Influence of Aquariums on Resident Behavior and Staff Satisfaction in Dementia Units

Effect of the presence of an aquarium in the waiting area on the stress, anxiety and mood of adult dental patients: A controlled clinical trial

BACKGROUND

Interaction with fish is known to reduce stress and anxiety in humans.

OBJECTIVE

This trial evaluated the effect of an aquarium present in a geriatric dental clinic waiting-area (WA) on blood pressure (BP), heart-rate (HR), anxiety, and mood of waiting patients.

METHODS

Participants were recruited into three groups: control (CG): WA without aquarium; partially-stocked aquarium (PSA): aquarium without fish; fully-stocked aquarium (FSA): aquarium with fish. BP and HR of the participants were recorded upon arrival and after 20-minutes of waiting, along with anxiety [State trait anxiety inventory (STAI-6)] and mood [Feeling scale (FS), Felt arousal scale (FAS)] scores. A purpose-built questionnaire evaluated the subjective assessment of the participants' experience in the WA. ANOVA with repeated measures and nonparametric tests were used for statistical analysis (p<0.05).

RESULTS

392 patients (mean age: 65.07±16.9y) completed this trial. There was an effect of time on the BP [systolic: F(1, 120) = 44.82, p<0.001; diastolic: F(1, 120) = 25.10, p<0.001] and HR [F(1, 120) = 40.94, p<0.001]. No effect of groups on BP [systolic: F(1, 120) = 1.01, p = 0.32; diastolic: F(1, 120) = 0.01, p = 0.92] was revealed, but a decrease of HR [F(1, 120) = 21.59, p<0.001]. No effect of time*group on BP [systolic: F(1, 120) = 0.89, p = 0.35; diastolic: F(1, 120) = 0.31, p = 0.58], or HR [F(1, 120) = 1.04, p-0.31]. WA groups had no effects on the participants' anxiety [H(2) = 2.76, p = 0.25], or mood [FS: H(2) = 2.28, p = 0.32; FAS: H(2) = 1.54, p = 0.46]. Patients rated FSA higher than others [H(2) = 20.98, p<0.001).

CONCLUSIONS

There was no influence of the presence of an aquarium on the patients' blood pressure, heart rate, anxiety, or mood.

Animal-Assisted Interventions for Dementia: A Systematic Review

Behavioral and psychological symptoms of dementia (BPSD) can be devastating for people who have dementia and their families. More than 5 million Americans are living with dementia, and approximately 97% of these individuals have BPSD, including agitation, aggression, anxiety, depression, apathy, sleep disturbances, wandering, and disinhibition. Animal-assisted interventions (AAI) have increasingly been used to treat these symptoms in individuals with dementia and constitute an optimal nonpharmacological treatment strategy. The current review aims to explore the literature regarding AAI in treating BPSD. Of 3,573 publications reviewed, 15 articles met inclusion criteria. All studies included a type of AAI exploring BPSD within individuals with dementia. The systematic review unveils AAI may be beneficial for those with dementia; however, further research is necessary to address limitations in the existing literature. [Research in Gerontological Nursing, 14(6), 317-324.].

Companion Animal Type and Level of Engagement Matter: A Mixed-Methods Study Examining Links between Companion Animal Guardianship, Loneliness and Well-Being during the COVID-19 Pandemic

Simple Summary

Companion animals (pets) may reduce loneliness and promote the well-being of their guardians (owners). This is important in the context of the COVID-19 pandemic, as companion animal guardians may be less negatively affected by the pandemic. This research examined the influence of companion animals, and specifically ornamental fishes, on mental well-being and loneliness during the pandemic. Data were collected via an online survey and interviews with companion animal guardians. Companion animal guardianship alone was not linked to loneliness or well-being during the pandemic, but there was evidence that people who interacted more with their dogs (and to a lesser extent cats) were lonelier and had poorer well-being; possibly, these individuals spent more time with their dogs/cats because they were more isolated. Open-ended survey responses and interview data identified that most people felt their companion animals were a positive influence during the pandemic, but ornamental fishes were perceived as having a less positive effect than other companion animals, possibly because they cannot provide comfort via physical touch. Consistent with past research, these findings indicate that people believe their companion animals positively influenced their lives during the pandemic, but there is a lack of quantitative evidence to support these beliefs.

Abstract

To reduce the spread of COVID-19, countries worldwide placed limitations on social interaction, which is anticipated to have severe psychological consequences. Although findings are inconsistent, prior research has suggested that companion animals may positively influence human well-being and reduce loneliness. In the context of COVID-19, this has important implications, as companion animal guardians may be less negatively affected by the pandemic. The primary aim of this research was to investigate the influence of companion animals on mental well-being and loneliness during the pandemic, with specific interest in the role of ornamental fishes. A mixed-methods study was conducted, using an international sample. Quantitative data were collected via an online survey (n = 1199) and analysed using robust hierarchical multiple regression analyses; the influence of level of engagement with companion animals was examined for dogs, cats and ornamental fishes. There was no evidence that companion animal guardianship was associated with loneliness and mental well-being during the pandemic but spending more time engaging physically or socially with dogs (and to a lesser extent cats) was generally associated with poorer outcomes. Qualitative data were collected through open-ended survey responses (n = 757) and semi-structured interviews (n = 25) and analysed using reflexive thematic analysis. Two themes were developed—one related to companion animals as providers of social and emotional support, and the other to companion animals as providers of purpose and perspective. Concerns regarding the impact of the pandemic on animal welfare were also identified. Compared to other animal types, more participants expressed indifference regarding the impact of their fishes on their well-being during the pandemic, possibly because fishes cannot provide comfort via physical touch. The findings of this study reflect the wider field of human–animal interaction; although qualitative data suggest guardians believe their companion animals are a positive influence in their lives, there is little convincing quantitative data to support these beliefs. This highlights the need to refine theories regarding which aspects of companion animal guardianship may influence human well-being; the findings from this research may be useful in the refinement of such theories.

Sensory Stimulation for Nursing-Home Residents: Systematic Review and Meta-Analysis of Its Effects on Sleep Quality and Rest-Activity Rhythm in Dementia

INTRODUCTION

Disrupted sleep-wake cycles might be associated with an exacerbation of behavioural disturbances and accelerate disease progression in dementia. The effect of sensory stimulation for improving sleep quality is unclear.

METHODS

A systematic literature search was performed and all studies examining the effects of a sensory stimulation intervention (i.e. bright light, massage, acupuncture, animal-assisted interventions) on rest-activity rhythm (RAR) and/or nocturnal restlessness in nursing-home residents with dementia were included.

RESULTS

Sensory stimulation was shown to improve nocturnal behavioural restlessness as well as sleep duration and continuation, but the effect on the number of awakenings, RAR, and daytime sleep was negligible. Notable was the high heterogeneity between studies regarding treatments and patients' characteristics and sleep parameters.

CONCLUSION

Sleep quality and nocturnal restlessness in nursing-home residents with dementia may benefit from sensory stimulation. An environment with sensory stimulation may prevent or improve sleep disturbances in nursing homes, and thereby contribute to a better quality of life for their patients.

Animal assisted intervention for oncology and palliative care patients: A systematic review

INTRODUCTION

Animal assisted interventions (AAI) have been used in different contexts including oncology/palliative care and can improve mood, quality of life and wellness. The goal of this review was to evaluate studies about AAI and its effects on oncological/palliative care patients.

METHODS

The search was conducted on PubMed, Scopus and Lilacs databases. The inclusion criteria were original articles that measured quantitatively the health-related outcomes of an AAI on oncological/palliative care patients.

RESULTS

Ten studies fulfilled the inclusion criteria. Benefits related to the AAI were described. Mood, pain perception and quality of life seemed to be the variables that had improvement with the intervention. Due to the small sample sizes/heterogeneous methodologies, additional analyses could not be performed.

CONCLUSIONS

AAI can be an important tool for improving psychosocial/physiological parameters in cancer/palliative care patients. Further well designed studies are needed to provide a better knowledge of the AAI benefits in this setting.

Qualitative Research on the Primary Effect of Fish Pet Ownership Using the Bottleium, a Bottle-Type Aquarium, on Community-Dwelling Older Adults in Japan: A Potential Preventive Measure Towards Social Isolation

Aging increases the risk of social isolation, which could lead to conditions such as depressive mood. Pet ownership is known to reduce social isolation. However, previous studies have mainly focused on mammals as pets, which could be difficult at old age. A small ornamental fish is relatively easy to culture and might be a suitable alternative. In this research, we aimed to elucidate the possible effects of fish ownership on the psychological state of community-dwelling older adults in Japan. A Bottleium, a bottle-type aquarium, was selected to lower the burden of fish ownership. A workshop was hosted in 2019 and participants brought home their own Bottleium, with fish and water snail inside. Nineteen participants gave consent to the follow-up interview a month later. Five themes, "observation of fish and water snail," "interaction between the fish and the owner," "taking care of the fish as pet owner," "facilitation of interpersonal interaction," and "development of support system," emerged from thematic analysis. The promotion of animal-to-human, and human-to-human interaction and development of responsibility could relate to a sense of social inclusion and ikigai-kan, a purpose of life. Fish ownership, when using equipment that suits the physical capability of older adults, could act as a positive stimulus.

Indoor Nature Interventions for Health and Wellbeing of Older Adults in Residential Settings: A Systematic Review

BACKGROUND AND OBJECTIVES

Having contact with nature can be beneficial for health and wellbeing, but many older adults face barriers with getting outdoors. We conducted a systematic review of quantitative studies on health and wellbeing impacts of indoor forms of nature (both real and simulated/artificial), for older adults in residential settings.

RESEARCH DESIGN AND METHODS

Search terms relating to older adults and indoor nature were run in 13 scientific databases (MEDLINE, CINAHL, AgeLine, Environment Complete, AMED, PsychINFO, EMBASE, HMIC, PsychARTICLES, Global Health, Web of Knowledge, Dissertations and Theses Global, and ASSIA). We also pursued grey literature, global clinical trials registries, and a range of supplementary methods.

RESULTS

Of 6,131 articles screened against eligibility criteria, 26 studies were accepted into the review, and were quality-appraised using the Effective Public Health Practice Project (EPHPP) tool. The participants were 930 adults aged over 60. Nature interventions and health/wellbeing outcomes were heterogeneous, which necessitated a narrative synthesis. The evidence base was generally weak, with 18 of 26 studies having a high risk of bias. However, several higher-quality studies found indoor gardening and horticulture programs were effective for cognition, psychological wellbeing, social outcomes, and life satisfaction.

DISCUSSION AND IMPLICATIONS

There is inconsistent evidence that indoor nature exposures are beneficial for older care residents. We expect that successful interventions were, at least partly, facilitating social interaction, supporting feelings of autonomy/control, and promoting skill development, that is, factors not necessarily associated with nature per se. Higher-quality studies with improved reporting standards are needed to further elucidate these mechanisms.

Companion Animals and Health in Older Populations: A Systematic Review

OBJECTIVES

. The aim of this systematic literature review (SLR) was to investigate the effect of companion animals (whether simply as pets or used in more formal intervention approaches) on the physical and mental health of older adults (aged 60+).

METHODS

. The reviewers identified key search terms and conducted a systematic search of the PsycINFO and PubMed databases. The 70 articles reviewed were evaluated through tabular and thematic analysis.

RESULTS

. In 52 of the studies examined, companion animals positively contributed to the mental and/or physical health of older adults. With respect to mental health, involvement with a companion animal improved participant quality of life and effectively attenuated symptoms of depression, anxiety, cognitive impairment, and the behavioral and psychiatric symptoms of dementia (BPSD). In relation to physical health, marked increases in physical activity and improvements in blood pressure and heart rate variability were the only consistent physical health improvements observed from companion animal interactions.

CONCLUSIONS

. Animal companionship can benefit the mental and physical health of older adults, although more and better controlled research on this topic is required.

CLINICAL IMPLICATIONS

. Use of companion animals has the potential to be an effective treatment or adjunct therapy to improve the health status and quality of life of older individuals.

Trained assistance dogs for people with dementia: a systematic review

This systematic review investigated evidence for the effectiveness of trained assistance dogs as an intervention and support for people with dementia. Peer-reviewed articles were retrieved from multiple databases (SCOPUS, Web of Science, and Google Scholar). Reference lists of the articles retrieved were also screened to identify key authors for inclusion. Articles were subject to a quality review, and the results synthesised to address the research questions. Both qualitative and quantitative data were reported. There was evidence of the potential positive effects of dog-assisted interventions in relation to mood, prosocial behaviours, activities of daily living and/or quality of life, cognitive impairment and symptoms specific to dementia, and existential functions. However, the form and quality of the studies varied considerably. It was concluded that further research is needed, particularly for those with younger onset dementia (YOD), for whom there were no specific studies available. Attention needs to be given to establishing adequate-sized samples and designs incorporating control groups. Research would benefit from employing mixed-methods, allowing for the triangulation of qualitative and quantitative data. For deteriorating conditions such as the dementias, studies need to be conducted over time. Furthermore, given the important place family members play in the lives of those with dementia, the effects of dog-assisted interventions on the wider family should also be considered.

The State of Animal-Assisted Interventions: Addressing the Contemporary Issues that will Shape the Future

As the worldwide popularity of animal-assisted interventions (AAIs) increases, the fieldis quickly approaching a paradigm shift, adjusting its image to incorporate more evidence-basedresearch and aligning its purpose for advancing a new future. Contemporary critical issues thatconfront the field today include, but are not limited, to research, animal welfare, practice guidelines,and public policy. This article will provide an overview of the history of AAI and the majormilestones that the field has undergone. The current state of AAI research will be scrutinized, andthe areas that warrant further study will be recommended. Special attention will be given to thecurrent state of animal welfare in AAI, the research that has been done in the area, and practiceguidelines that safeguard animal wellbeing. This article will then discuss how evidence-basedresearch and animal welfare guidelines inform the development of comprehensive professionalstandards and influence changes in public policy regarding AAI. The authors' perceptions for thefield's future trajectory will be presented, which will include solutions to move the field in thedirection that best advances the human-animal bond in research, practice, and public perception.

"There Is a Cat on Our Ward": Inpatient and Staff Member Attitudes toward and Experiences with Cats in a Psychiatric Ward

The aim of this study was to investigate inpatient and staff member attitudes toward and experiences with ward cats, and identify possible mechanisms for how cats affect patient satisfaction in a psychiatric clinic. Thirty-three inpatients diagnosed with depression or psychosis residing on wards with and without cats and 17 staff members working on wards with cats participated in semi-structured interviews using a cross-sectional study design. Data analysis included descriptive statistics and correlations. The results showed that 17 out of 19 inpatients and all the staff members liked having a cat on their ward. Further, 12 out of 14 inpatients on wards without cats would like having a cat on their ward. Inpatient perceptions of the cat’s impact on the ward atmosphere correlated significantly with their emotional relationship with the cat (p = 0.015, r = 0.561), how often they saw the cat (p = 0.002, r = 0.676), and if they liked cats in general (p = 0.041, r = 0.486). Our results highlight the positive attitudes of inpatients and staff members toward ward cats and the potential of ward cats to enhance patient satisfaction. This influence might be mediated by factors such as the frequency of contact, the relationship between each patient and the cat, and each patient’s attitude toward cats in general.

The effects of interacting with fish in aquariums on human health and well-being: A systematic review

BACKGROUND

Most research into the health benefits of human-animal interaction has focused on species that interact physically with humans, such as dogs. This may be unsuitable for certain populations for reasons including accessibility and the risk of negative consequences to both the person and the animal. However, some research has associated viewing fish in aquariums with positive well-being outcomes; as there is no physical contact with the animal, this form of interaction carries less risk. At present, little is known about the specific benefits of human-fish interaction.

OBJECTIVES

To explore current evidence relating to the psychological and physiological benefits of interacting with fish in aquariums.

METHODS

Systematic searches were conducted to identify relevant primary research of any design. All forms of interaction were considered, including keeping fish as companion animals and fish aquarium-based interventions. "Non-live" alternatives, such as videos, were also considered. This review was conducted according to a registered protocol (PROSPERO ID: CRD42018090466).

RESULTS

Nineteen studies were included. Two provided tentative evidence that keeping home aquaria is associated with relaxation. The remaining studies involved novel interactions with fish in home or public aquariums. Outcomes relating to anxiety, relaxation and/or physiological stress were commonly assessed; evidence was mixed with both positive and null findings. Preliminary support was found for effects on mood, pain, nutritional intake and body weight, but not loneliness. All studies had methodological issues and risk of bias was either high or unclear.

CONCLUSIONS

Review findings suggest that interacting with fish in aquariums has the potential to benefit human well-being, although research on this topic is currently limited. Future research should aim to address gaps in the evidence, such as whether and how the type of human-fish interaction can influence well-being outcomes. Researchers should also aim to address the methodological concerns highlighted in this review.

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.

Animal-Assisted Intervention and Dementia: A Systematic Review

This review discusses the relationship between animal-assisted interventions (AAI) and behavioral and psychological symptoms of dementia (BPSD). A systematic search was conducted within CINAHL, Web of Science CAB Abstracts, PubMed, Abstracts in Social Gerontology, Google Scholar, and PsycINFO for primary research articles. A total of 32 studies were included in the final review. Variation was noted in study designs and in study setting. Twenty-seven of 32 studies used dogs as the intervention. Agitation/aggression showed a significant decrease in nine of 15 studies. Eleven of 12 studies demonstrated increased social interaction with AAI. Mood had mixed results in nine studies. Quality of life was increased in three of four studies. Resident activity and nutritional intake were each increased in two studies. Animal assisted activities/interventions showed a strong positive effect on social behaviors, physical activity, and dietary intake in dementia patients and a positive effect on agitation/aggression and quality of life.

The effects of preferred natural stimuli on humans' affective states, physiological stress and mental health, and the potential implications for well-being in captive animals

Exposure to certain natural stimuli improves people's moods, reduces stress, enhances stress resilience, and promotes mental and physical health. Laboratory studies and real estate prices also reveal that humans prefer environments containing a broad range of natural stimuli. Potential mediators of these outcomes include: 1) therapeutic effects of specific natural products; 2) positive affective responses to stimuli that signalled safety and resources to our evolutionary ancestors; 3) attraction to environments that satisfy innate needs to explore and understand; and 4) ease of sensory processing, due to the stimuli's "evolutionary familiarity" and/or their fractal, self-repeating properties. These processes, and the benefits humans gain from natural stimuli, seem to be largely innate. They thus have strong implications for other species (including laboratory, farm and zoo animals living in environments devoid of natural stimuli), suggesting that they too may have nature-related "sensory needs". By promoting positive affect and stress resilience, preferred natural stimuli (including views, sounds and odours) could therefore potentially provide effective and efficient ways to improve captive animal well-being.

Living with the animals: animal or robotic companions for the elderly in smart homes?

Although the use of pet robots in senior living facilities and day-care centres, particularly for individuals suffering from dementia, has been intensively researched, the question of introducing pet robots into domestic settings has been relatively neglected. Ambient assisted living (AAL) offers many interface opportunities for integrating motorised companions. There are diverse medical reasons, as well as arguments from animal ethics, that support the use of pet robots in contrast to living with live animals. However, as this paper makes clear, we should not lose sight of the option of living with animals at home for as long as possible and in conformity with the welfare of the animal assisted by AAL technology.