Care-receivers with physical disabilities’ perceptions on having humanoid assistive robots as assistants: a qualitative study - BMC Health Services Research
Background People with physical disabilities due to disease or injury face barriers to their daily activities and participation in society. Many depend on formal or informal caregivers for assistance to live independently. However, future healthcare challenges due to demographic changes threaten access to home care and assistants. Assistive technologies, such as robots for physical assistance, can support the independence and autonomy of people with physical disabilities. This study explore Norwegian care-receivers’ perceptions of using robot assistance in their homes, including preferences for tasks acceptable or unacceptable for robot assistance and the underlying reasons. Method Purposive sampling was employed to recruit 18 participants, aged between 18 and 77 years, with differences in physical function including diagnoses such as stroke, spinal cord injury, amputations, and muscular dystrophy. Qualitative data were gathered through four focus group interviews wherein participants watched videos featuring a humanoid assistive robot, EVEr3. The collected data underwent analysis using reflexive thematic analysis. Results Three themes with associated sub-themes were constructed: (a) How a robot could assist in daily life, (b) The robot’s appearance and functionality, and (c) Concerns about having a robot as an assistant. The participants welcomed the idea of a future robotic assistant in areas that may contribute to an increased feeling of independence and autonomy. Conclusion A robot assisting in activities of daily living would need to be individually customized to meet the needs of each user in terms of which tasks to assist with, how to assist in these defined tasks, and how it is controlled.
The participants depended on help from formal or informal caregivers and many shared the experience of rarely having any time alone, which they missed and found challenging. Although the participants repeatedly expressed appreciation for their assistants, some wished they did not have to constantly interact with the caregivers. Some longed for a “silent caregiver” and desired to be silent themselves, yearning for some time alone. Expressing a desire for “free time,” some of the participants suggested that a robot could enable independence from caregivers for parts of the day.
it’s kind of demanding… living like that… yes almost like having strangers around you at all times….that.... that’s perhaps the nicest thing about something like that (a robot) you could actually not have to deal with other people all the time; (F2-1).
Some participants mentioned that they would occasionally send their caregivers home to spend time with their partners. This meant that their partners had to provide the necessary assistance during that time, but it allowed the couples to have much-appreciated private time. Others reported experiencing a type of social fatigue when their assistants were present. They noted that they expended all their social energy on their assistants and, as a result, would cancel appointments with friends, feeling like they had “nothing left” at the end of the day.
Can I say something about that. What’s dangerous for me is that I use up.... I am pretty social, therefore, I use up my social “thing” together with my assistants all day. So, in the afternoon…I should have talked to (family and friends)… then I have nothing left. So, in that sense it could maybe be ok with a robot and then I’d have to work on getting in touch with regular people. Because now I’m using up almost all my social “thing” with my assistants. (F3-2).
The ability to decide what to do and when to do itThe participants with the most severe impairments all had personal assistants, but they still spent some periods of the day alone. Many had applied for more hours of care, but their applications were denied. They explained how the assistance services the municipality offered lacked flexibility, preventing the option of being impulsive or participating in activities and society at large. Specifically, all appointments and social engagements had to be planned around the assistant’s presence. Some stated that having a robot that was always present in addition to a human assistant could potentially support their desire to do things on their terms.One of our participants was born with a physical disability but managed to maintain a full-time position and was actively engaged in organizational work until she suffered a stroke. Her function deteriorated, and she suddenly required full-time assistance and care from her relatives. Despite her cognitive function remaining intact, her carer could not prioritize her desire to continue her organizational work. In her statements, she repeatedly expressed her wish to return to this work. She stated that what she wanted most from a robot was assistance with answering emails and keeping up with the tasks she used to perform (F4-3).The participant’s ability to control and choose their activities and level of participation became a central theme in their statements. Some individuals expressed a desire for a robot capable of assisting in various tasks, linking this desire to their wish for the freedom to pursue personal preferences at their own discretion.
[…] because… I get assistance to shower once a week, but if I had it (EVE) as well, then I could shower… whenever I wanted. (F4-2).
I agree with (name), I get to shower twice a week, but I would really like four times or even five… (F4-1).
A participant with two limbs amputated struggled with getting dressed and was denied the hours of assistance he felt he needed. His statements reflected his dissatisfaction with the services provided by his municipality. When the participants discussed how a robot could potentially assist in becoming more independent, he shared that he often waited for carers who never showed up. He had to cancel plans some days as he could not leave the house alone.Other participants shared that waiting had become a part of their new reality and that waiting often dominated their days. This included waiting for home nurses to arrive, waiting for someone to assist when their regular carers were unavailable, or waiting for their spouse to come home to help with tasks they could easily do before becoming disabled. One participant expressed: “Well- then I just have to wait; I’m good at waiting; if there was a world championship in waiting, my chances would be really good”. (F2-1). He emphasized the benefits of having a robot on hand to address immediate needs.The feeling of being a burden was prominent in m