Background: Care robots have been proposed in response to nursing shortages in assisted living facilities (ALFs) and thegrowing population of older adults. While the use of care robots may improve the general health and well-being of older adults,their introduction changes the work of nursing staff fundamentally, and it has implications for the entire health care system. Indeveloping such technology, it is important to include end users, but so far, the nursing staff's perspectives have largely beenignored. Objective: This study aims to examine the literature on nursing staff's attitudes, needs, and preferences related to the use ofcare robots in ALFs, in order to discover gaps in the literature and guide future research. Methods: This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020protocol. On May 12, 2023, we searched PubMed, CINAHL Plus with Full Text, PsycINFO, the IEEE Xplore Digital Library,and the ACM Digital Library using predetermined search terms. Included publications, written in English, focused on thepredevelopment phase, in which information was gathered on nursing staff's attitudes, needs, and preferences regarding carerobots for ALFs. Publications were excluded if they did not provide peer-reviewed empirical data. The studies'findings weresummarized, coded, and analyzed into major themes using thematic analysis and narrative synthesis. Their quality was assessedusing McGill University's Mixed Methods Appraisal Tool and the Joanna Briggs Institute's critical appraisal tools. Results: The final sample included 15 studies. Most of the studies (n=11, 73%) were rated as good quality; however, there wasa general lack of reporting on important methodological decisions and sample characteristics. Nursing staff desired care robotsthat could assist with physically demanding tasks and reduce their workload but had mixed feelings on whether robots could orshould assist with social tasks. In addition, nursing staff are concerned about the ethics of care robots, as well as about their safety,accessibility, and operability. The nursing staff's culture, qualification, and role in the facility may influence their perspectivesof care robots. The studies lacked theory-driven designs and large sample sizes. Eight (53%) studies mentioned using a participatorydesign approach, but a lack of established criteria for what constitutes participatory design leads to varying degrees ofmethodological quality. Conclusions: There was consensus among nursing staff that care robots should serve as nursing assistants to reduce workload.Whether robots could or should assist with social tasks remains a question. Further research is needed to mitigate nursing staff'sconcerns and understand the socioecological factors that influence their perspectives of care robots and their adoption in ALFs.In addition, theory-driven and large sample size study designs are necessary, as well as work to develop clear criteria for relatedparticipatory design research.
