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O'Louglin M, Edwards R, Bould E, Devine S, Downing S. Animal-assisted interventions in adult hospital rehabilitation settings: A scoping review. Nurs Health Sci 2024; 26:e13138. [PMID: 39013555 DOI: 10.1111/nhs.13138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 05/27/2024] [Accepted: 06/19/2024] [Indexed: 07/18/2024]
Abstract
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.
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Affiliation(s)
- Mary O'Louglin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Rachael Edwards
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Em Bould
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Sue Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Sandra Downing
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
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Wei Q, Sun R, Liang Y, Chen D. Virtual reality technology reduces the pain and anxiety of children undergoing vein puncture: a meta-analysis. BMC Nurs 2024; 23:541. [PMID: 39112987 PMCID: PMC11304930 DOI: 10.1186/s12912-024-02184-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 07/15/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Pain management is an important part of nursing care for children. The objective of this study was to systematically assess the impact of virtual reality (VR) technology on alleviating the pain and anxiety experienced by children during venipuncture procedures. METHODS This study searched Pubmed, Web of Sciences, Scopus, The Cochrane Library, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, Medline, China National Knowledge Infrastructure (CNKI), Wanfang, Weipu and China biomedical databases on the randomized controlled trials (RCTs) of virtual reality technology for relieving pain and anxiety associated with venous puncture for children up to July 6, 2024. Risk of bias tool recommended by Cochrane library was used to evaluate the RCT quality. RevMan 5.3 software was used for statistical analysis. RESULTS A total of 10 RCTs involving 874 children were included. 429 children received VR intervention during vein puncture. VR was beneficial to reduce the children's self-reported pain scores [SMD=-0.48, 95% CI (- 0.61, - 0.35)], children's caregivers reported needle-related pain level [SMD=-0.93, 95% CI (-1.45, - 0.42)], children's self-reported anxiety scores [SMD=-0.45, 95% CI (- 0.65, - 0.25)], children's caregivers reported needle-related anxiety level [SMD=-0.47, 95% CI (- 0.73, - 0.21)]. Egger regression tests indicated that there were no publication biases in the synthesized outcomes (all P > 0.05). CONCLUSIONS VR technology has been shown to effectively mitigate the pain and anxiety experienced by children during venipuncture. Despite the positive findings, more research is needed to better understand the role of VR in children undergoing venipuncture.
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Affiliation(s)
- Qin Wei
- Department of Orthopedics, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Rong Sun
- Department of Orthopedics, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Yan Liang
- Department of Orthopedics, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China
| | - Dan Chen
- Department of Orthopedics, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, China.
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Wagner C, Gaab J, Hediger K. The Importance of the Treatment Rationale for Pain in Animal-Assisted Interventions: A Randomized Controlled Trial in Healthy Participants. THE JOURNAL OF PAIN 2023; 24:1080-1093. [PMID: 36641027 DOI: 10.1016/j.jpain.2023.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 12/12/2022] [Accepted: 01/04/2023] [Indexed: 01/13/2023]
Abstract
Animal-assisted interventions (AAIs) is a promising treatment approach for pain, but possible mechanisms still need to be elucidated. This study set out to investigate the analgesic effects of an animal provided with a treatment rationale in a randomized controlled trial employing a standardized experimental heat-pain paradigm. We randomly assigned 128 healthy participants to: dog treatment (DT), placebo treatment (PT), dog and placebo treatment (DPT), and no treatment (NT). Primary outcomes were heat-pain tolerance and the corresponding self-reported ratings of pain unpleasantness and intensity. Results revealed no differences in heat-pain tolerance between the conditions. However, participants in the DT condition experienced heat-pain as significantly less unpleasant at the limit of their tolerance compared to participants in the NT condition (estimate = -0.96, CI = -1.58 to 0.34, P = .010). Participants in the DT condition also showed lower ratings of pain intensity at the limit of their tolerance compared to participants in the NT condition (estimate = -0.44, CI = -0.89 to 0.02, P = .060). This study indicates that a dog has analgesic effects on pain perception when integrated into the treatment rationale. We assume that providing a treatment rationale regarding the animal is important in AAIs for pain. PERSPECTIVE: This study shows that the presence of an animal is not sufficient for animal-assisted interventions (AAIs) to have an analgesic effect on pain unless they are provided with a treatment rationale. This could imply that not only the animal but also contextual factors are important in AAIs. TRIAL REGISTRATION: Clinical Trials NCT04361968.
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Affiliation(s)
- Cora Wagner
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.
| | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Karin Hediger
- Division of Clinical Psychology and Animal-Assisted Intervention, Faculty of Psychology, University of Basel, Basel, Switzerland; Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Faculty of Psychology, Open University, Heerlen, Netherlands; Clinic for Neurorehabilitation and Paraplegiology, REHAB Basel, Basel, Switzerland
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Ribeiro CDPV, Alves JB, Kominami PA, Takeshita EM, Bezerra ACB, Massignan C. Does use of animal therapy during dental care help to reduce anxiety in children and adolescents? A systematic review. Int J Paediatr Dent 2023; 33:181-195. [PMID: 36208050 DOI: 10.1111/ipd.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/22/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Animal-assisted therapy (AAT) is considered a useful technique to reduce anxiety in children and adolescents in medical settings. AIM To investigate whether the use of AAT helps to reduce anxiety during dental care in children and adolescents. DESIGN Systematic review that included randomized and nonrandomized clinical trials with children up to 18-years of age undergoing dental appointments. The databases Embase, Cochrane, Pubmed/Medline, LILACS, PsycInfo, Scopus, and Web of Science were searched including gray literature. Random-effects meta-analyses using mean difference (MD) and narrative synthesis (vote counting) were implemented. Risk of bias was assessed using RoB2 for randomized clinical trials. The certainty of the evidence was performed using GRADE. RESULTS A total of 1103 references were identified, and after a two-phase selection, three studies were included. Anxiety, behavior, and pain were the outcomes. A meta-analysis with 146 participants was performed for anxiety at three time points: before treatment (MD -0.40, CI: -1.06 to 0.26; I2 = 0%; p = .24), during treatment (MD -3.64, CI: -11.18 to 3.91; I2 = 94%; p = .34), and after treatment (MD -5.97, CI: -17.08 to 5.14; I2 = 98% p = .29). There was no difference during dental treatment with or without ATT (dogs), as well as for narrative analysis for any outcome. The risk of bias was high mainly because of the randomization and outcome measurement. CONCLUSION There is no evidence to support or refute that the presence of AAT during dental care can help reduce anxiety in children (5-11 years). Studies with larger samples are suggested. Protocol registration (CRD42021293593).
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Affiliation(s)
| | | | | | | | | | - Carla Massignan
- Department of Dentistry, University of Brasilia, Brasilia, Brazil
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Gussgard AM, Carlstedt K, Meirik M. Intraoral clinical examinations of pediatric patients with anticipatory anxiety and situational fear facilitated by therapy dog assistance: A pilot RCT. Clin Exp Dent Res 2023; 9:122-133. [PMID: 36259429 PMCID: PMC9932233 DOI: 10.1002/cre2.679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVE To evaluate whether the presence of a certified therapy dog specially trained for working in a dental setting may facilitate dental care of anxious pediatric patients. METHODS The Norwegian Regional Committee for Medical and Health Research Ethics approved a randomized cross-over trial with a study sample of n = 16 children aged between 6 and 12 years. The trial was registered on clinicaltrials.gov. Pediatric patients referred to specialist care at the Public Dental Service Competence Center of Northern Norway (TkNN) because of anxiety were invited to partake in the trial. Study participants met twice for an intraoral examination by a specialist pediatric dentist. Per random allocation, a therapy dog team was present in the clinic operatory during the clinical examination on the first or the second visit. The primary outcome was the assessment of patient compliance during the intraoral examination (yes/no). Secondary outcomes were measurements of child satisfaction and anxiety using the CFSS-DS scale (Dental subscale of Children's Fear Survey Schedule) completed by a parent/guardian. Supplementary outcomes were salivary cortisol level, heart rate variability, and skin conductance. RESULTS Ten boys and six girls (mean age 8.5) were recruited. All completed both clinical visits and demonstrated full compliance while undergoing a dental examination. All study participants and guardians reported great satisfaction. The salivary cortisol level reduction during the clinical examination on the first visit decreased by 30% in the presence of the therapy dog and 20% without, while the decrease during the clinical examination on the second visit was 29% in the presence of the therapy dog and 3% without. Within the limitations of the experimental setup, the electrophysiological measurements were unreliable in the current study population. CONCLUSION Dog-assisted therapy in a dental care setting appears to have a positive effect on children with dental anxiety or children that avoid dental care.
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Affiliation(s)
- Anne M. Gussgard
- Department of Clinical DentistryUiT The Arctic University of NorwayTromsoNorway
| | - Kerstin Carlstedt
- Department of Clinical DentistryUiT The Arctic University of NorwayTromsoNorway
| | - Malin Meirik
- The Uppsala University Hospital, Sweden, Child, and Adolescent Psychiatric ServicesUppsalaSweden
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Cowfer BA, Akard TF, Gilmer MJ. Animal-Assisted Interventions for Children with Advanced Cancer: Child and Parent Perceptions. Palliat Med Rep 2021; 2:328-334. [PMID: 34927159 PMCID: PMC8675225 DOI: 10.1089/pmr.2021.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The burden of relapsed/refractory childhood cancer takes an immense toll on ill children and their caregivers, jeopardizing quality of life. Animal-assisted interventions (AAIs) have shown promising benefits for children with chronic conditions and their families. Little is known about child and caregiver perspectives on AAI participation for children with advanced cancer. Objective: To explore perspectives of children with advanced cancer and their caregivers on experiences with AAIs. Design: Cross-sectional qualitative design. Setting/Subjects: Participants were children (n = 9) aged 5 to 17 years with relapsed or refractory cancer and their parents (n = 12) from one academic children's hospital in the southeastern United States. Participants completed approximately weekly 15-minute AAI sessions with a trained dog and handler during oncology clinic visits or hospitalizations for up to 12 weeks. Measures: Semistructured interviews were carried out after completion of each family's final AAI session to assess child and parent perceptions of AAIs. Qualitative content analysis identified themes. Results: Five themes emerged: (1) positive aspects, (2) negative aspects, (3) preferred changes, (4) pet ownership, and (5) value of the study. Twenty (95%) participants shared positive aspects of AAIs. The only negative aspect reported was too little time with the dog. Conclusion: Children with advanced cancer and their parents perceive AAIs as desirable with few requested changes. Further studies are needed to fully evaluate impact of AAIs. ClinicalTrials.gov Identifier: NCT03765099.
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Affiliation(s)
- Brittany A. Cowfer
- Department of Pediatric Hematology/Oncology, Vanderbilt University Medical Center and Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA
| | | | - Mary Jo Gilmer
- Vanderbilt University School of Nursing, Nashville, Tennessee, USA
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Santaniello A, Cimmino I, Dipineto L, Agognon AL, Beguinot F, Formisano P, Fioretti A, Menna LF, Oriente F. Zoonotic Risk of Encephalitozoon cuniculi in Animal-Assisted Interventions: Laboratory Strategies for the Diagnosis of Infections in Humans and Animals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9333. [PMID: 34501921 PMCID: PMC8430659 DOI: 10.3390/ijerph18179333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 01/02/2023]
Abstract
The involvement of animals for therapeutic purposes has very ancient roots. To date, it is clear that animal-assisted interventions (AAIs), in addition to ensuring the replacement of missing or deficient affects, improves psychophysiological parameters connected to human health. However, AAI could potentially present risks related to the transmission of infectious agents from animals to humans. Among these microorganisms, E. cuniculi is a microspore which induces pathological effects (fever, headache, nausea, vomiting, diarrhea, breathlessness, respiratory symptoms, and weakness) in both humans and animals. Consequently, an accurate and fast diagnosis of E. cuniculi infection, as well as the identification of new diagnostic approaches, is of fundamental importance. This literature review was carried out to provide an extensive and comprehensive analysis of the most recent diagnostic techniques to prevent and care for E. cuniculi-associated risks in the AAI field.
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Affiliation(s)
- Antonio Santaniello
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (L.D.); (A.F.)
| | - Ilaria Cimmino
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (I.C.); (A.L.A.); (F.B.); (P.F.); (F.O.)
| | - Ludovico Dipineto
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (L.D.); (A.F.)
| | - Ayewa Lawoe Agognon
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (I.C.); (A.L.A.); (F.B.); (P.F.); (F.O.)
| | - Francesco Beguinot
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (I.C.); (A.L.A.); (F.B.); (P.F.); (F.O.)
| | - Pietro Formisano
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (I.C.); (A.L.A.); (F.B.); (P.F.); (F.O.)
| | - Alessandro Fioretti
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (L.D.); (A.F.)
| | - Lucia Francesca Menna
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (L.D.); (A.F.)
| | - Francesco Oriente
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (I.C.); (A.L.A.); (F.B.); (P.F.); (F.O.)
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Kim S, Nam Y, Ham MJ, Park C, Moon M, Yoo DH. Neurological Mechanisms of Animal-Assisted Intervention in Alzheimer's Disease: A Hypothetical Review. Front Aging Neurosci 2021; 13:682308. [PMID: 34335229 PMCID: PMC8317687 DOI: 10.3389/fnagi.2021.682308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/14/2021] [Indexed: 11/18/2022] Open
Abstract
Alzheimer's disease (AD) is an irreversible neurodegenerative brain disorder with aggregation of amyloid-beta (Aβ) and tau as the pathological hallmarks. AD is the most common form of dementia and is characterized by a progressive decline of cognition. The failure of pharmacological approaches to treat AD has resulted in an increased focus on non-pharmacological interventions that can mitigate cognitive decline and delay disease progression in patients with AD. Animal-assisted intervention (AAI), a non-pharmacological intervention, improves emotional, social, and cognitive dysfunction in patients with neurodegenerative diseases. In particular, AAI is reported to mitigate the effects of cognitive impairment in patients with AD. Despite the positive effects of AAI on cognitive dysfunction in patients with AD, there have been no studies on how AAI affects AD-related pathologies. This review postulates potential neurological mechanisms of emotional or social interaction through AAI in countering AD-related pathologies, such as Aβ deposition, tau hyperphosphorylation, neuroinflammation, and impaired adult hippocampal neurogenesis (AHN), and proposes insights for future research by organizing accumulated previous evidence.
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Affiliation(s)
- Sujin Kim
- Department of Biochemistry, College of Medicine, Konyang University, Daejeon, South Korea
- Research Institute for Dementia Science, Konyang University, Daejeon, South Korea
| | - Yunkwon Nam
- Department of Biochemistry, College of Medicine, Konyang University, Daejeon, South Korea
| | - Min-Joo Ham
- Department of Occupational Therapy, Konyang University, Daejeon, South Korea
| | - Chisoo Park
- Department of Occupational Therapy, Konyang University, Daejeon, South Korea
| | - Minho Moon
- Department of Biochemistry, College of Medicine, Konyang University, Daejeon, South Korea
- Research Institute for Dementia Science, Konyang University, Daejeon, South Korea
| | - Doo-Han Yoo
- Research Institute for Dementia Science, Konyang University, Daejeon, South Korea
- Department of Occupational Therapy, Konyang University, Daejeon, South Korea
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