Interventions Using Paro Robot in Dementia Care: A Systematic Review of Outcome Measures

Background and Objectives: The use of social robots has gained increasing attention in recent times. Paro robot, in particular, is an interactive therapeutic robot that has been used for older adults with dementia to alleviate dementia symptoms. However, there is a paucity of reviews on the outcome measures of the interventions using Paro robot. The aim of this study was to identify and delineate the outcome measures in studies on interventions using Paro robot for older adults with dementia. Methods: Randomized controlled trials of interventions from 2003 to October 2017 using Paro robot for older adults with dementia were systematically reviewed. We searched the databases (Web of Science, PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane, Scopus, etc.) for relevant articles in English. Reference lists of included articles were also hand-searched. The data were analyzed narratively. Results: Eight studies were included in the review. The interventions using Paro robot were individual or group-based with a maximum of 15 participants. Interventions varied across trials in terms of frequency (2 to 3 times per week) and duration (15 to 45 minutes per session for 5 to 12 weeks). The outcomes measured varied across studies, which included cognition, psychosocial (anxiety, depression, affect, social interaction, engagement), behavioral (agitation, neuropsychiatric symptoms), physiological (pulse rate, skin response), and other responses (quality of life, medication utilization). Video observation of participants was used to measure changes in the outcomes of affect, agitation, and social engagement. Outcome indicators such as anxiety, apathy, and agitation were measured separately using reliable scales or as part of mood states or neuropsychiatric symptoms. Conclusion: This study identified several outcome measures used to assess changes after interventions using Paro robot. There were variations in the types of outcomes measured across studies. It is essential to determine a core set of outcomes to be measured in order to build nursing knowledge and provide the best evidence for interventions using Paro robot for older adults with dementia.