An Effort to Develop a Web-Based Approach to Assess the Need for Robots Among the Elderly

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An Effort to Develop a Web-Based Approach to Assess the Need for Robots Among the Elderly K I M M O J. VÄ N N I, A N N I N A K. KO R P E L A T A M P E R E U N I V E R S I T Y O F A P P L I E D S C I E N C E S, K U N T O K A T U 3, 3 3 5 2 0 T A M P E R E, F I N L A N D { K I M M O. V A N N I, A N N I N A. K O R P E L A } @ T A M K. F I

Aim and background To develop an approach for assessing the need for assistive and/ or social robots Objective was that the approach would assist end-users to evaluate if robots are needed, and which robot type would match best with users expectations We have designed our approach to meet the future requirements of web-based evaluation tools As far as we know, there are no web-based tools available and only few non-web based concepts for utilizing classification tools have been introduced before The nature of this study was explorative and it gave an insight into the position of designing and providing social and/or assistive robots.

Need vs. Acceptance TAM Assistive vs. social UTAUT ACCEPTANCE ALMERE (Heerink et al.) NEED ICF FUNCTIONALITY WEB BASED MODEL PROCEDURES TO SELECT ASSISTIVE DEVICES Lack of knowledge and experience

Why this topic? Number of aged people will be 1.5 billion by 2050, which is triple compared to 2010 level Increase in life expectancy, increase in cognitive disorders, and the demands for long-term care European robotics strategy favors Internet-based tools in advancing health care and robotics Robots should be integrated and health monitoring systems should operate over the Internet Conventional design of robots still favors the technology oriented approaches instead of need oriented

But where are we now? Do I need a robot or not? I don t know Robots What robots are available and from where? What robots are able to do? We don t know. Users How robots are able to assist me. Can I manage without them? Should we understand something about robots? We have lack of information. Professionals

Theoretical approach Re-evaluate Current state of life Is desired state of life Is not desired state of life No robot needed just now Factors do not support robot intervention Factors support robot intervention Literature review, ICF and previous research Evaluation aspects and related factors Robot needed Re-evaluate Factors support Social robot Factors support assistive social robot Re-evaluate User interface, robot s type, ownership, deliverable content

Methods We inquired from 10 leading professionals who represented assistive technology units of the 10 biggest cities and hospital districts in Finland to evaluate: (a) would an approach to assess the need for personal robots be useful (b) what kind of computer-based approaches hospital districts are using for assessing the need for robots for elderly if any (c) what are the current procedures in selecting robots for elderly, and (d) is robots related advisory a part of their services 7 hospital districts replied, covering about 70 % of potential cases in Finland.

Methods cont. We conducted a pilot survey among 33 wellbeing technology professionals (Median age 38, SD 7.7) and inquired them to evaluate (Likert 1 to 5) the relevance of (a) our approach pointed to elderly people, and (b) suggested factors in our approach. Of them, 11 had background from engineering, 15 from health and 7 from computing sciences. After that we tested validity of our approach by conducting the survey questionnaire among 64 elderly persons (Median age 70, SD 7.8), consisting both men and women. We carried out also a targeted literature search and evaluated 123 articles, which were related to approaches, concepts, tools, methods and variables in assessing the need for assistive or social robots, even if none of them directly presented web-based approaches.

Design of Approach Based on our previous research, literature review and the International Classification of Functioning, Disability, and Health (ICF), we created the list of seven aspects and 46 variables, which might be relevant in assessing need for robots and for evaluating a type of robot (social and/or assistive) A. user s demography and profile. B. user s social relationships. C. user s overall health. D. user s functional capacity. E. user s skills and learning capacity. F. user s possibilities to invest in robots. G. robot s deployment environment from a technology point of view. We classified the greatest part of variables by a Likert scale from 1 to 5, excluding one social factor (B18) where we asked Are you living alone or with someone? and one health factor (C25) where we asked What is your current need for rehabilitation? where scales were from 1 to 3.

Variables Table 1. Topics in self-evaluation No Topic Method* Option ICF code A. User's profile 1 Gender Select male/female n/a 2 Age Fill in current age n/a 3 Interest areas Fill in many options d9204 4 Former occupation Fill in many options d859 5 Level of religiousness Likert low to high d9301 6 Perceived need for assistive robot Likert low to high e1158 7 Estimation of usage needed Likert days and hours e1158 B. Social aspect 8 Frequency for meeting family members Likert low to high e310 9 Distance from family members Likert near to far e310 10 Frequency for meeting a caregiver Likert low to high e340 11 Distance from a caregiver Likert near to far e340 12 Frequency for meeting friends Likert low to high e320 13 Distance from friends Likert near to far e320 14 Level of loneliness Likert low to high d9100 15 Level of fear Likert low to high b198 16 Level of social networks Likert passive to active d9100 17 Level of acceptance of e-monitoring Likert neg. to pos. d599 yes/some 18 Type of housing Likert extent/no d699

C. Overall health aspect 19 Perceived physical health Likert poor to excellent b7300 20 Perceived mental health Likert poor to excellent b122 21 Level of functional capacity Likert poor to excellent b7402 22 Level of body strength Likert poor to excellent b7306 23 Level of cognitive capacity Likert poor to excellent b117 24 Effect of chronic diseases on life Likert modest to severe b2800 25 Need for rehabilitation or care Likert no/sometimes/yes e5800 D. Functional limitations aspect Level of moving 26 Legs Likert poor to excellent b7303 27 Hands Likert poor to excellent b7300 28 Head/neck Likert poor to excellent b7300 29 Back Likert poor to excellent b7305 30 Level of hearing Likert poor to excellent b230 31 Level of seeing Likert poor to excellent b210 32 Ability to communicate Likert poor to excellent d330 E. Skills and learning aspect 33 Experience of technology overall Likert low to high e1250 34 Experience of robotics Likert low to high e1258 35 Experience of smart phones Likert low to high e1250 36 Experience of computers Likert low to high e1251 37 Experience of Internet and applications Likert low to high e1251 38 Programming skills Likert low to high d1551 39 Attitude towards robotics Likert neg. to pos. e498 40 Willingness to learn new things Likert low to high d198 41 Foreign language skills Likert low to high d1558 F. Economic aspect 42 Ability to invest in assistive robotics Likert little to much d8700 43 Willingness to share a robot with others Likert low to high d998 G. Operation environment aspect 44 Easiness to move Likert easy to difficult e1550 45 Level of smart building technology Likert poor to excellent e1251 46 Access to Internet Likert poor to excellent e1250 * Likert scale is from 1 to 5, except in variables 18 and 25, where it is from 1 to 3

Results Inquiry from 10 big cities Leading professionals from seven hospital districts replied and commented that there is no any web-based method for defining and selecting assistive and/or social robots for elderly. According to them, robots are still quite unfamiliar for elderly people and cases where customers are asking any kind of robots are still limited. Professionals found interesting if there would be a web-based method, which is able to help both them and customers. We don t have anything like that but we are definitely interested in if someone will develop a method. I suppose that elderly care professionals are not ready for selecting an assistive robot for the customers because of lack of knowledge and tools. They commented also that the way how they operate just now is quite traditional, and lot of introduction and training will be needed if robot technology will be embedded into health and elderly care sector.

Results cont. Evaluation among wellbeing technology professionals Aspects and variables were relevant overall but some adjustments would be needed. They considered that issues regarding users health, functional capacity and social networks were important. Their main criticism concerned elderly people s ability to understand selfassessment questions being associated with technical issues. In addition, they said that some questions were too general and not able to reveal the real need for robots. You are not asking directly what kind of robot a user might need? Could we ask directly how interested in are you to have a robot at home if a robot is able to entertain you? Some examples how to use robots in daily activities would have clarified to elderly the need for robots. The elderly people should have more information and knowledge about robots before assessing the need for. It would be better to assess the need for a robot together with a family member. What are the cognitive skills?

Table 2. Evaluation of some factors from wellbeing professionals point of view Assessment or evaluation of: unimportant (n) average (n) important (n) Possibility to see result for need for a robot 4 12 17 Former occupations and work career 14 11 8 Level of religiousness 25 4 4 Current need for a robot 6 4 22 End-user's feeling of loneliness 3 8 20 End-user's feeling of fear 9 6 16 Acceptance of remote control of health status 0 12 19 Physical and mental health 5 3 25 Prevalence of chronic illnesses 5 8 18 Functionality of body parts 0 8 21 Functionality of senses 2 4 26 Ability to communicate 2 5 24 Former experience about technical devices 1 5 24 Attitude towards robotics 3 5 22 Possibility to invest in a personal robot 11 4 18 Note. Some replies were incomplete and sums of rows differ from 33 participants

Results cont. Pilot study among the elderly people We dichotomized test persons by their perceived need for a robot. Both groups had rather good physical and mental health, but there were some differences in functional and cognitive capacity and ability to move body parts. Both groups had some experiences about Internet and applications, but experiences about robots were limited. However, attitudes towards robots were quite neutral, but financial resources to buy robots were poor. Our approach reported that 58 % of respondents who perceived no need for robots just now, might be potential users of robot assistance anyway. Regarding another group, who perceived need for robots, the corresponding figure was 61 %, which means that in reality 39 % of them do not need robots. The biggest difference was found between type of robots needed. An approach emphasized more often assistive robots to them, who perceived to need robots, and to another group an approach could not make distinction between assistive and social robots.

Table 3. Differences in variables among two groups of elderly people Need for a robot No Variable* No (n=49) Yes (n=15) diff. 2 Median age (SD) 69 (7.6) 75 (7.6) -6 7 Estimation of robot usage (how often) 1.30 2.81-1.51 19 Perceived physical health 3.63 3.13 0.5 20 Perceived mental health 4.00 4.00 0.00 21 Level of functional capacity 3.54 2.94 0.60 23 Level of cognitive capacity 3.89 3.27 0.62 24 Effect of chronic diseases on life 3.80 2.93 0.87 26 Level of moving legs 3.73 2.88 0.85 27 Level of moving hands 3.90 3.13 0.77 29 Level of moving back 3.57 3.00 0.57 34 Experience of robotics 1.37 1.13 0.24 35 Experience of smart phones 2.43 1.75 0.68 37 Experience of Internet and applications 2.85 2.31 0.54 38 Programming skills 1.46 1.00 0.46 39 Attitude towards robotics 3.04 3.06-0.02 42 Ability to invest in assistive robotics 1.85 1.63 0.22 43 Interest to share a robot with others 1.98 2.31-0.33 * Variables employ Likert scale from 1 (poor) to 5 (excellent), except age variable

Discussion The challenge seems to be that we do not have robust tools for evaluating customers needs. We have lack of methods which can be used into decision making and design processes of social and/or assistive robots. Web-based tools for assessing the need for robots and for selecting robots are still missing even if modern ICT offers all the applications and tools for creating such a system. Our approach introduces the new idea for defining the need for robots and selecting between social and assistive robots. Our approach tries to figure the big picture of an elderly person s life at the moment with respect to need for a robot. The used variables can be tracked with ICF.

Dicsussion, limitations The number of participants was small and more research is needed to validate the approach, variables, credits and those connections between. Creating the credit system requires lot of algorithm and software development and it is one of our future targets. We are not able to guarantee the validity and importance of some variables, and the number of variables needed. Algorithms behind the system are created by us and not yet validated by long-term field tests.

But finally We state that our approach might be an important step for advancing social robotics and it gives good insight for people who operate in elderly care or robotics sectors. The feedback from elderly care and technology professionals strengthened that the web-based system for defining the need for robots is still missing but very welcome. Thank you!