{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:56Z","timestamp":1785545036081,"version":"3.56.0"},"reference-count":26,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Medical and welfare facilities in the Noto region of Japan were severely affected by the 2024 Noto Peninsula earthquake and subsequent torrential rains. Staff working in these facilities were disaster survivors and frontline caregivers with limited psychological support. Nonverbal social robots may provide companionship and emotional comfort; however, their effects on the health-related quality of life (QoL) and well-being of care staff in disaster-affected settings remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study explored whether introducing a nonverbal artificial intelligence communication robot was associated with changes in health-related QoL and well-being among care facility staff working under disaster conditions. Secondary objectives were to evaluate safety, acceptability, and intention to continue use.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This pragmatic, exploratory pilot study used an ABAB design conducted between February 2025 and June 2025. After a 2-week baseline period, staff in dementia care, general care, and short-stay units underwent 2-week intervention, withdrawal, reintervention, and withdrawal phases. Questionnaires were administered at each phase end. The primary outcomes were health-related QoL (EQ-5D-5L), well-being (World Health Organization\u20135 Well\u2011Being Index), and positive mental health (Mental Health Continuum\u2013Short Form). Friedman tests compared outcomes across the 5 phases, and effect sizes were expressed as Kendall\n W<\/jats:italic>\n . Safety, acceptability, and intention to continue use were compared between the first and second intervention phases using Wilcoxon signed rank tests with Bonferroni adjustment and rank-biserial correlations as effect sizes.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 58 staff who completed the baseline assessment, 49 (84.5%) were included in the analytic sample (25 in dementia care, 12 in general care, and 12 in short-stay units). Among these participants, 40 (81.6%) were women, and 38 (77.6%) reported disaster-related damage to their homes or families. In the pooled analysis, no phase effect was observed for the EQ-5D-5L (\n P<\/jats:italic>\n =.10; Kendall\n W<\/jats:italic>\n =0.032, negligible), the World Health Organization\u20135 Well\u2011Being Index (\n P<\/jats:italic>\n =.70; Kendall\n W<\/jats:italic>\n =0.016, negligible), or the Mental Health Continuum\u2013Short Form (\n P<\/jats:italic>\n =.44; Kendall\n W<\/jats:italic>\n =0.022, negligible). No robot-related adverse events were reported. In the dementia care unit, nominal unadjusted differences were observed for \u201cmade me feel calm\u201d (\n P<\/jats:italic>\n =.045; rank-biserial correlation\n r<\/jats:italic>\n =0.571, large), \u201clike\u201d (\n P<\/jats:italic>\n =.03;\n r<\/jats:italic>\n =0.559, large), and \u201cfelt at peace\u201d (\n P<\/jats:italic>\n =.02;\n r<\/jats:italic>\n =0.718, large); however, none remained statistically significant after Bonferroni correction.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The short-term use of a nonverbal artificial intelligence communication robot did not measurably improve health-related QoL or well-being among staff in disaster-affected care facilities. Deployment appeared feasible and was not associated with reported adverse events, but efficacy as a mental health support intervention remains unproven. Exploratory acceptability and interaction signals may inform future adequately powered studies.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/89166","type":"journal-article","created":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T06:40:10Z","timestamp":1780209610000},"page":"e89166-e89166","source":"Crossref","is-referenced-by-count":0,"title":["Nonverbal AI-Based Communication Robot for Staff in Disaster-Affected Care Facilities: Exploratory ABAB Intervention Study"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8820-0952","authenticated-orcid":false,"given":"Daijiro","family":"Haba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riko","family":"Miyashita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Tatsukawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-884X","authenticated-orcid":false,"given":"Fumiya","family":"Oohashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1484-5261","authenticated-orcid":false,"given":"Aya","family":"Kitamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1954-4889","authenticated-orcid":false,"given":"Chizuko","family":"Konya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1912-1251","authenticated-orcid":false,"given":"Hiromi","family":"Sanada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0246-395X","authenticated-orcid":false,"given":"Masaru","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1620\/tjem.2024.J010","article-title":"The 2024 Noto Peninsula earthquake and the strategy of medical assistance from the Tohoku University Hospital","volume":"262","author":"Egawa","journal-title":"Tohoku J Exp Med"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1016\/j.actpsy.2025.105602","article-title":"Resilience and quality of life of disaster survivors six months after the Noto Peninsula earthquake: a population-based Shika study","volume":"260","author":"Sato","journal-title":"Acta Psychol (Amst)"},{"issue":"3","key":"R3","doi-asserted-by":"publisher","DOI":"10.3390\/nu17030506","article-title":"Impact of the 2024 Noto Peninsula earthquake on nutritional status in residents of an integrated medical and long-term care facility: a descriptive study","volume":"17","author":"Kokura","journal-title":"Nutrients"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-023-00979-5","article-title":"Systematic review and meta-analysis of AI-based conversational agents for promoting mental health and well-being","volume":"6","author":"Li","journal-title":"NPJ Digit Med"},{"issue":"9","key":"R5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0332207","article-title":"Artificial intelligence as a predictive tool for mental health status: insights from a systematic review and meta-analysis","volume":"20","author":"Humayun","journal-title":"PLoS One"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","first-page":"70","DOI":"10.24462\/jnse.6.2_70","article-title":"Exploration of communication robot use for older patients in an acute hospital based on case trials","volume":"6","author":"Noguchi","journal-title":"J Nurs Sci Eng"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.77635","article-title":"The long-term use of communication robots by users of visiting healthcare services: development of an integrated vital signs measurement system","volume":"17","author":"Takahashi","journal-title":"Cureus"},{"issue":"24","key":"R8","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1080\/01691864.2015.1079503","article-title":"Anshin as a concept of subjective well-being between humans and robots in Japan","volume":"29","author":"Kamide","journal-title":"Adv Robotics"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2015.00064","article-title":"Can a humanoid face be expressive? 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