1 Mlakar I, et al. BMJ Open 2022;12:e054310. doi:10.1136/bmjopen-2021-054310 Open access Study protocol: a survey exploring patients’ and healthcare professionals’ expectations, attitudes and ethical acceptability regarding the integration of socially assistive humanoid robots in nursing Izidor Mlakar , 1 Tadej Kampič, 2 Vojko Flis, 3 Nina Kobilica, 3 Maja Molan, 2 Urška Smrke, 1 Nejc Plohl, 4 Andrej Bergauer 3 To cite: Mlakar I, Kampič T, Flis V, et al. Study protocol: a survey exploring patients’ and healthcare professionals’ expectations, attitudes and ethical acceptability regarding the integration of socially assistive humanoid robots in nursing. BMJ Open 2022;12:e054310. doi:10.1136/ bmjopen-2021-054310 ► Prepublication history for this paper is available online. To view these files, please visit the journal online (http://dx.doi. org/10.1136/bmjopen-2021- 054310). Received 08 June 2021 Accepted 20 March 2022 For numbered affiliations see end of article. Correspondence to Dr Izidor Mlakar; izidor.mlakar@um.si Protocol © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. ABSTRACT Introduction Population ageing, the rise of chronic diseases and the emergence of new viruses are some of the factors that contribute to an increasing share of gross domestic product dedicated to health spending. COVID-19 has shown that nursing staff represents the critical part of hospitalisation. Technological developments in robotics and artificial intelligence can significantly reduce costs and lead to improvements in many hospital processes. The proposed study aims to assess expectations, attitudes and ethical acceptability regarding the integration of socially assistive humanoid robots into hospitalised care workflow from patients’ and healthcare professionals’ perspectives and to compare them with the results of similar studies. Methods/design The study is designed as a cross- sectional survey, which will include three previously validated questionnaires, the Technology-Specific Expectation Scale (TSES), the Ethical Acceptability Scale (EAS) and the Negative Attitudes towards Robots Scale (NARS). The employees of a regional clinical centre will be asked to participate via an electronic survey and respond to TSES and EAS questionaries. Patients will respond to TSES and NARS questionaries. The survey will be conducted online. Ethics and dissemination Ethical approval for the study was obtained by the Medical Ethics Commission of the University Medical Center Maribor. Results will be published in a relevant scientific journal and communicated to participants and relevant institutions through dissemination activities and the ecosystem of the Horizon 2020 funded project HosmartAI (grant no. 101016834). Ethical approval date 06 May 2021. Estimated start of the study December 2021. INTRODUCTION Healthcare systems worldwide are striving to rise to the challenges that result from an ageing population, the growth in chronic disease prevalence, the appearance of new viruses, burgeoning technical possibilities and a rise of public expectations. 1 With the increasing economic burden of modern health, the Organization for Economic Co-op- eration and Development estimates that up to 20% of health spending in Europe is spent on services that either do not deliver benefits or are even harmful, as they create additional costs and could be avoided by substituting them with (cheaper) alternatives with iden- tical or greater benefits. 2 Technological devel- opments in robotics and artificial intelligence could lead to improvements in many hospital processes. In fact, the robotic systems are being increasingly used to improve accuracy, 3 to improve diagnosis and enable remote treatment, 4 in supporting mental health and daily tasks 5 6 and in complementing the Strengths and limitations of this study ► The study sample will include only subjects from Slovenia, which may lead to cultural bias and limit the generalisability of our results. ► Data will be collected using self-report question- naires only, which may lead to random or systematic misreporting. ► A large and diverse study sample of patients and healthcare professionals, including physicians and nurses, will be recruited. ► The questionnaires that will be used in our study have previously been validated and used in several languages. Previous studies suggest that they are valid and reliable. ► Our study will provide a broad assessment of at- titudes, expectations and aspects of ethical ac- ceptability related to the use of socially assistive humanoid robots during hospitalisation. on January 12, 2024 by guest. Protected by copyright. http://bmjopen.bmj.com/ BMJ Open: first published as 10.1136/bmjopen-2021-054310 on 1 April 2022. Downloaded from