Dignity in the context of socially assistive robots in elder care : a scoping review (WP1)

Hvalič Touzery, Simona (author), Šetinc, Mojca (author)

Introduction: Existing empirical research addresses various dimensions of dignity and examines the impact of socially assistive robots (SAR) across diverse contexts of use, but an overview of these findings remains fragmented. Therefore, the aim was to provide a comprehensive synthesis of empirical research on the use of SAR in healthcare and long-term care settings involving older adults, with a particular focus on how SAR affect different dimensions of dignity. Methods: A scoping review methodology was applied, following the framework proposed by Arksey and O’Malley and its subsequent refinements. A comprehensive literature search was conducted in February 2026 using the mEga search tool, complemented by a grey literature search. Inclusion criteria focused on empirical studies published in English between 2020 and 2026 addressing SAR in relation to dignity among older adults in healthcare or long-term care settings. Sixteen articles were included after a multi-stage screening process. Data were analysed using qualitative content analysis, combining deductive coding based on predefined dignity dimensions with inductive coding. Results: Five dimensions of dignity were identified: universal dignity (Menschenwürde), dignity of identity, dignity in care practices and interactions, dignity in social relations and recognition, and dignity of bodily integrity and privacy. Universal dignity was only marginally addressed in SAR studies, so the analysis focused on the remaining dimensions. The most consistently positive effects of SAR were observed in relation to dignity of identity. SAR were associated with improved psychological well-being, reduced loneliness, and enhanced self-esteem and sense of purpose, particularly among vulnerable groups such as people with dementia. However, risks to this dimension were also identified, especially when SAR were perceived as intrusive or undermining autonomy. Dignity in care practices and interactions was predominantly associated with negative aspects, including concerns about dehumanisation of care, loss of human contact, inauthenticity, deception, and infantilisation. Positive effects were limited and context-dependent, emerging mainly when SAR complemented rather than replaced human care. Dignity in social relations and recognition showed a more balanced pattern. SAR were found to reduce loneliness and facilitate social interaction, but also raised concerns related to stigma, embarrassment, and the perceived inauthenticity of human–robot relationships. Dignity of bodily integrity and privacy presented both benefits and risks. SAR could enhance physical well-being and reduce embarrassment in intimate care situations, but were also associated with significant concerns regarding privacy, monitoring, data sharing, and safety. The findings further indicate that the impact of SAR is shaped by several contextual factors, including the type of robot, user characteristics, prior experience with SAR, and care setting. Studies involving direct interaction with SAR tend to report more positive or balanced outcomes compared to studies based on anticipated use. Conclusion: SAR do not have a uniform impact on dignity. Their effects depend on how they are designed, implemented, and integrated into care and everyday life, as well as on users’ characteristics, experiences, and care contexts. Importantly, the findings highlight a distinction between anticipatory perceptions and lived experiences: while individuals without direct experience often emphasise ethical concerns and potential risks, studies involving actual use tend to report more nuanced and, in some cases, more positive or balanced accounts. The findings underscore the need for context-sensitive, user-informed, and ethically grounded approaches to the design and implementation of SAR in care settings.

• Language: English
• Keywords: dignity, socially assistive robots, care robots, service robots, long-term care, healthcare, older adults
• Typology: 2.13 - Treatise, Preliminary Study, Study
• Organization: FDV - Faculty of Social Sciences
• Publication status: Published
• Publication version: Version of Record
• Publisher: Fakulteta za družbene vede, Center za družboslovno informatiko
• Year: 2026
• Number of pages: 49
• PID: 20.500.12556/RUL-181829
• UDC: 316.346-053.9:004
• COBISS.SI-ID: 275480835
• Publication date in RUL: 16.04.2026

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Title: Uporaba socialnih robotov in dostojanstvo v oskrbi starejših oseb : področni pregled literature (DP1)

Abstract

Uvod: Obstoječe empirične raziskave o vplivu socialnih robotov na različne dimenzije dostojanstva so bile izvedene v zelo raznolikih kontekstih, njihove ugotovitve pa so zelo razpršene. V pričujočem področnem pregledu literature smo zato izvedli celovit pregled empiričnih ugotovitev o uporabi socialnih robotov v različnih kontekstih zdravstvene in dolgotrajne oskrbe starejših oseb, s poudarkom na: a) dimenzijah dostojanstva ter b) vplivu socialnih robotov na dostojanstvo. Metode: Prispevek temelji na področnem pregledu literature po metodološkem okviru Arksey in O’Malley. V februarju 2026 je bilo izvedeno iskanje z orodjem mEga search NUK, ki smo ga dopolnili z iskanjem v sivi literaturi. Vključitveni kriteriji so zajemali empirične študije, objavljene v angleščini, med letoma 2020 in 2026, ki obravnavajo socialne robote v povezavi z dostojanstvom starejših oseb v kontekstu zdravstvene in dolgotrajne oskrbe. Po večstopenjskem postopku pregleda najdenih člankov, jih je bilo v analizo vključenih 16. Vsebinsko analizo smo izvedli s pomočjo programa ATLAS.ti 9. Rezultati: V literaturi smo prepoznali pet dimenzij dostojanstva: splošno dostojanstvo (nem. Menschenwürde), dostojanstvo identitete, družbeno dostojanstvo v kontekstu dostojanstva v procesu oskrbe, družbeno dostojanstvo v kontekstu priznavanja posameznika in dostojanstva v odnosih, ter dostojanstvo telesne integritete in zasebnosti. Splošno dostojanstvo je bilo v pregledanih študijah obravnavano le obrobno, zato se analiza osredotoča na preostale štiri dimenzije. Pozitivni učinki socialnih robotov so bili najpogosteje opaženi in pričakovani v povezavi z dostojanstvom identitete. V pregledani literaturi so bili socialni roboti pogosto povezani z večjim duševnim blagostanjem, višjim samospoštovanjem, okrepljeno samozavestjo in samopodobo ter občutkom smisla, zlasti pri ranljivih skupinah, kot so osebe z demenco. Pregled je pokazal tudi potencialne nevarnosti, saj lahko socialni roboti ogrozijo dostojanstvo identitete, če so zaznani kot vsiljivci, ki izvajajo nadzor, ali kot grožnja samostojnosti. Družbeno dostojanstvo v kontekstu dostojanstva v procesu oskrbe, je bilo pretežno povezano z negativnimi vidiki, vključno z dehumanizacijo oskrbe, izgubo človeškega stika in pristnosti, zavajanjem in infantilizacijo. Pozitivni učinki so bili omejeni in odvisni od konteksta, zlasti, kadar so bili socialni roboti uporabljeni kot dopolnitev človeške oskrbe ali kot podpora za socialno vključevanje in lažjo komunikacijo starejših oseb. Literatura o družbenem dostojanstvu v kontekstu priznavanja posameznika in dostojanstva v odnosih, ponuja bolj uravnoteženo sliko. Pozitivni vidiki so povezani z večjo socialno vključenostjo, družabništvom in priložnostmi za interakcijo. Po drugi strani so negativni povezani s tveganjem za stigmo, socialno izključenostjo, strahom pred zmanjšanjem medčloveškega stika, socialno neenakostjo in prekomerno odvisnostjo od socialnih robotov. Dostojanstvo telesne integritete in zasebnosti prav tako zajema pozitivne in negativne vidike. Pozitivni vidiki se nanašajo na izboljšanje telesnega počutja in zmanjšanje zadrege v intimnih situacijah oskrbe. Negativni vidiki pa se nanašajo na skrb glede vdora v zasebnost ter pomisleke o delovanju in zanesljivosti, hkrati pa so povezani s pomembnimi skrbmi glede zasebnosti, nadzora, deljenja podatkov in varnosti. Rezultati kažejo tudi na pomembno vlogo kontekstualnih dejavnikov pri proučevanju vpliva socialnih robotov na dostojanstvo, kot so: vrsta socialnega robota, značilnosti uporabnikov, predhodne izkušnje s socialnimi roboti ter okolje v katerem poteka oskrba. Študije, v katerih so udeleženci socialne robote dejansko uporabljali, praviloma poročajo o bolj pozitivnih ali uravnoteženih rezultatih v primerjavi s študijami, ki temeljijo na predvidevanjih pred dejansko uporabo socialnih robotov. Zaključek: Socialni roboti nimajo enoznačnega vpliva na dostojanstvo. Učinki njihove uporabe so odvisni od tega, kako so zasnovani in vključeni v oskrbo ter vsakdanje življenje, pa tudi od značilnosti uporabnikov, njihovih izkušenj in okoliščin oskrbe. V raziskavi smo prepoznali razlike v pogledu na dostojanstvo glede na predhodne izkušnje s socialnimi roboti: medtem ko starejše osebe brez neposrednih izkušenj pogosto izpostavljajo etična vprašanja in potencialna tveganja, študije, ki vključujejo dejanske uporabnike, navadno poročajo o bolj niansiranih in v nekaterih primerih bolj pozitivnih ali uravnoteženih opisih. Ugotovitve poudarjajo potrebo po kontekstualno občutljivih, na potrebah uporabnikov temelječih in etično utemeljenih pristopih k oblikovanju in implementaciji socialnih robotov v oskrbi.

• Keywords: dostojanstvo, socialni roboti, družabni roboti, storitveni roboti, dolgotrajna oskrba, zdravstvena oskrba, starejše osebe

Projects

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: J5-70195
• Name: Socialni roboti v oskrbi starejših oseb: sprejemanje, starizem, cenovna dostopnost in učinki uporabe