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Chubak J, Adler A, Bobb JF, Hawkes RJ, Ziebell RA, Pocobelli G, Ludman EJ, Zerr DM. A Randomized Controlled Trial of Animal-assisted Activities for Pediatric Oncology Patients: Psychosocial and Microbial Outcomes. J Pediatr Health Care 2024; 38:354-364. [PMID: 37930283 PMCID: PMC11066653 DOI: 10.1016/j.pedhc.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/19/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023]
Abstract
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.
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Stefana A, Gamba A. Making the Best in a Bad Job: A Psychoanalytic Perspective on Communication with Children and Adolescents with Severe Physical Condutions. THE PSYCHOANALYTIC QUARTERLY 2023; 92:463-497. [PMID: 38032764 DOI: 10.1080/00332828.2023.2269940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/08/2023] [Indexed: 12/02/2023]
Abstract
Ill children/adolescents who suffer from severe organic diseases have to cope with their inner experiences, therapies, and the global burden of the disease. Although sometimes depression, anger, and death anxiety are openly encountered in medical settings, other times they can be partially hidden by a reactive and defensive path. In these scenarios, psychoanalysis is challenged to contribute the best comprehension of the intimate communication, maybe hidden, and the needs of the ill patients to express themselves. The best way a child can talk about himself is through spontaneous creativity. The adult's task is to facilitate the creation of an empty space and to recognize the child's mode of communication. There may be intense emotional reactions that the adult has to tolerate to not move the patient towards an over-adaptation. These over-adaptations entail the child being forced to feel good or have fun, thereby causing them to escape from their inner experience. The loss of the child's reality forms an additional burden to the child. The most valid indicator of this attitude is the ability to not take counterphobic attitudes but to allow the depression to be shared in a contact space between the child's true self and the perceived environment.
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Affiliation(s)
- Alberto Stefana
- Alberta Stefana Corso Giacomo Matteotti 40, 25122 Brescia, Italy
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Liguori G, Costagliola A, Lombardi R, Paciello O, Giordano A. Human-Animal Interaction in Animal-Assisted Interventions (AAI)s: Zoonosis Risks, Benefits, and Future Directions-A One Health Approach. Animals (Basel) 2023; 13:ani13101592. [PMID: 37238022 DOI: 10.3390/ani13101592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Animal-assisted interventions (AAI)s represent the expression of integrated medicine, according to the One Health approach. Actually, animal-assisted therapies and animal-assisted activities are implemented in hospitals, rehabilitation centers, etc. The efficacy of AAIs is based on interspecific interactions and would be impacted by different factors, such as the characters of both the animal and the handler, a suitable selection of animal species, an appropriate animal educational protocol, the relationship between the handler and the animal, and mutual relationship among the animal, the patients, and members of the working team. AAIs produce many advantages for the patients but could expose them to zoonotic-pathogens transmission. Therefore, positive animal welfare, as preventative medicine to avoid incidents or transmission of zoonosis, is a relevant aspect with implications for human and animal health and wellbeing. This review aims to summarize the current published knowledge regarding the occurrence of pathogens in AAIs and to discuss their relevance in light of health and safety in AAIs participants. In addition, this review will contribute to defining the state of the art of AAIs through a careful benefits/challenges analysis and offers discussion points on the possible future developments according to the One Health approach.
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Affiliation(s)
- Giovanna Liguori
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, 80138 Napoli, Italy
- Local Health Authority, ASL Foggia, 71122 Foggia, Italy
| | - Anna Costagliola
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, 80138 Napoli, Italy
| | | | - Orlando Paciello
- Department of Veterinary Medicine and Animal Productions, University of Napoli Federico II, 80138 Napoli, Italy
| | - Antonio Giordano
- Sbarro Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA
- Department of Medical Biotechnology, University of Siena, 53100 Siena, Italy
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Chubak J, Pocobelli G, Ziebell RA, Hawkes RJ, Adler A, Bobb JF, Zerr DM. Effects of the COVID-19 Pandemic on Animal-Assisted Activities in Pediatric Hospitals. J Pediatr Health Care 2023; 37:173-178. [PMID: 36266165 PMCID: PMC9547756 DOI: 10.1016/j.pedhc.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/23/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The goal of this study was to document current hospital-based animal-assisted activities (AAA) practices. METHOD We contacted 20 hospitals and asked about their AAA programs, including COVID-19 precautions. RESULTS Eighteen of 20 hospitals responded. Before 2020, all offered either in-person only (n = 17) or both in-person and virtual AAA visits (n = 1). In early 2022, 13 provided in-person visits; the five hospitals that had not resumed in-person visits planned to restart. Most hospitals stopped group visits. Most required that patients and handlers be free of COVID-19 symptoms and that handlers be vaccinated and wear masks and eye protection. Most did not require COVID-19 vaccination for patients. None required handlers to test negative for COVID-19. DISCUSSION The COVID-19 pandemic impacted hospital-based pediatric AAA. Future studies should assess the effectiveness of virtual AAA and of precautions to prevent COVID-19 transmission between patients and AAA volunteers.
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Affiliation(s)
- Jessica Chubak
- Jessica Chubak, Senior Investigator, Kaiser Permanente Washington Health Research Institute, Seattle, WA.
| | - Gaia Pocobelli
- Gaia Pocobelli, Senior Collaborative Scientist, Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Rebecca A Ziebell
- Rebecca A. Ziebell, Manager, Data Reporting & Analytics, Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Rene J Hawkes
- Rene J. Hawkes, Project Manager, Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Amanda Adler
- Amanda Adler, Clinical Research Manager, Seattle Children's Hospital, Seattle, WA
| | - Jennifer F Bobb
- Jennifer F. Bobb, Associate Investigator, Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Danielle M Zerr
- Danielle M. Zerr, Professor and Division Chief of Pediatric Infectious Disease, Seattle Children's Hospital, Seattle, WA
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5
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Animal-assisted activities in the intensive care unit: A scoping review. Intensive Crit Care Nurs 2022; 73:103304. [DOI: 10.1016/j.iccn.2022.103304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/09/2022] [Accepted: 07/15/2022] [Indexed: 11/18/2022]
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Race, Zoonoses and Animal Assisted Interventions in Pediatric Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137772. [PMID: 35805427 PMCID: PMC9265881 DOI: 10.3390/ijerph19137772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022]
Abstract
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.
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Carey B, Dell CA, Stempien J, Tupper S, Rohr B, Carr E, Cruz M, Acoose S, Butt P, Broberg L, Collard L, Fele-Slaferek L, Fornssler C, Goodridge D, Gunderson J, McKenzie H, Rubin J, Shand J, Smith J, Trask J, Ukrainetz K, Meier S. Outcomes of a controlled trial with visiting therapy dog teams on pain in adults in an emergency department. PLoS One 2022; 17:e0262599. [PMID: 35263346 PMCID: PMC9064456 DOI: 10.1371/journal.pone.0262599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 11/13/2021] [Indexed: 01/15/2023] Open
Abstract
CONTEXT Pain is a primary reason individuals attend an Emergency Department (ED), and its management is a concern. OBJECTIVES Change in symptoms and physiologic variables at 3 time points pre-post a ten-minute St. John Ambulance therapy dog team visit compared to no visit in ED patients who experienced pain. DESIGN, SETTING AND PARTICIPANTS Using a controlled clinical trial design, pain, anxiety, depression and well-being were measured with the Edmonton Symptom Assessment System (revised version) (ESAS-r) 11-point rating scales before, immediately after, and 20 minutes post- therapy dog team visit with Royal University Hospital ED patients participating in the study (n = 97). Blood pressure and heart rate were recorded at the time points. Control data was gathered twice (30 minutes apart) for comparison (n = 101). There were no group differences in age, gender or ethnicity among the control and intervention groups (respectively mean age 59.5/57.2, ethnicity 77.2% Caucasian/87.6%, female 43.6% /39.2%, male 56.4%/60.8%,). INTERVENTION 10 minute therapy dog team visit in addition to usual care. MAIN OUTCOME MEASURES Change in reported pain from pre and post therapy dog team visit and comparison with a control group. RESULTS A two-way ANOVA was conducted to compare group effects. Significant pre- post-intervention differences were noted in pain for the intervention (mean changeint. = -0.9, SD = 2.05, p = .004, 95% confidence interval [CI] = [0.42, 1.32], ηp2 = 04) but not the control group. Anxiety (mean changeint. = -1.13, SD = 2.80, p = .005, 95% CI = [0.56, 1.64], ηp2 = .04), depression (mean changeint. = -0.72, SD = 1.71, p = .002, 95% CI = [0.39, 1.11], ηp2 = .047), and well-being ratings (mean changeint. = -0.87, SD = 1.84, p < .001, 95% CI = [0.49, 1.25], ηp2 = .07) similarly improved for the intervention group only. There were no pre-post intervention differences in blood pressure or heart rate for either group. Strong responders to the intervention (i.e. >50% reduction) were observed for pain (43%), anxiety (48%), depression (46%), and well-being (41%). CONCLUSIONS Clinically significant changes in pain as well as significant changes in anxiety, depression and well-being were observed in the therapy dog intervention compared to control. The findings of this novel study contribute important knowledge towards the potential value of ED therapy dogs to affect patients' experience of pain, and related measures of anxiety, depression and well-being. TRIAL REGISTRATION This controlled clinical trial is registered with ClinicalTrials.gov, registration number NCT04727749.
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Affiliation(s)
- Ben Carey
- Department of Sociology, University of Saskatchewan, Saskatoon,
Canada
| | - Colleen Anne Dell
- Department of Sociology, University of Saskatchewan, Saskatoon,
Canada
- * E-mail:
| | - James Stempien
- College of Medicine, University of Saskatchewan, Saskatoon,
Canada
| | - Susan Tupper
- Quality, Safety & Standards, Saskatchewan Health Authority,
Saskatoon, Saskatchewan, Canada
| | - Betty Rohr
- Department of Sociology, University of Saskatchewan, Saskatoon,
Canada
| | - Eloise Carr
- Faculty of Nursing University of Calgary, Calgary, Alberta,
Canada
| | - Maria Cruz
- Department of Sociology, University of Saskatchewan, Saskatoon,
Canada
| | - Sharon Acoose
- School of Indigenous Social Work, First Nations University of Canada,
Saskatoon, Saskatchewan, Canada
| | - Peter Butt
- College of Medicine, University of Saskatchewan, Saskatoon,
Canada
| | - Lindsey Broberg
- College of Medicine, University of Saskatchewan, Saskatoon,
Canada
| | - Lisa Collard
- Emergency Services, Saskatchewan Health Authority, Saskatoon,
Saskatchewan, Canada
| | | | - Cathie Fornssler
- Saskatchewan Centre for Patient Oriented Research, University of
Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna Goodridge
- College of Nursing & Respirology, Critical Care and Sleep Medicine,
University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Janet Gunderson
- Saskatchewan Centre for Patient Oriented Research, University of
Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Holly McKenzie
- Department of Sociology, University of Saskatchewan, Saskatoon,
Canada
| | - Joe Rubin
- Veterinary Microbiology, University of Saskatchewan, Saskatoon,
Saskatchewan, Canada
| | - Jason Shand
- Clinical Analyst, Saskatchewan Health Authority, Saskatoon, Saskatchewan,
Canada
| | - Jane Smith
- St. John Ambulance, Saskatoon, Saskatchewan, Canada
| | - Jason Trask
- Emergency Services, Saskatchewan Health Authority, Saskatoon,
Saskatchewan, Canada
| | - Kerry Ukrainetz
- Saskatchewan Centre for Patient Oriented Research, University of
Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Simona Meier
- Clinical Research Professional Clinical Trial Support Unit, University of
Saskatchewan, Saskatoon, Canada
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Feng Y, Lin Y, Zhang N, Jiang X, Zhang L. Effects of Animal-Assisted Therapy on Hospitalized Children and Teenagers: A Systematic Review and Meta-Analysis. J Pediatr Nurs 2021; 60:11-23. [PMID: 33582447 DOI: 10.1016/j.pedn.2021.01.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/18/2022]
Abstract
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.
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Affiliation(s)
| | - Yeqing Lin
- Research Management Department, The Third Affiliated Hospital of Sun Yat-sen University, China.
| | | | | | - Lifeng Zhang
- School of Nursing, Sun Yat-sen University, China.
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Holder TRN, Gruen ME, Roberts DL, Somers T, Bozkurt A. A Systematic Literature Review of Animal-Assisted Interventions in Oncology (Part I): Methods and Results. Integr Cancer Ther 2021; 19:1534735420943278. [PMID: 32815410 PMCID: PMC7444110 DOI: 10.1177/1534735420943278] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Animal-assisted interventions (AAIs) use human-animal interactions to positive effect in various contexts including cancer care. As the first installment of a 2-part series, this systematic literature review focuses on the research methods and quantitative results of AAI studies in oncology. We find methodological consistency in the use of canines as therapy animals, in the types of high-risk patients excluded from studies, and in the infection precautions taken with therapy animals throughout cancer wards. The investigated patient endpoints are not significantly affected by AAI, with the exceptions of improvements in oxygen consumption, quality of life, depression, mood, and satisfaction with therapy. The AAI field in oncology has progressed significantly since its inception and has great potential to positively affect future patient outcomes. To advance the field, future research should consistently improve the methodological design of studies, report data more completely, and focus more on the therapy animal’s well-being.
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Affiliation(s)
- Timothy R N Holder
- University of North Carolina and North Carolina State University Joint Department of Biomedical Engineering, Chapel Hill, NC, USA.,North Carolina State University, Raleigh, NC, USA
| | | | | | | | - Alper Bozkurt
- University of North Carolina and North Carolina State University Joint Department of Biomedical Engineering, Chapel Hill, NC, USA.,North Carolina State University, Raleigh, NC, USA
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Lindström Nilsson M, Funkquist E, Edner A, Engvall G. Children report positive experiences of animal-assisted therapy in paediatric hospital care. Acta Paediatr 2020; 109:1049-1056. [PMID: 31597211 DOI: 10.1111/apa.15047] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022]
Abstract
AIM To evaluate children's experiences of and responses to animal-assisted therapy using a therapy dog as complementary treatment in paediatric hospital care. METHODS The study was performed using mixed methods, by means of qualitative and quantitative data. Fifty children in a paediatric surgery ward, at a tertiary hospital in Sweden, were included between February 2016 to May 2017. Children answered questions about feelings of well-being and experiences of the hospital stay before and after animal-assisted therapy, and experiences of their interaction with a therapy dog. RESULTS The children's well-being increased from moderately good before to very good after animal-assisted therapy, and the children assessed the hospital stay as better after than before. The vast majority of the children (93%) assessed the interaction with the dog as very good. The children described mixed experiences before and mainly positive aspects of joy, satisfaction and pain relief after animal-assisted therapy. CONCLUSION The children's responses before interaction, of both a positive and negative nature, show a focus shift after the interaction with a therapy dog to mainly positive nature regarding self-reported feeling of well-being and experiences of the hospital stay. Using a therapy dog in paediatric hospital care is suitable complementary treatment.
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Affiliation(s)
| | - Eva‐Lotta Funkquist
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Ann Edner
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Gunn Engvall
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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Brown S, Snelders J, Godbold J, Moran-Peters J, Driscoll D, Donoghue D, Mathew L, Eckardt S. Effects of Animal-Assisted Activity on Mood States and Feelings in a Psychiatric Setting. J Am Psychiatr Nurses Assoc 2020; 26:555-567. [PMID: 31179871 DOI: 10.1177/1078390319853617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Research has shown that animal-assisted activity (AAA) effectively improves physiological, psychological, emotional, and social well-being in various environments. AIMS: To identify how AAA affects mood states and feelings among both patients and staff on inpatient psychiatric units. METHODS: This study used a quasi-experimental, pre-/posttest design with nonequivalent comparison groups. Quantitative data were collected using the Visual Analog Mood Scale. Demographic data, with an open-ended question, were obtained postsessions. RESULTS: Significant changes were observed pre- and postexposure to AAA sessions with a therapy dog. Negative moods decreased, and positive moods increased as measured by the Visual Analog Mood Scale. Content analysis identified themes of feeling happy, feeling relaxed, and feeling calm. CONCLUSIONS: This research expands scientific evidence associated with AAA by identifying changes in mood states and feelings among individuals in a psychiatric setting.
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Affiliation(s)
- Sandra Brown
- Sandra Brown, BSN, RN-BC, Mather Hospital, Port Jefferson, NY, USA
| | - Jill Snelders
- Jill Snelders, BS, MBA, CTRS, Mather Hospital, Port Jefferson, NY, USA
| | - Joan Godbold
- Joan Godbold, BSN, RN, Mather Hospital, Port Jefferson, NY, USA
| | | | - Denise Driscoll
- Denise Driscoll, RN-BC, CARN, PMHCNS-BC, NPP, Mather Hospital, Port Jefferson, NY, USA
| | - Donna Donoghue
- Donna Donoghue, MD, Mather Hospital, Port Jefferson, NY, USA
| | - Lilly Mathew
- Lilly Mathew, PhD, RN, Mather Hospital, Port Jefferson, NY, USA; CUNY School of Professional Studies, NY, USA
| | - Sarah Eckardt
- Sarah Eckardt, BA, MS, Mather Hospital, Port Jefferson, NY, USA
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12
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Holder TRN, Gruen ME, Roberts DL, Somers T, Bozkurt A. A Systematic Literature Review of Animal-Assisted Interventions in Oncology (Part II): Theoretical Mechanisms and Frameworks. Integr Cancer Ther 2020; 19:1534735420943269. [PMID: 32698731 PMCID: PMC7378713 DOI: 10.1177/1534735420943269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/29/2020] [Accepted: 05/20/2020] [Indexed: 11/16/2022] Open
Abstract
Animal-assisted interventions (AAIs) can improve patients' quality of life as complementary medical treatments. Part I of this 2-paper systematic review focused on the methods and results of cancer-related AAIs; Part II discusses the theories of the field's investigators. Researchers cite animal personality, physical touch, physical movement, distraction, and increased human interaction as sources of observed positive outcomes. These mechanisms then group under theoretical frameworks such as the social support hypothesis or the human-animal bond concept to fully explain AAI in oncology. The cognitive activation theory of stress, the science of unitary human beings, and the self-object hypothesis are additional frameworks mentioned by some researchers. We also discuss concepts of neurobiological transduction connecting mechanisms to AAI benefits. Future researchers should base study design on theories with testable hypotheses and use consistent terminology to report results. This review aids progress toward a unified theoretical framework and toward more holistic cancer treatments.
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Affiliation(s)
- Timothy R. N. Holder
- University of North Carolina, Chapel
Hill, NC, USA
- North Carolina State University,
Raleigh, NC, USA
| | | | | | | | - Alper Bozkurt
- University of North Carolina, Chapel
Hill, NC, USA
- North Carolina State University,
Raleigh, NC, USA
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13
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Easing anxiety in preparation for pediatric magnetic resonance imaging: a pilot study using animal-assisted therapy. Pediatr Radiol 2019; 49:1000-1009. [PMID: 31030334 DOI: 10.1007/s00247-019-04407-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 03/15/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Children undergoing magnetic resonance imaging (MRI) can experience negative emotions both before and during their scan, causing them to move and often necessitating the use of procedural sedation. Several strategies to improve patient compliance have been attempted. OBJECTIVE This study was designed to evaluate the effectiveness of a non-pharmacological intervention to reduce anxiety in pediatric patients preparing for MRI using animal-assisted therapy. MATERIALS AND METHODS An animal intervention pilot study was performed in patients who agreed in advance to interact with a dog. Patients and caregivers filled out questionnaires, including questions designed to capture changes in patient emotion before and after the intervention. MRI diagnostic quality was compared to age- and gender-matched control groups with and without general anesthesia. RESULTS The intervention in 21 patients comparing pre- and post-scan surveys demonstrated a statistically significant improvement in patient anxiety levels (P<0.01). Diagnostic MRI scans were achieved in 19/21 (90%), with no significant difference in exam quality or times compared against control groups. The majority of caregivers and staff members agreed strongly that patients benefited from the therapy dog's presence. CONCLUSION The use of animal-assisted therapy in a pilot group in our MRI division resulted in a beneficial effect on patients' emotional status, easing anxiety in preparation for scheduled scans, without impacting MRI quality or duration. Further randomized studies will be needed to demonstrate its significance in reducing sedation rates in children undergoing MRI.
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Hinic K, Kowalski MO, Holtzman K, Mobus K. The Effect of a Pet Therapy and Comparison Intervention on Anxiety in Hospitalized Children. J Pediatr Nurs 2019; 46:55-61. [PMID: 30852256 DOI: 10.1016/j.pedn.2019.03.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 01/09/2023]
Abstract
The purpose of this study was to evaluate the effect of a brief pet therapy visit and a comparison intervention on anxiety in hospitalized children. This quasi-experimental study compared state anxiety before and after structured research interventions in a convenience sample of children between the ages six and 17 (N = 93) in two groups. Participants were assigned to the pet therapy group or control group, based upon timing of data collection. Participants in each group received either a visit from the research assistant, therapy dog and handler, or from the research assistant for completion of a puzzle. The child's anxiety was measured using the State-Trait Anxiety Scale for Children (STAIC) S-Anxiety Scale before and after the visit and parents completed a brief background questionnaire. Intervention and comparison groups had no significant differences in key demographic factors or baseline anxiety level. While state anxiety decreased significantly in both groups, children in the pet therapy group experienced a significantly greater decrease in anxiety (p = .004). In addition, parents reported high levels of satisfaction with the pet therapy program. Study findings provide support for a brief pet therapy visit with a trained dog and handler as a tool decrease to anxiety in hospitalized children while promoting parent satisfaction. When resources for providing pet therapy visits are limited, clinicians may consider prioritizing children who are most affected by anxiety.
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Affiliation(s)
- Katherine Hinic
- Seton Hall University College of Nursing, Nutley, NJ United States of America; Morristown Medical Center, Morristown, NJ, United States of America.
| | | | - Kristin Holtzman
- Morristown Medical Center, Morristown, NJ, United States of America.
| | - Kristi Mobus
- Morristown Medical Center, Morristown, NJ, United States of America.
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Abstract
Animal-assisted interventions are part of the therapeutic plan in pediatric oncology. This is the first systematic review to summarize the literature and provide insights for new clinical approaches, policy, best practices, and standards. The results underline the potentially beneficial role for pediatric patients, parents, caregivers, and medical staff.
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McLaughlan R, Sadek A, Willis J. Attractions to Fuel the Imagination: Reframing Understandings of the Role of Distraction Relative to Well-Being in the Pediatric Hospital. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 12:130-146. [PMID: 30526092 DOI: 10.1177/1937586718810878] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Ulrich's (1991) definition of "positive distraction" includes that which "elicits positive feelings and holds attention," implying that the capacity of an environmental feature to hold attention is a necessary component. This article examines whether, in the context of a pediatric hospital, a distraction needs to "hold attention" to secure positive benefits for patient well-being. BACKGROUND Data collected from 246 patients at Melbourne's Royal Children's Hospital (Australia) revealed a discrepancy between what children and young people told us they did, and valued, within the hospital, relative to the time they spent engaging in, or paying attention to, these same features. This motivated a closer interrogation of the relationship between well-being, distraction, and socialization within the pediatric context. METHOD Data were collected using a mixed-methods approach that included 178 surveys, 43 drawings contributed by patients/siblings within the outpatient waiting room, 25 photo-elicitation interviews with patients, and 100 hr of spatial observations within public and waiting room spaces. This was supplemented by interviews with architects and hospital staff. CONCLUSIONS The mechanism by which we have understood positive distraction to contribute to well-being within the pediatric hospital environment is more complex than existing models accept. Within this context, environmental features that can positively transform expectations of visiting the hospital-that can ignite the imagination and incite a desire to return-can offer significant benefits to well-being. This is particularly relevant in the context of absenteeism from outpatient appointments and in reducing patient resistance to future, or ongoing, treatments.
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Affiliation(s)
- Rebecca McLaughlan
- 1 Faculty of Architecture, Building and Planning, University of Melbourne, Melbourne, Victoria, Australia
| | - Ahmed Sadek
- 1 Faculty of Architecture, Building and Planning, University of Melbourne, Melbourne, Victoria, Australia
| | - Julie Willis
- 1 Faculty of Architecture, Building and Planning, University of Melbourne, Melbourne, Victoria, Australia
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McCullough A, Jenkins MA, Ruehrdanz A, Gilmer MJ, Olson J, Pawar A, Holley L, Sierra-Rivera S, Linder DE, Pichette D, Grossman NJ, Hellman C, Guérin NA, O’Haire ME. Physiological and behavioral effects of animal-assisted interventions on therapy dogs in pediatric oncology settings. Appl Anim Behav Sci 2018. [DOI: 10.1016/j.applanim.2017.11.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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McCullough A, Ruehrdanz A, Jenkins MA, Gilmer MJ, Olson J, Pawar A, Holley L, Sierra-Rivera S, Linder DE, Pichette D, Grossman NJ, Hellman C, Guérin NA, O’Haire ME. Measuring the Effects of an Animal-Assisted Intervention for Pediatric Oncology Patients and Their Parents: A Multisite Randomized Controlled Trial. J Pediatr Oncol Nurs 2017; 35:159-177. [PMID: 29268667 DOI: 10.1177/1043454217748586] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: This multicenter, parallel-group, randomized trial examined the effects of an animal-assisted intervention on the stress, anxiety, and health-related quality of life for children diagnosed with cancer and their parents. Method: Newly diagnosed patients, aged 3 to 17 years (n = 106), were randomized to receive either standard care plus regular visits from a therapy dog (intervention group), or standard care only (control group). Data were collected at set points over 4 months of the child’s treatment. Measures included the State-Trait Anxiety Inventory™, Pediatric Quality of Life Inventory, Pediatric Inventory for Parents, and child blood pressure and heart rate. All instruments were completed by the child and/or his/her parent(s). Results: Children in both groups experienced a significant reduction in state anxiety ( P < .001). Parents in the intervention group showed significantly decreased parenting stress ( P = .008), with no changes in stress among parents in the control group. However, no significant differences between groups over time on any measures were observed. Conclusions: Animal-assisted interventions may provide certain benefits for parents and families during the initial stages of pediatric cancer treatment.
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Affiliation(s)
| | | | | | - Mary Jo Gilmer
- Vanderbilt University School of Nursing, Nashville, TN, USA
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN, USA
- Pediatric Palliative Care Research Team, Nashville, TN, USA
| | - Janice Olson
- Randall Children’s Hospital at Legacy Emanuel, Portland, OR, USA
| | - Anjali Pawar
- UC Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | | | | | - Deborah E. Linder
- Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
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Chubak J, Hawkes R, Dudzik C, Foose-Foster JM, Eaton L, Johnson RH, Macpherson CF. Pilot Study of Therapy Dog Visits for Inpatient Youth With Cancer. J Pediatr Oncol Nurs 2017; 34:331-341. [PMID: 28614971 DOI: 10.1177/1043454217712983] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study assessed the feasibility of studying animal-assisted activities (AAA) in inpatient pediatric oncology and collected preliminary data on potential benefits of AAA for this population. Patients at a large pediatric hospital were identified using electronic medical records and approached with physician approval. Patients completed surveys before and after a therapy dog visit in their private hospital room. Data on infections were ascertained by electronic medical record review. Provider surveys were placed in provider common areas and distributed through a link in an e-mail. We summarized resultsusing descriptive statistics and estimated mean changes in pre- and postintervention distress and conducted hypothesis tests using the paired t test. The study population (mean age = 12.9 years) consisted of 9 females and 10 males. Following the therapy dog visit, patients had lower distress and significant decreases in worry, tiredness, fear, sadness, and pain. Providers were generally supportive of the intervention. Eight patients developed infections during the 14 days after the dog visit but none could be clearly attributed to the therapy dog visit. The study's primary limitation was that there was no control group. However, results support the feasibility of and need for future studies on AAA in pediatric oncology.
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Affiliation(s)
- Jessica Chubak
- 1 Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Rene Hawkes
- 1 Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | | | | | - Rebecca H Johnson
- 3 Mary Bridge Children's Hospital/MultiCare Health System, Tacoma, WA, USA
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