Pediatric Oncology and Animal-Assisted Interventions: A Systematic Review

A Randomized Controlled Trial of Animal-assisted Activities for Pediatric Oncology Patients: Psychosocial and Microbial Outcomes

INTRODUCTION

Evidence about the effectiveness and safety of dog visits in pediatric oncology is limited.

METHOD

We conducted a randomized controlled trial (n=26) of dog visits versus usual care among pediatric oncology inpatients. Psychological functioning and microbial load from hand wash samples were evaluated. Parental anxiety was a secondary outcome.

RESULTS

We did not observe a difference in the adjusted mean present functioning score (-3.0; 95% confidence interval [CI], -12.4 to 6.4). The difference in microbial load on intervention versus control hands was -0.04 (95% CI, -0.60 to 0.52) log10 CFU/mL, with an upper 95% CI limit below the prespecified noninferiority margin. Anxiety was lower in parents of intervention versus control patients.

DISCUSSION

We did not detect an effect of dog visits on functioning; however, our study was underpowered by low recruitment. Visits improved parental anxiety. With hand sanitization, visits did not increase hand microbial levels.

CLINICAL TRIAL REGISTRATION

Clinicaltrials.gov NCT03471221.

Race, Zoonoses and Animal Assisted Interventions in Pediatric Cancer

Emerging evidence accumulates regarding the benefits of animal-assisted interventions (AAIs) in facilitating pediatric cancer treatment and alleviating symptomatology through positive changes in the patients’ emotional, mental, and even physical status. A major concern expressed by healthcare providers and parents in implementing AAIs in hospital settings is the transmission of disease from animals to patients. Immunocompromised children, such as pediatric cancer patients are at increased risk for pet-associated diseases. Furthermore, existing disparities among the racial and ethnic minority groups of pediatric cancer patients can potentially exacerbate their risk for zoonoses. This literature review highlights the most common human infections from therapy animals, connections to the race and ethnic background of pediatric oncology patients, as well as means of prevention. The discussion is limited to dogs, which are typically the most commonly used species in hospital-based animal-assisted therapy. The aim is to highlight specific preventive measures, precautions and recommendations that must be considered in hospitals’ protocols and best practices, particularly given the plethora of benefits provided by AAI for pediatric cancer patients, staff and families.

A Single-center Report of the Admission to Intensive Care Unit Effectiveness on Treatment and Survival of Children Diagnosed with Cancer in Iran

Background: Childhood cancer is the second leading cause of death in children. Approximately, 40% of children with cancer need to be admitted to the intensive care unit (ICU), which plays a key role in their treatment procedure and overall survival. Objectives: In this study, we aimed at evaluating the impact of ICU admission on pediatric patients’ survival and prognosis at Mahak Pediatric Cancer Treatment and Research Center (MPCTRC), Tehran, Iran. Methods: Amongst a total number of 2693 hospitalized patients who were referred to our center from March 2014 to September 2019, 674 patients younger than 14 years of age who were at least admitted once to the ICU were included in this study. All the collected data were analyzed using IBM-SPSS software version 22. Results: Totally, 48.96% of patients were female and 51.03% of them were male. The most frequent types of cancer were central nervous system tumors (33.23%) and Leukemia (18.99%). Additionally, 43.62% of admitted patients were in the 1 - 4 age group, with the mean age of 1.5 ± 0.30. The mortality rate in ICU was 40.20% and the overall survival (OS) rate was 29.5% ± 2.6. Moreover, the OS in children with solid tumors and non-solid tumors were 27.1% ± 5.5 and 32.6% ± 3.1, respectively. Conclusions: The results of this conducted study provide a complete report on the status of children admitted to the ICU ward in Mahak Hospital. Because of this fact that the most frequent type of cancer was CNS tumors and children with CNS tumors are usually admitted to the ICU in the late stages of their disease, the overall survival rate in our study was 29.80%, which is lower than other studies.

Effects of Animal-Assisted Therapy on Hospitalized Children and Teenagers: A Systematic Review and Meta-Analysis

PROBLEM

Psychological and symptom disturbances seriously affect hospitalized children's subjective experiences of hospitalization and their prognosis. We systematically reviewed the effects of animal-assisted therapy (AAT) on pain, anxiety, depression, stress, blood pressure (BP), and heart rate (HR) in hospitalized children and teenagers.

ELIGIBILITY CRITERIA

A systematic review and meta-analysis were conducted using the English-language electronic databases PubMed, EMBASE, Web of Science, the Cochrane Library, Clinical Trials, Science Direct, EBSCOhost, Open Grey and Google Scholar, and the Chinese databases CNKI, Sinomed, Vip, and WanFang. These databases were searched through July 15, 2020.

SAMPLE

Eight studies, including four randomized controlled trials (RCTs) and four quasi-experimental studies were included, with a total of 348 participants.

RESULTS

Hospitalized children and teenagers with AAT had less pain (standardized mean difference = -0.49; 95% confidence interval [CI], -0.77 to -0.22; P < 0.001), lower systolic blood pressure (mean difference [MD] = -4.85; 95% CI, -9.50 to -0.21; P₌ 0.04), higher diastolic blood pressure (MD = 4.95; 95% CI, 1.90 to 8.00; P = 0.001) than controls, while there was no significant difference in depression, anxiety, stress, or HR.

CONCLUSION

As an adjuvant to traditional treatment, AAT was beneficial for controlling pain and BP in hospitalized children and teenagers.

IMPLICATION

AAT may be an effective strategy for relieving pain and controlling BP in hospitalized children and teenagers, especially those with cancer. High-quality RCTs conducted or supported by nurses on the effects of AAT are needed.

Implementation of Assisted Therapy With Dogs in the Therapeutic Approach to People With Autistic Spectrum Disorder

A holistic intervention is needed for individuals who suffer from autism spectrum disorders. Our objective was to work with these individuals in a multidisciplinary manner through the use of animal-assisted therapy, finding improvements in the experimental group as compared with the control group in the different evaluated areas.