El-Gazar et al.

BMC Nursing (2024) 23:718 BMC Nursing

https://doi.org/10.1186/s12912-024-02336-7

RESEARCH Open Access

Are nurses and patients willing to work

with service robots in healthcare? A mixed-
methods study
Heba Emad El-Gazar1* , Shymaa Abdelhafez1, Amira Mohammed Ali2, Mona Shawer3,4, Talal Ali F. Alharbi5,6 and
Mohamed Ali Zoromba7

Abstract
Introduction Scholars have become increasingly interested in incorporating robots into healthcare. While there is
a growing body of research examining nurses’ and patients’ attitudes towards using robots in healthcare, no prior
research has specifically explored their willingness to integrate service robots within the Egyptian healthcare context.
Aim The aim of this study was twofold: (a) to explore the behavioral intentions of nurses to accept robots in their
workplace, and (b) to examine the willingness of patients to use service robots in healthcare settings.
Methods A mixed-methods study was conducted. Quantitative data were collected from 301 nurses using the
Behavioral Intention to Accept Robots in the Workplace Scale and from 467 patients using the Service Robot
Integration Willingness Scale through convenience sampling at three tertiary public hospitals in Port Said, Egypt.
Qualitative data were obtained through in-depth, semi-structured interviews with 16 nurses, focusing on their
perspectives and concerns regarding robot integration. Descriptive analyses were used to analyze quantitative data,
and thematic analysis was used to analyze qualitative data.
Results Quantitative results indicated a moderate level of behavioral intention to use robots among nurses.
Patients demonstrated low willingness to use service robots. In the qualitative analysis of the data obtained from the
interviews with nurses, three categories (Concerns about Robots, Roles and Competencies, and Potential Benefits)
and eight themes (interaction and emotions, maintenance and reliability, job insecurity, role clarity, competence in
critical care, trustworthiness, reducing physical strain, and specialized applications) were identified.
Conclusion The results of this study indicate that nurses’ behavioral intention to accept service robots in healthcare
settings is moderate and their acceptance is influenced by various factors related to their concerns about robots, roles
and competencies, and potential benefits they could gain. Patients showed a low level of willingness to use service
robots in healthcare settings.
Implication Providing targeted educational programs to nurses and patients, assuring them with the provision of
robust maintenance protocols, enhancing their confidence in the capabilities of robots, and defining clear roles for
robots are crucial for the successful integration of robots into healthcare settings.

*Correspondence:
Heba Emad El-Gazar
heba.emad@nur.psu.edu.eg
Full list of author information is available at the end of the article

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El-Gazar et al. BMC Nursing (2024) 23:718 Page 2 of 12

Keywords Healthcare service robots, Mixed-methods study, Nurses’ behavioral intentions to accept robots, Patient
willingness to use robots

Introduction regarding robot integration, which may hinder nurse-

The integration of artificial intelligence (AI) into health- robot cooperation. By effectively addressing these
care settings is progressively expanding worldwide. AI concerns, this research responds to scholarly calls for
is playing an increasingly pivotal role in transforming exploring barriers to the acceptance of robots [14]. As a
health service deliveries, enhancing quality, efficiency, result, nurses and patients might become more welcom-
and setting new expectations [1]. Global expenditures on ing of the integration of robots in nursing practice.
these technologies in healthcare are projected to exceed
$36 billion by the year 2025, and they are expected to be Theoretical background and prior research
available to everyone, everywhere [2]. Within the realm Robotic technology is rapidly expanding across health-
of AI, the use of service robots—software-programmed care environments, propelled by innovations and the
machines capable of sensing and interacting with their pressing requirement for enhanced healthcare efficiency
environment to perform a variety of tasks—marks a sig- [15]. Robots, defined as programmable machines capa-
nificant shift in healthcare delivery [3]. Robots can per- ble of performing complex actions autonomously or
form tasks autonomously based on their programming, semi-autonomously, are now common in various medi-
operating independently without human intervention [4]. cal applications, from surgery to routine care [16]. In
There are various applications for robots in healthcare, nursing, the transformative potential of robots in care
from participating in exercise programs to potentially practices has attracted significant scholarly and practi-
providing companionship and emotional support [5]. cal attention. Empirical research has identified several
Recently, the integration of robots in nursing practice ways in which robots can enhance nursing practices.
has garnered increasing scholarly interest [1, 4]. Previous For example, prior studies have demonstrated that
research has demonstrated that robots can assist nurses robots assist nurses by delivering medication, monitor-
in delivering efficient patient care, such as handling sup- ing patients, and providing routine nursing treatments,
plies, materials, and medications [6], and monitoring which can extend and enrich the scope of nursing work
patient mobility and activities [7]. Additionally, robots [4]. Additionally, robots are recognized for their effec-
could help in job crafting by reducing workload and max- tiveness in minimizing non-value-added activities [7].
imizing job resources [8], which in turn increases passion Another line of research has studied the impact of robots
for work [9]. This support could improve nurses’ health in anticipation of the empathic behavior presented by
and job satisfaction, thereby potentially reducing turn- artificial humanoid robots [13] and their ethics in robot
over rates [3]. caring [11].
The integration of robots into healthcare settings is Despite these valuable insights, a critical question
not without its controversies [10]. Despite recognition in remains regarding the attitudes and acceptance levels
the literature for their precision and efficiency, robots in of nurses toward the integration of AI and robotics in
nursing practice face certain limitations [3]. For example healthcare. Most of the existing research has focused
Stokes and Palmer have raised ethical concerns regarding on nursing students [17], which may not fully represent
the use of robots in healthcare [11], while Tu et al. have the views of practicing nurses and patients who directly
highlighted potential issues such as loss of autonomy interact with this technology daily. An exception is a
and negative psychological outcomes [12]. These issues cross-sectional study that measured nurse managers’
have prompted scholars to question whether nurses and opinions on AI and robot nurses, identifying literacy as
patients would feel comfortable entrusting their well- a major concern [2]. However, comprehensive research
being to robots [13]. Given these concerns, it is crucial to that measures actual acceptance levels and practical inte-
investigate nurses’ and patients’ intentions and apprehen- gration experiences among frontline nurses and patients
sions about working with robots. Therefore, this study remains sparse.
aims to (a) explore the behavioral intentions of nurses Given that nurses are primary care providers and
to accept robots in their workplace, and (b) examine the patients are the recipients of such technology, it is crucial
willingness of patients to use service robots in healthcare to assess their actual acceptance levels. This gap under-
settings. scores the need for empirical research that captures real-
This study contributes to the nursing literature by world experiences and responses to robotic technologies
identifying the actual level of acceptance among nurses in healthcare settings. Hence, this study aims to bridge
and patients toward robot integration in nursing prac- this gap by empirically examining the behavioral inten-
tice. Additionally, it pinpoints the concerns nurses have tions of nurses and the willingness of patients to integrate

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El-Gazar et al. BMC Nursing (2024) 23:718 Page 3 of 12

service robots within the Egyptian healthcare context. By •  What is the level of willingness among patients to
doing so, we respond to scholarly calls for more empirical use service robots in healthcare settings?
research to explore the acceptability and effective imple- •  Do nurses’ and patients’ willingness to use service
mentation of AI technologies [2]. robots in healthcare settings differ based on their
Moreover, this study includes a quantitative analysis demographic characteristics?
that measures the perspectives and concerns of nurses
regarding the integration of robotic technologies into
healthcare settings. This approach allows for a compre- Methods
hensive understanding of the factors influencing accep- Study design
tance and identifies potential barriers to successful This study utilizes a mixed-methods approach with a
integration. By addressing these specific concerns, the convergent parallel design to obtain diverse yet comple-
study aims to facilitate smoother adoption of robots in mentary data, facilitating a comprehensive understand-
healthcare, ensuring enhanced provider satisfaction and ing of the research problem. In this design framework,
improved patient care quality. qualitative and quantitative data are collected simulta-
Additionally, this research specifically explored neously but independently, ensuring equal emphasis on
whether nurses’ and patients’ willingness to use ser- both types of data. Each dataset is analyzed separately
vice robots in healthcare settings varied based on their and subsequently integrated during the evaluation phase
demographic characteristics. In the field of healthcare to enhance the depth and breadth of the findings [25].
technology acceptance, demographic variables play a Throughout the research, adherence to the STROBE
pivotal role in shaping nurses’ attitudes and behavioral checklist for cross-sectional studies and the COREQ
intentions [18]. For instance, age and gender differences guidelines for qualitative research was rigorously
in the acceptance of artificial technology among nurses maintained.
have been well-documented, with studies indicating
that younger female nurses are more likely to accept AI Participants and setting
technologies [18, 19]. Similarly, educational background The quantitative part of this research aimed to assess the
has been linked to varying attitudes towards AI among readiness of nurses and patients for the integration of
nurses [20, 21]. Nurse acceptance of the use of AI also robots in healthcare settings. Data were collected using
varies according to their nursing experience [22] and the a convenience sampling method from clinical nurses and
department in which they work within the hospital [23]. patients at three tertiary public hospitals in Port Said,
Moreover, a study by Liu et al. revealed that individual Egypt. To determine the required sample size for nurses,
characteristics significantly influenced patients’ continu- we used Yamane’s (1967) formula for finite population
ance intention to use AI-powered service robots in hospi- [26]:
tals [10]. Furthermore, patients’ attitudes toward the use
of AI have been shown to vary according to their marital N 1219
n= = = 301 nurses
status [24]. These findings underscore the importance of 1 + N(e)2 1 + 1219(0.05)2
considering demographic variables when investigating
technology acceptance, such as robots in healthcare. Here, “n” represents the necessary sample size, “N” is the
total population size (N = 1219), and “e” denotes the error
The study term set at 0.05, yielding a minimum required sample of
Aim 301 nurses.
The aim of this study was twofold: (a) to explore the For patients, the appropriate sample size was calculated
behavioral intentions of nurses to accept robots in their using Cochran’s formula for infinite population [27]:
workplace, and (b) to examine the willingness of patients
to use service robots in healthcare settings. z2 × σ 2 1.962 × 0.68 2
n≥ = = 462 patients
d2 0.0622
Study questions
This study seeks to answer the following questions: Here, “n” indicates the required sample size, “z” is the
standardized normal deviation corresponding to a 95%
•  What is the level of behavioral intention among confidence level and a 5% alpha level (z = 1.96, two-
nurses to accept robots in their workplace? tailed), “σ” is the expected standard deviation in the
•  What are the perspectives and concerns of nurses population (0.68 from the pilot study), and “d” is the
regarding the integration of robots into healthcare acceptable margin of error for the mean (d = 0.062, based
settings? on the pilot study mean of 2.08 and a 0.03 margin of
error). To account for potential dropout, the sample sizes

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El-Gazar et al. BMC Nursing (2024) 23:718 Page 4 of 12

were increased by 20%, resulting in 361 surveys distrib- Study instrument – qualitative data
uted to nurses and 554 surveys to patients. Of the dis- For the qualitative part, semi-structured interview forms
tributed surveys, 306 from nurses and 467 from patients consisting of eight open-ended questions, developed by
were validly returned. the researchers specifically for this study (Supplementary
We applied Yamane’s formula for the nurse popula- file 1), were employed to explore nurses’ perspectives and
tion, as the number of the target population is known concerns regarding the integration of robots into health-
and finite. Meanwhile, we used Cochran’s formula for care settings.
the patient population, which is considered potentially
infinite. This approach ensures that the sampling meth- Validity and reliability
odology is both robust and appropriate for the diverse Face and content validity of the translated scales used for
conditions of the nurse and patient populations under quantitative data collection were assessed by involving
study. seven experts and professors in nursing. These experts
For the qualitative study, 16 nurses were recruited from were asked to evaluate whether the scales appeared to
two different tertiary public hospitals in Port Said, Egypt. measure the intended constructs, thus ensuring face
Sample size saturation was achieved when no new infor- validity. Content validity was assessed by having the
mation was gleaned from subsequent interviews [28]. experts rate each item on a 4-point Likert scale, ranging
Inclusion criteria for nurses were licensed staff nurses from 1 (not relevant) to 4 (highly relevant). If the item-
who were on duty during the study period and had at level Content Validity Index (I-CVI) was ≥ 0.78 and the
least one year of tenure in the nursing profession. Exclu- scale-level CVI average (S-CVI/Ave) was ≥ 0.90, the con-
sion criteria were nurses or patients who declined to par- tent validity of the scale was considered satisfactory [32].
ticipate in the study. The expert panel confirmed the face and content valid-
ity, with I-CVI scores ranging from 0.94 to 1.00 for the
Study Instrument – quantitative data BIARW and 0.93 to 1.00 for the SRIW. The S-CVI/Ave
Quantitative data were collected using two distinct was 0.97 for the BIARW and 0.95 for the SRIW, demon-
scales. The Behavioral Intention to Accept Robots in strating acceptable content validity.
the Workplace Scale (BIARW) was administered to The reliability of the scales was determined using Cron-
nurses, and the Service Robot Integration Willingness bach’s alpha coefficient, which was 0.853 for the BIARW
Scale (SRIW) was used for patients. Both surveys were and 0.966 for the SRIW, indicating acceptable internal
translated into Arabic through a back-translation proce- consistency [33].
dure [29]. Participants involved in the pilot testing were
excluded from the main sample. All items on both scales Data collection
were rated on a five-point Likert scale, ranging from 1 The study was conducted between January and May 2024.
(Strongly Disagree) to 5 (Strongly Agree).
Quantitative data
BIARW Developed by Sinha et al., the BIARW is a three- Quantitative data were collected by three trained
item scale used to assess nurses’ intentions to accept research assistants after obtaining permission from
robots in their workplace [30]. Example items include, “I hospital administrators. Eligible participants, includ-
am willing to accept robots in my workplace” and “I am ing nurses and patients, were personally approached
likely to interact with robotics in my workplace.” and given a thorough orientation about the study’s aims,
potential risks, and benefits. Only those who consented
SRIW Developed by Lu et al., the SRIW used to measures to participate and signed informed consent forms were
patients’ willingness to use service robots in healthcare provided with a closed package containing the survey.
settings [31]. This scale comprises 36 items distributed The questionnaire was administered using a paper-and-
across six dimensions: (a) performance efficacy (7 items), pencil format. The surveys were collected immediately
(b) intrinsic motivation (6 items), (c) anthropomorphism upon completion.
(7 items), (d) social influence (7 items), (e) facilitating
conditions (4 items), and (f ) emotions (5 items). Example Qualitative data
items include, “Information provided by robots is more Qualitative data were collected by researchers experi-
accurate with less human errors in healthcare services” enced and trained in qualitative research. Sixteen in-
and “If I use robots in healthcare settings, I will feel depth, semi-structured interviews were conducted online
satisfied.” with nurses. A semi-structured format was chosen to
focus on specific dimensions while allowing respondents
to introduce new insights related to the topic. Prior to the
interviews, written informed consent was obtained from

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El-Gazar et al. BMC Nursing (2024) 23:718 Page 5 of 12

eligible nurses. All interviews were audio-recorded and statistical significance, subsequent pairwise comparisons
later transcribed by two different researchers upon com- were conducted using Tukey’s HSD post-hoc tests.
pletion. On average, each interview lasted 60 min. Data
collection continued until data saturation was achieved. Rigor and reflexivity of qualitative analysis
Participation in this research was entirely voluntary. To
Statistical analysis ensure conformability, a single researcher conducted all
Qualitative data were analyzed using thematic analysis the interviews. After each interview, participants were
[34] to explore and categorize nurses’ perspectives and invited to add new information or clarify their responses.
concerns regarding the integration of robots in health- To ensure the dependability and validity of the data, two
care settings. Two researchers independently reviewed researchers independently identified the main themes
the transcripts to identify significant words and phrases, and sub-themes, which were then discussed until consen-
which were then coded to generate themes and sub- sus was achieved. Sample quotes were directly extracted
themes. They met to discuss their initial findings and from the interview reports.
themes, refining and adjusting them as necessary until
reaching a consensus. This iterative process ensured the Results
themes accurately reflected the data. The discussion and Quantitative results
analysis process spanned three meetings, each averaging Results from nurses
three hours. As shown in Table 1, the majority of participants were
Quantitative analysis was performed using SPSS 27.0 female (n = 218, 71.2%), married (n = 200, 65.4%), and held
software, with a p-value of < 0.05 considered statisti- an associate-level education (n = 153, 50.0%). Among the
cally significant. Descriptive statistics were used to 306 participants, 43.8% (n = 134) worked in medical or
outline participant characteristics and assess the lev- surgical units. Most participants were aged between 30
els of nurses’ behavioral intentions toward accepting and 40 years (n = 116, 37.9%) and had less than 10 years of
robots in their workplace, as well as patients’ willing- professional experience (n = 166, 54.3%). The mean score
ness to use service robots. Independent samples t-tests for behavioral intention to accept robots among the par-
and one-way ANOVA were utilized to compare nurses’ ticipating nurses was 2.65 (SD = 0.89) out of 5, indicating
behavioral intentions and patients’ willingness based on a moderate level of intention.
demographic characteristics. When ANOVA indicated One-way ANOVA with post hoc comparisons revealed
statistically significant differences in nurses’ behavioral

Table 1 Characteristics of participating nurses and their behavioral intention to accept robots in the workplace (N = 306)
Characteristic Category no % Behavioral intention to accept robots
M (SD) t/F (P)
Age (years) < 30 107 35 2.78 (0.93) F = 2.24 (0.108)
30–40 116 37.9 2.63 (0.84)
> 40 83 27.1 2.51 (0.89)
Gender Male 88 28.8 2.86 (0.84) t = 2.68 (0.008)
Female 218 71.2 2.57 (0.90)
Marital status Singlea 85 27.8 2.82 (1.02) F = 3.37 (0.019)
Marriedb 200 65.4 2.59 (0.85) a, d > b, c
Divorcedc 18 5.9 2.43 (0.48)
Widowedd 3 0.9 3.78 (0.69)
Education Diplomaa 76 24.8 2.27 (0.67) F = 9.94 (< 0.001)
Associateb 153 50.0 2.75 (0.94) b, c > a
Bachelor or abovec 77 25.2 2.83 (0.87)
Unit Intensive care 64 20.9 2.51 (0.81) F = 1.46 (0.227)
Emergency 68 22.2 2.78 (0.81)
Medical or surgical 134 43.8 2.69 (0.96)
Other 40 13.1 2.53 (0.89)
Nursing tenure (years) < 10 166 54.3 2.70 (0.91) F = 0.59 (0.556)
10–20 53 17.3 2.58 (0.89)
> 20 87 28.4 2.60 (0.86)
Behavioral intention to accept robots in the workplace 2.65 (0.89)
F = one-way analysis of variance; t = independent sample t-test
abcd
Differences between the means by Turkeys’ HSD post hoc test

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El-Gazar et al. BMC Nursing (2024) 23:718 Page 6 of 12

Table 2 Characteristics of participating patients and their willingness to use service robots (N = 467)
Characteristic Category no % Behavioral intention to accept robots
M (SD) t/F (P)
Age (years) < 25 40 8.6 2.20 (0.71) F = 2.25 (0.062)
25–34 125 26.8 2.32 (0.97)
35–44 175 37.5 2.10 (0.71)
45–55 102 21.8 2.08 (0.71)
> 55 25 5.4 1.99 (0.44)
Gender Male 274 58.7 2.17 (0.86) t = 0.54 (0.587)
Female 193 41.3 2.13 (0.66)
Marital status Singlea 128 27.4 2.37 (0.99) F = 4.25 (0.006)
Marriedb 289 61.9 2.08 (0.68) a>b
Divorcedc 35 7.5 2.10 (0.66)
Widowedd 15 3.2 2.09 (0.68)
Education High school 115 24.6 2.11 (0.66) F = 2.44 (0.064)
Associate 206 44.1 2.26 (0.88)
Bachelor 128 27.4 2.05 (0.74)
Postgraduate 18 3.9 2.02 (0.42)
Health Condition Acute 374 80.1 2.18 (0.83) t = 1.03 (0.304)
Chronic 93 19.9 2.08 (0.57)
Note: All participants had no previous experience with robots.
F = one-way analysis of variance; t = independent sample t-test
abcd
Differences between the means by Turkeys’ HSD post hoc test

Table 3 Patients’ willingness to use service robots (N = 467) participants had previous experience with robots. One-
Scale M (SD) way ANOVA with post hoc comparisons revealed statisti-
Willingness to use service robots total score 2.16 (0.78) cally significant differences in patients’ willingness to use
Performance efficacy 2.02 (0.89) robots based on marital status (F(3, 463) = 4.25, p = 0.006,
Intrinsic motivation 2.08 (0.96) η 2p = 0.027; mild effect size), with single patients showing
Anthropomorphism 2.05 (0.94) greater willingness than their married counterparts.
Social influence 2.09 (0.93) Table 3 indicates the mean score of patients’ willing-
Facilitating conditions 2.01 (0.89) ness to use service robots in healthcare settings. The
Emotions 2.80 (0.83) total mean score was 2.16 (SD = 0.78) on a scale of 1–5,
which indicates a low willingness to use service robots.
intention to accept robots based on marital status (F(3, Among the dimensions evaluated, emotions scored the
302) = 3.37, p = 0.019, η 2p = 0.032; mild effect size) and highest with a mean of 2.80 (SD = 0.83), followed by social
education level (F(2, 303) = 9.94, p < 0.001, η 2p = 0.062; influence at 2.09 (SD = 0.93), while facilitating conditions
moderate effect size). Specifically, single and widowed scored the lowest with a mean of 2.01 (SD = 0.89).
nurses demonstrated a significantly higher behavioral
intention to accept robots compared to married and Qualitative data
divorced nurses. Additionally, nurses with an associate The mean age of the nurses who participated in the
degree or higher showed a significantly greater intention qualitative interviews was 34.81 years (SD = 9.21). Of
to accept robots than those with a diploma. The t-test the participants, 75.0% were female (n = 12), 43.8% held
further indicated that male nurses had a significantly a diploma (n = 7), and 31.3% held a bachelor’s degree or
higher behavioral intention to accept robots compared higher (n = 5). Additionally, 68.8% were married (n = 11),
to female nurses (t(304) = 2.68, p = 0.008, d = 0.33; mild and the average years of professional experience was
effect size). 15.38 ± 8.72 years.

Results from patients Categories, themes, and subthemes

As shown in Table 2, most participating patients were As a result of the qualitative analysis of the data obtained
male (n = 274, 58.7%) and aged between 35 and 44 years from the interviews with nurses, three categories (Con-
(n = 175, 37.5%). Among the 467 participants, 61.9% cerns about Robots, Roles and Competencies, and Poten-
were married (n = 289), and 44.1% held an associate tial Benefits), eight themes, and thirteen subthemes were
degree (n = 206). The majority of them (n = 374, 80.1%) identified (Table 4).
were suffering from acute health conditions. None of the

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El-Gazar et al. BMC Nursing (2024) 23:718 Page 7 of 12

Table 4 Categories, themes, and subthemes related to nurses’ acceptance of robots in workplace
Category Theme Subtheme Details
Concerns about Interaction and Lack of human emo- Robots lack the ability to interact dynamically with patients.
Robots Emotions tions and interaction
Lack of Empathy Robots cannot provide the empathetic and compassionate care that human nurses offer.
Lack of resilience Robots may strictly follow predefined steps without flexibility, which could be problem-
atic for individual patient needs.
Lack of Negotiation Robots are systems that cannot be negotiated with, which could be problematic in situ-
Capability ations requiring human judgment.
Maintenance and Downtime Potential for robots to malfunction, require maintenance and disrupting care.
reliability Misuse Concerns that patients might inadvertently damage robots, raising questions about their
durability.
Reliability and Safety Concerns about robots failing during critical operations, which lead to delays or
complications.
Extensive training Extensive training required for nursing staff to operate robots effectively.
required
Job insecurity Job replacement Fears that robots replace human nurses in their job.
Roles and Role clarity Role of Robots vs. There is uncertainty about how the roles of robots and human nurses will be defined
competencies Human Nurses and managed.
Accountability for It is unclear who is responsible for errors caused by robots, whether the nurse or the
Errors robot itself.
Competence in Competence in Doubts if robots have the necessary skills to manage critical patients and situations
Critical Care dealing with critical effectively.
patients
Trustworthiness Decision-making Skepticism about robots’ ability to make nuanced decisions, especially in critical care
inability scenarios.
Potential Reducing Physi- Robots could alleviate physical strain by performing repetitive or physically demanding
Benefits cal Strain tasks.
Specialized Robots could minimize staff exposure to radiation and enhance safety in radiology
Applications departments.

Category 1: concerns about Robots Theme 2: Maintenance and Reliability

Theme 1: Interaction and Emotions Nurses (n: 7) stated concerns regarding the maintenance
Nurses (n: 12) mentioned concerns about the interac- and reliability of robots in patient care settings. They
tion and emotional aspects of using robots in patient emphasized the potential for robots to malfunction and
care. They reported that robots are unable to provide the require maintenance, which could disrupt the continu-
empathetic and compassionate care that human nurses ity of care. The need for regular maintenance and the
offer, which is crucial for building trust and rapport possibility of downtime were highlighted as significant
with patients. Additionally, robots may strictly follow issues. Additionally, there were concerns about patients
predefined steps without flexibility, leading to concerns inadvertently damaging robots, raising questions about
about their ability to address individual patient needs their durability and the impact on patient safety and care
effectively. This standardized approach to care may not delivery.
cater to the personalized needs of each patient. Further-
…. if the robot malfunctions or needs maintenance
more, as systems that cannot be negotiated with, robots
during a critical operation, it could cause delays
may struggle in situations requiring human judgment
and complications. I also worry about patients acci-
and adaptability.
dentally damaging the robot, which would not only
……the robot has no ability to interact. It’s a be costly but also affect the care we can provide.
machine that takes inputs and gives results, so it will (N14. F)
execute the care plan without adapting to the spe-
cific needs of each patient. Patients are not all the
same. The robot lacks flexibility; it will always follow
Theme 3: Job Security
predefined steps. (N8. F)
Nurses (n: 9) expressed concerns about the impact of
robots on job security in the nursing profession. They
feared that the integration of robots could lead to the
replacement of human nurses, reducing job opportunities

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El-Gazar et al. BMC Nursing (2024) 23:718 Page 8 of 12

and altering the traditional roles and responsibilities of and depth of understanding required to make the
nursing staff. This apprehension was tied to the broader right call in such scenarios is something I believe
uncertainty about how the roles of robots and human only a human can provide. (N16. F)
nurses would be defined and managed in the healthcare
setting.
Category 3: potential benefits
…. I am worried that robots might take over our jobs.
Theme 7: Reducing Physical Strain
It’s not just about the tasks they can perform, but
Nurses (n: 6) stated that robots could alleviate physical
also about how our roles will change. Will there still
strain by performing repetitive or physically demand-
be a place for us, or will we be sidelined. (N6. M)
ing tasks, which could help reduce the risk of injury and
fatigue among nursing staff.
…. Robots could be very helpful in taking over some
Category 2: concerns about Robots
of the more physically demanding tasks, like lifting
Theme 4: Role clarity
patients or handling heavy equipment. This would
Nurses (n: 11) expressed uncertainty about how the roles
reduce the physical strain on us and help prevent
of robots and human nurses will be defined and man-
injuries. (N9. F)
aged. They were concerned about the division of respon-
sibilities and accountability for errors. It is unclear who
would be held responsible for errors caused by robots –
whether it would be the nurse overseeing the robot. Theme 8: Specialized Applications
Nurses (n: 8) stated the potential for robots to be particu-
“……there is a lot of uncertainty about how the roles
larly beneficial in specialized applications, such as mini-
will be divided between us and the robots. Who will
mizing staff exposure to radiation and enhancing safety
be accountable if something goes wrong? (N4. F)”.
in radiology departments.
…. In departments like radiology, where there’s a risk
of radiation exposure, robots could be invaluable.
Theme 5: Competence in Critical Care
They can handle tasks that would otherwise put us
Nurses (n: 14) stated they had doubts about whether
at risk, improving overall safety. (N5. F)
robots have the necessary skills to manage critical
patients and situations effectively. They stated they
did not think the robot’s ability to handle complex and
unpredictable scenarios could match the human exper- Discussion
tise and quick decision-making required in such cases. The acceptance of service robots in healthcare settings
reveals complex, multifaceted perspectives shaped by
……I do not think that the robot’s competence in
practical, emotional, and professional considerations
critical care situations is adequate. Handling criti-
[35]. This study aimed to explore the behavioral inten-
cal patients requires nuanced understanding and
tions of nurses to accept robots in their workplace and to
adaptability, which I don’t believe a robot can pro-
examine the willingness of patients to use service robots
vide. In emergencies, quick, informed decisions are
in healthcare settings.
crucial, and I’m not confident a robot can meet these
The results indicate a moderate level of behavioral
demands. (N12. M)
intention among nurses to accept robots in their work-
place. This may be due to the integration of new aspects,
such as robots, which can encounter resistance to change
Theme 6: Trustworthiness [36]. These findings align with previous studies that have
Nurses (n: 10) reported skepticism about robots’ abil- shown a moderate readiness among nurses to embrace
ity to make nuanced decisions, especially in critical care AI applications in nursing [37, 38]. Interestingly, the
scenarios. They are concerned that robots may lack the adoption of robot nurses can be further encouraged [39].
capacity to exercise the judgment and discernment Therefore, providing in-service training and increasing
necessary for complex decision-making in high-stakes awareness about the benefits and usage of robot nurses
situations. may help healthcare organizations enhance nurses’
acceptance of service robots in healthcare settings.
…. robots might be efficient in some tasks, but when
Furthermore, findings from the quantitative data
it comes to critical decision-making, especially in
showed that marital status influences nurses’ willing-
emergency situations, I am skeptical. The subtlety
ness to accept robots in the workplace. Specifically,

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El-Gazar et al. BMC Nursing (2024) 23:718 Page 9 of 12

single and widowed nurses exhibit a significantly higher that they find it difficult to trust the system, especially
intention to accept robots compared to their married in emergency situations. These results align with previ-
and divorced counterparts. One possible explanation ous studies showing that trust in AI plays a crucial role in
for this finding could be that single and widowed nurses the intention to use it in healthcare [10, 37]. In non-nurs-
may have fewer family responsibilities, potentially mak- ing contexts, research has also shown that one pitfall to
ing them more open to new technologies and workplace accepting robots in the workplace is employees’ inability
changes. Meanwhile, married and divorced nurses might to trust them [41].
be more cautious or resistant to change due to their exist- Despite the concerns, several potential benefits of
ing commitments and the stability they seek in both their integrating robots in healthcare were identified. Nurses
personal and professional lives. However, this contrasts acknowledged that robots could significantly reduce
with previous findings that showed marital status did not physical strain by taking over repetitive and physically
influence nurses’ attitudes toward AI in nursing practice demanding tasks. This could help prevent injuries and
[19]. reduce fatigue among nursing staff, thereby enhancing
Additionally, the study found that male nurses with their overall efficiency and well-being. Moreover, they
an associate degree or higher exhibited a significantly stated that robots could be particularly beneficial in
greater intention to accept robots than female nurses specialized applications, such as minimizing staff expo-
with a diploma. This result is consistent with research by sure to radiation in radiology departments and enhanc-
Alruwaili et al. which highlighted variations in attitudes ing safety in other high-risk areas. By handling tasks that
toward AI among nurses based on their education level pose health risks to humans, robots can create a safer
[19]. Furthermore, another study showed that nurses working environment for healthcare professionals. This
with postgraduate education had a more positive attitude is consistent with an integrative review that indicated
toward using AI in nursing practice [20]. robots and automated devices can play a role in alleviat-
Interviews with nurses support these findings, showing ing the workload of nurses, thereby facilitating their use
that most nurses have concerns about robots’ ability to [4]. Additionally, a study by Chang et al. showed that
interact with and display emotions toward patients. This nurses perceive that robots enable them to focus more on
aligns with a prior study that found intelligent humanoid professional task engagement [3].
robots capable of displaying empathy, interacting, and Regarding patient willingness to use service robots, the
responding in a humanlike manner are essential for inte- study showed a low willingness among patients to use
grating robots into nursing practice [13]. Additionally, service robots. This is an important finding, as patients
it aligns with the findings of Ergin et al., who reported are the recipients of these services. If patients are unwill-
that nurse managers also believe robots cannot meet the ing or unable to work with robots, this could undermine
social and emotional needs of patients [2]. the effectiveness and implementation of robot services in
Maintenance and reliability were additional concerns healthcare settings. This aligns with the results of Laaka-
among nurses. They highlighted the potential for robots suo et al., who found that patients were more accepting
to malfunction and require regular maintenance, which of human nurses compared to robot nurses [1]. Addition-
could disrupt the continuity of care. Developing robust ally, previous studies have shown that patients’ intentions
maintenance protocols and providing adequate train- to use robots in hospitals depend on various factors,
ing for staff on troubleshooting and maintaining these including ease of use, independent personality, and trust
machines can help mitigate these issues. This aligns with in AI techniques [10].
findings from Kato et al., who revealed that the mainte- The study results also showed a variation in patients’
nance of robots is one of the challenges for introducing willingness to use service robots based on their marital
robotic care equipment [40]. Nurses also have concerns status, with single patients demonstrating greater will-
about job security, fearing that robots might replace ingness than their married counterparts. This may be
human roles. This view contrasts with that of nurse man- because single patients feel more comfortable or open to
agers, who indicated that robot nurses would not replace interacting with new technologies, such as service robots,
human nurses [2]. as they might have fewer immediate concerns about how
Additionally, the specific roles and functions of these technologies could impact family dynamics or
robots are also a point of confusion among nurses. They caregiving responsibilities. Conversely, married patients
expressed concerns about how tasks would be divided might be more cautious or skeptical about relying on
between nurses and robots. This concern echoes prior robots for care, possibly due to concerns about the qual-
nursing literature, which highlighted the importance of ity of care or the potential impact on their family life.
clearly identifying the division of tasks between nurses Married patients may prioritize human interaction in
and robots [11]. Nurses also expressed doubts about the healthcare settings, which they perceive as more reliable
competence of robots in critical care scenarios, reporting or emotionally supportive. In line with these findings, a

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El-Gazar et al. BMC Nursing (2024) 23:718 Page 10 of 12

study by Liu et al. asserted that personal individual char- in the research. The study, conducted with nurses and
acteristics influence patients’ continuous intention to use patients, was carried out in public tertiary hospitals in
service robots in healthcare [10]. Port Said, Egypt, using convenience sampling. Thus, it
is difficult to generalize the findings to other regions or
Practical implications types of healthcare facilities, such as private hospitals
This study reveals numerous practical implications for or clinics. Future studies should include a more diverse
healthcare organizations seeking to implement service range of healthcare settings and employ random sam-
robots into their work processes. Our findings indicate pling methods to enhance the generalizability of the
that nurses have a moderate level of behavioral inten- results. Additionally, expanding the research to include
tion to accept robots in their workplace. To increase their different cultural contexts and a broader geographic
willingness, healthcare administrators should provide in- scope would provide a more comprehensive understand-
service training on AI applications, including robots, to ing of the factors influencing the acceptance and integra-
enhance nurses’ literacy in AI, thereby fostering greater tion of service robots in healthcare.
acceptance of service robots in healthcare settings.
Additionally, nurses reported concerns that affect their Conclusions
willingness to work with robots. One major concern This study aimed to explore the behavioral intentions of
among nurses is about robots’ ability to interact with nurses to accept robots in their workplace and to exam-
and display emotions toward patients. It is important to ine the willingness of patients to use service robots in
inform nurses about intelligent humanoid robots [13], healthcare settings. The results of this study indicate that
which can effectively communicate, interact, and respond nurses’ behavioral intention to accept service robots in
empathetically and flexibly to patient needs. Educating healthcare settings is moderate. Nurses’ acceptance is
nurses about these advanced capabilities can help alle- influenced by various factors, including concerns about
viate concerns about the lack of human-like interaction interaction and emotions, maintenance and reliabil-
and emotional display. ity, job security, role clarity, competence in critical care
Another finding related to robot maintenance indicates scenarios, and trustworthiness. Additionally, nurses
that robust maintenance protocols could enhance nurses’ acknowledge potential benefits of robots such as reduc-
willingness to work with robots. Ensuring that nurses are ing physical strain and specialized applications. Patients
aware of and confident in these protocols can mitigate showed a low level of willingness to use service robots in
fears about potential malfunctions and the disruption of healthcare settings. These findings highlight the necessity
care continuity. Nurses also expressed concerns about for targeted educational programs to enhance AI literacy
job security with the presence of robots. Assuring nurses among nurses and patients, robust maintenance proto-
that robots are tools designed to augment human capa- cols, and clear communication about the roles and capa-
bilities rather than replace them can help alleviate fears bilities of service robots to foster their acceptance and
about job displacement. Furthermore, there are concerns integration in healthcare. Future research should focus
about the roles and competencies of robots. It is impor- on longitudinal studies to assess changes in perceptions
tant to provide clear guidelines about the specific roles among nurses and patients over time, especially following
and functions of robots in healthcare settings. Identifying direct exposure to service robots. Additionally, further
the tasks that robots can perform and those that require studies in diverse cultural and healthcare contexts are
human supervision can reduce confusion and enhance essential to provide a more comprehensive understand-
acceptance among nurses. ing of the global readiness for healthcare service robots.
Regarding patients, the study showed a low willingness
to use service robots. To address this, integrating robots Supplementary Information
in a pilot phase and ensuring they are user-friendly could The online version contains supplementary material available at https://doi.
org/10.1186/s12912-024-02336-7.
be helpful. Providing awareness sessions for patients
about the benefits of robots and how to interact with Supplementary Material 1
them can enhance their willingness to use these technol-
ogies. Educating patients about the ease of use and the Acknowledgements
potential improvements in care quality, well as building Authors would like to thank all of the responded nurses and patients for their
trust in AI technologies can foster a more favorable per- cooperation.
ception of service robots. Author contributions
HE, MZ, and SA planned the study. MZ, SA, and MS conducted the literature
Limitations analysis. HE handled the qualitative data collection, while MA and TE
performed the qualitative data analysis. HE performed the quantitative data
The findings of this study are restricted to the views and analysis. HE, MZ, and AA were major contributors to writing the manuscript.
experiences of nurses and patients who participated

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

El-Gazar et al. BMC Nursing (2024) 23:718 Page 11 of 12

Funding 7. Lee J-Y, Song YA, Jung JY, Kim HJ, Kim BR, Do H-K et al. Nurses’ needs for care
Open access funding provided by The Science, Technology & Innovation robots in integrated nursing care services. Journal of Advanced Nursing
Funding Authority (STDF) in cooperation with The Egyptian Knowledge Bank [Internet]. 2018;74:2094–105. https://doi.org/10.1111/jan.13711
(EKB). 8. Song Y, Zhang M, Hu J, Cao X. Dancing with service robots: The impacts of
employee-robot collaboration on hotel employees’ job crafting. International
Data availability Journal of Hospitality Management [Internet]. 2022;103:103220. https://www.
Upon request for scientific purposes, the researcher of correspondence will sciencedirect.com/science/article/pii/S0278431922000822
provide researchable information of the research. 9. El-Gazar HE, Abdelhafez S, Ibrahim N, Shawer M, Zoromba MA. Effect of Job
Crafting Intervention Program on Harmonious Work Passion and Career
Commitment among Nurses: A Randomized Controlled Trial. Mrayyan MT,
Declarations editor. Journal of Nursing Management [Internet]. 2023;2023:9623866.
https://doi.org/10.1155/2023/9623866
Consent for publication 10. Liu X, He X, Wang M, Shen H. What influences patients’ continuance intention
Not applicable. to use AI-powered service robots at hospitals? The role of individual char-
acteristics. Technology in Society [Internet]. 2022;70:101996. https://www.
Competing interests sciencedirect.com/science/article/pii/S0160791X22001373
The authors declare no competing interests. 11. Stokes F, Palmer A. Artificial Intelligence and Robotics in Nursing: Ethics
of Caring as a Guide to Dividing Tasks Between AI and Humans. Nursing
Ethics approval and consent to participate Philosophy [Internet]. 2020;21:e12306. https://doi.org/10.1111/nup.12306
The Faculty of Nursing’s Research Ethics Committee at Port Said University, 12. Tu Y, Liu W, Yang Z. Exploring the influence of service employees’ char-
Egypt, approved the study. Conducted in accordance with the ethical acteristics on their willingness to work with service robots. Journal of
standards of the Helsinki Declaration, the research ensured that all participants Service Management [Internet]. 2023;34:1038–63. https://doi.org/10.1108/
received a detailed explanation of the study’s purpose and procedures. JOSM-05-2022-0174
The study strictly adhered to the principles of voluntary participation and 13. Pepito JA, Ito H, Betriana F, Tanioka T, Locsin RC. Intelligent humanoid robots
anonymity, coding participants to maintain their confidentiality. Additionally, expressing artificial humanlike empathy in nursing situations. Nursing Phi-
participants were explicitly informed of their right to cease participation in losophy [Internet]. 2020;21:e12318. https://doi.org/10.1111/nup.12318
the study at any time without facing any penalties. All participants signed 14. Maalouf N, Sidaoui A, Elhajj IH, Asmar D. Robotics in Nursing: A Scoping
informed consent forms before participating in the research. Review. Journal of Nursing Scholarship [Internet]. 2018;50:590–600. https://
doi.org/10.1111/jnu.12424
Author details 15. Betriana F, Tanioka R, Gunawan J, Locsin RC. Healthcare robots and
1
Nursing Administration Department, Faculty of Nursing, Port-Said human generations: consequences for nursing and healthcare. Collegian.
University, Port-Said, Egypt 2022;29:767–73.
2
Department of Psychiatric Nursing and Mental Health, Faculty of 16. Kim J, Gu GM, Heo P. In: Jo H, Jun H-W, Shin J, Lee S, editors. Robotics for
Nursing, Alexandria University, Alexandria, Egypt healthcare BT - biomedical engineering: Frontier research and converging
3
Nursing Education and Advanced Practice Lead, King’s College Hospital technologies. Cham: Springer International Publishing; 2016. pp. 489–509.
London-Jeddah, Jeddah, Saudi Arabia 17. Chang C-Y, Jen H-J, Su W-S. Trends in artificial intelligence in nursing: impacts
4
Technical Institution of Nursing, Mansoura, Egypt on nursing management. J Nurs Adm Manag. 2022;30:3644–53.
5
Department of Psychiatric, Mental Health and Community Health, 18. Özçevik Subaşi D, Akça Sümengen A, Semerci R, Şimşek E, Çakır GN, Temizsoy
College of Nursing , Qassim University, Buraydah, Saudi Arabia E. Paediatric nurses’ perspectives on artificial intelligence applications: a
6
College of Nursing, Sulaiman Al Rajhi University, Al Bukayriah, Saudi cross-sectional study of concerns, literacy levels and attitudes. Journal of
Arabia Advanced Nursing. n/a.
7
College of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, 19. Alruwaili MM, Abuadas FH, Alsadi M, Alruwaili AN, Elsayed Ramadan
Saudi Arabia OM, Shaban M, et al. Exploring nurses’ awareness and attitudes toward
artificial intelligence: implications for nursing practice. Digit HEALTH.
Received: 4 August 2024 / Accepted: 9 September 2024 2024;10:20552076241271804.
20. Tuncer GZ, Tuncer M. Investigation of nurses’ general attitudes toward
artificial intelligence and their perceptions of ChatGPT usage and influencing
factors. Digit HEALTH. 2024;10:20552076241277024.
21. Lin H-L, Liao L-L, Wang Y-N, Chang L-C. Attitude and utilization of ChatGPT
References among registered nurses: a cross-sectional study. International Nursing
1. Laakasuo M, Palomäki J, Kunnari A, Rauhala S, Drosinou M, Halonen J et al. Review. n/a.
Moral psychology of nursing robots: Exploring the role of robots in dilem- 22. Abuzaid MM, Elshami W, Fadden SM. Integration of artificial intelligence into
mas of patient autonomy. European Journal of Social Psychology [Internet]. nursing practice. Health Technol. 2022;12:1109–15.
2023;53:108–28. https://doi.org/10.1002/ejsp.2890 23. Hamedani Z, Moradi M, Kalroozi F, Manafi Anari A, Jalalifar E, Ansari A, et al.
2. Ergin E, Karaarslan D, Şahan S, Çınar Yücel Ş. Artificial intelligence and robot Evaluation of acceptance, attitude, and knowledge towards artificial intel-
nurses: From nurse managers’ perspective: A descriptive cross-sectional ligence and its application from the point of view of physicians and nurses: a
study. Journal of Nursing Management [Internet]. 2022;30:3853–62. https:// provincial survey study in Iran: a cross-sectional descriptive-analytical study.
doi.org/10.1111/jonm.13646 Health Sci Rep. 2023;6:e1543.
3. Chang H-Y, Huang T-L, Wong M-K, Ho L-H, Wu C-N, Teng C-I. How Robots Help 24. Baghdadi LR, Mobeirek AA, Alhudaithi DR, Albenmousa FA, Alhadlaq LS,
Nurses Focus on Professional Task Engagement and Reduce Nurses’ Turnover Alaql MS, et al. Patients’ attitudes toward the use of artificial intelligence as
Intention. Journal of Nursing Scholarship [Internet]. 2021;53:237–45. https:// adiagnostic tool in radiology in Saudi Arabia: cross-sectional study. JMIR Hum
doi.org/10.1111/jnu.12629 Factors. 2024;11:e53108.
4. Kangasniemi M, Karki S, Colley N, Voutilainen A. The use of robots and other 25. Plano Clark VL. Mixed methods research. The Journal of Positive Psychology
automated devices in nurses’ work: An integrative review. International Jour- [Internet]. 2017;12:305–6. https://doi.org/10.1080/17439760.2016.1262619
nal of Nursing Practice [Internet]. 2019;25:e12739. https://doi.org/10.1111/ 26. Yamane T, Statistics. An introductory analysis. 2nd ed. New York: Harper and
ijn.12739 Ro; 1967.
5. Deo N, Anjankar A. Artificial intelligence with robotics in healthcare: a narra- 27. Nundy S, Kakar A, Bhutta Z. How to practice academic medicine and publish
tive review of its viability in India. Cureus. 2023;15:e39416. from developing countries? A practical guide. Singapore: Springer; 2022.
6. Gombolay M, Yang XJ, Hayes B, Seo N, Liu Z, Wadhwania S et al. Robotic 28. Sandelowski M. Sample size in qualitative research. Res Nurs Health.
assistance in the coordination of patient care. The International Jour- 1995;18:179–83.
nal of Robotics Research [Internet]. 2018;37:1300–16. https://doi.
org/10.1177/0278364918778344

Content courtesy of Springer Nature, terms of use apply. Rights reserved.

El-Gazar et al. BMC Nursing (2024) 23:718 Page 12 of 12

29. Brislin RW. Back-translation for cross-cultural research. Journal of Cross-Cul- 37. Salem GMM, El-Gazar HE, Mahdy AY, Alharbi TAF, Zoromba MA. Nursing
tural Psychology [Internet]. 1970 [cited 2021 Jan 5];1:185–216. http://journals. students’ personality traits and their attitude toward artificial intelligence: A
sagepub.com/doi/10.1177/135910457000100301 Multicenter cross-sectional study. Journal of Nursing Management [Internet].
30. Sinha N, Singh P, Gupta M, Singh P. Robotics at workplace: An integrated 2024;2024:6992824. https://doi.org/10.1155/2024/6992824
Twitter analytics – SEM based approach for behavioral intention to accept. 38. Labrague LJ, Aguilar-Rosales R, Yboa BC, Sabio JB. Factors influencing student
International Journal of Information Management [Internet]. 2020;55:102210. nurses’ readiness to adopt artificial intelligence (AI) in their studies and their
https://www.sciencedirect.com/science/article/pii/S0268401219313441 perceived barriers to accessing AI technology: a cross-sectional study. Nurse
31. Lu L, Cai R, Gursoy D. Developing and validating a service robot integra- Educ Today. 2023;130:105945.
tion willingness scale. International Journal of Hospitality Management 39. Karaarslan D, Kahraman A, Ergin E. How does training given to pediatric
[Internet]. 2019;80:36–51. https://www.sciencedirect.com/science/article/pii/ nurses about artificial intelligence and robot nurses affect their opinions and
S0278431918306455 attitude levels? A quasi-experimental study. J Pediatr Nurs. 2024;77:e211–7.
32. Polit DF, Beck CT. Essential of nursing research: appraising evidence for nurs- 40. Kato K, Yoshimi T, Tsuchimoto S, Mizuguchi N, Aimoto K, Itoh N et al. Iden-
ing practice. 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams tification of care tasks for the use of wearable transfer support robots – an
& Wilkins; 2010. observational study at nursing facilities using robots on a daily basis. BMC
33. Nunnally J. Psychometric theory. New York: McGraw-Hill; 1978. Health Services Research [Internet]. 2021;21:652. https://doi.org/10.1186/
34. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res s12913-021-06639-2
Psychol. 2006;3:77–101. 41. Paluch S, Tuzovic S, Holz HF, Kies A, Jörling M. My colleague is a robot –
35. Defi IR, Iskandar S, Charismawati S, Turnip A, Novita D. Healthcare Workers’ exploring frontline employees’ willingness to work with collaborative service
Point of View on Medical Robotics During COVID-19 Pandemic – A Scoping robots. Journal of Service Management [Internet]. 2022;33:363–88. https://
Review. International Journal of General Medicine [Internet]. 2022;15:3767– doi.org/10.1108/JOSM-11-2020-0406
77. https://www.tandfonline.com/doi/abs/10.2147/IJGM.S355734
36. Zeid MAGA, Mostafa B, Zoromba MA, Abdelnaby R, Elsayed M, El-Gazar
HE. Effects of organizational agility on readiness for change in nurses: A Publisher’s note
cross-sectional study. International Nursing Review [Internet]. 2024;71:140–7. Springer Nature remains neutral with regard to jurisdictional claims in
https://doi.org/10.1111/inr.12869 published maps and institutional affiliations.

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