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arxiv: 2604.15325 · v1 · submitted 2026-03-05 · 💻 cs.HC · cs.ET· cs.RO

NEFFY 2.0: A Breathing Companion Robot: User-Centered Design and Findings from a Study with Ukrainian Refugees

Ilona Buchem , Jessica Kazubski , Charly Goerke This is my paper

Pith reviewed 2026-05-15 15:53 UTC · model grok-4.3

classification 💻 cs.HC cs.ETcs.RO
keywords social robotbreathing companionstress reductionUkrainian refugeeshaptic interactionuser studymixed methodsHRI
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The pith

A breathing companion robot reduces perceived stress more than audio guidance alone in a study with Ukrainian refugees.

A machine-rendered reading of the paper's core claim, the machinery that carries it, and where it could break.

The paper describes the user-centered design of NEFFY 2.0, a social robot that provides haptic and multi-sensory cues to guide slow-paced breathing for stress relief. In an experiment with 14 Ukrainian refugees, the robot condition produced a substantially larger reduction in self-reported stress than an audio-only breathing exercise. Qualitative interviews found the robot intuitive and calming, while physiological signals showed mixed outcomes and high individual differences. Three distinct patterns of how participants used the robot emerged from clustering the breathing data.

Core claim

NEFFY 2.0, built as an embodied haptic breathing companion through iterative user-centered design, yields a substantially larger significant drop in perceived stress than audio-only guidance when tested with 14 Ukrainian refugees; qualitative data confirm users experience the robot as intuitive, calming and supportive, physiological measures display mixed results with large inter-personal variability, and k-means clustering identifies three patterns of breathing practice.

What carries the argument

Embodied multi-sensory interaction that guides slow-paced breathing, directly compared against an audio-only baseline.

If this is right

  • Embodied robots can deliver accessible breathing support for people facing prolonged anxiety.
  • Direct robot-versus-audio comparisons provide evidence that physical presence adds value beyond voice instructions.
  • Clustering breathing patterns with the robot can reveal distinct user styles that may guide personalization.
  • Such tools offer a low-threshold option for stress relief in vulnerable groups like refugees.

Where Pith is reading between the lines

These are editorial extensions of the paper, not claims the author makes directly.

  • If the benefit stems from embodiment rather than novelty, the same robot might help other stressed populations without requiring cultural adaptation.
  • Controlling for attention effects in future trials would clarify whether the robot's physical form is the active ingredient.
  • Linking the identified breathing clusters to long-term stress outcomes could turn the robot into a more adaptive coach.

Load-bearing premise

The robot's physical presence and multi-sensory features, rather than novelty or extra attention from the experiment, are what produce the greater stress reduction.

What would settle it

A larger follow-up study that equalizes attention and expectation across conditions and still finds no reliable difference in stress reduction between robot and audio would falsify the central claim.

Figures

Figures reproduced from arXiv: 2604.15325 by Charly Goerke, Ilona Buchem, Jessica Kazubski.

Figure 1
Figure 1. Figure 1: NEFFY 2.0 – A Slow-Paced Breathing Companion Robot. [PITH_FULL_IMAGE:figures/full_fig_p001_1.png] view at source ↗
read the original abstract

This paper presents the design of NEFFY 2.0, a social robot designed as a haptic slow-paced breathing companion for stress reduction, and reports findings from a mixed-methods user study with 14 refugees from Ukraine. Developed through a user-centered design process, NEFFY 2.0 builds on NEFFY 1.0 and integrates embodiment and multi-sensory interaction to provide low-threshold, accessible guidance of slow-paced breathing for stress relief, which may be particularly valuable for individuals experiencing prolonged periods of anxiety. To evaluate effectiveness, an experimental comparison of a robot-assisted breathing intervention versus an audio-only condition was conducted. Measures included subjective ratings and physiological indicators, such as heart rate (HR), heart rate variability (HRV) using RMSSD parameter, respiratory rate (RR), and galvanic skin response (GSR), alongside qualitative data from interviews exploring user experience and perceived support. Qualitative findings showed that NEFFY 2.0 was perceived as intuitive, calming and supportive. Survey results showed a substantially larger effect in significant reduction of perceived stress in the NEFFY 2.0 condition compared to audio-only. Physiological data reveled mixed results combined with large inter-personal variability. Three patterns of breathing practice with NEFFY 2.0 were identified using k-means clustering. Despite the small sample size, this study makes a novel contribution by providing empirical evidence of stress reduction in a vulnerable population through a direct comparison of robot-assisted and non-robot conditions. The findings position NEFFY 2.0 as a promising low-threshold tool that supports stress relief and contributes to the vision of HRI empowering society.

Editorial analysis

A structured set of objections, weighed in public.

Desk editor's note, referee report, simulated authors' rebuttal, and a circularity audit. Tearing a paper down is the easy half of reading it; the pith above is the substance, this is the friction.

Referee Report

3 major / 2 minor

Summary. The manuscript describes the iterative user-centered design of NEFFY 2.0, a social robot for guiding slow-paced breathing with haptic feedback, and presents findings from a mixed-methods experiment with 14 Ukrainian refugees. The study compares the robot condition to an audio-only breathing guidance condition, reporting a substantially larger reduction in perceived stress for the robot arm, mixed outcomes on physiological measures (HR, HRV, RR, GSR) with high inter-individual variability, positive qualitative perceptions of the robot as calming and supportive, and three distinct breathing practice patterns identified via k-means clustering on the robot data.

Significance. If the subjective stress reduction difference holds after addressing confounds and statistical reporting, the work would supply a direct empirical comparison of robot versus non-robot breathing guidance in a vulnerable population, offering concrete data on user experience and practice patterns that could inform accessible HRI interventions for anxiety.

major comments (3)
  1. [Results] Results section: the claim of a 'substantially larger effect in significant reduction of perceived stress' in the NEFFY 2.0 condition is presented without statistical details such as the test used, p-value, effect size, confidence intervals, or power analysis for the n=14 sample. This is load-bearing for the central empirical claim, especially given the noted large inter-personal variability.
  2. [Methods] Methods section: the robot versus audio-only comparison lacks controls for novelty, attention, or demand characteristics (no sham-embodiment arm, no blinding, no placebo measures). This undermines attribution of the effect specifically to embodiment and multi-sensory features rather than non-specific factors.
  3. [Results] Results (physiological measures): the mixed HR, HRV (RMSSD), RR, and GSR outcomes with large variability are noted but without reported analysis details, pre-registered hypotheses, or explicit linkage to the subjective findings, weakening the overall support for intervention effectiveness.
minor comments (2)
  1. [Abstract] Abstract: 'reveled' is a typo and should read 'revealed'.
  2. [Abstract] Abstract: the statement that the study 'makes a novel contribution' despite small n could be qualified more precisely regarding the scope of novelty (direct comparison in this population).

Simulated Author's Rebuttal

3 responses · 0 unresolved

We thank the referee for the detailed and constructive feedback on our manuscript. We address each major comment point by point below, agreeing where revisions are needed to improve statistical transparency and discussion of limitations. We plan to submit a revised version incorporating these changes.

read point-by-point responses

  1. Referee: [Results] Results section: the claim of a 'substantially larger effect in significant reduction of perceived stress' in the NEFFY 2.0 condition is presented without statistical details such as the test used, p-value, effect size, confidence intervals, or power analysis for the n=14 sample. This is load-bearing for the central empirical claim, especially given the noted large inter-personal variability.

    Authors: We agree that the statistical details were insufficiently reported. In the revised manuscript, we will add the specific test performed (paired t-test on stress score differences), exact p-value, effect size (Cohen's d), 95% confidence intervals, and a post-hoc power analysis for n=14. This will be presented alongside the existing note on inter-individual variability to provide a balanced and rigorous account of the central finding. revision: yes

  2. Referee: [Methods] Methods section: the robot versus audio-only comparison lacks controls for novelty, attention, or demand characteristics (no sham-embodiment arm, no blinding, no placebo measures). This undermines attribution of the effect specifically to embodiment and multi-sensory features rather than non-specific factors.

    Authors: We acknowledge this as a genuine limitation of the current design. The study was conducted with a vulnerable population under time and resource constraints that precluded additional control arms or blinding. In revision, we will expand the Methods and Discussion sections to explicitly describe these design choices, discuss their potential impact on causal attribution, and outline them as priorities for future controlled trials. revision: partial

  3. Referee: [Results] Results (physiological measures): the mixed HR, HRV (RMSSD), RR, and GSR outcomes with large variability are noted but without reported analysis details, pre-registered hypotheses, or explicit linkage to the subjective findings, weakening the overall support for intervention effectiveness.

    Authors: We will revise the Results section to include full details of the statistical tests applied to each physiological measure, descriptive statistics on variability, and any exploratory nature of the analyses (the study was not pre-registered). We will also add explicit cross-references in the Discussion linking the mixed physiological patterns to the subjective stress reduction results, framing the overall evidence more cautiously. revision: yes

Circularity Check

0 steps flagged

Empirical user study reports direct comparisons and clustering with no derivations or self-referential loops

full rationale

The paper contains no equations, fitted parameters, or mathematical derivations. Claims rest on observed survey differences, mixed physiological measures, qualitative interviews, and standard k-means clustering applied to collected breathing data. No self-citations are invoked to justify uniqueness theorems or load-bearing premises, and the design does not rename known results or smuggle ansatzes. The analysis is self-contained as a report of empirical outcomes from a small-sample comparison, with no reduction of predictions to inputs by construction.

Axiom & Free-Parameter Ledger

0 free parameters · 2 axioms · 0 invented entities

The central claim rests on standard assumptions in HCI user studies rather than new mathematical constructs; no free parameters or invented entities are introduced.

axioms (2)
  • domain assumption Subjective stress ratings and physiological signals (HR, HRV via RMSSD, RR, GSR) validly measure stress reduction from breathing guidance.
    These measures are used to evaluate effectiveness without independent validation in the abstract.
  • domain assumption The user-centered design process produces an intuitive and calming interaction for the target population.
    Qualitative findings rely on this without further justification in the provided text.

pith-pipeline@v0.9.0 · 5620 in / 1384 out tokens · 42796 ms · 2026-05-15T15:53:09.904039+00:00 · methodology

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Reference graph

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