Major Operating Theatre Department, Woodlands Health, 2 Yishun Central 2, Tower E, Level 5, Yishun Community Hospital, Singapore 768024, Singapore.
Emergency Medicine, Woodlands Health, 2 Yishun Central 2, Tower E, Level 5, Yishun Community Hospital, Singapore 768024, Singapore.
Int J Nurs Stud. 2023 Sep;145:104530. doi: 10.1016/j.ijnurstu.2023.104530. Epub 2023 May 19.
To evaluate the effectiveness of a therapeutic robot, 'Paro', on anxiety, agitation, depression, apathy, medication use, total sleep time, and sociability among older adults with dementia.
Systematic review and meta-analysis with narrative synthesis.
Older adults aged 60 years and above with any form of dementia in the community, nursing homes, or care facilities.
A three-step search strategy was conducted by two independent reviewers. Nine databases were searched (January 2003 to November 2022). Randomised controlled, crossover, and cluster trials on Paro for older adults with dementia published in English were included. All relevant trials were screened and assessed for risk of bias. Data were extracted using the Cochrane data collection form. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to assess the quality of evidence.
In total, 12 articles involving 1461 participants were included. Results of the meta-analysis showed that Paro had a moderate effect on medication use (SMD: -0.63) and small effect on anxiety (SMD: -0.17), agitation (SMD: -0.27) and depression (SMD: -0.40). However, Paro exhibited negligible effect on total sleep time (SMD: -0.12). The overall quality of evidence for all outcomes were graded as low due to methodological limitations, small sample size, and wide confidence intervals. Narrative synthesis suggested that Paro reduced apathy and increase sociability.
Paro could be a beneficial non-pharmacological approach to improve behavioural and psychological symptoms of dementia, reducing medication use, and increasing sociability for older adults with dementia. However, the results should be interpreted with caution as limited studies were available. Additionally, there were a variety of approaches across the studies (i.e. group and individual interventions, facilitated and non-facilitated) which made it difficult to determine which interventional approach is optimal to produce beneficial effects of Paro. Hence, more rigorous studies with a larger sample size are needed to fully understand the mechanism and effectiveness of Paro in older adults with dementia. The protocol was registered on PROSPERO (CRD42022296504).
评估治疗机器人“帕罗”对痴呆老年人的焦虑、激越、抑郁、淡漠、药物使用、总睡眠时间和社交能力的疗效。
系统评价和 meta 分析，结合叙述性综合。
年龄在 60 岁及以上，患有任何形式痴呆症的社区、养老院或护理机构中的老年人。
两位独立审查员进行了三步搜索策略。共检索了 9 个数据库（2003 年 1 月至 2022 年 11 月）。纳入了关于帕罗治疗痴呆老年人的英语随机对照、交叉和聚类试验。所有相关试验均进行了筛选，并评估了偏倚风险。使用 Cochrane 数据采集表提取数据。使用推荐、评估、开发和评估（GRADE）对证据质量进行分级。
共纳入 12 篇文章，涉及 1461 名参与者。meta 分析结果显示，帕罗对药物使用（SMD：-0.63）和焦虑（SMD：-0.17）、激越（SMD：-0.27）和抑郁（SMD：-0.40）有中度影响。然而，帕罗对总睡眠时间（SMD：-0.12）的影响可以忽略不计。由于方法学限制、样本量小和置信区间宽，所有结局的总体证据质量均被评为低质量。叙述性综合表明，帕罗减少了淡漠，增加了社交能力。
帕罗可能是一种有益的非药物干预措施，可以改善痴呆老年人的行为和心理症状，减少药物使用，并增加痴呆老年人的社交能力。然而，由于研究数量有限，结果应谨慎解释。此外，研究之间存在各种方法（即小组和个人干预、促进和非促进），这使得难以确定哪种干预方法最能产生帕罗的有益效果。因此，需要进行更多具有更大样本量的严格研究，以充分了解帕罗在痴呆老年人中的作用机制和有效性。该方案已在 PROSPERO（CRD42022296504）上注册。
