Is there a scientific basis for pet therapy?

Using Pet Therapy to Decrease Patients' Anxiety on Two Diverse Inpatient Units

BACKGROUND

The physical benefits for patients who spend time with a therapy dog have been reported, including decreased anxiety. Pet therapy has decreased anxiety in various hospitalized patient populations. The human-animal bond is the foundation for the positive interaction therapy dogs create.

AIMS

This study's purpose was to explore the use of pet therapy as an intervention to decrease patients' anxiety levels on two diverse inpatient units: Behavioral Health (BHU) and Pediatrics (PEDS).

METHODS

This was a quantitative study using a convenience sample, with systematic assignment to the experimental and control group. The State Anxiety Scale (SAS), a 6-item, Likert-type Short Form version of the State-Trait Anxiety Inventory, was used with adults and children; a Pediatric Emoji Method was constructed to assist children with the SAS. After consent, both groups completed the SAS pretest. Intervention patients then spent up to 15 minutes with a therapy dog and handler. The SAS posttest was completed 1 hour later by the experimental and control group. Descriptive and inferential statistics were used, including an independent samples t test, paired-sample t test, Wilcoxon signed rank tests, and Spearman correlation coefficients.

RESULTS

Findings revealed that the therapy dog visitations had a positive effect on lowering anxiety supporting the hypothesis. Both the PEDS and BHU participants experienced a significant decrease in their anxiety level following the dog visits.

CONCLUSION

Patients on the BHU and PEDS units benefitted from their visit with a therapy dog by experiencing a decrease in their anxiety level.

Exploring Animal-Assisted Therapy for Creating Rich Communicative Environments and Targeting Communication Goals in Subacute Rehabilitation

PURPOSE

This study continues our research examining the use of animal-assisted therapy (AAT) for patients with acquired neurogenic communication disorders. AAT pairs an animal/handler team with a licensed therapist during sessions to target discipline-specific goals. Our original study focused on dog/handler teams paired with occupational and physical therapists during inpatient rehabilitation sessions. We documented multiple ways that AAT enriched the communicative environment, increasing the amount, complexity, and voluntariness of patient participation. This study focuses on speech-language pathology sessions, comparing communicative environments during AAT and traditional sessions. We also examined the speech-language pathologists' (SLPs') experiences in learning to plan for and target communication goals for patients during AAT sessions.

METHOD

This interpretive design combines ethnographic methods with participatory action research. We recruited 10 patients from an inpatient rehabilitation unit and two SLPs. We video-recorded 20 speech-language pathology sessions (one AAT and one traditional for each patient) and conducted 26 interviews. We consulted with SLPs on how to incorporate AAT into their treatment during their preparation time and used self-report measures to track changes in their planning time and confidence across the 6-week study.

FINDINGS

Across participants, AAT sessions provided richer communicative environments than traditional speech-language pathology sessions as measured by participant talk time, mean length of turns, and use of interactional discourse resources such as narrative use and playful language. The SLPs were rapidly able to adapt their clinical practice to incorporate AAT and displayed rapid and marked decreases in their initial planning time and increases in confidence.

CONCLUSION

AAT sessions created meaningful, rich, and complex communicative environments in a clinical space for participants to align with others around a shared interest.

Associations between Pet Ownership and Frailty: A Systematic Review

Frailty is defined as a state of increased vulnerability due to age-related decline in reserve and function across multiple physiological systems. Increasing physical activity level is considered to be a measure to counteract frailty. Some studies have indicated that pet owners are more engaged in physical activity than non-owners. We conducted a systematic review regarding associations between pet ownerships and frailty among community-dwelling older adults and critically assessed the findings. PubMed was searched in April 2020 according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for cross-sectional or prospective studies examining associations between pet ownership and frailty in community-dwelling older adults with a mean age of 60 or above. A supplementary search was done using Google Scholar. Identified articles were reviewed by two investigators independently and assessed for methodological quality. The search identified 48 studies, among which three studies (two cross-sectional and one prospective) were included in this review. These studies suggested that pet ownership may be associated with a lower risk of frailty. This systematic review found only a limited amount of relevant research. More research is needed to establish the link between pet ownership and frailty as well as healthy aging and well-being.

Increasing physical activity by four legs rather than two: systematic review of dog-facilitated physical activity interventions

OBJECTIVES

Regular walking is a critical target of physical activity (PA) promotion, and dog walking is a feasible PA intervention for a large segment of the population. The purpose of this paper was to review PA interventions that have involved canine interactions and to evaluate their effectiveness. A secondary aim of this review was to highlight the populations, settings, designs and intervention components that have been applied so as to inform future research.

DESIGN

Systematic review.

DATA SOURCES

We carried out literature searches to August 2019 using six common databases.

ELIGIBILITY CRITERIA

Studies included published papers in peer-reviewed journals and grey literature (theses and dissertations) in the English language that included any PA behaviour change design (ie, randomised controlled trial, quasi-experimental) that focused on canine-related intervention. We grouped findings by population, setting, medium, research design and quality, theory and behaviour change techniques applied.

RESULTS

The initial search yielded 25 010 publications which were reduced to 13 independent studies of medium and high risks of bias after screening for eligibility criteria. The approaches to intervene on PA were varied and included loaner dogs, new dog owners and the promotion of walking among established dog owners. Findings were consistent in showing that canine-assisted interventions do increase PA (82% of the studies had changes favouring the canine-facilitated intervention). Exploratory subanalyses showed that specific study characteristics and methods may have moderated the effects. Compared with studies with longer follow-up periods, studies with shorter follow-up favoured behaviour changes of the canine intervention over the control condition.

CONCLUSION

Canine-based PA interventions appear effective, but future research should move beyond feasibility and proof of concept studies to increase rigour, quality and generalisability of findings.

Dog Ownership and Training Reduces Post-Traumatic Stress Symptoms and Increases Self-Compassion Among Veterans: Results of a Longitudinal Control Study

Objectives: The aims of this study were to measure the potential impact of a therapeutic dog ownership and training program for Veterans with symptoms of post-traumatic stress. Design: The study used a quasi-experimental design with two cohorts of Veterans-a dog owner-trainer intervention and a wait list control group. Participants completed baseline and 12-month follow-up assessments. Setting: Clear Path for Veterans, a nonclinical, open recreation facility whose mission is to support Veterans and their families in the reintegration process after military service. Subjects: Participants (n = 48) were either enrolled in the veterans therapeutic dog owner-trainer program (Dogs2Vets) or were placed in the wait list control group. Intervention: Veterans were enrolled in the Dogs2Vets program, a 12-month structured dog owner-trainer program that engages veterans in the training and care of a dog that they ultimately adopt. The Dogs2Vets Program focuses on the healing aspects of the human-animal bond. Outcome measures: PTSD Checklist, Military Version (PCL-M), perceived stress scale, self-compassion scale (SCS) composite, and SCS subscales for isolation and self-judgment. Results: Veterans participating in the Dogs2Vets owner-trainer program experienced significant reductions in symptoms of post-traumatic stress, perceived stress, isolation, and self-judgment accompanied by significant increases in self-compassion. In contrast there were no significant improvements in these measures among veterans in the wait list control group. Qualitative data reinforced the statistical findings with themes of decreased isolation, unconditional acceptance and companionship, and a renewed sense of safety and purpose from their relationships with their dogs. Conclusion: Veterans benefit significantly from dog ownership in combination with a structured dog training program. Not only do they experience significant decreases in stress and post-traumatic stress symptoms but also they experience less isolation and self-judgment while also experiencing significant improvements in self-compassion.

Undercover Dogs: Pet Dogs in the Sleep Environment of Patients with Chronic Pain

(1) Background: Chronic pain is a significant and prevalent condition in many industrialized nations. Pain and sleep’s reciprocal nature suggests that interventions to improve sleep may decrease pain symptoms. Little attention has been paid to the influence that owning a pet dog has on the pain/sleep relationship. Typical advice to remove pets from the bedroom negates the possible positive benefit of human-animal co-sleeping. Aim: To investigate pain patients’ perceived impact of pet dog ownership on sleep. (2) Methods: We carried out a content analysis of interview data focused on the impact of pet dog ownership on sleep. The qualitative dataset comes from a subgroup of participants in a larger study examining the pain patient/canine relationship. This subgroup of participants from the larger study was asked, “Does your dog have a positive or negative impact on your sleep?” The data were thematically coded using an iterative approach. (3) Findings: Codes included: companionship; physical presence/’cuddles’; routine/schedule; distraction from anxiety/worry at night; reassuring/protective presence; active intervention to keep participant safe; daytime activity to promote sleeping at night; and reciprocal concern for the sleep of the pet dog. (4) Conclusions: Pet dogs may play important roles in helping people with chronic pain achieve sleep onset and maintenance. Removing the dog to improved sleep could be counter-productive and lead to additional sleep-related issues.

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.

Prevention of transmitted infections in a pet therapy program: An exemplar

The focus of the patient experience in health care delivery has afforded the opportunity to integrate pet therapy as a part of patient care. The purpose of this article is to present the implementation of a pet therapy program that includes guidelines for the prevention of transmitted infections. Consideration of infection prevention strategies has resulted in a 16-year program with no documented incidences of transmitted infections, averaging 20,000 pet therapy interactions per year.

Canine Comfort: Pet Affinity Buffers the Negative Impact of Ambivalence over Emotional Expression on Perceived Social Support

This study evaluated pet affinity as a buffer between ambivalence over emotional expression (AEE) and social support. AEE occurs when one desires to express emotions but is reluctant to do so and is related to negative psychological outcomes. Individuals high in AEE may have difficulty receiving social support and thus may not gain accompanying benefits. Social support has been associated with positive health outcomes, and pet support is positively associated with human social support. The present study explores the potential protective effect of pet affinity. One hundred ninety-eight undergraduate dog owners completed measures assessing perceived social support, pet affinity, and AEE. AEE was expected to be negatively associated with social support, and pet affinity was expected to buffer the negative effects of AEE on social support. We found that AEE was negatively associated with perceived social support. An interaction between pet affinity and AEE emerged such that the negative association between AEE and social support was weaker among those higher in pet affinity. Thus, at high levels of AEE, those who felt a close connection with their pets reported more perceived social support than those less connected with their pets. Overall, these findings emphasize the potential benefits of pet affinity.

Students With Autism, Service Dogs, and Public Schools

Children with autism spectrum disorder (ASD) increasingly receive assistance from service dogs. Nonetheless, confusion surrounding service dogs for students with ASD has precipitated litigation between parents and schools. The purpose of this review was to examine state laws pertaining to the use of service dogs among children with ASD. Statutes were evaluated to identify all disability classifications eligible to use a service dog, regulations related to the authorized training of service animals, and school access for service animals. Results suggest that current state laws do not facilitate the use of service dogs by children with ASD or provide sufficient guidance for parents and schools. Recommendations for policy follow a discussion of the results.

Psychosocial and psychophysiological effects of human-animal interactions: the possible role of oxytocin

During the last decade it has become more widely accepted that pet ownership and animal assistance in therapy and education may have a multitude of positive effects on humans. Here, we review the evidence from 69 original studies on human-animal interactions (HAI) which met our inclusion criteria with regard to sample size, peer-review, and standard scientific research design. Among the well-documented effects of HAI in humans of different ages, with and without special medical, or mental health conditions are benefits for: social attention, social behavior, interpersonal interactions, and mood; stress-related parameters such as cortisol, heart rate, and blood pressure; self-reported fear and anxiety; and mental and physical health, especially cardiovascular diseases. Limited evidence exists for positive effects of HAI on: reduction of stress-related parameters such as epinephrine and norepinephrine; improvement of immune system functioning and pain management; increased trustworthiness of and trust toward other persons; reduced aggression; enhanced empathy and improved learning. We propose that the activation of the oxytocin system plays a key role in the majority of these reported psychological and psychophysiological effects of HAI. Oxytocin and HAI effects largely overlap, as documented by research in both, humans and animals, and first studies found that HAI affects the oxytocin system. As a common underlying mechanism, the activation of the oxytocin system does not only provide an explanation, but also allows an integrative view of the different effects of HAI.