Katrin Kangur

Artificial Intelligence (AI) applications are increasingly used to support independent living and care for older adults, particularly those in vulnerable situations. Yet, how vulnerability is constructed when AI enters later-life care remains poorly theorized. Existing approaches to vulnerability in old age inadequately address AI-related risks, structural conditions, exposure pathways, and life course disadvantages. Using a theory-synthesis approach, this article proposes “vulnerability intersections” as an integrative framework for how vulnerability is constructed, enacted, and negotiated in AI-assisted care for older adults. The framework extends existing sociotechnical accounts by conceptualizing vulnerability as taking four overlapping forms: anticipatory, opaque, routinized, and normative. It locates vulnerability factors at the micro level of older adults’ lives, the meso level of care organizations and technology providers, and the macro level of political-economic and regulatory arrangements, with life-course accumulation spanning all three. It also proposes three exposure pathways through which vulnerability factors become consequential: AI-mediated information and representations of aging; AI-powered care organization and delivery; and AI-configured power, participation, and social relations. The framework shifts attention away from viewing older adults as inherently vulnerable toward examining the sociotechnical arrangements under which vulnerability is anticipated, classified, distributed, and negotiated when AI enters care.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: The growing demand for elderly care due to aging populations and healthcare workforce shortages requires innovative solutions. Socially assistive robots (SARs) are increasingly explored for their potential to reduce workload by handling routine tasks. Yet, adoption can be hindered by various healthcare workers’ concerns. Objective: This study examined the perceptions of healthcare workers toward SARs before and after a pilot use in a clinical nursing care setting. The study focused on SAR usability, emotional appropriateness, and readiness for adoption. Methods: A mixed-methods pilot study was conducted at the East Tallinn Central Hospital’s Nursing Care Clinic in collaboration with Tallinn University of Technology. The TEMI v3 robot was used for two weeks for visitor guidance, goods delivery, and patrolling tasks. Healthcare workers filled in pre- and post-intervention questionnaires with Likert-scale items and a broad open-ended question. Quantitative data were analyzed for changes in perceived safety, trust, and usability. Qualitative data underwent thematic analysis to understand participants’ opinions. Results: Out of 45 involved healthcare workers, 20 completed the pre-test questionnaire, and 5 completed the post-test questionnaire (a 75% attrition). Pre-test results show that 17 of 20 participants (85%) had limited previous exposure to SARs and mixed perceptions of their role, with 9 (45%) viewing SARs as machines and 6 (30%) as somewhat human-like. Although 60% believed SARs could become mainstream within 5-10 years, there were concerns about the robot’s emotional adequacy and job displacement. Post-test findings showed increased confidence in SARs, with all respondents perceiving them as safe tools. Qualitative results indicate improved trust and readiness to integrate SARs into daily routines, with 4 out 5 (80%) being willing to advocate for SAR use. Still, participants noted limited impact on facilitating their jobs. Conclusions: The study indicates that short-term collaboration with SARs can enhance healthcare workers’ confidence and their readiness for adoption. However, actual use would need proper emotional adequacy from the robot and aligning its functionalities with specific care needs. The future studies need to examine long-term impacts on care quality and job satisfaction, and also strategies to address generational differences and technophobia among healthcare staff. Transparent communication and proper training are required for ensuring acceptance.

BACKGROUND The growing demand for elderly care due to aging populations and healthcare workforce shortages requires innovative solutions. Socially assistive robots (SARs) are increasingly explored for their potential to reduce workload by handling routine tasks. Yet, adoption can be hindered by various healthcare workers’s concerns. OBJECTIVE This study examined the perceptions of healthcare workers toward SARs before and after a pilot use in a clinical nursing care setting. The study focused on SAR usability, emotional appropriateness, and readiness for adoption. METHODS A mixed-methods pilot study was conducted at the East Tallinn Central Hospital’s Nursing Care Clinic in collaboration with Tallinn University of Technology. The TEMI v3 robot was used for two weeks for visitor guidance, goods delivery, and patrolling tasks. Healthcare workers filled in pre- and post-intervention surveys with Likert-scale items and open-ended questions. Quantitative data were analyzed for changes in perceived safety, trust, and usability. Qualitative data underwent thematic analysis to understand participants’ opinions. RESULTS Out of 45 involved healthcare workers, 20 completed the pre-test survey, and 5 completed the post-test survey. Pre-test results show limited previous exposure to SARs (85%) and mixed perceptions of their role, with 45% viewing SARs as machines and 30% as somewhat human-like. Although 60% believed SARs could become mainstream within 5-10 years, there were concerns about the robot’s emotional adequacy and job displacement. Post-test findings showed increased confidence in SARs, with all respondents perceiving them as safe tools. Qualitative results indicate improved trust and readiness to integrate SARs into daily routines, with 80% being willing to advocate for SAR use. Still, participants noted limited impact on facilitating their jobs. CONCLUSIONS The study indicates that short-term collaboration with SARs can enhance healthcare workers’ confidence and their readiness for adoption. However, actual use would need proper emotional adequacy from the robot and aligning its functionalities with specific care needs. The future studies need to examine long-term impacts on care quality and job satisfaction, and also strategies to address generational differences and technophobia among healthcare staff. Transparent communication and proper training are required for ensuring acceptance. CLINICALTRIAL This trial was registered with the Research Ethics Committee of the National Institute for Health Development in Estonia under protocol number #8.3/13-24, dated May 29, 2024.

This study investigates the perceived value of social service robots within simulated healthcare settings, focusing on the TEMI robot. Utilizing Likert questionnaires, 25 diverse participants engaged in scenarios involving the robot's interaction in a hospital context. The research aimed to understand adults' perceptions of service robots' value in healthcare and the factors influencing this perception. Results revealed overwhelmingly positive assessments across various facets of perceived value, indicating significant interest in integrating service robots into healthcare practices. Notably, gender and age variations influenced specific aspects of perceived value, with males showing more interest in utilization and females valuing comprehensibility and interaction positions. However, concerns arose regarding learning challenges and physical dimensions, particularly for taller individuals. To enhance the study's reliability, future research should replicate the experiment in real hospital environments, focusing on a larger sample of hospital workers, and include healthcare college teachers and medical students as participants to enrich the study's scope.