Developing an evidence-based tool for implementing robotic pets into continuing care facilities for older adults living with dementia in Canada: a sequential exploratory mixed methods study

Abstract

Background: Animatronic (“robotic”) pets are an emerging technology found within continuing care (CC) settings that has been shown to improve the quality of life of persons living with dementia (PLWD). While research has focused on the therapeutic benefits of robotic pets, an evidence-informed implementation guide has not been developed for Canadian care providers to utilize when implementing robotic pets into CC. An evidence-based implementation guide is needed to maximize the therapeutic benefits of robotic pets and mitigate implementation challenges. Objectives: (1) Map the information collected from the international literature and ethnographic fieldnotes about the barriers and facilitators of implementing robotic pets into CC for PLWD onto the domains of the Theoretical Domains Framework (TDF) and components of the Capability, Opportunity, Motivation and Behaviour (COM-B) model. (2) Elicit feedback from Canadian care providers on the importance of these barriers and facilitators to inform the development of a robotic pet implementation guide for care providers to use. Methods: We used a sequential exploratory research design. Phase 1 consisted of a scoping review that followed the methodological framework outlined by Arksey and O'Malley, and ethnographic participant observations. Statements were developed from the findings of phase 1 and were used in phase 2, which consisted of a RAND/UCLA Modified Delphi. An implementation guide was then developed based on the findings. Results: Phase 1: Barriers and facilitators were identified across all 14 domains of the TDF and all 6 COM-B components. Common barriers include concerns over infantilization and hygiene, while common facilitators include knowledge of the benefits of robotic pets and how to use robotic pets. Phase 2: Canadian care providers believed it was important for care providers to maintain the robotic pets, that use be adaptable to the context, and that CC residents lead robotic pet interactions based on the resident’s perception of the robotic pet. Conclusion: These findings will inform healthcare practice by providing Canadian care providers with evidence-based guidance on implementing robotic pets. The guided use of robotic pets will help to improve the mental well-being and quality of life of PLWD in CC, while mitigating barriers to their use.