Attitudes to animal-assisted therapy with farm animals among health staff and farmers

Animal-Assisted Green Care Farming for Patients With Mental and Physical Disorders: A Narrative Review

Green care is an umbrella term that includes numerous therapeutic interventions that immerse the patient into nature and natural environments. Animal-assisted therapy (AAT) with farm animals is a component of green care that may benefit patients with mental health disorders. While the majority of research exploring farm AATs originated in Europe, interest in this therapeutic intervention is emerging in the United States. While there are green care farms utilizing animal therapies in the United States, these therapeutic interventions have not been reported in the scientific literature. Further exploration of this topic in the United States may benefit various patient populations and contribute to overall better health care. A literature review found that farm AATs may be beneficial for patients with mental health disorders, but did not identify any studies addressing AAT with farm animals in the context of physical health disorders. This may be a desirable direction for future research.

Leveraging Campus Landscapes for Public Health: A Pilot Study to Understand the Psychological Effects of Urban Sheep Grazing on College Campuses

Since the 1980s, college students in the U.S. have self-reported a decline in their physical and emotional health. With these conditions compounded by the COVID-19 pandemic and its physical distancing restrictions, higher education institutions have an increased responsibility to establish strategic interventions and health-promoting programs for their students. Research collaborations between public health professionals and environmental designers have highlighted the benefits of environmental factors, such as wildlife, street trees, and public parks, on mental health. This pilot project aims to build upon the transdisciplinary dialogue between ecology, design, and public health by examining the social benefits of grazing lawnscape management, which is the practice of using herbivorous livestock to manage turfgrass areas. Through the design of an accessible central campus grazing space for a flock of 25 sheep and use of online questionnaires, a smartphone-based single-item survey, and open-ended feedback given via social media, the UC Davis Sheepmower Project addresses three primary questions: (1) Are there differences in self-reported stress levels and well-being between people who did not watch grazing sheep (no sheepmower group) compared with those who did watch grazing sheep (sheepmower group)? (2) Does holding sheep grazing events create opportunities for education about well-being and engagement with the campus community? (3) Can this type of urban grazing installation ultimately contribute to the overall identity of a college campus? Web-based questionnaire results indicate there is no significant difference in self-reported stress levels between the two groups; however, the moment-in-time smartphone-based single item question suggests that the presence of sheep provides temporary, noticeable relief and enhanced mood for those who observe the animals. Reflections posted on social media suggested that participants found the sheep grazing events fostered feelings of community and placemaking within the campus identity. However, the questionnaire sample indicated the grazing events did not have a significant effect on participants' sense of place or overall campus identity. This transdisciplinary effort breaks down traditionally siloed approaches to human and environmental health and is an example of a whole-systems approach to developing innovative solutions and encouraging applied collective action.

Personalized Strategy for Animal-Assisted Therapy for Individuals Based on the Emotions Induced by the Images of Different Animal Species and Breeds

Simple Summary

In this study, we hypothesized that the personalized strategies for the animal-assisted therapy (AAT) could be improved by selecting animal species and breeds for individuals (persons) according to the emotions induced in the persons by different animal species and breeds. To our knowledge, this study is the first in the area in which the FaceReader technique has been applied to improve the methodology of AAT, which could be the first step to avoiding and/or minimizing stressful situations during a person’s contact with an animal. To implement the aim, the images of different animal species (dogs, cats, pigs, sheep, and horses) and various breeds of those species were used. This study showed that the animal species is a significant factor in the intensity of the ‘neutral’ and ‘happy’ emotions as well as valence. In addition, animal breed is a significant factor in the intensity of the emotion ‘happy’ and valence. Finally, in this study, we obtained results that could be used as a personalized strategy for improvement of the AAT and to help the individuals select a pet.

Abstract

The aim of this study was to apply the FaceReader technique to select the animal species and breed for a personalized AAT based on the emotions (‘neutral’, ‘happy’, ‘sad’, ‘angry’, ‘surprised’, ‘scared’, ‘disgusted’, and ‘contempt’) induced in the persons (18–64 years old) by the images of different animal species and breeds. To implement the aim, the images of different animal species (Canis familiaris, Felis silvestriscatus, Sus scrofa domesticus, Ovis aries, and Equus caballus) and their breeds (dogs: Australian shepherd, pug, Labrador retriever, Doberman, miniature schnauzer, beagle, three mixed-breed types, Yorkshire terrier, Cane Corso, Samoyed, and Chihuahua; cats: British shorthair, Himalayan cat, three mixed breed types, Siamese cat, Sphynx, and Bengal cat; horses: Norwegian Fjord, Exmoor pony, Andalusian, and Friesian; pigs: Vietnamese pot-bellied and Kunekune; sheep: Herdwick sheep and Suffolk sheep) were used. This study showed that the animal species is a significant factor in the intensity of the emotions ‘neutral’ and ‘happy’ as well as valence, and the animal breed is a significant factor for the emotion ‘happy’ intensity and valence. The obtained results could be used as a personalized strategy for improving AAT and helping the individuals to select a pet.

Animal Assisted Interventions in the Green Care Framework: A Literature Review

Green Care (GC) and Animal Assisted Interventions (AAI) are recognised practices useful to enhance the wellbeing of people through interaction with nature and animals. This study aims at understanding the interconnections between GC and AAI by analysing deeply which interaction with animals is conducted. Therefore, we carried out a literature search through Web of Science and Google Scholar that allowed retrieval of 993 records; after the PRISMA selection process, 42 were included. Relevant information was extracted: year of publication, geographical location, objectives, settings in agricultural environment, animal species, characteristics of users involved, type of human–animal interaction, coexistence of other activities without animals, animal health and welfare issues. From the review emerged that research on GC with animals is common in high-income countries and that the line between AAI and occupational therapy is often vague. Moreover, the most common setting for these interventions appears to be the farm, and frequently animals involved are not selected according to their ethological characteristics. Users in this context are extremely various and not only involved in activities with animals. Within the included studies, we noted a lack in the consideration of animal welfare that indicates the need for increased awareness among practitioners and a more ethical approach when animals are involved.

Green Care as Alternative Therapy: The Situation in Ghana

Green care, an alternative healthcare system that involves the use of nature, is proven to be useful in the management of organic and psychological disorders worldwide. There are various forms of Green care including Animal-Assisted Therapy (AAT), a type where animals play pivotal roles in the healing process and is widely used in many developed countries. We assessed the level of awareness and attitude towards Green care among medical students of Ghana. Using a cross-sectional study design and a semistructured questionnaire designed on Google Forms, data were collected from randomly selected 4th-, 5th-, and 6th-year medical students of the University for Development Studies, Tamale, Ghana. The data submitted by 206 of the students were analyzed using Statistical Package for the Social Sciences, Version 25, and the results were presented as frequencies, percentages, and charts. The association between sociodemographic characteristics of respondents and awareness about Animal-Assisted Therapy (AAT) was considered significant at $p<0.05$ . The study found that only 7 (3.4%) of the medical students had ever heard of Green care while a higher number of 36 (17.5%) were aware of AAT mostly through movies and television. However, the majority, 122 (59.3%), had a positive attitude towards the introduction of AAT, into their medical training curriculum. Up to 146 (70.9%) of the respondents suggested lectures and practical sessions as their preferred way of acquiring knowledge and skills on AAT. Only the sex of the respondents was significantly associated with awareness of AAT, with females having a better awareness of AAT (28.6% vs. 11.0%, $p=0.003$ ). We conclude that awareness of Green care practices among medical students in Ghana was highly inadequate, but the desire of the majority of them to acquire knowledge and skills in this proven alternative therapy makes its future use in Ghana promising.

The Care Farming Sector in The Netherlands: A Reflection on Its Developments and Promising Innovations

This paper describes the development of care farming in the Netherlands, one of the pioneering countries in this sector, where care farming has developed into a very diverse sector, with some farmers focussing primarily on agricultural production and others more specifically on providing care services. Care farms are increasingly open to a diversity of participants. The sector has become professionalised with the establishment of strong regional organisations and a steady growth increase in revenues, providing employment opportunities and boosting the economy of rural areas. In this paper, we highlight two promising innovations in care farming: education for school dropouts and the establishment of social farming activities in cities. These innovations face the challenge of connecting not only the agricultural and care sectors, but also the educational sector and the urban context. Initiators face a number of challenges, like trying to embed their activities in the educational sector, a mismatch in regulations and a lack of legitimacy in the case of education on care farms, as well as problems gaining access to land and a lack of recognition in the case of social farming in urban areas. However, the prospects are promising in both cases, because they match the changing demands in Dutch society and are able to integrate social, ecological and economic benefits.

[Design and validation of two scales about attitudes and knowledge regarding doll therapy in dementia]

INTRODUCTION

Non-pharmacological interventions are often the subject of debate in the scientific field. Therefore, it is essential to know the attitudes that health professionals have towards the novel Doll Therapy in Dementia (DTD). The objective of this study was to design and validate two questionnaires to find out the attitudes and knowledge on DTD in health professionals.

MATERIAL AND METHODS

A total of 120 Spanish-speaking Geriatrics and Gerontology professionals, with a mean age of 38.3 years (DT = 10.99), participated, mostly women (88.3%). A questionnaire (TCM_DEMCO) on knowledge about the DTD and a questionnaire (TCM_DEMAC) on attitudes towards the DTD were designed and applied. The construct validity was assessed by exploratory factor analysis, and reliability was calculated using Cronbach's α.

RESULTS

The exploratory factor analysis of the TCM_DEMCO questionnaire retained 10 items in 5 factors ("environment and dementia", "therapeutic application", "activities", "methodology" and "benefits and implications") that explained 70.1% of the total variability, giving a Cronbach α coefficient value > 0.50. The exploratory factor analysis of the TCM_DEMAC questionnaire retained 10 items in two factors ("positive attitudes" and "negative attitudes") that explained 61.2% of the total variability, giving a Cronbach α value > 0.85.

CONCLUSIONS

Both questionnaires are a brief tool to learn about the attitudes and knowledge of Spanish-speaking Geriatrics and Gerontology professionals in matters of DTD. The reliability and validity analyses performed showed good psychometric properties of these tools.

The impact of care farms on quality of life, depression and anxiety among different population groups: A systematic review

Care farming (also called social farming) is the therapeutic use of agricultural and farming practices. Service users and communities supported through care farming include people with learning disabilities, mental and physical health problems, substance misuse, adult offenders, disaffected youth, socially isolated older people and the long term unemployed. Care farming is growing in popularity, especially around Europe. This review aimed to understand the impact of care farming on quality of life, depression and anxiety, on a range of service user groups. It also aimed to explore and explain the way in which care farming might work for different groups. By reviewing interview studies we found that people valued, among other things, being in contact with each other, and feeling a sense of achievement, fulfilment and belonging. Some groups seemed to appreciate different things indicating that different groups may benefit in different ways but, it is unclear if this is due to a difference in the types of activities or the way in which people take different things from the same activity. We found no evidence that care farms improved people's quality of life and some evidence that they might improve depression and anxiety. Larger studies involving single service user groups and fully validated outcome measures are needed to prove more conclusive evidence about the benefits of care farming.

Farming for Life Quality and Sustainability: A Literature Review of Green Care Research Trends in Europe

Green care is an innovative approach that combines simultaneously caring for people and caring for land through three elements that have not been previously connected: (1) multifunctional agriculture and recognition of the plurality of agricultural system values; (2) social services and health care; and (3) the possibility of strengthening the farming sector and local communities. The current research provides a comprehensive overview of green care in Europe as a scientific discipline through a literature review (n = 98 studies). According to our results, the Netherlands, the UK, Norway and Sweden followed by Italy have led the scientific studies published in English. Green care research comprises a wide range of perspectives and frameworks (social farming, care farming, nature-based solutions, etc.) with differences in their specificities. Green care studies have mainly focused on measuring the effectiveness of therapeutic interventions. Studies that evaluate its relevance in socio-economic and environmental terms are still limited. According to our results, the most common users studied were people suffering from psychological and mental ill health, while the most common activities were horticulture, animal husbandry and gardening. Finally, we discuss the potential of green care to reconnect people with nature and to diversify the farming sector providing new public services associated with the relational values society obtains from the contact with agricultural systems.

Medical practitioners' attitudes towards animal assisted interventions. An Italian survey

OBJECTIVES

The present study had a dual purpose: to obtain a comprehensive picture of the Italian medical practitioners' opinions, professional experiences, training needs and knowledge of Animal Assisted Interventions (AAI); and to provide a detailed description of the medical practitioners who are characterized by a strongly positive attitude towards AAI.

METHODS

An online survey addressed to Italian medical practitioners was carried out using a 35-items structured questionnaire. Data obtained from the survey were analysed through appropriate summary statistics, analysis of variance (ANOVA) and logistic regression analysis.

RESULTS

670 medical practitioners participated in the online survey. Among them, 508 stated that they knew of AAI. 93.7% of these described themselves fully favourable towards the use of the human-animal relationship for therapeutic purposes, 84.4% defined themselves as confident and interested in studying the theme. A positive attitude towards AAI was greater in females, in people between 45 and 54 years old, in those who are pet owners and in those who believe that conferences are the most suitable tool to share information on AAI.

CONCLUSIONS

The chance of having a positive attitude towards AAI is higher in respondents with specific characteristics. Data collected could be used as a starting point to promote and implement communication and training activities on AAI addressed to medical practitioners.

Evidence for Using Farm Care Practices to Improve Attachment Outcomes in Foster Children: A Systematic Review

Anecdotal evidence suggests that care farming practices have the potential to provide positive outcomes for young people in foster-care and residential care environments. A systematic review (searching; CINAHL, Web of Knowledge, PsychInfo) was conducted to explore how participation in care farming initiatives impacts attachment in children in foster-care and what aspects of care farming initiatives provides positive attachment outcomes. The systematic review did not identify any research publication in care farming and foster-care. Therefore, it is imperative that practitioners realise that the evidence is lacking when using these types of interventions and keep a close account of the benefit and harms that may be encountered during the interaction processes.

Animal Assisted Therapy (AAT) Program As a Useful Adjunct to Conventional Psychosocial Rehabilitation for Patients with Schizophrenia: Results of a Small-scale Randomized Controlled Trial

Currently, one of the main objectives of human-animal interaction research is to demonstrate the benefits of animal assisted therapy (AAT) for specific profiles of patients or participants. The aim of this study is to assess the effect of an AAT program as an adjunct to a conventional 6-month psychosocial rehabilitation program for people with schizophrenia. Our hypothesis is that the inclusion of AAT into psychosocial rehabilitation would contribute positively to the impact of the overall program on symptomology and quality of life, and that AAT would be a positive experience for patients. To test these hypotheses, we compared pre-program with post-program scores for the Positive and Negative Syndrome Scale (PANSS) and the EuroQoL-5 dimensions questionnaire (EuroQol-5D), pre-session with post-session salivary cortisol and alpha-amylase for the last four AAT sessions, and adherence rates between different elements of the program. We conducted a randomized, controlled study in a psychiatric care center in Spain. Twenty-two institutionalized patients with chronic schizophrenia completed the 6-month rehabilitation program, which included individual psychotherapy, group therapy, a functional program (intended to improve daily functioning), a community program (intended to facilitate community reintegration) and a family program. Each member of the control group (n = 8) participated in one activity from a range of therapeutic activities that were part of the functional program. In place of this functional program activity, the AAT-treatment group (n = 14) participated in twice-weekly 1-h sessions of AAT. All participants received the same weekly total number of hours of rehabilitation. At the end of the program, both groups (control and AAT-treatment) showed significant improvements in positive and overall symptomatology, as measured with PANSS, but only the AAT-treatment group showed a significant improvement in negative symptomatology. Adherence to the AAT-treatment was significantly higher than overall adherence to the control group's functional rehabilitation activities. Cortisol level was significantly reduced after participating in an AAT session, which could indicate that interaction with the therapy dogs reduced stress. In conclusion, the results of this small-scale RCT suggest that AAT could be considered a useful adjunct to conventional psychosocial rehabilitation for people with schizophrenia.

Mental health rehabilitation in a care farm context: A descriptive review of Norwegian intervention studies

BACKGROUND

C are farming is a service developed at farms for promoting mental and physical health and is increasingly used in mental health rehabilitation in Norway.

OBJECTIVE

This article aims to present a descriptive review of Norwegian intervention research on care farms that provide rehabilitation for people with mental health disorders.

METHODS

This literature review applied a non-systematic search strategy: all articles in the field known to the authors were selected for inclusion. The selected studies were intervention studies that were conducted on farms in Norway, that used adult participants with mental health problems/disorders, and that reported outcome measures related to mental health. The studies and articles presented quantitative and/or qualitative data.

RESULTS

The findings from the published articles report improvements to mental health problems, such as depression, anxiety, perceived stress, positive affect, rumination, and self-efficacy. Qualitative data describe a variety of positive experiences, such as improved coping ability, increased social support, and appreciation of the care farm activity.

CONCLUSION

Participating in interventions on care farms positively influences mental health. Care farming may therefore be used as a supplementary approach in mental health rehabilitation, as it offers meaningful and engaging occupations and social inclusion.

Understanding the impacts of care farms on health and well-being of disadvantaged populations: a protocol of the Evaluating Community Orders (ECO) pilot study

INTRODUCTION

Care farms, where all or part of the farm is used for therapeutic purposes, show much potential for improving the health and well-being of a range of disadvantaged groups. Studies to date have been qualitative or observational, with limited empirical evidence of the effectiveness of care farms in improving health and well-being. Understanding the underlying mechanisms that lead to improvements for different disadvantaged groups is a further gap in the evidence. Participants in this study are offenders serving community orders. Their low socioeconomic status and poor health outcomes relative to the general population exemplifies disadvantage.

METHODS AND ANALYSIS

This paper describes the protocol of a study to understand the impacts of care farms and to pilot the design and tools for a study to assess cost-effectiveness of care farms in improving the quality of life of offenders. As a pilot study, no power calculation has been conducted. However, 150 offenders serving community sentences on care farms and 150 on other probation locations (eg, litter picking, painting) will be recruited over a 1-year period. Changes in quality of life, measured by Clinical Outcome in Routine Evaluation-Outcome Measure, health and reconvictions of offenders at care farms compared to other probation locations will be analysed to inform the sample size calculation for the follow on study. The feasibility of recruitment, retention, collecting cost data and modelling cost-effectiveness will also be assessed. The study will use qualitative methods to explore the experiences of offenders attending care farms and perceptions of probation and care farm staff on the processes and impacts of the intervention.

ETHICS AND DISSEMINATION

Findings will be published and inform development of a natural experiment and will be disseminated to probation services, care farms and academics. University of Leeds Ethical Review Board approved: SoMREC/13/014. National Offender Management Service (NOMS) approved: 2013-257.

Farm-based interventions for people with mental disorders: a systematic review of literature

PURPOSE

Farms are increasingly used in mental healthcare. This study aimed to systematically review the evidence on the effectiveness of farm-based interventions for patients with mental disorders.

METHODS

Controlled and uncontrolled studies of farm-based interventions were included. Within- and between group effect sizes were calculated. Qualitative data were summarized using thematic synthesis. The review followed the PRISMA, Cochrane and COREQ standards.

RESULTS

The eleven articles included reported results of five studies, three of which were randomized control trials (RCTs). Overall, 223 patients with depressive disorders, schizophrenia or heterogeneous mental disorders attended three types of farms-based interventions. Favourable effects on clinical status variables were found in one study in patients with depressive disorders that did not respond to medication and/or psychotherapy, and in one RCT in patients with schizophrenia. Assessment of rehabilitative effects (functioning and quality of life) was limited and yielded conflicting results. Patients' experiences revealed that social and occupational components of interventions were perceived as beneficial, and provided insights into how farm-based interventions may facilitate recovery.

CONCLUSIONS

Our results suggest that the farm environment should be considered, especially for patients with mental disorders who do not achieve an adequate response with other treatment options. Further research is needed to clarify potential social and occupational benefits.