Close
About
FAQ
Home
Collections
Login
USC Login
Register
0
Selected
Invert selection
Deselect all
Deselect all
Click here to refresh results
Click here to refresh results
USC
/
Digital Library
/
University of Southern California Dissertations and Theses
/
Socially-assistive robots using empathy to reduce pain during peripheral IV placement in children: a randomized controlled trial
(USC Thesis Other)
Socially-assistive robots using empathy to reduce pain during peripheral IV placement in children: a randomized controlled trial
PDF
Download
Share
Open document
Flip pages
Contact Us
Contact Us
Copy asset link
Request this asset
Transcript (if available)
Content
1
Title: Socially-assistive robots using empathy to reduce pain during peripheral IV placement in children:
A randomized controlled trial.
Author: Margaret Trost, MD
Conferring Major/Program: Clinical, Biomedical, and Translational Investigations
Degree being conferred: MS
University of Southern California
May 2019
2
Table of Contents
Introduction .................................................................................................................................................. 3
Methods ........................................................................................................................................................ 4
Results ........................................................................................................................................................... 7
Discussion.................................................................................................................................................... 12
References .................................................................................................................................................. 15
3
Introduction
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, post-traumatic stress disorder, or even changes in neuronal architecture [1-4]. In addition
to implications for patient satisfaction and safety, IV placement incurs costs related to the number of
attempts and personnel time. A recent study determined that 28% of patients require 3 or more IV
attempts and these patients consume 43% of total IV costs [5]. Reducing a child's perception of pain
and anxiety associated with the procedure could lead to both increased success of placement,
decreased long-term adverse effects, and reduced costs. Products currently available to reduce pain
may require long application times (topical analgesics) [6], or additional needle sticks (intradermal
lidocaine), therefore there is increased interest in new preventative techniques.
Socially Assistive Robotics (SAR) offers a unique opportunity to mitigate pain during medical
procedures. SARs establish communication and create a shared relationship without touching the child
by utilizing embodiment, personality, empathy, and adaptation skills [7-10]. Relevant to pediatrics, SAR
systems have been extensively explored in the context of autism diagnosis, intervention and therapy,
and have been shown to increase verbalization, socialization, and emotional expression, among other
desired effects [11]. In non-autistic children, SAR systems have been used to promote child learning,
provide therapy for depression, and to interview children about sensitive topics, among other uses [12-
15]. Such robots have been shown to reduce pain and anxiety associated with hospitalization [16] and
during short procedures such as vaccine administration [17] in a limited number of studies that generally
use the robot solely as distraction. Preliminary work from the University of Southern California
Interaction Lab has shown that SARs that display empathy create an interaction perceived as more
positive by the adults [18]. Therefore, we carried out a randomized controlled clinical trial to test the
hypothesis that empathic SAR interactions reduces pain and distress more than a non-empathic SAR
4
(distraction) or no SAR (control) in children receiving an IV in an in-hospital setting. Finally, we
hypothesized that parents and children will be more satisfied and apt to want further robot interactions
with the empathic SAR compared to the distracting SAR or control.
Methods
We conducted a randomized controlled study at Children’s Hospital Los Angeles (CHLA), a large free-
standing urban tertiary-care children’s hospital, from November 2015 to July 2018. 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. We used a non-probabilistic convenience sample to
recruit children into the study. Each week all eligible children were identified by child life using that
week’s MRI schedule, and all of these were approached for enrollment if study personnel were
available. Inclusion criteria included: children between 4-14 years old, that understood English (due to
the SAR’s English script), with English or Spanish speaking parents, already ordered to receive an IV by
their medical team, and parent or self-report of not being afraid of robots. Children with severe
developmental delays as determined by ability to assent and parent report were excluded. All
participants were offered a small honorarium ($20 gift card) for participation.
The MRI area of the hospital was targeted because IVs are frequently placed for sedation or
contrast and the same child life specialist helps all children in this department. Child life specialists use
play and psychological preparation as tools to help children cope with hospitalization or painful
procedures, and are available in most hospitals specializing in pediatric care [19].
After consent, patients were randomized using a random-condition generating document (each
time opened gave a new assignment) to one of three test conditions: (1) usual child life and empathetic
robot, (2) usual child life and non-empathetic robot, or (3) control, usual distraction services provided by
child life. All study procedures were approved by the CHLA Institutional Review Board.
5
A sample size of 66 (22 per condition) was needed to achieve 80% power, assuming a significance level
of 0.05 and 2-sided hypothesis to detect a large effect size of at least f=0.40 for between group
comparisons in an analysis of variance (ANOVA) framework. This effect size was chosen based on a
similar study (7) which showed effect sizes >0.40 in change in FACES pain scales.
After randomization, the patient's parent (or legal guardian) completed the age-appropriate
validated Children’s Behavior Questionnaire (CBQ) or Temperament in Middle Childhood Questionnaire
(TMCQ) to assess temperament, a demographic survey, and questions assessing previous experience
with and pain/anxiety associated with IV placement. The patient rated their pain using the Wong-Baker
FACES scale [20] and distress using the Children’s Fear Scale [21] at three time points: the beginning of
the intervention, immediately prior to the IV placement, and after the interaction. The patient’s heart
rate was recorded at those three time points using a pulse oximeter (Masimo Corporation) that
connected into a tablet computer. The tablet was also used to allow the child to select pre-programmed
responses to the SAR’s questions during the intervention. Following placement of the IV, parents and
children in the two robot conditions completed short surveys regarding their attitudes about the SAR.
The parent survey was developed de novo for this work, while the child survey was adapted from a
validated measure of empathic bonding with companion animals, which has previously been applied to
social robotics research [22].
The SAR used for this study was a table-top robot MAKI (Figure 1a; renamed IVEY for this study),
an open-source 3D printable robot (size: 13.5” x 6.1” x 7.2”) designed by Hello Robo, Inc. A light-
emitting diode (LED; Figure 1b) mouth was designed by the USC Interaction Lab and added post-
production to allow a greater range of affect expressed by the robot.
6
Figure 1: (A) IVEY (B) IVEY with LED mouth
The robot interacted with children in one of two small rooms in the radiology suite at CHLA; it stood on
a small table at the foot of the child’s bed and operated autonomously, with a study member present to
troubleshoot if needed[23]. (Figure 2)
Figure 2: Experimental set-up showing IVEY in position with child preparing for IV placement
7
All interactions were video recorded. After completion of the study, videos were reviewed by
two individuals blinded to the research hypotheses and coded for children’s pain using both the Face,
legs, activity, cry, consolability (FLACC) and Children’s Hospital of Eastern Ontario Pain (CHEOPS) scales
[24, 25]. Coders were trained and tested on a subset of videos prior to final coding (kappa = 0.832).
Scores were applied at the same three time points as mentioned previously.
To evaluate success of randomization, we compared differences in demographic characteristics
between the empathic SAR and comparison groups using chi square for nominal level data (i.e., sex,
age). Differences in children’s pain and distress between the empathetic robot and comparison
conditions were analyzed with an analysis of variance (ANOVA). Likert-scale responses to survey
questions were compared between empathic and distracting robot conditions using t-tests. Statistical
analyses were performed using R software (13).
Results
A total of 32 children with an overall average age of 9.6 years were enrolled and included in the final
analysis. In general, children and their parents/guardians in all three conditions had no significant
demographic differences [Table 1]. One guardian in the control condition reported an extremely high
level of anxiety on the Beck Anxiety scale. Children in the empathy condition had slightly lower numbers
of lifetime IVs placed than in the other conditions.
8
Table 1: Demographics
Characteristic
Control
(n=9)
Empathy
(n=11)
Distraction
(n=12)
P-value
Child
Age (years) (n = 29) 9.44 (1.51) 10.00 (1.79) 9.60 (40.5) .810
Ethnicity* .208
Hispanic 3 (37.50) 8 (72.73) 4 (40.00)
Other 5 (62.50) 3 (27.27) 6 (60.00)
Opinion re: robots (n=27)
3.22 (.97) 3.80 (.42) 3.63 (.52) .190
Baseline pain (n=29) 1.89 (.60) 2.40 (.84) 2.10 (.88) .378
Baseline anxiety (n=30) 2.78 (.83) 2.73 (1.01) 2.70 (.95) .984
Child IV history (Lifetime)
(n = 28)
.029
None 1 (12.50) 2 (20.00) 3 (30.00)
1-15 2 (25.00) 8 (80.00) 3 (30.00)
>15 5 (62.50) 0 (00.00) 4 (40.00)
Previous pain (n=24) 2.36 (.74) 2.33 (7.1) 2.14 (.90) .831
Previous anxiety 1.63 (.52) 2.10 (.32) 2.10 (.88) .209
Medical Fears Scale Score
(n=29)
7.38 (.362) 7.73 (4.58) 7.20 (2.39) .946
Guardian
Gender* 1.00
Mother 7 (87.50) 9 (90) 10 (90.91)
Father 1 (12.50) 1 (10.00) 1 (9.09)
Age, years (n=29) 36.00 (8.49) 35.45 (5.87) 37.30 (7.76) .842
Beck Anxiety (n=29) 7.89 (15.00) 2.73 (4.15) 1.11 (.33) .241
Education (n = 29) .100
High school or less 1 (12.50) 7 (63.64) 4 (40.00)
More than High school 7 (87.50) 4 (36.36) 6 (60.00)
Values are Mean (Standard deviation) unless marked with * which are absolute value (%)
Opinion re: robots = 5-point Likert scale, 5= “loves them”
Baseline pain = 4-point Likert scale, 4= “Always”
Baseline anxiety = 4-point Likert scale, 4= “Never”
Previous pain = 4-point Likert scale, 4= “Terrible amount of pain”
Anxiety about IV = 4-point Likert scale, 4= “Not anxious at all”
Anxiety = score on Beck Anxiety Index
Pain and Fear Outcomes
Patients in the empathy condition had the lowest mean scores on the pain and fear scales immediately
after interacting with the empathetic robot (time point 2) and at the end of the study following IV
placement (time point 3). Children in the distraction condition ended the study with the highest (worst)
9
average scores. Differences were not significant between groups on repeated measures ANOVA [Table
2, Figure 3, Figure 4].
Table 2: Repeated Measures ANOVA
Characteristic
F-value (Df) P-value Effect Size*
Faces (n = 30)
Between Subject .280 (2, 27) .758 .015
Within Subject .510 (2, 54) .603 .005
Interaction 2.181 (4, 54) .083 .044
Fear (n = 30)
Between Subject .776 (2,27) .470 .041
Within Subject 3.264 (2 ,54) .046 .030
Interaction .968 (4, 54) .433 .018
*Effect size is generalized least squared (form of η2)
Figure 3: Scores on the pain (FACES) scale over time by condition
10
Figure 4: Scores on the distress (FEAR) scale over time by condition
Parent Satisfaction Outcomes
Parents of enrolled children who interacted with either the distracting or the empathy robot completed
an exit survey regarding their opinions with seven items scored on a 7-point Likert scale. Overall,
parents with children participating in the empathy group had more positive scores than those in the
distraction group [Table 3]. There was a trend towards significance with parents in the empathy
condition more likely to disagree with the statement “Talking to the robot DID NOT help my child”.
11
Table 3: Parent Satisfaction Questions for Robot Conditions
Parent Question Empathy
(n=10)
Distraction
(n=11)
P-value
I would recommend the robot to other parents when their
children get IVs
1.30 (.95) 1.27 (.47) .936
I DO NOT want the robot the next time my child gets an IV* 6.80 (.63) 6.00 (1.84) .200
Having the robot made my child getting the IV easier 1.40 (1.26) 1.73 (1.10) .537
The robot made my child have less pain 1.30 (.95) 2.00 (1.26) .166
The robot made my child have less anxiety 1.30 (.95) 1.82 (.98) .234
The robot seemed to understand how my child feels 1.40 (.84) 2.45 (1.57) .071
Talking to the robot DID NOT help my child* 6.70 (.95) 5.09 (2.34) .056
1 = strongly agree, 7=strongly disagree, 7 point-Likert scale
*negatively worded question
Mean (Standard Deviation) compared by t-test
Child Opinions about IVEY
Following interaction with the robot in either robot condition, children were asked to complete a survey
on an 8-point Likert scale. The survey was divided into subsections, three taken from prior literature
(attraction, utility, intelligence) and two sections added for this study to determine if children (1)
recognized the robot as showing empathy and (2) if they felt the robot helped with IV placement.
Children had the most positive responses in the empathy condition across all subsections surveyed
[Table 4]. Most importantly, children interpreted that the empathetic robot “has feelings” (p=0.011)
compared to the distracting robot. In addition, children in the empathy condition were statistically
more likely to perceive that interacting with the robot reduced the pain they felt when having an IV
placed (p=0.026).
12
Table 4: Child Impressions of IVEY
Characteristic Empathy
(n=11)
Distraction
(n=10)
P-value
Good 7.64 (.81) 7.00 (1.63) .286
Loving 7.82 (.40) 7.00 (1.49) .123
Friendly (n = 20) 7.80 (.63) 6.90 (1.85) .174
Cuddly 6.27 (2.15) 4.70 (2.75) .165
Warm 7.45 (1.04) 5.30 (2.75) .039
Nice 7.64 (.92) 7.30 (1.25) .497
Close 6.55 (2.16) 5.00 (2.58) .157
*Attraction Total: (n = 20) 7.40 (.69) 6.17 (1.44) .030
Useful 7.18 (1.40) 7.11 (1.05) .899
Important 7.55 (1.07) 5.78 (2.68) .092
Helpful 7.73 (.65) 7.33 (.87) .276
*Utility Total: 7.48 (.92) 6.74 (1.09) .124
Intelligent 7.82 (.40) 7.00 (1.12) .064
*Intelligence Total: 7.82 (.40) 7.00 (1.12) .064
The robot understands how I feel 7.18 (1.08) 5.33 (2.78) .090
The robot has feelings 7.27 (1.27) 4.33 (2.65) .011
Talking about my feelings with the robot helped me 7.27 (1.10) 4.44 (2.96) .022
Empathy Total: 7.24 (.87) 4.70 (2.35) .012
Would recommend that my friends use the robot when
they get an IV
7.45 (1.29) 7.50 (.76) .925
I want the robot with me the next time I get an IV 7.73 (.47) 6.50 (2.14) .152
Having the robot with me made getting the IV easier 7.82 (.40) 6.88 (1.36) .093
Having the robot with me made getting the IV hurt less 7.45 (.82) 4.88 (2.59) .026
IV Total: 7.61 (.57) 6.44 (1.16) .025
*from The Young Children’s Empathy Measure (see methods), empathy and IV subsections de novo
8-point Likert scale, 1= IVEY is the opposite of this characteristic 8 = IVEY has this characteristic
Subsection totals = mean of sum of each subject’s responses
Mean (Standard Deviation) compared by t-test
Discussion
This study adds to the growing body of literature exploring the use of socially assistive robots in
pediatric medicine to reduce distress and pain encountered during hospitalization. A major strength of
this study is its randomized-controlled design which allows direct comparison between empathic SAR
and control groups.
A previous study used the socially assistive robot Nao (Aldebaran Robotics®) to distract children
and reduce pain during vaccination [17]. Our study differs significantly from that work because our
13
robot, IVEY, is not a simple distraction. Rather, the robot uses similar techniques to those used by child
life specialists to encourage better coping by the child. The empathic elements of the speech allow
creation of a more meaningful child-robot interaction. Another previous study specifically addressed
medical-related fears and anxiety using Paro, a soft robotic seal robot. Paro acted similar to a
companion animal and did not speak to the patient or offer any medical information [16]. The design of
our study allows a more seamless integration of IVEY as a “helper” to the child life specialist who
facilitates child coping and provides medical information.
Limitations of this study include the single-center design, restriction to English-speaking
children, under powering, use of non-ideal measures of pain detection, and convenience sampling. We
attempted to control for these issues by expanding our participant pool to include children with Spanish
speaking parents, and used prospective screening for potentially eligible patients to maximize
recruitment.
Importantly, our study is underpowered. However, we feel that as a pilot study, trends in our
data could influence future studies. For example, our distraction condition resulted in higher child-
reported pain and fear scores at the end of the intervention than both the control and empathy
condition. For this reason, we feel that distraction alone may not be sufficient for longer medical
procedures (mean time to place IV in our study: 30.13 minutes). Perhaps even more significantly, we
informed the design of the robot’s behavior, which were implemented by the USC Interaction Lab, so
that it was ultimately perceived by children as both helping them by talking about feelings and having
feelings itself.
Future directions of this research will be to attempt to determine the mechanisms leading to
higher child satisfaction with the empathic IVEY. Biochemical, electroencephalographic, and
neuroimaging data taken during child interaction with IVEY may better explain the results we report
here and allow better assessment of both distress and pain. We also plan to explore the use of SAR
14
during other painful or anxiety-provoking procedures in a hospital setting. Long term uses of SAR could
include transition between the hospital and home environment for chronically ill patients to both
decrease stress of hospitalization and act as physician extenders for medical reference at home.
Background: Children experiencing painful medical procedures can have long-term negative
physical and emotional problems. Socially assistive robots (SAR) have been used as a distraction tool to
reduce pain and anxiety during short medical procedures.
Objective: (1) To determine if SAR displaying empathy can reduce pain and anxiety more than a
distracting SAR or control and (2) To compare child and parent opinions regarding effectiveness of
empathic or distracting SAR.
Methods: We performed a randomized controlled trial at a large free-standing children's
hospital with children who were receiving peripheral intravenous line (IV) placement prior to an imaging
study. The SAR used for this study was an open-source 3D-printable robot we renamed "IVEY".
Randomized children interacted with either (1) an empathic IVEY that discussed the child's feelings and
coping techniques (2) a distraction IVEY that played a dress-up game or (3) no robot. Child life
specialists are current best practice for helping children with painful procedures, and they participated
in all 3 conditions. Children completed validated pain (FACES) and distress (FEAR) scales at three
timepoints: start of condition, after IVEY interaction (or child life in control), and after IV placement.
Parents and children in the two robot conditions completed surveys about their attitudes towards SAR.
Differences in children’s pain and distress between the empathetic robot and comparison conditions
were analyzed with an analysis of variance (ANOVA). Likert-scale responses to survey questions were
compared using t-tests.
Results: 32 children (average age of 9.6 years) were enrolled; children and their
parents/guardians in all three conditions had no significant demographic differences. Patients in the
15
empathy condition had the lowest (best) mean scores on the pain and distress scales immediately after
interacting with IVEY and at after IV placement, although it was not statistically signficant. Parents that
observed their children in the empathy condition had more positive but not significantly different survey
responses than those in the distraction group. On the patient survey, children interpreted that the
empathetic robot “has feelings” (p=0.011) compared to the distracting robot. Also, in the empathy
condition compared to distraction, children were statistically more likely to perceive that interacting
with the robot reduced the pain they felt when having an IV placed (p=0.026).
Conclusions: Children recognized our novel empathic SAR model as "having feeling" compared
to a SAR designed to only provide distraction. Children interacting with an SAR displaying empathy
reported the lowest average pain and distraction scores, although this was not statistically significant
which is likely impacted by underpowering in our study.
References
1. Humphrey GB, Boon CM, van Linden van den Heuvell GF, van de Wiel HB. The occurrence of
high levels of acute behavioral distress in children and adolescents undergoing routine venipunctures.
Pediatrics. 1992;90(1 Pt 1):87-91. PubMed PMID: 1614786.
2. Kennedy RM, Luhmann J, Zempsky WT. Clinical implications of unmanaged needle-insertion pain
and distress in children. Pediatrics. 2008;122 Suppl 3:S130-3. doi: 10.1542/peds.2008-1055e. PubMed
PMID: 18978006.
3. Anand KJ. Effects of perinatal pain and stress. Prog Brain Res. 2000;122:117-29. PubMed PMID:
10737054.
4. Rennick JE, Johnston CC, Dougherty G, Platt R, Ritchie JA. Children's psychological responses
after critical illness and exposure to invasive technology. J Dev Behav Pediatr. 2002;23(3):133-44.
PubMed PMID: 12055495.
5. Goff DA, Larsen P, Brinkley J, Eldridge D, Newton D, Hartzog T, et al. Resource utilization and
cost of inserting peripheral intravenous catheters in hospitalized children. Hosp Pediatr. 2013;3(3):185-
91. PubMed PMID: 24313085.
6. Russell SC, Doyle E. A risk-benefit assessment of topical percutaneous local anaesthetics in
children. Drug Saf. 1997;16(4):279-87. doi: 10.2165/00002018-199716040-00005. PubMed PMID:
9113495.
7. Feil-Seifer D, Mataric MJ, editors. Defining socially assistive robotics. 9th International
Conference on Rehabilitation Robotics, 2005 ICORR 2005; 2005: IEEE.
8. Matarić MJ. Socially assistive robotics: Human augmentation versus automation. Sci Robot.
2017;2(4):eaam5410. doi: 10.1126/scirobotics.aam5410.
16
9. Matarić MJ, Scassellati B. Socially Assistive Robotics. In: Siciliano B, Khatib O, editors. Springer
Handbook of Robotics. Cham: Springer International Publishing; 2016. p. 1973-94.
10. Deng E, Mutlu B, Mataric MJ. Embodiment in Socially Interactive Robots. Foundations and
Trends® in Robotics. 2019;7(4):251-356.
11. Scassellati B, Admoni H, Mataric M. Robots for use in autism research. Annu Rev Biomed Eng.
2012;14:275-94. doi: 10.1146/annurev-bioeng-071811-150036. PubMed PMID: 22577778.
12. Baxter P, Ashurst E, Read R, Kennedy J, Belpaeme T. Robot education peers in a situated primary
school study: Personalisation promotes child learning. PLoS One. 2017;12(5):e0178126. doi:
10.1371/journal.pone.0178126. PubMed PMID: 28542648; PubMed Central PMCID: PMCPMC5441605.
13. Vogt P, de Haas M, de Jong C, Baxter P, Krahmer E. Child-Robot Interactions for Second
Language Tutoring to Preschool Children. Front Hum Neurosci. 2017;11:73. doi:
10.3389/fnhum.2017.00073. PubMed PMID: 28303094; PubMed Central PMCID: PMCPMC5332435.
14. Wood LJ, Dautenhahn K, Rainer A, Robins B, Lehmann H, Syrdal DS. Robot-mediated interviews--
how effective is a humanoid robot as a tool for interviewing young children? PLoS One.
2013;8(3):e59448. doi: 10.1371/journal.pone.0059448. PubMed PMID: 23533625; PubMed Central
PMCID: PMCPMC3606117.
15. Scassellati B, Boccanfuso L, Huang CM, Mademtzi M, Qin MY, Salomons N, et al. Improving social
skills in children with ASD using a long-term, in-home social robot. Sci Robot. 2018;3(21). doi: UNSP
eaat754410.1126/scirobotics.aat7544. PubMed PMID: WOS:000443232300008.
16. Okita SY. Self-other's perspective taking: the use of therapeutic robot companions as social
agents for reducing pain and anxiety in pediatric patients. Cyberpsychol Behav Soc Netw.
2013;16(6):436-41. doi: 10.1089/cyber.2012.0513. PubMed PMID: 23505968.
17. Beran TN, Ramirez-Serrano A, Vanderkooi OG, Kuhn S. Reducing children's pain and distress
towards flu vaccinations: a novel and effective application of humanoid robotics. Vaccine.
2013;31(25):2772-7. doi: 10.1016/j.vaccine.2013.03.056. PubMed PMID: 23623861.
18. Tapus A, Mataric MJ, editors. Socially Assistive Robots: The Link between Personality, Empathy,
Physiological Signals, and Task Performance. AAAI spring symposium: emotion, personality, and social
behavior; 2008.
19. American Academy of Pediatrics Child Life C, Committee on Hospital C, Wilson JM. Child life
services. Pediatrics. 2006;118(4):1757-63. doi: 10.1542/peds.2006-1941. PubMed PMID: 17015572.
20. (2016) W-BFF. Wong-Baker FACES® Pain Rating Scale [cited 2018 December 16]. Available from:
Retrieved with permission from http://www.WongBakerFACES.org.
21. McMurtry CM, Noel M, Chambers CT, McGrath PJ. Children's fear during procedural pain:
preliminary investigation of the Children's Fear Scale. Health Psychol. 2011;30(6):780-8. doi:
10.1037/a0024817. PubMed PMID: 21806301.
22. Poresky RH. The Young Children's Empathy Measure: reliability, validity and effects of
companion animal bonding. Psychol Rep. 1990;66(3 Pt 1):931-6. doi: 10.2466/pr0.1990.66.3.931.
PubMed PMID: 2377714.
23. Caitlyn Clabaugh and Maja Matarić. Escaping Oz: Autonomy in Socially Assistive Robotics. Annual
Review of Control, Robotics, and Autonomous Systems. 2019;2.
24. Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring
postoperative pain in young children. Pediatr Nurs. 1997;23(3):293-7. PubMed PMID: 9220806.
25. McGrath PJ. CHEOPS: a behavioral scale for rating postoperative pain in children. Adv Pain Res
Ther. 1985;9:395.
Abstract (if available)
Abstract
Background: Children experiencing painful medical procedures can develop long-term physical and emotional problems. Socially assistive robots (SAR) have been used as a distraction tool to reduce pain and anxiety during short medical procedures. ❧ Objective: (1) To determine if SAR displaying empathy can reduce pain and anxiety more than a distracting SAR or control and (2) To compare child and parent opinions regarding effectiveness of empathic or distracting SAR. ❧ Methods: We performed a randomized controlled trial at a large free-standing children's hospital with children who were receiving peripheral intravenous line (IV) placement prior to an imaging study. The SAR used for this study was an open-source 3D-printable robot we renamed “IVEY”. Randomized children interacted with either (1) an empathic IVEY that discussed the child's feelings and coping techniques (2) a distraction IVEY that played a dress-up game or (3) no robot. Child life specialists are current best practice for helping children with painful procedures, and they participated in all 3 conditions. Children completed validated pain (FACES) and distress (FEAR) scales at three timepoints: start of condition, after IVEY interaction (or child life in control), and after IV placement. Parents and children in the two robot conditions completed surveys about their attitudes towards SAR. Differences in children’s pain and distress between the empathetic robot and comparison conditions were analyzed with an analysis of variance (ANOVA). Likert-scale responses to survey questions were compared using t-tests. ❧ Results: 32 children (average age of 9.6 years) were enrolled
Linked assets
University of Southern California Dissertations and Theses
Conceptually similar
PDF
Towards socially assistive robot support methods for physical activity behavior change
PDF
The Filipino family initiative: preliminary effects of an evidence-based parenting intervention offered in churches on parent and child outcomes
PDF
Using mobile health to improve social support for low-income Latino patients with diabetes: a randomized mixed methods feasibility trial of TExT-MED FANS
PDF
Socially assistive and service robotics for older adults: methodologies for motivating exercise and following spatial language instructions in discourse
PDF
Association of Pediatric Early Warning Score with early intensive care unit readmission
PDF
Randomized clinical trial generalizability and outcomes for children and adolescents with high-risk acute lymphoblastic leukemia
PDF
Simulation-based training is associated with lower risk-adjusted mortality in ACS Pediatric TQIP centers
PDF
Risk factors for unanticipated hospitalizations in children and youth with spina bifida at an urban children’s hospital: a cross-sectional study
PDF
Integrated management of atrial fibrillation in women in an underserved, safety-net health care system: a multicenter, single health system randomized control efficacy trial protocol
PDF
Pushing the limits of detection: Investigation of cell-free DNA for aneuploidy screening in embryos
PDF
The effect of vitamin D supplementation on the progression of carotid intima-media thickness and arterial stiffness in elderly African American women: Results of a randomized placebo-controlled trial
PDF
Addressing federal pain research priorities: drug policy, pain mechanisms, and integrative treatment
PDF
Use of a low fidelity contained manual tissue extraction simulation to improve gynecology resident competence and confidence
PDF
Clinical research in women's reproductive health and the human immunodeficiency virus
PDF
Clinical outcomes of allogeneic hematopoietic stem cell transplant in acute lymphoblastic leukemia patients: a quality improvement project and systematic review meta-analysis
PDF
The footprint of pain: investigating persistence of altered trunk control in recurrent low back pain
PDF
An examination of child protective service involvement among offspring born to young mothers in foster care
Asset Metadata
Creator
Trost, Margaret J.
(author)
Core Title
Socially-assistive robots using empathy to reduce pain during peripheral IV placement in children: a randomized controlled trial
School
Keck School of Medicine
Degree
Master of Science
Degree Program
Clinical, Biomedical and Translational Investigations
Publication Date
04/01/2019
Defense Date
03/28/2019
Publisher
University of Southern California
(original),
University of Southern California. Libraries
(digital)
Tag
OAI-PMH Harvest,Pain,Pediatrics,social robotics
Format
application/pdf
(imt)
Language
English
Contributor
Electronically uploaded by the author
(provenance)
Advisor
Matarić, Maja (
committee chair
), Gold, Jeffrey I. (
committee member
), Tolomiczenko, George (
committee member
)
Creator Email
mtrost@chla.usc.edu,mtrost@usc.edu
Permanent Link (DOI)
https://doi.org/10.25549/usctheses-c89-137832
Unique identifier
UC11675702
Identifier
etd-TrostMarga-7181.pdf (filename),usctheses-c89-137832 (legacy record id)
Legacy Identifier
etd-TrostMarga-7181-1.pdf
Dmrecord
137832
Document Type
Thesis
Format
application/pdf (imt)
Rights
Trost, Margaret J.
Type
texts
Source
University of Southern California
(contributing entity),
University of Southern California Dissertations and Theses
(collection)
Access Conditions
The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...
Repository Name
University of Southern California Digital Library
Repository Location
USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA
Tags
social robotics