Consideration of Safety Management When Using Pepper, a Humanoid Robot for Care of Older Adults

Pepper, a humanoid robot, is 1.2 m in height and is designed to move its limbs. There are risks of the older adults experiencing falling and collision accidents when they interact with Pepper. When physical interaction happens between a humanoid robot and human beings, potential harmful physical contact might occur. The aim of this report was to examine the safety management aspects when using Pepper, a humanoid robot for the care of older adults. The older adults’ reactions to Pepper’s functions cannot be predicted. Hence, it is necessary to clarify methods to guarantee its safety in advance and to increase the safety and properties of the robots. The benefits of introducing support robots such as Pepper for aging medical and nursing care settings are obvious. Therefore, engagement in robot development while considering both the risks and benefits is critical. Our academic initiatives have just begun. Through information exchange among researchers, users, engineers, and law specialists, we need to identify latent and prominent risks in situations where Pepper and the older adults interact and deepen our examination of measures against such risks.

The Impact of Multidisciplinary Care in a Large Volume Robot-Assisted Radical Prostatectomy Program: A Paradoxical Stage Migration toward More Aggressive Disease

Introduction: With the widespread use of robot-assisted radical prostatectomy (RARP), a stage migration to less aggressive prostate cancer (CaP) may be expected in pathological specimens due to over-treatment of low risk disease. It is unclear whether implementation of a multidisciplinary clinic (MDC) model would offset this phenomenon. We sought to analyze our database for possible stage migration in prostatectomy specimens in the setting of MDC. Methods: A total of 262 patients who underwent open prostatectomy (OP) from 2004 to 2006 and 757 patients who underwent RARP from 2007 to 2011 were identified from our prospective database. The implementation of MDC occurred concurrently at the time of RARP initiation. Demographic data, pathology, positive margin rates along with standard CaP reporting data were recorded. The two groups were compared with regards to percentage of cases stratified by Gleason grade. Results: The number of CaP cases managed at our institution increased considerably after the introduction of robotics and MDC. There was a significant decrease in the patients with Gleason 6 CaP undergoing RARP as compared with OP (p = 0.001). Additionally, RARP was performed on a significantly greater percentage of Gleason 7 disease (p < 0.001). When comparing pathological stage, there was a significant increase in the incidence of pT3 disease following RARP (p < 0.0001). Conclusions: The introduction of a MDC and minimally invasive radical prostatectomy did not result in an increased application of surgery for the treatment of low risk prostate cancer. This highlights the importance of MDC in a large volume RARP program.

The Intermediary Roles of Public Health Nurses (PHNs) in Utilizing Communication Robots (CRs) in Community Health Care Practice

Robot technology is expected to reduce the burden of medical professionals, a concern in the super-aged society. The aim of this article is to determine the intermediary roles of Public Health Nurses (PHNs) in using Communication Robots (CRs) in Community Health care. It is necessary to consider who will manage, and how to draw lines of responsibility when a problem occurs when using robots in the future. Regarding the mediator or intermediary role of PHNs in the use of CRs, PHNs are expected to be cognizant of varieties of robots for use with persons of diverse ages and health levels, as well as of robot performances. As one of the community healthcare workers who service the elderly living in the community, the role of PHNs as mediators or intermediaries is to pay attention to ethical and moral issues while working with CRs to manage the health of the community. Lack of understanding of the intermediary role might create possible ethico-moral issues in the future. Therefore, it is critical for PHNs to understand their role as intermediaries. In doing so, it is expected that older people at home will be able to live peaceful lives, as well as be physically and mentally healthy.

智能机器人在基层慢性病管理中的应用与挑战

全球慢性病患病率不断上升,给社会的发展和个人健康带来重大挑战。管理慢性病需要长期治疗和监测,对患者的生活方式提出了一定要求。随着人口老龄化和人们生活方式的改变,慢性病防控正变得越发重要。近年来,随着医疗卫生领域科技创新向纵深发展,借助人工智能的智能机器人在医疗领域的应用也逐渐成为国家重要战略方向之一,传统的慢性病管理方法过于依赖医生和患者之间的线下交流,导致医生无法与患者保持长期且有效的沟通和随访,患者病情出现变化时医生可能无法及时发现和监测。此外,传统的慢性病管理方法通常是一种通用化的方法,无法充分考量到每位患者的个体差异。鉴于传统慢性病管理方法的局限性,本文提倡利用智能机器人提供更便捷高效的基层服务。本文认为,通过个性化健康管理方案、辅助医疗诊断、定时提醒服药等功能,使智能机器人能够致力于改善患者生活质量、减轻医疗资源压力,从而推动全球智能化医疗管理的发展。

Implementation of Robotic Hygiene System for Surveillance and Prevention of Hospital Infections in Non-Self-Sufficient Patients

Background: Personal hygiene in non-self-sufficient patients is essential to prevent the proliferation and spread of bacteria from one patient to another, both through inanimate objects (fomites) and directly through healthcare workers. The first 1000 bed hygiene treatments performed by the collaborative robot “COPERNICO Surveillance & Prevention” in 229 non-self-sufficient patients were analyzed. Materials and Methods: A total of 229 patients were included: 215 patients came from emergency contexts or home, and 14 from long-term care facilities;the presence of sepsis, venous or urinary catheters, non-invasive ventilation, bedsores, clinical condition at discharge, and treatment sessions performed were recorded. All patients were hospitalized in the Geriatrics, Medicine and Pneumology departments. The system is able to collect and process data in real time. Results: Seventy-one patients with community-acquired sepsis and fourteen with healthcare-associated infections were treated;sixty-two had pressure ulcers. The analysis of the first 1000 treatments shows the healing of almost all sepsis cases, positive evolution of pressure ulcers, and hospital stays comparable to those of the entire group of 1008 hospitalized in the same period. There was no onset of side effects or complications. Conclusions: Although the healthcare setting is not among those at greatest risk of infections, the clinical efficacy, along with excellent evaluations from patients, family members, and healthcare personnel and the absence of side effects and complications, makes the system exceptionally manageable and user-friendly for non-self-sufficient patients.

场驱动医疗微机器人:材料制备工艺不断优化的应用前景

背景:微机器人具有体积小、灵活、靶向性强等特点,可以在狭窄的环境下通过单体或集群的方式完成复杂的工作。随着材料、制备工艺以及驱动方式的不断优化,其在生物医学领域内显示出越来越重要的应用价值。目的:分析场驱动微机器人在生物医学领域的应用并展望其应用前景。方法:以“微机器人,纳米机器人,驱动,生物医学,医疗”为中文关键词,以“microrobots,micro-robots,nanorobots,micromachine,microswimmer,medical”为英文关键词,分别检索万方以及Pub Med数据库,检索时间范围重点为2010年1月至2024年1月,同时纳入少数远期文献。通过阅读文题、摘要初步筛选,排除重复性研究、低质量期刊以及与内容不相关的文献,阅读全文后最终纳入66篇文献进行综述。结果与结论:场驱动医疗微机器人涵盖了磁、光、热、超声及多种混合因素驱动机器人。场驱动机器人已被应用于肠道诊断、药物靶向治疗及干细胞治疗等多个领域。尽管医用微机器人在临床医学中已有少数应用,但大多数还处于理论和实验阶段。医用微机器人的未来面临诸多挑战,如实现大规模制备、进一步提升精确控制、解决回收或体内降解问题,以及所用材料是否会对人体产生不良反应等,此外微机器人还需与相应的微创医学手术相配合。

Estimation of an Object＇s Physical Parameter by Force Sensors of a Dual-arm Robot

We are developing a nursing-care robot for physical care tasks. The concept of this robot is to promote the cared persons by the robot to activate their own motion ability as long as possible. This may lead to the improvement of the cared person＇s movement volition and movement abilities. In order to realize safe and human friendly robot care tasks, full body manipulation is an important technology, for which it is necessary to estimate the subject＇s center of gravity from the contact positions and forces with the robot＇s two arms. In this paper, we estimate the center of gravity of object based on the contact point and the contact force estimated by force sensor on both robot arms. The position of gravity center is important to realize care tasks stably. We performed experiments and simulations for the single point contact and dual points contact cases using a cylindrical object. As a result, it is found that although some errors were recognized in the experiments compared with the simulations, the relations between the contact positions and such errors were observed. Such experimental error mainly comes from the difference of shape between the real robot and the model of the robot in simulation.

Posture Maintenance Control of 2-Link Object By Nonprehensile Two-Cooperative-Arm Robot Without Compensating Friction

In this paper, a method to posture maintenance control of 2-link object by nonprehensile two-cooperative-arm robot without compensating friction is proposed. In details, a mathematical model of the 2-link object is firstly built. Based on the model, stable regions for holding motion of nonprehensile two-cooperative-arm robot are obtained while the 2-link object is kept stable on the robot arms with static friction. Among the obtained stable regions, the robust pairs of orientation angles of the 2-link object are found. Under the robust orientation angles, a feedback control system is designed to control the arms to maintain the 2-link object's posture while it is being held or lifted up. Finally, experimental results are shown to verify the effectiveness of the proposed method.

Recommended Design and Direction of Development for Humanoid Nursing Robots Perspective from Nursing Researchers

The purpose of this article is to describe recommendations towards the design and direction of development for Humanoid Nursing Robots (HNRs) from the standpoint of researchers of nursing care practice. Efforts to introduce robot technologies in nursing practice and to use them in elderly and high-tech healthcare environments have begun in developed countries like Japan. Companies are developing various types of robots, although their types and functionalities continue to require a clear identification and definition. Regardless, robot developments for health care purposes are progressing well to meet universal technological demands. While human caring has been a human-to-human relationship, in a nonhuman-to-human relationship in the case of HNRs, it is essential to consider ethical concerns and human safety. If HNRs are to support patients directly, they must be required to have the same level of comprehensive judgment ability and responsiveness as that of human nurses. This includes abilities to genuinely observe, judge, rapidly respond, and conduct human caring practice emphasizing individuality. If HNRs support patients independently, abilities which are much like those of humans will be required of them in addition to the appropriate intelligence and skillfulness to do so. A low level robot nurse exerts work that should be called non-nursing or as a medical aid assistant no matter who thinks and what these technologies can do. Similarly, a higher level HNR with higher level artificial intelligence is expected to exceed the capabilities of human beings. As such, current discourse and debate also include the concern that HNRs may now become one’s superior or rather that the HNR is a subordinate thereby requiring human management.

改良Robocare管理模式在达芬奇机器人子宫内膜癌手术患者中的应用

目的探讨改良Robocare管理模式在达芬奇机器人子宫内膜癌手术患者围手术期中的应用效果。方法以广西贵港市人民医院妇科进行达芬奇机器人子宫内膜癌手术的患者为研究对象,其中,2020年7月—2021年3月入选的31例患者为对照组;2021年4—12月入选的32例患者观察组。观察组采用改良Robocare管理模式对患者进行围手术期管理,对照组采用妇科常规护理方法。比较两组患者手术前后转送交接时间、漏实施项目发生率、首次下床活动及首次肛门排气的时间、并发症发生率、干预前后焦虑评分、患者满意度、住院时间。结果观察组手术前后转送交接时间、漏实施项目发生率与对照组比较差异均有统计学意义(P<0.05);观察组首次下床活动及首次肛门排气的时间短于对照组,两组比较差异均有统计学意义(P<0.05);两组干预后焦虑评分均低于干预前,且观察组焦虑评分低于对照组,差异有统计学意义(P<0.05);观察组患者满意度高于对照组,差异无统计学意义(P>0.05),两组住院时间及并发症发生率比较,差异无统计学意义(P>0.05)。结论子宫内膜癌手术患者应用改良Robocare管理模式,能有效缩短交接时间,降低转送交接漏项发生率,改善患者焦虑情绪,促进术后康复,有利于提高患者满意度。

福祉机器人基础研究与系统开发及展望

以沈阳工业大学中日福祉机器人研究中心科技成果为主线,指出福祉机器人领域中某些观念误区、基础研究的重要性及推广应用中的技术瓶颈。提出福祉机器人的简明定义,从系统构成角度阐明福祉机器人与工业机器人的本质区别,并以自主研发的机能康复机器人、部分失能者自立生活辅助机器人、完全失能者护理机器人等为例,通俗地论述了其社会背景、基本研究理念、具体研究内容及难点、取得的创新性成果及正在攻关的挑战性课题。对福祉机器人新兴领域的科研机遇、人才需求、市场规模及就业前景等进行了展望。

Influence of Robot-Assisted Tumor Surgery Nursing on Patient Rehabilitation in Operating Room and Discussion on Nursing Strategies

Objective: To evaluate the effect of operating room nursing on the outcome of patients undergoing robot-assisted tumor surgery. Methods: This research starts from October 2021 to October 2022. The number of patients with robot-assisted tumor surgery included in our hospital is 769. The patients are treated in the operating room, and the prognosis of the patients is summarized. Results: The intraoperative blood loss in patients undergoing robot-assisted tumor surgery was (57.51 ± 12.01) ml;the operation time was (3.57 ± 0.66) h;and the hospital stay was (6.04 ± 0.53) d. There were 21 cases of complications after robot-assisted tumor surgery, accounting for 2.73%. After surgery, all robot-assisted tumor surgery patients recovered and were discharged smoothly after being checked by doctors. Conclusion: Robot-assisted tumor surgery nursing has a definite effect on patients’ rehabilitation in the operating room.

人工智能在养老护理中的应用与展望

人工智能的理论与技术日益成熟,其主要目标是让机器代替人完成复杂的工作。人工智能技术与养老护理相结合,有效地弥补传统养老模式的不足,有力推动养老护理行业的发展。人工智能在养老护理中的应用主要表现为生活照护、健康账款监测、病情变化预测、运动康复训练、智能药物管理等方面。目前,人工智能的应用在缓解职业压力、弥补养老护理人力资源的不足、改变养老护理模式等方面取得了一定成效,同时也存在着智能养老护理产品功能单一、缺乏管理法规、产品价格偏高、技术安全不能完全保障和一定的伦理风险等问题。人工智能在养老护理中的应用虽然存在一些问题,但它是一种新生事物,具有广阔的发展前景。在未来,应提高对人工智能的认识,着力解决存在的问题,积极推动人工智能在养老护理中的应用。

教育机器人在空巢老年糖尿病患者延续护理中的应用

目的 探讨空巢老年糖尿病患者运用教育机器人实施延续护理的效果。方法 选取118例空巢老年糖尿病患者作为研究对象,按入院时间分为观察组和对照组各59例,对照组接受常规延续护理方案,观察组应用教育机器人进行延续护理。6个月后对两组血糖相关指标、自我管理行为得分、糖尿病特异性生存质量得分进行比较。结果 出院后6个月复查时观察组自我管理行为得分、血糖相关指标、糖尿病特异性生存质量得分显著优于对照组(均P<0.05)。结论 应用教育机器人对空巢老年糖尿病患者进行延续护理,能够提升空巢老年糖尿病患者自我管理能力,改善血糖指标,提升生活质量。

双臂移乘护理机器人起抱位置与移乘姿态规划

首先,建立被护理人的4连杆模型,并结合机器人姿态信息建立人机系统力学模型,分析移乘中被护理人的受力(内力、外力);其次,通过问卷调查,确定各内力、外力对人体舒适性影响的权重,建立舒适性评价函数,并运用所建立的舒适性评价函数以优化被护理人移乘舒适性为目的规划起抱位置与姿态。本文进行了接触力和表面肌电(sEMG)测试实验。结果显示:本文方法规划的起抱位置与姿态,能够有效降低被护理人与机器人之间的接触压力,并把移乘中的腰部内力负担减轻44.2%,提高了移乘的舒适性。

机器人在危重症患者护理中的应用现状及挑战

当前机器人产业蓬勃发展,正改变着人类生产和生活方式,为经济社会发展注入强劲动能。危重症护理的特殊性使其成为机器人发挥重要作用的领域之一。该文通过综述机器人在危重症护理领域中的应用现状,介绍机器人在远程查房、辅助早期活动、药物配置、情感支持方面的研究概况,分析在实用性、经济和伦理、职业发展及护理人才方面的挑战,旨在为危重症护理的智能化建设提供参考。

医护一体化模式在经口入路机器人甲状腺手术全程管理中的应用

目的探讨医护一体化模式对经口入路机器人甲状腺手术配合中的应用效果。方法采取历史对照研究方法,以湖南省某三级甲等肿瘤医院85例行经口入路机器人甲状腺手术患者为研究对象,2021年7月至2022年3月收治的43例患者为对照组,采取常规护理模式;2022年4月至11月收治的42例患者为观察组,采取医护一体化模式。比较两组单只无菌臂罩套装时间、连接机械臂的时间、平均术中调整机械臂的次数、医生对护士的满意度和患者对护士的满意度。结果观察组单只无菌臂罩的套装时间、连接机械臂的时间均短于对照组,平均术中机械臂调整的次数少于对照组,医生对护士的满意度高于对照组,患者对护士的满意度高于对照组,差异均有统计学意义(P<0.05)。结论医护一体化的经口入路机器人甲状腺患者手术全程管理,增强医护间的有效沟通,提高手术配合默契度及手术效率与效能,有利于改善患者的手术治疗结局,提升手术护理质量。

基于循证理念的无缝隙护理在机器人辅助根治性膀胱全切术患者围手术期中的应用

目的:探讨基于循证理念的无缝隙护理在机器人辅助根治性膀胱全切术患者围手术期中的应用效果。方法:选取2021年10月—2023年10月于南京医科大学第一附属医院行机器人辅助根治性膀胱全切术的120例膀胱癌患者为研究对象,将其随机分为对照组(n=60)和试验组(n=60)。对照组患者给予常规护理,试验组患者接受基于循证理念的无缝隙护理。观察两组患者的自我管理能力评分、视觉模拟量表(VAS)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、应激反应指标及不良反应等情况。结果:干预后,试验组患者的自我管理能力评分、VAS评分、SAS评分、SDS评分优于对照组(P<0.05)。与对照组相比,试验组患者干预后的心率、皮质醇、舒张压及收缩压等应激反应指标更优(P<0.05)。试验组患者深静脉血栓、肠梗阻及感染等不良反应的总发生率低于对照组(P<0.05)。结论:基于循证理念的无缝隙护理在机器人辅助根治性膀胱全切术患者围手术期中的应用效果较好,能够提升患者的自我管理能力,缓解疼痛,减轻负面情绪和应激反应,减少不良反应的发生。

机器人介入老年人护理的道德边界

琼•特隆托的道德边界框架旨在通过对于道德边界的认识,意识到边界内外包含以及排除的东西,获得一种尊重和公正对待他人和世界的方式,对于阐明机器人介入老年人护理中的道德边界的复杂性,实现“好”的护理具有启发意义。通过引用琼•特隆托的道德边界框架,概述并就道德与政治的边界、“道德观点”的边界和公共/私人的边界,对于机器人在介入老年人护理中的护理分配不平等、隐私侵入、情感欺骗以及责任归属困难等伦理争议予以回应,并基于关怀的伦理原则对于护理机器人的护理实践提出相应对策,以推进未来机器人介入护理的规范性发展。

护理机器人辅助家庭养老的伦理反思与治理策略

通过分析护理机器人在家庭养老中的伦理问题,有针对性地提出机器人辅助居家养老的治理策略,发现护理机器人在家庭养老中存在着孝养关系淡化、社会关系异化、个人隐私透支等伦理问题。因此,需要从伦理价值嵌入、产品功能设计和法律法规完善等方面进行综合治理,构建更加人性化的养老护理智能化模式,以确保护理机器人更好地满足老年人的护理需求。