “recreation.” The thematic analysis identified four themes, including “Support for self-regulation of emotions and behavior” and “Regaining social roles and interpersonal interactions.” While many professionals recognized that Paro interventions have a positive impact on core symptoms, BPSD, and caregivers, a small number of reports indicated negative effects. Matching the characteristics of people with dementia to their environment and ensuring appropriate professional intervention are essential.

Conclusions:

This survey confirmed that professionals recognize that Paro’s activities have a positive effect on people with dementia. This perception is influenced by factors such as the participants' expertise and gender. Continuous use for three years or more may be a key factor in reducing the burden of care, regardless of perspectives or attributes. To maximize the benefits of robot use, it is important to understand how staff members’ attributes influence their perception of these benefits and to adopt specific implementation strategies tailored to the unique characteristics of each setting, such as medical institutions and long-term care facilities. Clinical Trial: N/A