Abstract
Objectives Socially-assistive robots (SAR) have been used to reduce pain and distress in children in medical settings. Patients who perceive empathic treatment have increased satisfaction and improved outcomes. We sought to determine if an empathic SAR could be developed and used to decrease pain and fear associated with peripheral IV placement in children. Methods We conducted a pilot study of children receiving IV placement. Participating children were randomized to interact with (1) no robot, or a commercially available 3D printed humanoid SAR robot programmed with (2) empathy or (3) distraction conditions. Children and parents completed demographic surveys, and children used an adapted validated questionnaire to rate the robot's empathy on an 8-point Likert scale. Survey scores were compared by the t-test or chi-square test. Pain and fear were measured by self-report using the FACES and FEAR scales, and video tapes were coded using the CHEOPS and FLACC. Scores were compared using repeated measures 2-way ANOVA. This trial is registered with NCT02840942. Results Thirty-one children with an average age of 9.6 years completed the study. For all measures, mean pain and fear scores were lowest in the empathy group immediately before and after IV placement. Children were more likely to attribute characteristics of empathy to the empathic condition (Likert score 7.24 v. 4.70; p=0.012) and to report that having the empathic vs. distraction robot made the IV hurt less (7.45 vs. 4.88; p=0.026). Conclusions Children were able to identify SAR designed to display empathic characteristics and reported it helped with IV insertion pain and fear. Mean scores of self-reported or objective pain and fear scales were the lowest in the empathy group and the highest in the distraction condition before and after IV insertion. This result suggests empathy improves SAR functionality when used for painful medical procedures and informs future research into SAR for pain management.
Highlights
Painful medical procedures such as the insertion of peripheral intravenous (IV) catheters in infants and children can have long-lasting effects, such as increased sensitivity to future painful stimuli, avoidance of medical care, posttraumatic stress disorder, or even changes in neuronal architecture [1,2,3,4]
Socially-Assistive Robotics (SAR) offers a unique opportunity to mitigate pain during medical procedures. ey establish communication and create a shared relationship without touching the child by utilizing embodiment, personality, empathy, and adaptation skills. ese robots have been shown to reduce pain and anxiety associated with hospitalization [8, 9] and during short procedures such as vaccine administration [10] in a limited number of studies that generally use the robot solely as distraction
Children arriving to the radiology suite for IV placement prior to sedated magnetic resonance imaging (MRI) and utilizing child life services were screened for inclusion
Summary
Socially-assistive robots (SAR) have been used to reduce pain and distress in children in medical settings. We sought to determine if an empathic SAR could be developed and used to decrease pain and fear associated with peripheral IV placement in children. Mean pain and fear scores were lowest in the empathy group immediately before and after IV placement. Children were more likely to attribute characteristics of empathy to the empathic condition Children were able to identify SAR designed to display empathic characteristics and reported it helped with IV insertion pain and fear. Mean scores of self-reported or objective pain and fear scales were the lowest in the empathy group and the highest in the distraction condition before and after IV insertion. Mean scores of self-reported or objective pain and fear scales were the lowest in the empathy group and the highest in the distraction condition before and after IV insertion. is result suggests empathy improves SAR functionality when used for painful medical procedures and informs future research into SAR for pain management
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