Abstract
Objectives
To evaluate the effect of interaction with a robotic seal (PARO) on pain and behavioral
and psychological symptoms of people with dementia and chronic pain.
Design
A parallel pilot randomized controlled trial conducted between January 2018 and January 2019.
Setting
Three long-term care facilities in Australia.
Participants
Forty-three participants aged ≥65 years living with dementia and chronic pain.
Intervention
Participants were randomized to the PARO group (individual, nonfacilitated, 30-minute
sessions, 5 days per week for 6 weeks) or a usual care group using a computer-generated
random number.
Measurements
The primary outcome was researcher-rated observational pain behaviors before and after
each session. Secondary outcomes were staff-rated pain level, agitation, depression,
and anxiety measured at baseline and the end of week 6. Medications regularly prescribed
and as needed were recorded weekly. Analyses followed intention-to-treat, using the
generalized estimating equation model. Australian New Zealand Clinical Trials Registry
(ACTRN12618000082202).
Results
Participants in the PARO group had a significantly lowered level of observed pain
[−0.514, 95% confidence interval (CI) −0.774 to −0.254, P < .001] and used fewer pro re nata medications (−1.175, 95% CI −2.205 to −0.145,
P = .025) than those in usual care after controlling for age, sex, cognitive function
and medications. There were no significant differences in staff-rated pain, agitation,
anxiety, and depression, nor regularly scheduled medications between intervention
and control group.
Conclusions and Implications
PARO shows promise in reducing pain and medications for individuals with dementia
and chronic pain in long-term care facilities. This intervention might be incorporated
into daily practice as an alternative to manage pain in people with dementia. Larger
randomized controlled trials with longer time frames are needed to identify further
and test the use of PARO in long-term care settings.
Keywords
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Article info
Publication history
Published online: February 29, 2020
Footnotes
This work was supported by a PhD scholarship from Griffith University and the China Scholarship Council.
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
