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1 | INTRODUCTION
The ageing o he popula ion, inc easing ca e needs and p obable
sho age o heal hca e wo ke s pose majo socie al challenges in
many Wes e n socie ies. New echnologies and no el gene a ions
o se ice obo s a e expec ed o open oppo uni ies o de elop
enewed ways o p o iding ca e and, mo eo e , enable signi ican
e o ms o se ice p o ision and ca e wo k (Bae , Tillie e, Jele ,
Ozgule , & Loeb, 2014; Decke e al., 2011). Robo s a e expec ed o
alle ia e he sho age o ca e p o essionals (Zsiga e al., 2013) and
o inc ease he au onomy o elde ly people (So ell & D ape , 2014).
Robo s a e p og ammable mecha onic de ices ha can mo e
and pe o m asks in hei en i onmen . Ca e obo s, e e ing o
se ice obo s in a ca e con ex , a e de ices ha conduc asks
au onomously, semi- au onomously o h ough eleope a ion
(Goeldne , He s a , & Tie ze, 2015). A ca e obo may be in eg a ed
in o ca e p ac ices and ei he assis heal hca e pe sonnel o wo k
di ec ly wi h ca e ecei e s. Ca e obo s a e o eseen o be used
as, o example, assis an s ha help wi h daily asks like oile ing,
d essing and ge ing om a bed o a wheelchai (Pino, Boulay, Jouen,
& Rigaud, 2015; Shin & Choo, 2011; Spa ow & Spa ow, 2006),
inc easing he au onomy o disabled pe sons o ail olde people.
Second, obo s can be used in ca e con ex as hey a e al eady used
in households doing basic ou ine asks like cleaning o lawn mow-
ing (Ka z & Halpe n, 2014). Thi d, moni o ing obo s can keep ack
and egis e heal h- and sa e y- ela ed ac o s and call o help when
needed (Sha key & Sha key, 2012). Fou h, social obo s a e de-
signed o emo ional, cogni i e and physical ehabili a ion o people
Recei ed: 27 Sep embe 2017
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Accep ed: 30 Janua y 2018
DOI: 10.1002/nop2.138
RESEARCH ARTICLE
Finnish heal hca e p o essionals’ a i udes owa ds obo s:
Re lec ions on a popula ion sample
Tuuli Tu ja  | Lina Van Ae scho  | Tuomo Sä kikoski | A e Oksanen
This is an open access a icle unde he e ms o he C ea i e Commons A ibu ion License, which pe mi s use, dis ibu ion and ep oduc ion in any medium,
p o ided he o iginal wo k is p ope ly ci ed.
© 2018 The Au ho s. Nu sing Open published by John Wiley & Sons L d.
Facul y o Social Sciences, Uni e si y o
Tampe e, Tampe e, Finland
Co espondence
Tuuli Tu ja, Facul y o Social Sciences,
Uni e si y o Tampe e, Tampe e, Finland.
Email: uuli. u ja@s a .u a. i
Funding in o ma ion
This esea ch is pa o he p ojec Robo s
and he Fu u e o Wel a e Se ices 2015–
2020, which is unded by he Academy o
Finland’s S a egic Resea ch Council Suomen
Aka emia
Abs ac
Aim: To answe he ques ion: ‘How p epa ed heal hca e p o essionals a e o ake
obo s as hei assis an s in e ms o expe ience and accep ance?’
Backg ound: The ageing popula ion, inc easing ca e needs and sho age o heal h-
ca e p o essionals pose majo challenges in Wes e n socie ies. Special se ice obo s
designed o ca e asks ha e been in oduced as one solu ion o hese p oblems.
Design: A co ela i e design
Me hods: Eu oba ome e da a (N = 969) and su ey da a o nu ses and o he heal h-
ca e p o essionals (N = 3800) we e used o assess he ela ionship be ween obo
accep ance and expe iences wi h obo s while con olling o he esponden s’ age,
gende , occupa ional s a us and manage ial expe ience.
Resul s: Heal hca e p o essionals had less expe ience wi h obo s and mo e nega i e
a i udes owa ds hem han he gene al popula ion. Howe e , in heal hca e, obo
assis ance was welcomed o ce ain asks. These ega ded, o example, hea y li -
ing and logis ics. P e ious expe iences wi h obo s we e consis en ly co ela ed wi h
obo accep ance.
KEYWORDS
a i udes, heal hca e wo ke , quan i a i e app oaches, echnology
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who, o example, su e om demen ia (Sha key & Sha key, 2012;
Spa ow & Spa ow, 2006).
A majo conce n ega ding he in oduc ion o no el ca e ech-
nology is whe he i a ec s he ca e ecipien s in a posi i e o neg-
a i e manne (Bo ens ein & Pea son, 2010). People a e wo ied
ha obo s will eplace wo ke s in heal hca e and hence endange
he quali y, e hical p inciples and cu en s anda ds o ca e wo k
(Beedholm, F ede iksen, Sko sgaa d F ede iksen, & Lombo g, 2015;
Ho mann, 2013; Sha key, 2014; Vallo , 2011). Robo s a guably “pose
a h ea o he holis ic ca e” ( an Wynsbe ghe, 2013, p. 427). Signs
o hese conce ns a e also isible in public opinion. Only abou 4% o
Eu opeans hink ha obo s a e sui able o ca e o child en, elde ly
and he disabled (Special Eu oba ome e 382, 2012).
1.1 | Backg ound
In gene al, men, younge adul s and hose wi h highe educa ion a e
mo e p one o accep obo s (de G aa & Ben Allouch, 2013). Posi i e
a i udes owa ds obo s also consis en ly co ela e wi h he amoun
o expe iences wi h obo ic de ices (Hee ink, 2011; Louie, McColl,
& Neja , 2014; Nomu a, Kanda, & Suzuki, 2006). Howe e , s udies
on heal hca e p o essionals’ a i udes owa ds obo s a e a e. P io
indings imply ha nu ses app ecia e obo s as assis i e ools and
moni o ing de ices, bu no o asks ha equi e social in e ac-
ion (Alaiad & Zhou, 2014; Jenkins & D ape , 2015). In Beedholm
e al. (2015) s udy, manage s o an elde ly cen e had mo e posi i e
iews o a ba h ub obo compa ed wi h o he s a and esiden s.
Apa om he e hical discussion, manage s app ecia ed he image-
ele a ing ad an ages ha obo iza ion would b ing o hei uni .
Remo ely ope a ed obo s a e mo e posi i ely app aised han
au onomous obo s (Sa ela, Tu ja, & Oksanen, 2017). Heal hca e
p o essionals see excep ional po en ial in elep esence obo s used
in eleca e (Koceski & Koceska, 2016; K is o e sson, Co adeschi,
Lou i, & Se e inson- Eklundh, 2011). Via elep esence, heal hca e
p o essionals can isi pa ien s om a emo e loca ion. Simila ly,
elep esence can be used, o example, as mobile ideo commu-
nica ion de ices be ween home ca e clien s and hei ela i es.
Telep esence o e s an impo an and in e es ing p ospec o eo -
ganizing and p io i izing asks in ca e wo k. A he momen , nu sing
s a is conce ned abou esou ce sho ages as well as adminis a i e
asks and a elling aking ime om ac ual ca e wo k (Ausse ho e
e al., 2014; Ball, Mu ells, Ra e y, Mo ow, & G i i hs, 2014;
Kodama & Fukaho i, 2017; Menon, 2015; T ydegå d, 2012).
Ca e o olde people has i s own speci ic challenges, such as ime
p essu e in home ca e (Ande sen & Wes gaa d, 2013) and a heigh -
ened isk o clien s’ o hei ela i es’ iolen beha iou (Bane jee
e al., 2012). In Finland, a majo i y (70%) o p ac ical nu ses desc ibe
hei wo k as oo labo ious and a e conside ing a change in occupa-
ion (E kkilä, Simbe g, & Hy ä inen, 2016). Mo eo e , among nu sing
s uden s, ca e o olde pa ien s is no pe cei ed as a desi able ield
o wo k (Koskinen, Salminen, S ol , & Leino- Kilpi, 2014).
Beyond he aspec o eo ganizing wo k, in oducing ca e o-
bo s o en aims a cos sa ings (Qu eshi & Syed, 2014). A hough
e o s ha e been made o apply econome ic c i e ia (P es on,
1993) o managemen heo ies like he heo y o cons ain s
(G oop, 2012) o p oduc i i y gains in ca e se ices, i has been
emphasized ha ca e is essen ially di e en om he p oduc ion
o o he goods and se ices. The alues o nu sing equi e p ac i-
ione s o make he ca e o people hei i s conce n, ocusing on
espec ulness, compassion, us wo hiness, pa ne ship, com-
pe ence and sa e y (NMC, 2015; Scammell, Tai , Whi e, & Tai ,
2017). Howe e , he ca e- ecei e s’ igh s o au onomy, choice
and con ol ha e also been inc easingly emphasized. People wi h
disabili ies and ca e needs should be able o make choices ega d-
ing he assis ance and help hey ecei e (Fine, 2007, p. 92–95;
K öge , 2009). Hence, ca e obo s a e seen as bo h posing a isk o
good- quali y ca e and b inging posi i e chances o inc easing he
au onomy o ca e ecei e s.
Acco ding o Aimee an Wynsbe ghe (2013), obo s should be
designed o suppo and p omo e he undamen al alues o ca e. I
is possible o decide whe he ca e obo s a e sui able and accep able
o di e en ca e asks when we can ell which alues a e in ol ed
in hose ac i i ies and whe he hese alues and he ini ial poin s
o he ca e asks a e endange ed o os e ed (San oni de Sio & an
Wynsbe ghe, 2016). The na u e o ac i i ies app oach dis inguishes
be ween goal- di ec ed ac i i ies and p ac ice- o ien ed ac i i ies.
The poin o goal- di ec ed ac i i ies is o each an end ha is ex-
e nal o he ac i i y, whe eas he main poin o p ac ice- o ien ed
ac i i ies is he pe o mance o he ac i i y i sel (San oni de Sio &
an Wynsbe ghe, 2016). Thinking abou ca e wo k mo e conc e ely,
he di e en asks can be di ided in o di ec pa ien ca e, indi ec
pa ien ca e and o he ac i i ies, including, o example, documen-
a ion, adminis a ion and planning medica ion (Balle mann, Shaw,
Maye s, Gibney, & Wes b ook, 2011).
As ca e obo s a e no ye commonly used by heal hca e p o-
essionals, we need heo e ical ools o analysing he sui abili y o
obo s o ca e wo k. In his s udy, we examined heal hca e p o es-
sionals’ expe iences wi h obo s and how hese expe iences asso-
cia e wi h he gene al iew o obo s (GVR) o obo accep ance a
wo k (RAW). We compa ed he GVR and RAW o heal hca e p o-
essionals using a su ey da a o Finnish heal hca e p o essionals o
he a i udes o he gene al popula ion, using Eu oba ome e da a
o Finland.
In addi ion, we examined he asks o which heal hca e p o es-
sionals conside he idea o obo assis ance o be mos ag eeable
and used he na u e o ac i i ies heo y o gain an unde s anding o
he u u e p ospec s o in oducing obo s o ca e wo k. Ou i s
hypo hesis is ha he esponden s app o e obo assis ance o in-
di ec pa ien ca e asks a he han o di ec and p ac ice- o ien ed
asks. This includes he idea o indi ec pa ien ca e being aside he
ac ual ca e wo k (Ausse ho e e al., 2014; Ball e al., 2014; Menon,
2015). Fu he mo e, because p e ious s udies ha e shown ha
nu ses pe cei e physical demands as one o he main challenges in
hei wo k (E kkilä e al., 2016; Kodama & Fukaho i, 2017; T ydegå d,
2012), ou second hypo hesis was ha he esponden s a e mo e ap-
p o ing owa ds obo s ha assis in physically bu dening ca e asks.
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2 | METHOD
2.1 | Design
Quan i a i e, co ela i e s udy was conduc ed ia h ee ques ion-
nai e da a se s. Two iden ical su eys o Finnish heal hca e p o-
essionals we e illed ou online. Ques ionnai e o Eu oba ome e
popula ion sample, hen, was execu ed as s uc u ed, ace- o- ace
in e iews.
2.2 | Da a
Su ey da a o heal hca e p o essionals we e collec ed om Oc obe
o No embe 2016. The i s sample was andomly selec ed om he
membe s o he Finnish Union o P ac ical Nu ses, who we e cu -
en ly wo king wi h he elde s (N = 2218). E e y o he indi idual in
he popula ion was selec ed wi h an equal likelihood o selec ion.
The pa icipan s we e aged 17–68 (mean = 45.5; SD 12.1) and 89.8%
we e emale. The second sample was collec ed om he Union o
Heal h and Social Ca e P o essionals in Finland. The andom sam-
pling included e e y nu se (p ac ical o egis e ed) and physio he a-
pis cu en ly wo king a elde ly and homeca e se ices as well as
e e y hi d andomly selec ed nu se and physio he apis wo king a
a heal h cen e o a hospi al. The second sample consis ed o mos ly
emale (89.0%) nu ses (N = 1701) and physio he apis s (N = 81) aged
19–70 (mean = 47.5; SD 10.4).
The ques ionnai e included mul iple choice ques ions abou
educa ional and occupa ional backg ound, expe iences wi h assis-
i e ools in heal hca e and a i udes owa ds obo s. Responden s
who comple ed he i s page o sociodemog aphic in o ma ion
and a ques ion conce ning in e es in echnology we e included
in he inal and combined sample (N = 3800). Table 1 summa izes
he backg ound cha ac e is ics o he esponden s and compa es
hem o he popula ion s a is ics o Finnish nu ses (Ailasmaa,
2014).
In addi ion o he heal hca e p o essional da a, we used a
Finnish popula ion sample e ie ed om he Eu oba ome e
s a is ics o 2014 (N = 969). The Eu opean Commission- unded
Eu oba ome e polls moni o EU ci izens’ social and poli ical
iews and accoun o phenomena such as obo iza ion. The
Eu oba ome e esponden s we e aged 15–91 (mean = 48.3;
SD 19.06), wi h 51.3% being emale.
2.3 | Measu es
A i udes owa ds obo s we e co e ed by wo a iables: he gen-
e al iew o obo s (GWR) and obo accep ance a wo k (RAW).
GVR was measu ed wi h he ques ion: “Gene ally speaking, do
you ha e a ‘ e y posi i e’ (4); ‘ ai ly posi i e’ (3); ‘ ai ly nega i e’
(2); o ‘ e y nega i e’ (1) iew o obo s?” This ques ion was p e-
sen ed iden ically in he Eu oba ome e and he su eys o he
heal hca e p o essionals. In he Eu oba ome e ques ionnai e,
RAW was measu ed wi h a ques ion on how he esponden el
abou “ha ing a obo assis hem a wo k (e.g., in manu ac u ing).”
The scale o he answe s anged om 1 ( o ally uncom o able) o
10 ( o ally com o able) in he heal hca e p o essionals’ su eys,
RAW was summed om 13 ques ions conce ning obo s assis ing
in di e en ca e wo k scena ios (excluding obo ic su ge y). The
scale o he answe s anged om 1 ( o ally uncom o able)–10
( o ally com o able). The composi e a iable ( ange 13–130) was
e u ned o i s o iginal scale om 1–10 (α 0.933). Figu e 1 shows
he means o all 13 scena ios and he ull ques ions a e p esen ed
in Appendix S1.
The de ini ion o obo s used o p ime he ques ions on bo h
he Eu oba ome e and heal hca e ques ionnai es was as ollows:
“Robo is de ined as a machine which can assis humans in e e y-
day asks wi hou cons an guidance o ins uc ion, e.g., as a kind
o co- wo ke helping on he ac o y loo o as a obo cleane , o
in ac i i ies which may be dange ous o humans, like sea ch and
escue in disas e s. Robo s can come in many shapes o sizes and
some may be o human appea ance. T adi ional ki chen appliances,
such as a blende o a co ee make , a e no conside ed as obo s”
(Eu oba ome e ques ionnai e 2014).
Expe iences wi h obo s we e inqui ed abou by asking he e-
sponden s whe he hey possessed conc e e expe iences wi h o-
bo s in di e en con ex s: home, wo k and elsewhe e. In addi ion,
he heal hca e p o essionals’ expe iences wi h obo s a wo k we e
ob ained by asking whe he he e had been expe iences in ca e wo k
o o he wo k. A composi e a iable o med a scale om 0–3 in he
Eu oba ome e sample and a scale om 0–4 in he heal hca e p o-
essional samples. Ze o, indica ing no expe ience anywhe e, was he
mode in e e y da a se .
In he ques ionnai es, he pa icipan s we e asked abou hei
age, gende , occupa ional s a us and manage ial expe ience.
TABLE1 Occupa ional, gende and age dis ibu ions:
Compa isons wi h he popula ion
Finnish popula ion
Ca e wo ke
sample
2013 2016
Dis ibu ion be ween nu ses
P ac ical nu ses 64.7% 64.9%
Regis e ed nu ses 35.3% 35.1%
Females
P ac ical nu ses 90.4% 95.1%
Regis e ed nu ses 92.1% 94.8%
Head nu ses 93.3% 95.8%
Physio he apis s 81.2% 91.3%
Age mean
P ac ical nu ses 43.0 45.3
Regis e ed nu ses 43.3 47.5
Head nu ses 50.7 53.6
Physio he apis s 42.6 47.1
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TURJA eT Al.
Occupa ional s a us a he ime o he s udy was dicho omized as
employed (1) o no (0). Among he esponden s o he popula ion
sample, 38.1% and 92.2% o he heal hca e p o essional sample
we e employed a he ime o he s udy. The heal hca e p o essional
su eys included a ques ion abou ha ing manage ial expe ience
(1) o no (0). 17.7% epo ed ha ing manage ial expe ience. In he
popula ion sample, 18.4% o esponden s desc ibed hemsel es as
manage s o o he whi e- colla employees.
2.4 | S a is ical analysis
The desc ip i e indings a e p esen ed as pe cen ages, con idence
in e als, means (M) and s anda d de ia ions (SD), along wi h
Pea son co ela ions ( ), z- es s o an obse ed p opo ion and a i-
ance analysis (F) o g oup compa isons. E o ba s used in he igu e
indica e s a is ical signi icance be ween means.
The ela ionship be ween a i udes owa ds obo s and di -
e en expe iences wi h obo s, as well as some impo an back-
g ound a iables, was es ed using mul iple o dina y leas squa es
(OLS) eg ession analysis. Va iables we e en e ed oge he in o
he analysis. This p edic i e analysis was applied sepa a ely o
he popula ion da a and o he agg ega e da a o he wo heal h-
ca e p o essionals’ samples. In o al, ou eg ession models a e
p esen ed: GVR and RAW in he popula ion da a and GVR and
RAW in he heal hca e p o essional da a. The esul s a e e-
po ed as bo h uns anda dized (a e age change in he dependen
a iable) and s anda dized (compa able e ec size) eg ession
coe icien s.
3 | RESULTS
Expe iences wi h obo s we e mo e equen among he popula ion
(16.2%) han among he heal hca e p o essionals (11.9%; z = 4.13,
p < .0001). The di e ences be ween di e en heal hca e occupa-
ions we e no s a is ically signi ican , as de ined by he 95% con i-
dence in e als. Table 2 shows speci ic pe cen ages o usage con ex
and p o ession.
FIGURE1 A e age assessmen s o “How com o able would you eel abou a obo assis ing you wi h a ca e wo k- ela ed ask?
304
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TURJA eT Al.
Rega ding GVR, he a i udes o he gene al popula ion we e
mo e posi i e (mean = 2.85; SD .71) compa ed wi h he heal hca e
p o essionals (mean = 2.57; SD .71). The di e ence be ween he
popula ion sample and he agg ega e heal hca e p o essional sample
was s a is ically signi ican based on he 95% con idence in e al.
Those Eu oba ome e esponden s, who we e cu en ly employed,
had e en mo e posi i e iew on obo s in gene al (mean = 2.94;
SD .68).
Among he heal hca e p o essionals, head nu ses and o he
manage s had he mos posi i e iews o obo s (mean = 2.84;
SD .643), ollowed by physio he apis s and ehabili a ion wo ke s
(mean = 2.72; SD .680), egis e ed nu ses (mean = 2.70; SD .677)
and p ac ical nu ses (mean = 2.46; SD .725) [F(4) = 25.35; p < .001].
Dunne ’s T3 es e ealed ha he signi ican di e ence was be-
ween p ac ical nu ses and all o he occupa ional g oups.
In an opposi e ein, a lowe a e age le el o RAW was ound
among he popula ion (mean = 5.99; SD 2.95) compa ed wi h he
heal hca e p o essionals (mean = 6.57; SD 2.19). Among he heal h-
ca e p o essionals, head nu ses had he highes accep ance o o-
bo s a wo k (mean = 7.42; SD 1.78), ollowed by egis e ed nu ses
(mean = 6.95; SD 2.05), physio he apis s/ ehabili a ion wo ke s
(mean = 6.80; SD 1.83) and p ac ical nu ses (mean = 6.26; SD 2.24).
Figu e 1 shows he a e age assessmen o obo assis ance
o each ca e wo k ask. Tasks in ol ing hea y li ing ecei ed he
mos posi i e assessmen s and, hence, heigh ened he o al RAW
he mos in he da a o heal hca e p o essionals. Co ela ions be-
ween heal hca e p o essionals’ GVR, RAW, gende , age, manage-
ial expe ience and o al expe iences o obo s a e p esen ed in
Appendix S2.
When he analysis was limi ed o he esponden s who had pe -
sonal expe ience wi h obo s, we ound highe a e age accep ance
and less a iance in assessmen s o GVR and RAW. This was u he
analysed by OLS eg ession models o assess he ela ionship be-
ween obo accep ance and he esponden s’ expe iences o obo s
while con olling o age, gende , employmen s a us and manage-
ial expe ience. The esul s om he popula ion da a a e shown in
Tables 3 and 4 and he esul s om he heal hca e p o essionals a e
shown in Tables 5 and 6.
In ou da a, RAW was assessed he highes among hose wi h
manage ial expe ience and hose who had used obo s in hei wo k.
Among he popula ion, highe accep ance was also associa ed wi h
male gende , no wo king a he ime o he s udy and younge age.
Among heal hca e p o essionals, younge age, on he con a y,
p edic ed a lowe le el o RAW. GVR was consis en ly he highes
among men, hose who had manage ial expe ience and hose who
had used obo s in hei wo k.
Pe sonal expe iences wi h obo s in di e en con ex s we e sys-
ema ically associa ed wi h highe obo accep ance in all ou mod-
els. In he popula ion sample, hose who had used a obo a wo k
had on a e age 14% highe le els o RAW compa ed wi h hose wi h
no expe ience o wo king wi h obo s. Fu he mo e, hose who had
expe ience wi h obo s a home had on a e age 10% highe app aisal
o obo s in gene al. Heal hca e p o essionals who epo ed ha ing
used a obo a home had on a e age 9% highe le els o RAW and
8% highe le els o GVR.
As ano he cohe en esul , esponden s wi h manage ial expe-
ience had mo e (4%–9%) posi i e iews on obo s. In he popula-
ion sample, he employed esponden s had on a e age 8% lowe
le els o RAW. Male gende p edic ed consis en ly highe (6%–
10%) accep ance in he popula ion, ye he heal hca e p o essional
da a only showed highe RAW o males and no di e ences in GVR
be ween gende s. Younge age p edic ed highe le els o GVR and
RAW in he popula ion sample bu lowe GVR and RAW among he
heal hca e p o essionals.
4 | DISCUSSION
We examined he expe ience heal hca e p o essionals ha e wi h
obo s and how i associa es wi h a i udes owa ds obo s. The a -
i udes among he heal hca e p o essionals we e e lec ed o he a -
i udes in he popula ion. We also analysed how obo assis ance is
app o ed depending on he ca e ask in ques ion. Hypo heses o
heal hca e da a we e based on na u e o ac i i ies heo y (San oni
de Sio & an Wynsbe ghe, 2016) and segmen a ion o ca e asks
(Balle mann e al., 2011). The wo hypo heses ega ded asks o
TABLE2 Pe cen ages o obo use by con ex and sample. Ca e wo ke sample subg ouped by occupa ion
Ha e used a
obo %
Popula ion
sample (N = 969)
P ac ical
nu ses
(N = 1914)
Regis e ed
nu ses
(N = 1032)
Head nu ses/o he
manage s (N = 129)
Physio he apis s/
ehabili a ion wo ke s
(N = 86)
O he heal hca e
wo ke s (N = 238)c
A home 3.7 6.3 7.5 10.9 9.3 6.3
A ca e
wo k
2.9 3.0 3.9 2.3 1.3
A o he
wo ka
9.8 2.1 0.5 2.3 1.2 2.1
Elsewhe eb3.2 1.5 1.6 1.6 5.8 3.8
Anywhe e 16.2 11.2 12.2 15.5 16.3 12.7
aThis indica es any wo k con ex ega ding he popula ion sample.
bSuch as ai s, in o se ice, a ic and a iend’s house.
cSuch as public heal h nu se, medical ecep ionis .

|
305
TURJA eT Al.
which heal hca e p o essionals would ind obo assis ance mos
ag eeable.
The esul s show ha gene al iews on obo s a e mo e posi i e
among he Finnish popula ion compa ed wi h he heal hca e p o es-
sionals. Among occupa ional g oups, p ac ical nu ses s ood ou as
ha ing he mos ese ed a i udes owa ds obo s. Hence, e en i
labo ious (E kkilä e al., 2016; T ydegå d, 2012) and pa ly ou ine-
like (Spa ow & Spa ow, 2006) p ac ical ca e wo k in pa icula
could bene i om obo ics, he wo ke s did no see his solely as
posi i e. Tha said, his inding e lec s he wo ies ega ding quali y
and e hics o ca e, which a e ela ed o esponsi eness, humani y
and a en i eness (Beedholm e al., 2015; Ho mann, 2013; Sha key,
2014; Vallo , 2011; an Wynsbe ghe, 2013). Rega dless o hei el-
a i ely nega i e a i udes owa ds obo s in gene al, he heal hca e
p o essionals app o ed he idea o obo assis ance in some ca e
asks a he han in o he s.
Re lec ed agains he na u e o ac i i ies app oach (San oni de
Sio & an Wynsbe ghe, 2016), di ec pa ien ca e is mos o en a
p ac ice- o ien ed ac i i y ha migh be as impo an as he end e-
sul ; hus, he goal is in e nal o he ac i i y (Balle mann e al., 2011).
Indi ec pa ien ca e and o he ac i i ies o ca e wo k could, on he
con a y, be conside ed as goal- di ec ed asks. In ou i s hypo hesis,
we p esumed ha heal hca e p o essionals would app o e obo as-
sis ance in indi ec a he han in di ec pa ien ca e asks. Howe e ,
he e was no such dicho omy ound be ween iews ega ding obo
assis ance in handling ma e ials o pa ien s (e.g. Alaiad & Zhou, 2014;
Jenkins & D ape , 2015). The hypo hesis mus be ejec ed, gi en ha
excluding he ask o mo ing a pa ien , o he obo - assis ed asks
wi h high ag eemen (mo ing, so ing and shel ing ma e ials) a e
conside ed indi ec and goal o ien ed. Also, he esponden s we e
leas com o able wi h he idea o obo s assis ing wi h mo e holis ic
asks ( an Wynsbe ghe, 2013, p. 427), namely elep esence heal h
checks, unhygienic wo k, ans e ing pa ien s on a s e che and
planning ca e o medica ion, which in pa a ou ed he hypo hesis.
Suppo ing ou second hypo hesis, he heal hca e p o ession-
als ound obo assis ance mos sui able o e gonomically chal-
lenging wo k (mo ing pa ien s o hea y objec s) as well as o asks
ou side o ac ual nu sing wo k (so ing, shel ing and deli e ing ma-
e ials). The esul s po ay some o he challenges in nu sing wo k.
Heal hca e p o essionals see obo assis an s as being wo hwhile
o physically demanding asks (E kkilä e al., 2016; T ydegå d,
2012) bu also as ansla o s and assis ing in h ea ening si ua ions.
Fi s ly, we conclude ha he assis i e de ices o hea y li ing in
heal hca e do no mee he cu en needs o a sa is ac o y le el.
Robo s hold p omise as mo e adequa e nex - gene a ion assis i e
ools ha a e ei he easy o use o e en au onomous. Secondly,
heal hca e p o essionals deal wi h non- na i e Finnish speake s,
bo h as pa ien s and as colleagues and end up aking ca e o , o
example, immig an s wi h whom hey do no ha e any common
language a all. Robo s as mobile i ual assis an s could help wi h
ansla ing o sign language. Thi dly, we associa e he app o al o
obo assis ance in h ea ening si ua ions o he home o esiden-
ial ca e wo ke s’ wo ies ega ding agg essi e beha iou among
esiden s and hei ela i es (Bane jee e al., 2012).
GVR (1–4), Popula ion
Uns anda dized S anda dized
BSE βp
(Cons an ) 3.413 0.105 .000
Female −0.230 0.044 −0.163 .000
Age −0.005 0.001 −0.126 .000
Employed −0.087 0.060 −0.060 .148
Manage /whi e- colla 0.230 0.070 0.127 .001
Robo s used a home 0.404 0.115 0.110 .000
Robo s used a wo k 0.199 0.074 0.085 .007
Robo s used elsewhe e 0.115 0.126 0.029 .363
TABLE3 Gene al iew on obo s,
eg ession analysis o he popula ion da a
(N = 969)
RAW (1–10), Popula ion
Uns anda dized S anda dized
BSE βp
(Cons an ) 9.127 0.431 .000
Female −1.016 0.184 −0.172 .000
Age −0.029 0.005 −0.190 .000
Employed −0.823 0.245 −0.136 .001
Manage /whi e- colla 0.884 0.291 0.117 .002
Robo s used a home 0.346 0.481 0.022 .472
Robo s used a wo k 1.399 0.303 0.144 .000
Robo s used elsewhe e 0.623 0.520 0.037 .231
TABLE4 Robo accep ance a wo k,
eg ession analysis o he popula ion da a
(N = 969)
306
|
TURJA eT Al.
Ou esul s a e consis en wi h he s udies implica ing ha o-
bo s a e iewed mo e posi i ely a e pe sonal expe ience (Hee ink,
2011; Louie e al., 2014; Nomu a e al., 2006). The expe ience
heal hca e p o essionals ha e wi h obo s a home o wo k ou side
heal hca e is associa ed wi h highe accep ance o obo s, bo h in
gene al and as assis an s a wo k. The di e ence is ha mos o he
popula ion’s expe iences wi h obo s o igina e om wo k, whe eas
mos o he heal hca e p o essionals’ expe iences o igina e om
home. This also explains he eason behind he mo e equen obo
use among he popula ion. People wo king in an indus ial ield a e
mo e amilia wi h obo s han people who wo k in se ice ields due
o he obo iza ion o indus ial p oduc ion. Robo use a home was
mo e equen ly epo ed among he heal hca e p o essionals com-
pa ed wi h he popula ion, bu his mos likely e e s o he empo al
2- yea di e ence in da a collec ion. Household obo s such as au o-
nomic acuum cleane s ha e become mo e common in ecen yea s.
The a i udes o heal hca e p o essionals seem o be no ably in-
luenced by expe iences wi h obo s, o due o he ob ious he e o-
geneous causali y; hose wi h mo e posi i e iews on obo s s i e
o oppo uni ies o use obo s. In he popula ion sample, young
men who had expe ience wi h obo s a wo k had he mos posi i e
o e all a i udes owa ds obo s. Among heal hca e p o essionals,
he olde esponden s who had expe ience wi h obo s a home had
he mos posi i e o e all a i udes. This pe haps implies he heigh -
ened use needs ( an Wynsbe ghe, 2013) among olde heal hca e
p o essionals. Along ageing, he need o assis i e echnology be-
comes mo e ele an and appealing.
The gende di e ences seem o e lec he ac ha he e a-
di ionally has been a cul u al di ide be ween masculine echnologi-
cal and eminine social p o essions in Finland. The di e ing gende
p o iles be ween hese ields a e s ill isible. Women ep esen jus
one- i h o all g adua ions in highe echnological educa ion bu
wo- hi ds o g adua ions in social and heal hca e educa ion (Finnish
S a is ics, 2015). Inc easing use o obo ic and o he ICT appliances
in ca e asks and o ganiza ions may change his pic u e. In ensi e
de elopmen and deploymen o inno a ions in he ca e sec o may
make he sec o mo e a ac i e o echnologically o ien ed males
and, opposi ely, call o mo e echnological aining o human-
o ien ed heal hca e p o essionals. I has indeed been implied ha
obo s ep oduce concep s o social o de , such as gende ed no ions
o wo k (Boye , 2004).
Manage ial expe ience eme ged as an impo an ac o explain-
ing he a iance in obo accep ance, especially in he heal hca e
p o essional da a. In addi ion, head nu ses and o he manage s had
ela i ely ex ensi e expe ience wi h obo s in heal hca e wo k.
This co esponds wi h p io s udies showing ha highe educa ion
and manage ial expe ience go hand in hand wi h obo accep ance
(Beedholm e al., 2015; de G aa & Ben Allouch, 2013). Manage s
conside echnology, a leas pa ly, om an o ganiza ion’s pe spec-
i e. In es ing in mode n echnology can be seen use ul o a ac
GVR (1–4), ca e wo ke s
Uns anda dized S anda dized
BSE βp
(Cons an ) 2.352 0.069 .000
Female −0.232 0.060 −0.074 .000
Age 0.002 0.001 0.037 .057
Employed 0.031 0.051 0.012 .538
Manage ial expe ience 0.164 0.035 0.090 .000
Robo s used a home 0.325 0.051 0.121 .000
Robo s used a heal hca e 0.142 0.077 0.035 .066
Robo s used a o he wo k 0.289 0.102 0.054 .004
Robo s used elsewhe e 0.196 0.094 0.039 .039
TABLE5 Gene al iew on obo s,
eg ession analysis o he ca e wo ke
da a (N = 3399)
RAW (1–10), ca e wo ke s
Uns anda dized S anda dized
BSE βp
(Cons an ) 5.827 0.201 .000
Female 0.071 0.179 0.007 .692
Age 0.011 0.004 0.057 .002
Employed 0.067 0.148 0.008 .650
Manage ial expe ience 0.453 0.103 0.080 .000
Robo s used a home 0.863 0.154 0.101 .000
Robo s used a heal hca e 0.041 0.231 0.003 .860
Robo s used a o he wo k 0.632 0.315 0.036 .045
Robo s used elsewhe e 0.360 0.294 0.022 .220
TABLE6 Robo accep ance a wo k,
eg ession analysis o he ca e wo ke
da a (N = 3399)
|
307
TURJA eT Al.
bo h po en ial cus ome s and op employees. On he o he hand,
employees may ha e hei conce ns o e how implemen ing new
echnology will a ec he subs ance o amoun o hei wo k.
Inconsis ency was ound in occupa ional s a us o whe he he e-
sponden was wo king a he ime o he s udy. The employed espon-
den s in he popula ion sample had mo e nega i e a i udes owa ds
obo s, con a y o he heal hca e sample. The pessimism in he gen-
e al wo king popula ion can indica e common unce ain ies ega ding
job losses caused by he u u e au oma iza ion (Manyika e al., 2013;
Paja inen & Rou inen, 2014), while he op imism among heal hca e
p o essionals may illus a e he iew o holis ic and emo ional ca e (e.g.
Scammell e al., 2017) which canno be au oma ed o done by obo s.
A heo e ical modelling sugges s ha he p obabili y o compu e izing
in ca e asks is ela i ely low (F ey & Osbo ne, 2013), bu up o now,
he e has been no empi ical e idence o he labou e ec s o he pos-
sibili ies o inc ease p oduc i i y in ca e se ices due o obo iza ion.
In gene al, assessing p oduc i i y is a less s aigh o wa d o
se ices han o indus ial p oduc ion, o which inpu s and ou pu s
can be objec i ely iden i ied. The uni s o se ices a e di icul o
de ine and he quali y o se ices will no necessa ily imp o e in a
di ec ela ionship wi h bigge inpu s (G ön oos & Ojasalo, 2004).
Robo iza ion o ca e se ice o enhance p oduc i i y sounds pu ely
dys opic o many people: Will u u e ca e homes be s a ed by o-
bo s only? Would he olde people ha e con ac mainly wi h ma-
chines ha ake ca e o deli e ing ood, cleaning, doing medical
measu emen s and o ganizing social ac i i ies?
4.1 | E hics and alidi y o he s udy
The s udy complies wi h he egula ions o he Finnish Ad iso y
Boa d o Resea ch In eg i y and mo e b oadly wi h he Decla a ion
o Helsinki. All o he pa icipan s we e in o med abou he aims o
he s udy and hey had he igh o decline pa icipa ion. Consen
was eques ed a he beginning o he su ey and he da a handling
was designed o ensu e he pa icipan s’ anonymi y. No e hical ap-
p o al was needed.
In Finland, a high majo i y (90%) o nu ses a e unionized
(Kilpeläinen, 2010). This and he andom sampling conduc ed
suppo he ep esen a i e na u e o he heal hca e p o essional
da a al hough emale and olde esponden s we e sligh ly o e -
ep esen ed compa ed wi h he popula ion (Ailasmaa, 2014) in he
combined sample. As a limi a ion o his s udy, RAW was measu ed
di e en ly in he popula ion and heal hca e p o essional samples;
hus, hey we e only compa ed by desc ip i e means.
5 | CONCLUSIONS
Se e al di e ences we e ound be ween he popula ion and heal h-
ca e p o essionals; hus, i seems ui ul o s udy heal hca e wo ke s
as a dis inc obo use g oup. Mo eo e , he di e ences among di e -
en le el heal hca e p o essionals show he u he impo ance o ac-
knowledging di e en in e es g oups in s udies o obo accep ance.
The mos cons an inding be ween he esponden g oups was
ha indi iduals who ha e expe ience wi h obo s, ha e mo e posi-
i e a i udes owa ds hem. Heal hca e p o essionals ha e ai ly op-
imis ic expec a ions owa ds obo assis ance, bu only wi h ce ain
kinds o asks. Ins ead o iewing obo iza ion as a o m o dehuman-
izing ca e (Scammell e al., 2017), obo s may be used o assis ca e-
gi e s by doing p ac ical ou ine wo k, hus allowing he wo ke s o
concen a e on human- cen ed asks (Spa ow & Spa ow, 2006).
These esul s oge he unde line he impo ance o de eloping p o-
ac i e wo kplace p ac ices whe e di e en - le el employees a e able
o plan oge he he possible implemen a ions o ca e obo ics.
CONFLICT OF INTEREST
No con lic o in e es has been decla ed by he au ho s.
ORCID
Tuuli Tu ja h p://o cid.o g/0000-0001-7815-9511
A e Oksanen h p://o cid.o g/0000-0003-4143-5580
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