Incorporating Pets into Acute Inpatient Rehabilitation: A Case Study

Animal-assisted interventions in adult hospital rehabilitation settings: A scoping review

Animal-assisted interventions (AAIs) have the potential to enhance people's well-being and function and are increasingly being implemented across a range of settings. This scoping review explored how AAIs have been used in adult hospital rehabilitative care. Using JBI and PRISMA-ScR guidelines, a systematic search of four databases was undertaken. Inclusion criteria involved adults, aged >18 years, who had received AAIs in the hospital rehabilitation setting. Twenty-two articles met the inclusion criteria. Results identified two intervention types: visitation activities (n = 8 studies) and structured therapeutic interventions (n = 14 studies). Dogs were the most common animal species. Improvements in social and emotional well-being were reported across both types of interventions, with improvements in ambulation, motor skills, and verbal communication reported by those engaged in structured therapeutic interventions. Implementation challenges included a dependency on volunteer dog-handlers; the need for better recording of interventions in medical records to enable evaluation; and cost, safety, infection control, and animal welfare considerations. Strengthening the planning of AAIs is fundamental for the realization of potential outcomes from human-animal interactions in hospital rehabilitative care.

Developing and Planning a Protocol for Implementing Health Promoting Animal Assisted Interventions (AAI) in a Tertiary Health Setting

The Ottawa Charter identifies that multiple levels of government, non-government, community, and other organizations should work together to facilitate health promotion, including in acute settings such as hospitals. We outline a method and protocol to achieve this, namely an Action Research (AR) framework for an Animal Assisted Intervention (AAI) in a tertiary health setting. Dogs Offering Support after Stroke (DOgSS) is an AR study at a major tertiary referral hospital. AAI has been reported to improve mood and quality of life for patients in hospitals. Our project objectives included applying for funding, developing a hospital dog visiting Action Research project, and, subsequent to ethics and governance approvals and finance, undertaking and reporting on the Action Research findings. The Action Research project aimed to investigate whether AAI (dog-visiting) makes a difference to the expressed mood of stroke patients and their informal supports (visiting carers/family/friends), and also the impact these visits have on hospital staff and volunteers, as well as the dog handler and dog involved. We provide our protocol for project management and operations, setting out how the project is conducted from conception to assess human and animal wellbeing and assist subsequent decision-making about introducing dog-visiting to the Stroke Unit. The protocol can be used or adapted by other organizations to try to avoid pitfalls and support health promotion in one of the five important action areas of the Ottawa Charter, namely that of reorienting health services.

Pet Therapy as a Nonpharmacological Treatment Option for Neurological Disorders: A Review of the Literature

Animal therapy and ownership have been studied as a nonpharmacologic treatment option for cardiovascular and psychological disorders. Animal companionship is less studied in neurological disorders such as stroke, dementia, Parkinson's disease, multiple sclerosis, Huntington's disease, epilepsy, and acute brain injury. This review examines the effects that emotional support dogs, dog therapy, or dog ownership has on these specific neurological disorders. It may serve as a nonpharmaceutical option to improve patient symptoms, quality of life, or the disease course itself. Articles were gathered which studied the effect of animal-assisted therapy, pet therapy, dog ownership, and physical activity on neurological disorders. Studies relating to the topic were then assessed for the impact on neurological disorders which ranged from cognition, mobility, quality of life, mood, and improvement of disease course. Dog therapy and ownership were found to improve mood, quality of life, and disease symptoms across multiple neurological disorders. It also encouraged physical activity which was shown to help many diseases studied, even ones associated with skeletal muscle apoptosis, such as Huntington's disease. Dog therapy and ownership are a safe and effective nonpharmaceutical approach to treating chronic and progressive neurological disorders.

Optimizing delivery to meet demand for integrative medicine services in an academic hospital setting: A pilot study

CONTEXT

A rapidly growing body of evidence shows the positive benefits of integrative medicine (IM) services for patients in hospital-based settings. IM therapies, such as acupuncture, massage, meditation and relaxation, and animal-assisted therapy, reduce symptom burden of pain, anxiety, and stress and increase sense of well-being and satisfaction in hospitalized patients. Current challenges facing hospitals are to move beyond proof-of-concept studies and to provide hospital-based IM therapies.

OBJECTIVE

The aim of our quality improvement project was to develop, implement, and evaluate a feasible, scalable, hospital-based "best practice" model for increasing demand for IM services and optimizing their delivery.

DESIGN

A multidisciplinary team convened to use quality improvement tools to outline a process for providing IM services.

SETTING

A large academic medical center in the Midwestern United States.

PARTICIPANTS

IM leadership staff, IM providers, nurses, hospital team members, support staff, and quality improvement staff.

INTERVENTIONS

After determining baseline levels of demand and service delivery, we sought to (1) increase nursing staff awareness of available IM services; (2) improve communication between IM providers and nurses; and (3) reinforce communication at the level of nurse supervisors, patients, and family members.

MAIN OUTCOME MEASURES

We recorded the numbers and types of IM services ordered at baseline and postimplementation and determined the new delivery rate of requested services.

RESULTS

We noted an increase in the number of IM orders, percentage of delivered IM services, and percentage of patients who reported that IM services improved their hospital stay.

Stroke Rehabilitation

Acute stroke care is completed, and it is time for discharge. Depending on patient needs, they may continue care with outpatient therapies, home health, long-term acute care, or an acute inpatient rehabilitation facility. This is an overview of the rehabilitation process, nursing care, an interdisciplinary team approach, and psychosocial aspects of acute inpatient rehabilitation. Rehabilitation nursing focuses on goals, outcomes, the attainment or maintenance of functional capacity, understanding long-range patient needs, and wellness. From the moment care delivery is initiated we should all be a part of the rehabilitation process, a link in the chain toward improved quality of life.

Animal assisted therapy: systematic review of literature

PURPOSE

to verify the applications of AAT in health by performing a systematic review of the literature.

RESEARCH STRATEGY

a survey was carried out in four databases with the descriptors: animal assisted therapy, horse assisted therapy, speech therapy.

SELECTION CRITERIA

article published between 2010 and 2018, in Portuguese or English, free electronic access and that mentioned the characteristics of the intervention program.

DATA ANALYSIS

criteria: casuistry, area of knowledge, program characteristic, type of research, year and language of publication, nationality, periodical and impact factor.

RESULTS

43 articles published in 30 journals, 16 with impact factor, were reviewed. Clinical studies prevailed (93.02%), 37.20% were from Medicine, the population studied had different diagnoses and ages, 55.81% with adults / elderly. AAT was used preferentially for physical rehabilitation (67.44%) and the main mediator was the dog, mentioned in 72.09% of the articles. Eight (n = 8) programs with a focus on communication intervention were described.

CONCLUSION

There is scientific evidence on the use of AAT published in the period studied, in Brazil and in the world. The programs were used by different health and education professionals. The AAT goals were specific to the profile of the participants, and consistent with the characteristics of the mediator animal and the site.

The use of animal-assisted therapy in combination with physical therapy in an inpatient rehabilitation facility: A case report

BACKGROUND

Animal-assisted therapy (AAT) is a growing form of intervention in the field of rehabilitation often with the goals of decreasing pain, anxiety, and depression. There is a lack of literature on the use of AAT in inpatient rehabilitation facilities (IRF).

PURPOSE

This intrinsic case report describes the use of AAT in combination with physical therapy (PT) in the treatment of a middle-aged female status-post spinal surgery.

MATERIALS AND METHODS

This patient was treated with standard of care physical and occupational therapy in an IRF with the addition of AAT within 32% of the therapy sessions. AAT sessions focused on sitting and standing tolerance, standing balance, endurance, ambulation, stair negotiation and kitchen mobility. Clinical measures included the 6 Minute Walk Test (6MWT), the Functional Independence Measure (FIM) total score and the FIM motor subscale score.

CLINICAL FINDINGS

From admission to discharge from the IRF, change was noted in the areas of sitting tolerance, total FIM score, the motor subscale score of the FIM, and on 6MWT distance. Due to other therapies simultaneously occurring, no conclusions on AAT as a treatment can be made. AAT did provide more opportunities for this patient to engage in therapeutic activities.

CONCLUSION

AAT was used during PT, in attempt to facilitate participation and distract from pain in order to work on therapeutic activities and achieve the patient's functional goals. This case report can be used as a model for other IRF therapy programs interested in AAT, can provide information about a therapeutic modality and hopefully will inspire future rigorously designed research studies.

Effect of Canine Play Interventions as a Stress Reduction Strategy in College Students

Forty-eight students engaged with a therapy dog for 15 minutes during finals week to evaluate the effect on stress. Psychological (Perceived Stress Scale, visual analog scales) and physiologic stress (vital signs, salivary cortisol) measures were collected before and after the intervention. Paired t tests showed significant reductions in all psychological and physiologic measures except diastolic blood pressure. This supports animal-assisted therapy as an effective stress management strategy for nursing and other college students.

Associations of Pet Ownership with Older Adults Eating Patterns and Health

Pet ownership has been shown to improve quality of life for older adults. The objective of this cross-sectional study was to compare older pet owners and older non-pet owners and assess differences between groups. This study was conducted on adults over 50 years of age, who owned either one cat or one dog versus nonowners based on age, race, gender, and education. Matched older pet owners (OPO) versus non-pet owners (NPO) pairs (n = 84), older cat owners (OCO) versus non-cat owners (NCO) (n = 29), and older dog owners (ODO) versus non-dog owners (NDO) pairs (n = 55) were analyzed. No differences were found between OPO and NPO for dietary, activity, or lifestyle, except OPO had fewer health conditions [p < 0.03]. Total OCO had greater body mass indices [BMI] (μ = 29.6 ± 8.2) than ODO (μ = 23.2 ± 5.2) [p < 0.02], less activity [p < 0.02], and shorter duration of activity [p < 0.05] and took fewer supplements [p < 0.003]. OCO and NCO differed on health conditions (μ = 0.8 ± 0.9 versus μ = 1.9 ± 1.3, [p < 0.008]) and ODO versus NDO differed on BMI (μ = 25 ± 4 versus μ = 27 ± 6, [p < 0.04]). Although there are limitations to this study, data may be useful for targeting marketing and health messages to older persons.