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Villarreal-Zegarra D, Yllescas-Panta T, Malaquias-Obregon S, Dámaso-Román A, Mayo-Puchoc N. Effectiveness of animal-assisted therapy and pet-robot interventions in reducing depressive symptoms among older adults: A systematic review and meta-analysis. Complement Ther Med 2024; 80:103023. [PMID: 38232905 DOI: 10.1016/j.ctim.2024.103023] [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: 11/03/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Systematic reviews suggest that animal-assisted therapy (AAT) and pet-robot interventions (PRI) achieve a reduction in mental health variables such as depressive symptoms. However, these systematic reviews include both randomised and non-randomised studies, which prevents an adequate assessment of the effect of confounding variables. OBJECTIVE This systematic review and meta-analysis aimed to evaluate the comparative effectiveness of AAT and PRI through randomized controlled trials (RCTs) in reducing depression in older adults. METHODS Our study is a systematic review. We searched three databases of scientific articles: SCOPUS, Web of Science and PubMed. We included studies that their population was older adults, aged 65 years or older, with or without a clinical condition, clinical diagnosis based on mental examination/test or documentation from medical records, accredited by the facilities' staff. We included trials in which the comparator was a passive intervention or an active intervention. We used the Cochrane risk-of-bias tool for randomised trials (RoB 2) to assess the risk of bias for each study. Our study was registered in PROSPERO (CRD42023393740). RESULTS Twenty-three studies were included in this systematic review. However, only 19 trials were included in the meta-analysis. At the overall risk of bias level, 78.9% of the studies were at high risk of bias (n = 15). We found that AAT (g= -0.72; 95%CI -1.13 to -0.31; p = 0.001) has a moderate and statistically significant effect as an intervention to reduce depressive symptoms in older adults. However, the PRIs do not show a significant effect on reducing depressive symptoms in older adults. In addition, a sub-analysis based on dog-assisted therapy (g= -0.65; 95%CI -1.21 to -0.08; p = 0.025), a specific type of AAT, showed a modest effect on reducing depressive symptoms. CONCLUSIONS Our study concluded that AAT and DAT had a moderate and statistically significant effect as interventions to reduce depressive symptoms in older adults. On the other hand, PRI did not show a significant effect in reducing depressive symptoms.
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Affiliation(s)
- David Villarreal-Zegarra
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru; Instituto Peruano de Orientación Psicológica, Lima, Peru.
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Granai G, Borrelli C, Mariti C, Di Iacovo F. Animals and Cities: A Reflection on Their Potential in Innovating Nature-Based Solutions. Animals (Basel) 2024; 14:680. [PMID: 38473065 DOI: 10.3390/ani14050680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 03/14/2024] Open
Abstract
In recent decades, nature-based solutions (NBSs) have spread in scientific research, and they are increasingly deployed in cities' strategic planning. While the number of nonhuman animals in cities is growing, a specific reflection on the advantages of human-animal interactions as potential NBSs is still lacking. This article aims to provide an overview of the current situation of animals in cities and to explore the roles of animals and their interactions with humans in such a context. These topics are crucial to the European project IN-HABIT in Lucca (Italy), which aims to codify an integrated policy on the relationship between people and animals; its outputs will then be transferred and replicated in other cities. This article concludes by highlighting the need for the involvement of different stakeholders in public-private-people partnerships to implement actions that aim to valorize human-animal relationships and their positive effects. This study presents a perspective on the relevance of animal NBSs to increase the quality of life in cities, both for citizens and for animals living in cities, and to also introduce the opportunity to develop an integrated animal urban policy able to valorize human-animal interactions in cities.
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Affiliation(s)
- Giulia Granai
- Department of Veterinary Science, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy
| | - Carmen Borrelli
- Department of Veterinary Science, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy
| | - Chiara Mariti
- Department of Veterinary Science, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy
| | - Francesco Di Iacovo
- Department of Veterinary Science, University of Pisa, Viale delle Piagge 2, 56124 Pisa, Italy
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Du H, Bo L, Lai X, Zhu H, Huo X. Network meta-analysis of comparative efficacy of animal-assisted therapy vs. pet-robot therapy in the management of dementia. Front Aging Neurosci 2023; 15:1095996. [PMID: 37323139 PMCID: PMC10264590 DOI: 10.3389/fnagi.2023.1095996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/21/2023] [Indexed: 06/17/2023] Open
Abstract
Objective This network meta-analysis aimed to compare and rank the efficacy of animal-assisted therapy (AAT) and pet-robotic therapy (PRT) in the management of dementia. Methods Relevant studies were identified by searching PubMed, EMBASE, the Cochrane Library, SCOPUS, and Web of Science (WoS) until October 13, 2022. Traditional meta-analysis was first conducted based on the random-effects model, then random network meta-analysis was conducted to determine the relative efficacy and rank probability of AAT and PRT. Results Nineteen randomized controlled trials (RCTs) were included in this network meta-analysis. Network meta-analysis revealed that PRT marginally benefited agitation alleviation compared with control (standard mean difference [SMD]: -0.37, 95% confidence interval [95%CI]: -0.72 to -0.01) although both AAT and PRT did not improve cognitive function, reduce depression, and improve Quality of Life (QoL). The SUCRA probabilities indicated that PRT ranked better than AAT in agitation, cognitive function, and QoL, although there were no differences between the two therapies. Conclusion The present network meta-analysis reveals that PRT may help alleviate agitated behaviors in people with dementia. However, future studies are warranted to establish evidence of the effectiveness of PRT and further evaluate the differences between different robot types in managing dementia.
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Affiliation(s)
- Hongdi Du
- Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Lin Bo
- Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoxing Lai
- Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hongwei Zhu
- Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaopeng Huo
- Nursing Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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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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Jin B, Xv Y, Zhang B, Qiao L, Liu H. Comparative efficacy and acceptability of treatments for depressive symptoms in cognitive impairment: A systematic review and Bayesian network meta-analysis. Front Aging Neurosci 2022; 14:1037414. [PMID: 36578447 PMCID: PMC9790988 DOI: 10.3389/fnagi.2022.1037414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022] Open
Abstract
Background Depressive symptoms play an essential role in cognition decline, while the benefit and acceptability of treatments for depressive symptoms in cognitive impairment are still unknown. Objective To comprehensively evaluate the comparative efficacy and acceptability of treatments for depressive symptoms in cognitive impairment based on the quantitative Bayesian network meta-analysis method (NMA). Method We searched MEDLINE, Embase, the Cochrane Library, CINAHL, and PsycINFO from inception until August 2022 to identify randomized clinical trials (RCTs) evaluating treatments for depressive symptoms in cognitive impairment. Efficacy was evaluated by the Cornell Scale for Depression in Dementia (CSDD), the Hamilton Depression Rating Scale (HDRS), and the Geriatric Depression Scale (GDS) for depression; the Neuropsychiatric Inventory (NPI) and the Cohen-Mansfeld Agitation Inventory (CMAI) for behavior; and the Mini-Mental State Examination (MMSE) for cognition. Safety was evaluated by total adverse events (AEs), serious AEs, diarrhea, headache, and nausea. Results In this study, 13,043 participants from 107 RCTs were included, involving 28 treatments and the discontinuation of antidepressants. On CSDD, aerobic exercise (MD -4.51, 95%CrI -8.60 to -0.37), aripiprazole (MD -1.85, 95%CrI -3.66 to -0.02), behavioral training (MD -1.14, 95%CrI -2.04 to -0.34), electrical current stimulation (MD -3.30, 95%CrI -5.94 to -0.73), massage (MD -12.67, 95%CrI -14.71 to -10.59), music therapy (MD -2.63, 95%CrI -4.72 to -0.58), and reminiscence therapy (MD -2.34, 95%CrI -3.51 to -1.25) significantly outperformed the placebo. On MMSE, cognitive stimulation therapy (MD 1.42, 95%CrI 0.49 to 2.39), electrical current stimulation (MD 4.08, 95%CrI 1.07 to 7.11), and reminiscence therapy (MD 1.31, 95%CrI 0.04 to 2.91) significantly outperformed the placebo. Additionally, no treatments showed a significantly higher risk than the placebo. Conclusion Our NMAs indicated that non-pharmacological interventions were more efficacious and safe than pharmacological treatments for reducing depressive symptoms as well as improving cognitive impairment. Electrical current stimulation, aerobic exercise, and reminiscence therapy could be first recommended considering their beneficial performance on both depression and cognition. Hence, non-pharmacological treatments deserve more attention and extensive application and should at least be considered as an alternative or assistance in clinical settings. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021239621, identifier: CRD42021239621.
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Affiliation(s)
- Boru Jin
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China,Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yunting Xv
- Department of Rehabilitation, Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Bixuan Zhang
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lei Qiao
- Department of General Surgery, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning, China,*Correspondence: Lei Qiao
| | - Huayan Liu
- Department of Neurology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China,Huayan Liu
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Maurice C, Engels C, Canouï‐Poitrine F, Lemogne C, Fromantin I, Poitrine E. Dog ownership and mental health among community-dwelling older adults: A systematic review. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5815. [PMID: 36184824 PMCID: PMC9828431 DOI: 10.1002/gps.5815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/13/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND The population is ageing, and psychiatric disorders are common in older people. Those are associated with worsened quality of life. Although the positive relationship between dog ownership and physical health has been documented, data on mental health are scarcer, especially in community-dwelling older adults. OBJECTIVE We sought to establish whether owning a dog was associated with a lower number of symptoms of psychological disorders in community-dwelling older adults. METHODS We conducted a systematic review of the literature published between January 2005 and December 2020. We analysed comparative studies of the level of insomnia and symptoms of depression and/or anxiety among community-dwelling dog owners aged 70 and over. RESULTS The search identified 191 articles, of which 117 full texts were assessed for eligibility. Five cross-sectional studies and one before-after with control group study (assessing a total of 25,138 older adults) were included. The mean (range) NOS score (five studies) was 6.8/9 (5-9) and the EPOC score (one study) was 2/8. The association between the presence of a dog and depressive symptoms did not appear to be significant. Regular contact with a dog was associated with fewer symptoms of anxiety. None of the studies specifically examined sleep disorders. CONCLUSIONS Although the presence of a dog did not appear to be related to the level of depressive symptoms among community-dwelling older adults, there might be a beneficial relationship with anxiety. Further investigation is needed - especially with regard to the type of dog and the type of relationship with the dog.
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Affiliation(s)
| | - Cynthia Engels
- Universite Paris Est CreteilINSERMIMRBCEpiA TeamCréteilFrance,Universite Paris Est CreteilFaculty of HealthCréteilFrance
| | - Florence Canouï‐Poitrine
- Universite Paris Est CreteilINSERMIMRBCEpiA TeamCréteilFrance,AP‐HPHenri Mondor HospitalPublic Health ServiceCréteilFrance
| | - Cédric Lemogne
- AP‐HPCentre‐Université de ParisDMU Psychiatrie et AddictologieHôpital Hôtel‐DieuService de Psychiatrie de l'adulteParisFrance,INSERMInstitut de Psychiatrie et Neurosciences de ParisUniversité de ParisFaculté de SantéUFR de MédecineParisFrance
| | - Isabelle Fromantin
- Universite Paris Est CreteilINSERMIMRBCEpiA TeamCréteilFrance,Research and Wound Care UnitCurie InstituteParisFrance
| | - Eric Poitrine
- Maison de Santé Pluridisciplinaire Michael BalintLe Mée‐sur‐SeineFrance
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Effects of animal-assisted therapy on patients with dementia: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res 2022; 314:114619. [PMID: 35623240 DOI: 10.1016/j.psychres.2022.114619] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/25/2022] [Accepted: 05/08/2022] [Indexed: 11/23/2022]
Abstract
The purpose of this meta-analysis is to systematically examine the efficacy of animal-assisted therapy (AAT) for patients with dementia. PubMed, Embase, and Cochrane libraries were searched till November 2021 to collect studies in relation to AAT that had been adopted in patients with dementia. Eleven randomized controlled trials (RCTs) involving 825 participants were included. Compared with the control group, the AAT group showed a significant reduction in behavioral and psychological symptoms of dementia (BPSD), especially depression. However, no significant improvement was found in cognitive function, activities of daily living, agitation, or the quality of life. This meta-analysis shows that AAT can effectively reduce BPSD in patients with dementia.
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Chen CR, Hung CF, Lee YW, Tseng WT, Chen ML, Chen TT. Functional Outcomes in a Randomized Controlled Trial of Animal-Assisted Therapy on Middle-Aged and Older Adults with Schizophrenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106270. [PMID: 35627807 PMCID: PMC9141906 DOI: 10.3390/ijerph19106270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/10/2022]
Abstract
Deficits in cognition, physical, and social functions in adults with schizophrenia may become salient with aging. While animal-assisted therapy (AAT) can benefit physical function in older adults and improve symptoms of psychotic disorders, the effect of AAT on middle-aged patients with schizophrenia is unclear. The current randomized controlled trial aimed to explore the efficacy of AAT for middle-aged patients with schizophrenia. Forty participants were randomly assigned to either the AAT or control group. The AAT group participated in one-hour sessions with dog-assisted group activities once a week for 12 weeks. The controls participated in dose-matched, non-animal-related recreational activities. Both groups remained on their usual psychotropic medication during the trial. Evaluations included the Chair Stand Test (CST), Timed Up-and-Go (TUG) test, Montreal Cognitive Assessment (MoCA), 5-Meter walk test (5MWT), and Assessment of Communication and Interaction Skills (ACIS). The increases in CST repetitions and ACIS scores were larger in the AAT group than in the controls. The two groups did not differ significantly in MoCA scores, TUG performance, or the 5MWT. The AAT group showed a greater increase in lower extremity strength and social skills, but no improvement in cognitive function, agility, or mobility. Further research with more sensitive evaluations and longer follow-up is needed.
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Affiliation(s)
- Chyi-Rong Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-R.C.); (C.-F.H.); (W.-T.T.)
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan
| | - Chi-Fa Hung
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-R.C.); (C.-F.H.); (W.-T.T.)
- Department of Post-Baccalaureate Medicine, National Sun Yat-Sen University, Kaohsiung 804201, Taiwan
- College of Humanities and Social Sciences, National Pintung University of Science and Technology, Pingtung 912301, Taiwan
| | - Yi-Wen Lee
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan;
| | - Wei-Ting Tseng
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-R.C.); (C.-F.H.); (W.-T.T.)
| | - Mei-Li Chen
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
- Professional Animal-Assisted Therapy Association of Taiwan, Taipei 112303, Taiwan
| | - Tzu-Ting Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-R.C.); (C.-F.H.); (W.-T.T.)
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan
- Professional Animal-Assisted Therapy Association of Taiwan, Taipei 112303, Taiwan
- Correspondence: or
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Effect of human-dog interaction on therapy dog stress during an on-campus student stress buster event. Appl Anim Behav Sci 2022. [DOI: 10.1016/j.applanim.2022.105659] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Välimäki T, Koivisto A, Kärkkäinen V, Selander T, Hongisto K, Rusanen M. Pet ownership supports quality of life in home-dwelling people with Alzheimer's disease. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5698. [PMID: 35286737 PMCID: PMC9314047 DOI: 10.1002/gps.5698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/01/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Human-animal interactions have beneficial psychosocial and psychophysiological effects on individuals in both the presence and absence of medical health conditions. No previous prospective studies with long follow-up have investigated the effects of domestic pets on individuals with Alzheimer's disease (AD) who live at home. We examined the effects of pets on quality of life (QoL) and general well-being during a 5-year follow-up of home-dwelling persons with AD. METHODS In a prospective study including 223 patients with very mild (Clinical Dementia Rating Scale [CDR] 0.5) or mild (CDR 1) AD at baseline who participated in the ALSOVA study, 40 (18%) had a pet. Self- and proxy-rated QoL in AD quality of life-AD (QoL-AD), 15D, and self-rated visual analogic scale (VAS) were assessed annually for 3 years and after 5 years. The Mini-Mental State Examination, Neuropsychiatric Inventory, and CDR sum of boxes (CDR sum of boxes) were measured at the same visits. RESULTS A significant positive effect of pet ownership (p = 0.003, proxy-rated QoL-AD) on QoL was found over the entire follow-up. However, self-rated QoL-AD, 15D, and VAS did not significantly differ between pet owners and non-pet owners. CONCLUSIONS The findings suggest that having a pet may support QoL in home-dwelling persons with AD. Self-rated or general QoL or well-being measurements are not an accurate method for studying QoL in individuals with dementia over time due to a lack of insight. Adding proxy-rated evaluations to this kind of study is recommended.
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Affiliation(s)
- Tarja Välimäki
- Department of Nursing ScienceUniversity of Eastern FinlandKuopioFinland
| | - Anne Koivisto
- Department of NeurologyInstitute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
- Neurology of Neuro CenterKuopio University HospitalKuopioFinland
- Geriatrics, Internal Medicine and Rehabilitation, Helsinki University Hospital and Department of Neurosciences, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | | | - Tuomas Selander
- Science Service CenterKuopio University HospitalKuopioFinland
| | - Kristiina Hongisto
- Department of GeriatricsInstitute of Public Health and Clinical Nutrition, University of Eastern FinlandKuopioFinland
| | - Minna Rusanen
- Department of NeurologyInstitute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
- Neurology of Neuro CenterKuopio University HospitalKuopioFinland
- Population Health UnitFinnish Institute for Health and WelfareHelsinkiFinland
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Braun B, Demling J, Loew TH. Alzheimer's disease: history, ethics and medical humanities in the context of assisted suicide. Philos Ethics Humanit Med 2022; 17:4. [PMID: 35351154 PMCID: PMC8966262 DOI: 10.1186/s13010-021-00111-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 09/06/2021] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Dementia diseases, especially Alzheimer's disease (AD), are of considerable importance in terms of social policy and health economics. Moreover, against the background of the current Karlsruhe judgement on the legalisation of assisted suicide, there are also questions to be asked about medical humanities in AD. METHODOLOGY Relevant literature on complementary forms of therapy and prognosis was included and discussed. RESULTS Creative sociotherapeutic approaches (art, music, dance) and validating psychotherapeutic approaches show promise for suitability and efficiency in the treatment of dementia, but in some cases still need to be scientifically tested. Biomarker-based early diagnosis of dementia diseases is increasingly becoming a subject of debate against the background of the Karlsruhe ruling. DISCUSSION Needs-oriented and resource-enhancing approaches can make a significant contribution to improving the quality of life of people with dementia. The discussion on the issue of "assisted suicide" should include questions of the dignity and value of a life with dementia. OUTLOOK The integrative dementia therapy model can be complemented by a religion- and spirituality-based approach. Appropriate forms of psychotherapy should be scientifically evaluated.
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Affiliation(s)
- Birgit Braun
- Department of Psychosomatic Medicine, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
| | - Joachim Demling
- Department of Psychiatry and Psychotherapy, University Hospital of Erlangen, Erlangen, Germany
| | - Thomas Horst Loew
- Department of Psychosomatic Medicine, University Hospital of Regensburg, Regensburg, Germany
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Beck AJ, Barber T, McKenzie H, Thorlakson J, Dell C, Keeping-Burke L. Perceptions and experiences of health care professionals and staff with animal-assisted interventions in health care settings: a qualitative systematic review protocol. JBI Evid Synth 2022; 20:924-930. [PMID: 35019870 DOI: 10.11124/jbies-21-00151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to examine the perceptions and experiences of health care professionals and staff in implementing or coordinating animal-assisted interventions in health care settings. INTRODUCTION Animal-assisted interventions are applied in the areas of health, education, and human services to help improve individuals' health and wellness. The positive effects of animal-assisted interventions on individuals have been shown in multiple health disciplines from pediatrics to long-term care and include outcomes such as decreased feelings of loneliness and increased feelings of support. The increase of animal-assisted interventions in human health initiated growing research on health care professionals' perceptions and experiences of these interventions. No current qualitative systematic reviews have focused solely on health care professionals' and staff's perceptions of animal-assisted interventions. Conducting such a review will advance understanding of how these providers perceive and engage with animal-assisted interventions as well as their influence and role in coordinating these interventions. INCLUSION CRITERIA This review will consider qualitative primary studies that address the perceptions and experiences of health care professionals and staff in implementing or coordinating animal-assisted interventions in health care settings. Studies published from database inception to present and in English will be considered. METHODS Nine bibliographic databases will be systematically searched for published and unpublished studies by employing a three-step search strategy. Two reviewers will independently appraise the studies and extract qualitative data using the standardized JBI critical appraisal and data extraction instruments. Findings from the review will be categorized according to similarity in meaning and categories subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42021258909).
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Affiliation(s)
- Amy J Beck
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada Department of Family Medicine, University of Alberta, Edmonton, AB, Canada Department of Sociology, University of Saskatchewan, Saskatoon, SK, Canada Cameron Science, Technology, and Business Library, University of Alberta, Edmonton, AB, Canada Nursing and Health Sciences, University of New Brunswick, Saint John, NB, Canada The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, NB, Canada
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Dincer B, Bahçecik N, Sollami A. Effect of animal assistant therapy on quality of life in older adults: A meta-analysis. Geriatr Nurs 2021; 43:38-44. [PMID: 34814014 DOI: 10.1016/j.gerinurse.2021.11.005] [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: 08/11/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 11/04/2022]
Abstract
This meta-analysis was conducted to determine the effect of animal-assistant therapy on the quality of life of older adults. This research systematically searched electronic databases (CINAHL, Cochrane Central, Medline/PubMed, Web of Science, Science Direct, and the National Thesis Centre and ULAKBİM of the Council of Higher Education) for studies published between April - June 2021. Seven studies with experimental design were used, three were quasi-experimental and four were randomly controlled studies. The total sample size in the meta-analysis was 375 (experimental group: 177 and control group: 198). The mean duration of animal-assistant therapy was 38.5 ± 12.4 min. Animal-assistant therapy had a significant effect on the quality of life of older adults (mean difference: -4.59 p: 0.03, Z:2.23). Therefore, animal assistant therapy is an effective method to improve older adults' quality of life.
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Affiliation(s)
- Berna Dincer
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Medical Nursing, Istanbul Medeniyet University, Health Science Faculty, Cevizli Yerleşkesi, Şehit Hakan Kurban Caddesi, No:44, 34862, Kartal/İstanbul/Turkey.
| | - Nefise Bahçecik
- Istanbul Sabahattin Zaim University Faculty of Health Sciences, Department of Nursing, Halkalı Kampüsü Eğitim Bilimleri Binası, 2. Kat - Küçükçekmece/ İstanbul /Turkey
| | - Alfonso Sollami
- University Teaching Hospital, Via Don Tonani, 17, 43126 Parma, Italy.
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14
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Effects of animal-assisted interventions for people with dementia: A systematic review and meta-analysis. Geriatr Nurs 2021; 43:26-37. [PMID: 34800888 DOI: 10.1016/j.gerinurse.2021.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/23/2022]
Abstract
Animal-assisted interventions (AAIs) are non-pharmacological, cost-effective interventions developed to improve outcomes in patients with dementia; however, the effects remain inconclusive. The purpose of this study was to analyze the efficacy of AAIs for people with dementia. A systematic review and meta-analysis was performed of English-language literature published from January 1, 2001, to July 3,2021, and indexed in the following databases: CINAHL, EMBASE, MEDLINE, PubMed, Web of Science, Cochrane, and PsycINFO. Intervention groups were people with dementia who received AAIs. Study quality was assessed using the Joanna Briggs Institute tool. Among 10 included studies, significant differences in depression levels were identified between the intervention and control groups (p < 0.001). No significant differences in cognitive function, neuropsychiatric syndrome, or independence in activities of daily living were observed between groups. Future research remains necessary to examine the effects of AAIs on depression during different stages of dementia. AAIs therapists may collaborate with healthcare workers to improve AAIs benefits.
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15
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Rusanen M, Selander T, Kärkkäinen V, Koivisto A. The Positive Effects of Pet Ownership on Alzheimer's Disease. J Alzheimers Dis 2021; 84:1669-1675. [PMID: 34719492 DOI: 10.3233/jad-210557] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Human-animal interactions are known to have many beneficial psychosocial and psychophysiological effects on persons with and without medical health conditions. There are no previous prospective studies with long follow-up times on the effects of domestic pets on the persons with Alzheimer's disease (AD) living at home. OBJECTIVE To investigate the effects of pets on the activities of daily living (ADL), disease progression, and neuropsychiatric symptoms (NPS) during a five-year follow-up on the persons with AD. METHODS Altogether 223 home-dwelling persons (mean age 75.2 years) with very mild (CDR 0.5) or mild (CDR 1) AD at baseline were included for this study. ADCS-ADL, NPI, MMSE, and CDR-SOB were measured at baseline, annually for three years and after five years. RESULTS Totally 40 (17.9%) participants had a pet. At the baseline, pet owners and non-pet owners had no significant differences in age, gender, or the ADCS-ADL, NPS, and CDR-SOB scores, while MMSE was lower in pet owners than non-pet owners (20.2 versus 21.7; p = 0.009). Over the follow-up, pet owners had significantly better mean ADCS-ADL (57.5 versus 54.0; p = 0.031), NPI (9.3 versus 13.0; p = 0.038), and CDR-SOB scores (5.7 versus 6.6; p = 0.004) compared to non-pet owners. The differences in the MMSE scores between the groups detected at baseline attenuated over time. CONCLUSION Significant positive effects of the pets on ADL functions, NPS, and disease progression were detected over the whole follow-up suggesting that having a pet may support daily activity and slow the disease progression in AD.
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Affiliation(s)
- Minna Rusanen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurology of Neuro Center, Kuopio University Hospital, Kuopio, Finland.,Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuomas Selander
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Virve Kärkkäinen
- Neurosurgery of Neuro Center, Kuopio University Hospital, Kuopio, Finland
| | - Anne Koivisto
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurology of Neuro Center, Kuopio University Hospital, Kuopio, Finland.,Geriatrics, Internal Medicine and Rehabilitation, Helsinki University Hospital, and Department of Neurosciences, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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16
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Sbrizzi C, Sapuppo W. Effects of Pet Therapy in Elderly Patients with Neurocognitive Disorders: A Brief Review. Dement Geriatr Cogn Dis Extra 2021; 11:198-206. [PMID: 34703453 PMCID: PMC8460886 DOI: 10.1159/000518469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/10/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Neurocognitive disorders (NCDs) are disturbances highly related to age. This means that, with the increasing trend in life expectancy, there is also an increase in this diagnosis, although NCDs are not exclusively found in the population over 65 years old. Likely, they will increase in the coming years together with improvements in diagnosis. In addition to the use of medicines and rehabilitative techniques, pet therapy is also used. Pet therapy makes use of animals with therapeutic, rehabilitative, educational, and recreational purposes for people affected by physical, neuromotor, and psychiatric disorders. Pet therapy seems to be functional for increasing social and communication competencies, facilitating verbal and body language, increasing self-esteem, improving quality of life, and reducing anxiety/stress. Methods This study was based on scientific papers and publications obtained from the PubMed and Google Scholar databases. Moreover, other articles from further cross-references were included. Specific database research criteria were (a) articles published in 2018 or later, (b) samples containing only adults over 65 years old, (c) written in English or Italian, and (d) on the topic of animal-assisted intervention. Results Uncertain results were obtained. Although a positive effect was found, the included articles were of insufficient methodological rigor. Discussion/Conclusion Although many studies reported positive results, these could not be generalized because of the numerous biases present (e.g., small sample size, lack of methodological rigor, lack of protocol, etc.). Future studies, therefore, should seek to address the limitations found in the analyzed studies.
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Affiliation(s)
- Chiara Sbrizzi
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Walter Sapuppo
- Department of Psychology, Sigmund Freud University, Milan, Italy.,Division of Psychology, London South Bank University, London, United Kingdom
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17
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Santaniello A, Cimmino I, Dipineto L, Agognon AL, Beguinot F, Formisano P, Fioretti A, Menna LF, Oriente F. Zoonotic Risk of Encephalitozoon cuniculi in Animal-Assisted Interventions: Laboratory Strategies for the Diagnosis of Infections in Humans and Animals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9333. [PMID: 34501921 PMCID: PMC8430659 DOI: 10.3390/ijerph18179333] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 01/02/2023]
Abstract
The involvement of animals for therapeutic purposes has very ancient roots. To date, it is clear that animal-assisted interventions (AAIs), in addition to ensuring the replacement of missing or deficient affects, improves psychophysiological parameters connected to human health. However, AAI could potentially present risks related to the transmission of infectious agents from animals to humans. Among these microorganisms, E. cuniculi is a microspore which induces pathological effects (fever, headache, nausea, vomiting, diarrhea, breathlessness, respiratory symptoms, and weakness) in both humans and animals. Consequently, an accurate and fast diagnosis of E. cuniculi infection, as well as the identification of new diagnostic approaches, is of fundamental importance. This literature review was carried out to provide an extensive and comprehensive analysis of the most recent diagnostic techniques to prevent and care for E. cuniculi-associated risks in the AAI field.
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Affiliation(s)
- Antonio Santaniello
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (L.D.); (A.F.)
| | - Ilaria Cimmino
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (I.C.); (A.L.A.); (F.B.); (P.F.); (F.O.)
| | - Ludovico Dipineto
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (L.D.); (A.F.)
| | - Ayewa Lawoe Agognon
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (I.C.); (A.L.A.); (F.B.); (P.F.); (F.O.)
| | - Francesco Beguinot
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (I.C.); (A.L.A.); (F.B.); (P.F.); (F.O.)
| | - Pietro Formisano
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (I.C.); (A.L.A.); (F.B.); (P.F.); (F.O.)
| | - Alessandro Fioretti
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (L.D.); (A.F.)
| | - Lucia Francesca Menna
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (L.D.); (A.F.)
| | - Francesco Oriente
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (I.C.); (A.L.A.); (F.B.); (P.F.); (F.O.)
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18
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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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19
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Thodberg K, Videbech PB, Hansen TGB, Pedersen AB, Christensen JW. Dog visits in nursing homes - increase complexity or keep it simple? A randomised controlled study. PLoS One 2021; 16:e0251571. [PMID: 34038451 PMCID: PMC8153477 DOI: 10.1371/journal.pone.0251571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/25/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To compare the immediate response of nursing home residents to dog visits with or without an activity, and the impact of cognitive ability. Methods In a randomly controlled trial, 174 nursing home residents were allocated to 12 bi-weekly 10-minute visits: either ordinary dog visits (D, n = 57, 49 analysed), dog visits with an activity (DA, n = 56, 48 analysed), or visits with activity but no dog (A, n = 61, 54 analysed). We recorded frequency and duration of residents’ verbal and physical interactions with the dog and persons. Data were analysed in three periods of four visits (period 1–3) as binomial variables (generalised linear models) or durations (non-parametric statistics). Results Both visit type and impairment level affected the likelihood of interacting with the dog (D and DA). In some periods increased cognitive impairment lowered odds of touching the dog in DA visits (period 1: F1,85 = 5.17, P < 0.05) and talking to it directly (period 1: F1,90 = 4.60, P < 0.05; period 3: F1,87 = 5.34, P < 0.05). Throughout, residents talked less to persons during DA visits compared to D and A (P = 0.01–0.05), and level of cognitive impairment correlated negatively with talk duration (P < 0.001). Generally, high cognitive impairment level lowered odds of interacting with (period 1: F1,89 = 7.89, P < 0.01; period 2: F1,97 = 6.76, P = 0.01; period 3: F1,92 = 13.57, P < 0.001) and talking about the activities (period 1: F1,89 = 13.78, P <0.001; period 2: F1,88 = 3.27, P = 0.07; period 3: F1,86 = 3.88, P = 0.05). Conclusion Visits without specific activities stimulated residents to interact with the dog, whereas increasing the complexity of dog visits by adding activities resulted in less interaction with the dog for severely impaired residents. The optimal dog visit for the less cognitively impaired residents could include activities and thereby a possibility to interact with the dog in different ways, whereas for severely impaired residents, just being with the dog seems more appropriate.
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Affiliation(s)
- Karen Thodberg
- Department of Animal Science, Aarhus University, Aarhus, Denmark
- * E-mail:
| | | | - Tia G. B. Hansen
- Center for Developmental and Applied Psychological Science, Aalborg University, Aalborg, Denmark
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20
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Effects of Dog-Assisted Therapies on Cognitive Mnemonic Capabilities in People Affected by Alzheimer's Disease. Animals (Basel) 2021; 11:ani11051366. [PMID: 34064930 PMCID: PMC8151255 DOI: 10.3390/ani11051366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/29/2021] [Accepted: 05/04/2021] [Indexed: 02/02/2023] Open
Abstract
Simple Summary Alzheimer’s disease is the most common cause of dementia in humans and, as the disease progresses, symptoms become more relevant, with significant interference in daily activities and social relations. Currently, a valid treatment is lacking and no highly effective drug has yet been approved for Alzheimer’s disease treatment. Animal-assisted interventions play a significant role in the lives of people with dementia. The purpose of the present study is to provide a contribution to research on elderly patients suffering from Alzheimer’s disease in whom dog-assisted therapies prove to be effective and fully validated during the period of time for which the patient has contact with the animal. The index of impairment of cognitive skills was assessed through different tests. Two months after the end of the sessions, the test results decreased to their initial values. Abstract Alzheimer’s disease (AD) is the most common cause of dementia in humans and, currently, a valid treatment is lacking. Our goal is to demonstrate the importance and benefits of the relationship with companion animals (considered as co-therapists), intended as a means of facilitating social relations and promoting evident wellbeing in AD patients. The study involved 30 randomly chosen patients with Alzheimer’s disease (group T) and three dogs. The group participated in a total of 24 animal-assisted interventions (AAIs) sessions over a span of 12 weeks, using the Mini-Mental State Examination (MMSE), Wellness and Cognitive Ability Questionnaire (Brief Assessment Cognition or BAC), and Alzheimer’s Disease Assessment Scale (ADAS) as assessment tests. A second group (group C), consisting of 10 people with AD, was enrolled as control group and underwent the same assessment tests but did not benefit from the presence of the dogs. Tests were carried out at time T0 (before starting sessions), T1 (end of sessions), and T2 (two months after last session). People belonging to group T achieved an overall improvement in their perceived state of wellbeing, even on a cognitive and mnemonic plane. However, two months after the end of the sessions, the test results in people suffering from AD decreased towards the baseline (T0). The study shows how such progress can be achieved through activities based on the relationship with an animal, as long as the animal is a steady presence in the life of the patient receiving the intervention. Dogs involved in other dog-assisted therapies have been found suitable also for assisting patients with AD.
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21
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Vegue Parra E, Hernández Garre JM, Echevarría Pérez P. Benefits of Dog-Assisted Therapy in Patients with Dementia Residing in Aged Care Centers in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041471. [PMID: 33557254 PMCID: PMC7914582 DOI: 10.3390/ijerph18041471] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/26/2021] [Accepted: 01/31/2021] [Indexed: 11/29/2022]
Abstract
(1) Background: Currently, the scientific evidence on the benefits of assisted therapy with dogs in dementia is not clear. In this study, we want to evaluate such benefits through a randomized controlled clinical trial in multiple centers across the country. (2) Methods: The participants were people over 65 years old with dementia, residing in senior centers in Spain (n = 334). The experimental group underwent assisted therapy with dogs based on the Comprehensive Cognitive Activation Program in Dementia, for 8 months, with weekly sessions of 45 min. Data were collected at the commencement, middle, and end of the program, to evaluate the aspects using the Mini-Examination Cognitive, the modified Bartell Index, the Cornell Scale for Depression in Dementia and the Neuropsychiatric Inventory. (3) Results: The results show significant improvements in the experimental group versus the control group in the affective (T1 = p 0.000; T2 = p 0.000) and behavioral (T1 = p 0.005; T2 = p 0.000) aspects, with the affective aspect displaying greater progress in participants with additional depressive (p = 0.022) or anxiety (p = 0.000) disorders, shorter institutionalization periods (r = −0.222, p = 0.004), and those undergoing complementary psychotherapy (p = 0.033) or alternative therapy (p = 0.011). (4) Conclusions: Dog therapy is effective in improving the affective and behavioral aspects of institutionalized patients with dementia.
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Affiliation(s)
- Eva Vegue Parra
- Health Sciences PhD Program, Campus de los Jerónimos nº135, Universidad Católica de Murcia (UCAM), Guadalupe, 30107 Murcia, Spain;
| | - Jose Manuel Hernández Garre
- Department of Political Sciences, Social Anthropology and Public Finance, Calle Campus Universitario, University of Murcia, s/n, El Puntal, 30100 Murcia, Spain;
| | - Paloma Echevarría Pérez
- Health Sciences PhD Program, Campus de los Jerónimos nº135, Universidad Católica de Murcia (UCAM), Guadalupe, 30107 Murcia, Spain;
- Correspondence: ; Tel.: +34-628213984
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22
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Rodriguez KE, Herzog H, Gee NR. Variability in Human-Animal Interaction Research. Front Vet Sci 2021; 7:619600. [PMID: 33521092 PMCID: PMC7843787 DOI: 10.3389/fvets.2020.619600] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/17/2020] [Indexed: 12/22/2022] Open
Abstract
The field of Human-Animal Interaction (HAI) is plagued with mixed results. Some findings appear to indicate that interacting with a companion animal is beneficial for some aspect of human health and well-being, while other research outcomes are inconclusive or even indicate the opposite. The purpose of this paper is to take a closer look at this variability in research outcomes and to provide plausible explanations and potential remedies. Some of the reasons for mixed results are likely due to the wide variety of methodologies implemented, intermittent use of standardized measures and manualized protocols, variability in human and animal participants, and limited quantification of human-animal interactions or definitions of pet ownership. Variability in research outcomes is not unique to HAI and is, in fact, not uncommon in many more established fields such as psychology and medicine. However, the potential reasons for the variability may be linked to the unique nature of HAI in that, in its' simplest form, it involves two complex organisms, a human and an animal, interacting in dynamic ways. We argue that this complexity makes research in this field particularly challenging and requires a broad spectrum of theoretical and methodological considerations to improve rigor while ensuring the validity and reliability of conclusions drawn from study results.
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Affiliation(s)
- Kerri E Rodriguez
- Human-Animal Bond in Colorado, School of Social Work, Colorado State University, Fort Collins, CO, United States
| | - Harold Herzog
- Department of Psychology, Western Carolina University, Cullowhee, NC, United States
| | - Nancy R Gee
- Department of Psychiatry, Center for Human Animal Interaction, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
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Hediger K, Wagner J, Künzi P, Haefeli A, Theis F, Grob C, Pauli E, Gerger H. Effectiveness of animal-assisted interventions for children and adults with post-traumatic stress disorder symptoms: a systematic review and meta-analysis. Eur J Psychotraumatol 2021; 12:1879713. [PMID: 34377357 PMCID: PMC8330800 DOI: 10.1080/20008198.2021.1879713] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Animal-assisted interventions (AAI) are increasingly applied for people with post-traumatic stress disorder (PTSD) symptoms albeit its effectiveness is unclear.Objectives: To examine the effectiveness of AAI for treating PTSD symptoms.Method: We searched 11 major electronic databases for studies reporting quantitative data on effects of AAI for children and adults with PTSD symptoms. Of 22'211 records identified, we included 41 studies with 1111 participants in the systematic review comprising eight controlled studies with 469 participants in the meta-analysis. We conducted random-effects meta-analyses with all controlled studies based on standardized mean differences (SMD), and calculated standardized mean change (SMC) as effect sizes for studies with a pre-post one-group design. Two independent researchers assessed the quality of the included studies using the NIH Study Quality Assessment Tools. The primary outcome was PTSD or depression symptom severity measured via a standardized measurement at pre- and post-intervention assessments.Results: There was a small but not statistically significant superiority of AAI over standard PTSD psychotherapy (SMD = -0.26, 95% CI: -0.56 to 0.04) in reducing PTSD symptom severity while AAI was superior to waitlist (SMD = -0.82, 95% CI: -1.56 to 0.08). Getting a service dog was superior to waiting for a service dog (SMD = -0.58, 95% CI: -0.88 to -0.28). AAI led to comparable effects in reducing depression as standard PTSD psychotherapy (SMD = -0.03, CI: -0.88 to 0.83). Pre-post comparisons showed large variation for the reduction in PTSD symptom severity, with SMCs ranging from -0.38 to -1.64, and for depression symptom severity, ranging from 0.01 to -2.76. Getting a service dog lowered PTSD symptoms between -0.43 and -1.10 and depression with medium effect size of -0.74.Conclusions: The results indicate that AAI are efficacious in reducing PTSD symptomatology and depression. Future studies with robust study designs and large samples are needed for valid conclusions.
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Affiliation(s)
- Karin Hediger
- Faculty of Psychology, Division of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland.,REHAB Basel, Clinic for Neurorehabilitation and Paraplegiology, Basel, Switzerland.,Department of Epidemiology and Public Health, Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Institute for Interdisciplinary Research on the Human-Animal Relationship Switzerland, c/o Swiss TPH, Basel, Switzerland
| | - Julia Wagner
- Faculty of Psychology, Division of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland
| | - Pascale Künzi
- REHAB Basel, Clinic for Neurorehabilitation and Paraplegiology, Basel, Switzerland
| | - Anna Haefeli
- Faculty of Psychology, Division of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland
| | - Felicitas Theis
- Faculty of Psychology, Division of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland
| | - Carmina Grob
- Faculty of Psychology, Division of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland
| | - Elena Pauli
- Faculty of Psychology, Division of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland
| | - Heike Gerger
- Faculty of Psychology, Division of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland.,Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Rodriguez KE, Greer J, Yatcilla JK, Beck AM, O’Haire ME. The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review. PLoS One 2020; 15:e0243302. [PMID: 33264370 PMCID: PMC7710121 DOI: 10.1371/journal.pone.0243302] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/18/2020] [Indexed: 01/07/2023] Open
Abstract
Beyond the functional tasks that assistance dogs are trained for, there is growing literature describing their benefits on the psychosocial health and wellbeing of their handlers. However, this research is not only widely disparate but, despite its growth, has not been reviewed since 2012. Our objective was to identify, summarize, and methodologically evaluate studies quantifying the psychosocial effects of assistance dogs for individuals with physical disabilities. Following PRISMA guidelines, a systematic review was conducted across seven electronic databases. Records were independently screened by two authors. Studies were eligible for inclusion if they assessed outcomes from guide, hearing, medical, or mobility service dogs, if they collected original data on handlers' psychosocial functioning, and if the outcome was measured quantitatively with a validated, standardized measure. Studies on psychiatric service dogs, emotional support dogs, and pet dogs were excluded. Of 1,830 records screened, 24 articles were identified (12 publications, 12 theses) containing 27 studies (15 cross-sectional, 12 longitudinal). Studies assessed the effects of mobility (18), hearing (7), guide (4), and medical (2) assistance dog partnerships with an average sample size of N = 83. An analysis of 147 statistical comparisons across the domains of psychological health, quality of life, social health, and vitality found that 68% of comparisons were null, 30% were positive in the hypothesized direction, and 2% were negative. Positive outcomes included significant effects of having an assistance dog on psychological wellbeing, emotional functioning, self-esteem, and vitality. However, it is of note that several methodological weaknesses of the studies make it difficult to draw any definitive conclusions, including inadequate reporting and a failure to account for moderating or confounding variables. Future research will benefit from stronger methodological rigor and reporting to account for heterogeneity in both humans and assistance dogs as well as continued high-quality replication.
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Affiliation(s)
- Kerri E. Rodriguez
- Center for the Human-Animal Bond, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, United States of America
| | - Jamie Greer
- Vassar College, Poughkeepsie, New York, United States of America
| | - Jane K. Yatcilla
- Purdue University Libraries, Purdue University, West Lafayette, Indiana, United States of America
| | - Alan M. Beck
- Center for the Human-Animal Bond, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, United States of America
| | - Marguerite E. O’Haire
- Center for the Human-Animal Bond, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, United States of America
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Zeng H, Pacheco-Barrios K, Cao Y, Li Y, Zhang J, Yang C, Fregni F. Non-invasive neuromodulation effects on painful diabetic peripheral neuropathy: a systematic review and meta-analysis. Sci Rep 2020; 10:19184. [PMID: 33154432 PMCID: PMC7645738 DOI: 10.1038/s41598-020-75922-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 10/06/2020] [Indexed: 12/30/2022] Open
Abstract
Diabetic Peripheral Neuropathy (DPN) typically is accompanied by painful symptoms. Several therapeutic agents have been tried for symptomatic relief, but with varying results. The use of non-invasive neuromodulation (NINM) is a potential treatment option for DPN. The objective of our study is to evaluate NINM effects on pain rating and nerve conduction velocity in DPN patients. The search was carried out in seven databases until Aug 30th, 2019. Finally, twenty studies met the inclusion criteria. We found a significant reduction of pain scores by central NINMs (effect size [ES] = - 0.75, 95% CI = - 1.35 to - 0.14), but not by the overall peripheral techniques (electrical and electromagnetic) (ES = - 0.58, 95% CI = - 1.23 to 0.07). However, the subgroup of peripheral electrical NINMs reported a significant higher effect (ES = - 0.84, 95% CI = - 1.57 to - 0.11) compared to electromagnetic techniques (ES = 0.21; 95% CI = - 1.00 to 1.42, I2 = 95.3%) . Other subgroup analysis results show that NINMs effects are higher with intensive protocols and in populations with resistant symptoms or intolerance to analgesic medications. Besides, NINMs can increase motor nerves velocity (ES = 1.82; 95% CI = 1.47 to 2.17), and there were no effects on sensory nerves velocity (ES = 0.01, 95% CI = - 0.79 to 0.80). The results suggest that central and peripheral electrical NINMs could reduce neuropathic pain among DPN patients, without reported adverse events. Well-powered studies are needed to confirm that NINM techniques as an alternative effective and safe treatment option.
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Affiliation(s)
- Huiyan Zeng
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 261 Datong Road, Er Sha Island, Guangzhou, 510105, China
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 96 13th Street, Charlestown, Boston, MA, USA
- Unidad de Investigación Para La Generación Y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Ying Cao
- Department of Endocrinology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Ying Li
- Department of Endocrinology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jinming Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 261 Datong Road, Er Sha Island, Guangzhou, 510105, China
| | - Caifeng Yang
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 261 Datong Road, Er Sha Island, Guangzhou, 510105, China.
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 96 13th Street, Charlestown, Boston, MA, USA.
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Opdebeeck C, Katsaris MA, Martyr A, Lamont RA, Pickett JA, Rippon I, Thom JM, Victor C, Clare L. What Are the Benefits of Pet Ownership and Care Among People With Mild-to-Moderate Dementia? Findings From the IDEAL programme. J Appl Gerontol 2020; 40:1559-1567. [PMID: 33025847 PMCID: PMC8564240 DOI: 10.1177/0733464820962619] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Pet ownership has been associated with positive outcomes in many populations, yet
the associations with physical and psychological wellbeing in people with
dementia remain unclear. The current study used baseline data from 1,542 people
living at home with mild-to-moderate dementia from the Improving the experience
of Dementia and Enhancing Active Life (IDEAL) programme. Regression analyses
investigated associations of pet ownership and pet care with self-reports of
walking, loneliness, depression, and quality of life (QoL). After adjusting for
covariates, having any pet was associated with higher likelihood of walking over
3 hr in the last week. Those with a dog and who were involved in its care were
less likely to be lonely than those with no dog. Having any pet but no
involvement in its care was associated with increased depression and decreased
QoL compared with those without a pet. The key factor in the associations was
involvement in the care of the pet by the person with dementia.
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Affiliation(s)
- Carol Opdebeeck
- Manchester Metropolitan University,
UK
- Carol Opdebeeck, Department of Psychology,
Manchester Metropolitan University, Manchester, M15 6GX, UK.
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Stern C, Lizarondo L, Carrier J, Godfrey C, Rieger K, Salmond S, Apóstolo J, Kirkpatrick P, Loveday H. Impact of canine-assisted interventions on the health and well-being of older people residing in long-term care: a mixed methods systematic review protocol. JBI Evid Synth 2020; 18:2140-2147. [PMID: 33038126 DOI: 10.11124/jbisrir-d-19-00224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to synthesize and integrate the best available evidence on the impact of canine-assisted interventions on the health and well-being of older people residing in long-term care. INTRODUCTION Canine-assisted interventions are commonly used as an adjunct therapy to enhance health and well-being, and are often implemented in long-term care facilities. The number of studies undertaken in this area has increased substantially over the previous five years; therefore, an update of two previous systematic reviews is warranted. INCLUSION CRITERIA This review will consider older people who reside in long-term care facilities and who receive canine-assisted interventions. For the quantitative component, canine-assisted interventions will be compared to usual care, alternative therapeutic interventions, or no interventions, and outcomes will be grouped under the following headings: biological, psychological, and social. For the qualitative component, the experiences of older people receiving canine-assisted interventions, as well as the views of people directly or indirectly involved in delivering canine-assisted interventions, will be explored. Quantitative, qualitative, and mixed methods studies published from 2009 to the present will be considered. METHODS A search of 10 bibliographic databases and other resources for published and unpublished English language studies will be undertaken. Study selection, critical appraisal, data extraction, and data synthesis will be undertaken by two independent reviewers following the segregated JBI approach to mixed methods reviews. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020161235.
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Affiliation(s)
- Cindy Stern
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Lucylynn Lizarondo
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Judith Carrier
- School of Healthcare Sciences, Cardiff University, Cardiff, Wales
- The Wales Centre for Evidence Based Care: A JBI Centre of Excellence, Cardiff, Wales
| | - Christina Godfrey
- School of Nursing, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Kendra Rieger
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Susan Salmond
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA
- The Northeast Institute for Evidence Synthesis and Translation (NEST): A JBI Centre of Excellence, Newark, NJ, USA
| | - João Apóstolo
- Health Sciences Research Unit: Nursing, Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence, Coimbra, Portugal
| | - Pamela Kirkpatrick
- Robert Gordon University, Aberdeen, Scotland
- The Scottish Centre for Evidence-based, Multi-professional Practice: A JBI Centre of Excellence, Aberdeen, Scotland
| | - Heather Loveday
- Richard Wells Research Centre, College of Nursing, Midwifery and Healthcare, University of West London, London, England
- The University of West London Centre for Evidence-Based Healthcare: A JBI Affiliated Group, London, England
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Exercise-induced pain threshold modulation in healthy subjects: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2020; 6:11-28. [PMID: 33409362 DOI: 10.21801/ppcrj.2020.63.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background The use of exercise is a potential treatment option to modulate pain (exercise-induced hypoalgesia). The pain threshold (PT) response is a measure of pain sensitivity that may be a useful marker to assess the effect of physical exercise on pain modulation. Aim The aim of this systematic review and meta-analysis is to evaluate the PT response to exercise in healthy subjects. Methods We searched in MEDLINE, EMBASE, Web of Science, Lilacs, and Scopus using a search strategy with the following search terms: "exercise" OR "physical activity" AND "Pain Threshold" from inception to December 2nd, 2019. As criteria for inclusion of appropriate studies: randomized controlled trials or quasi-experimental studies that enrolled healthy subjects; performed an exercise intervention; assessed PT. Hedge's effect sizes of PT response and their 95% confidence intervals were calculated, and random-effects meta-analyses were performed. Results For the final analysis, thirty-six studies were included (n=1326). From this we found a significant and homogenous increase in PT in healthy subjects (ES=0.19, 95% CI= 0.11 to 0.27, I2=7.5%). According to subgroup analysis the effect was higher in studies: with women (ES=0.36); performing strength exercise (ES=0.34), and with moderate intensity (ES=0.27), and no differences by age were found. Confirmed by the meta-regression analysis. Conclusion This meta-analysis provides evidence of small to moderate effects of exercise on PT in healthy subjects, being even higher for moderate strength exercise and in women. These results support the idea of modulation of the endogenous pain system due to exercise and highlight the need of clinical translation to chronic pain population.
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Santaniello A, Garzillo S, Amato A, Sansone M, Fioretti A, Menna LF. Occurrence of Pasteurella multocida in Dogs Being Trained for Animal-Assisted Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176385. [PMID: 32887269 PMCID: PMC7503519 DOI: 10.3390/ijerph17176385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 02/06/2023]
Abstract
Animal-assisted therapy (AAT) is a non-pharmacological therapy aimed at people with physical and/or mental disabilities. Therefore, it is necessary to carry out interventions that guarantee its benefits for patients while also avoiding the risk of zoonoses due to contact with the animals or their mucous membranes. The present study aimed to detect the occurrence of Pasteurella multocida in the oral cavity of dogs attending a “dog educational centre” and training for AAT interventions. In addition, some of the potential predictable factors of infection (i.e., age, sex, breed, and living conditions) were analyzed. In total, 25/200 dogs examined (12.5%; 95% confidence interval = 8.4–18.1%) were positive for P. multocida, as confirmed by PCR. Sex, breed, and living conditions were risk factors associated with P. multocida as revealed by the logistic regression analysis. Specifically, cross-bred female dogs living prevalently outdoors were significantly associated with the presence of P. multocida (p < 0.05). This study represents the first epidemiological survey of the prevalence of P. multocida in the oral cavity of dogs involved subsequently in AAT interventions, highlighting the potential risk of P. multocida infection in patients, often belonging to risk categories (e.g., children, the elderly, and immunocompromised individuals). Therefore, healthcare guidelines could be suggested to integrate the current literature related to the health check of dogs involved in AAT. In this way, it could be ensured that, even with bodily contact during AAT, the risk of pathogen transmission by the co-therapist dog can be avoided.
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Affiliation(s)
- Antonio Santaniello
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (S.G.); (A.A.); (A.F.); (L.F.M.)
- Correspondence: (A.S.); (M.S.); Tel.: +39-081-253-6134 (A.S.); +39-081-768-3807 (M.S.)
| | - Susanne Garzillo
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (S.G.); (A.A.); (A.F.); (L.F.M.)
| | - Alessia Amato
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (S.G.); (A.A.); (A.F.); (L.F.M.)
| | - Mario Sansone
- Department of Electrical Engineering and Information Technology, Federico II University of Naples, 80125 Naples, Italy
- Correspondence: (A.S.); (M.S.); Tel.: +39-081-253-6134 (A.S.); +39-081-768-3807 (M.S.)
| | - Alessandro Fioretti
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (S.G.); (A.A.); (A.F.); (L.F.M.)
| | - Lucia Francesca Menna
- Department of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (S.G.); (A.A.); (A.F.); (L.F.M.)
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Cai Y, Li L, Xu C, Wang Z. The Effectiveness of Non-Pharmacological Interventions on Apathy in Patients With Dementia: A Systematic Review of Systematic Reviews. Worldviews Evid Based Nurs 2020; 17:311-318. [PMID: 32767834 DOI: 10.1111/wvn.12459] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Apathy is one of the behavioral and psychological symptoms of dementia (BPSD), which is the most frequent and can accelerate the progress of dementia. AIMS To systematically review the evidence of effectiveness of non-pharmacological interventions on apathy in patients with dementia. METHODS Databases including the Cochrane Library, Joanna Briggs Institute (JBI) Library, PubMed, EMBASE, CINAHL, PsycINFO, Psychology and Behavioral Sciences Collection, CNKI, and Wan Fang Data were searched for systematic reviews of the effectiveness of non-pharmacological interventions on apathy in patients with dementia. AMSTAR 2 was applied to assess the methodological quality of reviews. RESULTS Nine systematic reviews were included. The average level of overall confidence for included systematic reviews was low. Among all the non-pharmacological interventions involved in this review, the effectiveness of multisensory stimulation, music therapy, cognitive stimulation, and pet therapy was relatively robust. The effects of reminiscence therapy, therapeutic conversation, progressive muscle relaxation, art therapy, exercise therapy, occupational therapy, dementia special care units, nursing staff education, and comprehensive interventions need to be validated further. Meanwhile, the current evidence failed to support the effects of psychomotor therapy and validation therapy on apathy. LINKING EVIDENCE TO ACTION Non-pharmacological interventions for apathy in patients with dementia are acceptable. In spite of requirements for adequate and high-quality original studies and quantitative systematic reviews to validate the efficacy of non-pharmacological interventions, multisensory stimulation, music therapy, cognitive stimulation, and pet therapy are deemed the most helpful according to evidences available.
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Affiliation(s)
- Yan Cai
- School of Nursing, Peking University, Beijing, China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Liyu Li
- School of Nursing, Peking University, Beijing, China
| | - Chang Xu
- School of Nursing, Peking University, Beijing, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China
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Current Status of Animal-Assisted Interventions in Scientific Literature: A Critical Comment on Their Internal Validity. Animals (Basel) 2020; 10:ani10060985. [PMID: 32517010 PMCID: PMC7341252 DOI: 10.3390/ani10060985] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Animal-assisted interventions (AAIs) have been receiving ever-increasing attention from both practitioners (including psychologists, educators, social workers, and physicians) and clients alike. However, despite this interest, the literature does not provide an unanimous support for including dogs, horses, cats, or other animals in interventions. The present work analyzes whether or not this lack of support could be understood as the result of inconsistencies and/or biases present in the literature, analyzing the definition of AAIs, the role of animals in interventions, the relationship among AAIs and the way humans relate to non-human animals, and the way in which researchers study these phenomena. The present comment provides some clues on how to improve the development of the field, including the following: giving more prominence to cultural, anthrozoological aspects of AAIs; considering AAIs as modalities of well-known interventions, avoiding their representation as “alternative”, “new”, or “groundbreaking”; and making changes to the study and intervention of designs, thus making it easier to demonstrate the impact of human–animal interactions on improving outcomes. Abstract Many meta-analyses and systematic reviews have tried to assess the efficacy of animal-assisted interventions (AAIs), reaching inconsistent conclusions. The present work posits a critical exploration of the current literature, using some recent meta-analyses to exemplify the presence of unattended threats. The present comment illustrates that the field (1) comprehends inconsistencies regarding the terms and definitions of AAIs; (2) pays more attention to the characteristics of the animals than to the action mechanisms of AAIs; (3) does not provide a clear connection between anthrozoology (how humans and non-human animals interact in communities), benefits of the human–animal interaction (HAI), and the design of AAIs; and (4) implicitly reinforces these phenomena through research designs. Thus, some conclusions extracted from these meta-analyses need further discussion. Increasing the internal validity of AAIs in empirical studies is an urgent task, which can be addressed by (1) developing a better understanding of how anthrozoology, the HAI, and AAIs relate to each other; (2) highlighting the mechanisms that explain the results in an empirical and specific way; and (3) changing the design of interventions, adopting a component-centered approach, and focusing on the incremental efficacy and efficiency of AAI programs.
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Park S, Bak A, Kim S, Nam Y, Kim HS, Yoo DH, Moon M. Animal-Assisted and Pet-Robot Interventions for Ameliorating Behavioral and Psychological Symptoms of Dementia: A Systematic Review and Meta-Analysis. Biomedicines 2020; 8:biomedicines8060150. [PMID: 32498454 PMCID: PMC7345589 DOI: 10.3390/biomedicines8060150] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 01/12/2023] Open
Abstract
Patients with dementia suffer from psychological symptoms such as depression, agitation, and aggression. One purpose of dementia intervention is to manage patients’ inappropriate behaviors and psychological symptoms while taking into consideration their quality of life (QOL). Animal-assisted intervention (AAI) and pet-robot intervention (PRI) are effective intervention strategies for older people with cognitive impairment and dementia. In addition, AAI and PRI have been shown to have positive effects on behavioral and psychological symptoms of dementia (BPSD). However, studies into the association between AAI/PRI and BPSD have elicited inconsistent results. Thus, we performed a meta-analysis to investigate this association. We analyzed nine randomized controlled trials on AAI and PRI for dementia patients published between January 2000 and August 2019 and evaluated the impact of AAI/PRI on agitation, depression, and QOL. We found that AAI and PRI significantly reduce depression in patients with dementia. Subsequent studies should investigate the impact of AAI and PRI on the physical ability and cognitive function of dementia patients and conduct a follow-up to investigate their effects on the rate of progression and reduction of symptoms of dementia. Our research will help with neuropsychological and environmental intervention to delay or improve the development and progression of BPSD.
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Affiliation(s)
- Sangki Park
- Department of Occupational Therapy, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea;
| | - Ahream Bak
- Department of Occupational Therapy, Jeonju Kijeon College, 267, Jeonjucheonseo-ro, Wansan-gu, Junju 54989, Korea;
| | - Sujin Kim
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
| | - Yunkwon Nam
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
| | - Hyeon soo Kim
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
| | - Doo-Han Yoo
- Department of Occupational Therapy, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea;
- Correspondence: (D.-H.Y.); ; (M.M.); Tel.: +82-42-600-8414 (D.-H.Y.); +82-42-600-8691 (M.M.)
| | - Minho Moon
- Department of Biochemistry, College of Medicine, Konyang University, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea; (S.K.); (Y.N.); (H.s.K)
- Correspondence: (D.-H.Y.); ; (M.M.); Tel.: +82-42-600-8414 (D.-H.Y.); +82-42-600-8691 (M.M.)
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Santaniello A, Sansone M, Fioretti A, Menna LF. Systematic Review and Meta-Analysis of the Occurrence of ESKAPE Bacteria Group in Dogs, and the Related Zoonotic Risk in Animal-Assisted Therapy, and in Animal-Assisted Activity in the Health Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093278. [PMID: 32397230 PMCID: PMC7246456 DOI: 10.3390/ijerph17093278] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/04/2020] [Accepted: 05/07/2020] [Indexed: 12/21/2022]
Abstract
Animal-assisted interventions are widely implemented in different contexts worldwide. Particularly, animal-assisted therapies and animal-assisted activities are often implemented in hospitals, rehabilitation centers, and other health facilities. These interventions bring several benefits to patients but can also expose them to the risk of infection with potentially zoonotic agents. The dog is the main animal species involved used in these interventions. Therefore, we aimed at collecting data regarding the occurrence of the pathogens ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.) in dogs, in order to draft guidelines concerning the possible monitoring of dogs involved in animal-assisted therapies and animal-assisted activities in healthcare facilities. We performed a literature search using the PRISMA guidelines to examine three databases: PubMed, Web of Science, and Scopus. Out of 2604 records found, 52 papers were identified as eligible for inclusion in the review/meta-analysis. Sixteen papers reported data on E. faecium; 16 on S. aureus; nine on K. pneumoniae; four on A. baumannii; eight on P. aeruginosa; and six on Enterobacter spp. This work will contribute to increased awareness to the potential zoonotic risks posed by the involvement of dogs in animal-assisted therapies, and animal-assisted activities in healthcare facilities.
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Affiliation(s)
- Antonio Santaniello
- Departments of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (A.F.); (L.F.M.)
- Correspondence: ; Tel.: +39-081-253-6134
| | - Mario Sansone
- Department of Electrical Engineering and Information Technology, Federico II University of Naples, 80125 Naples, Italy;
| | - Alessandro Fioretti
- Departments of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (A.F.); (L.F.M.)
| | - Lucia Francesca Menna
- Departments of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy; (A.F.); (L.F.M.)
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Thompson S, Elad J. Managing emotional support animal letters in clinical practice. J Am Assoc Nurse Pract 2020; 33:766-770. [PMID: 32384355 DOI: 10.1097/jxx.0000000000000420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 02/26/2020] [Indexed: 11/26/2022]
Abstract
ABSTRACT The purpose of this brief report is to inform clinical practice and decision making in addressing the increased number of individuals requesting and receiving emotional support animal (ESA) waivers. It is important for providers including nurse practitioners to carefully consider the diagnostic and legal implications of endorsing ESAs. Nurse practitioners should be aware of the legal implications of writing ESA letters before providing them to their patients, understanding that a letter constitutes a determination of a disability. The literature on this topic is sparse, making it difficult to support the evidence-based practice of writing ESA letters. The therapeutic effects and benefits from human-animal interactions warrant further study in the case of ESAs to further support their use. Ultimately, it is up to the individual provider's clinical judgment supported by due diligence on a case-by-case basis should they decide to provide an ESA letter to their patient.
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Affiliation(s)
- Summer Thompson
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California
| | - Jennifer Elad
- Cedars-Sinai Medical Center, Center for the Undiagnosed Patient and Multidiscipinary Adrenal Program Los Angeles, California
- Center for Undiagnosed Patients
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Abstract
BACKGROUND Dementia is a chronic condition which progressively affects memory and other cognitive functions, social behaviour, and ability to carry out daily activities. To date, no treatment is clearly effective in preventing progression of the disease, and most treatments are symptomatic, often aiming to improve people's psychological symptoms or behaviours which are challenging for carers. A range of new therapeutic strategies has been evaluated in research, and the use of trained animals in therapy sessions, termed animal-assisted therapy (AAT), is receiving increasing attention. OBJECTIVES To evaluate the efficacy and safety of animal-assisted therapy for people with dementia. SEARCH METHODS We searched ALOIS: the Cochrane Dementia and Cognitive Improvement Group's Specialised Register on 5 September 2019. ALOIS contains records of clinical trials identified from monthly searches of major healthcare databases, trial registries, and grey literature sources. We also searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), CINAHL (EBSCOhost), ISI Web of Science, ClinicalTrials.gov, and the WHO's trial registry portal. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster-randomised trials, and randomised cross-over trials that compared AAT versus no AAT, AAT using live animals versus alternatives such as robots or toys, or AAT versus any other active intervention. DATA COLLECTION AND ANALYSIS We extracted data using the standard methods of Cochrane Dementia. Two review authors independently assessed the eligibility and risk of bias of the retrieved records. We expressed our results using mean difference (MD), standardised mean difference (SMD), and risk ratio (RR) with their 95% confidence intervals (CIs) where appropriate. MAIN RESULTS We included nine RCTs from 10 reports. All nine studies were conducted in Europe and the US. Six studies were parallel-group, individually randomised RCTs; one was a randomised cross-over trial; and two were cluster-RCTs that were possibly related where randomisation took place at the level of the day care and nursing home. We identified two ongoing trials from trial registries. There were three comparisons: AAT versus no AAT (standard care or various non-animal-related activities), AAT using live animals versus robotic animals, and AAT using live animals versus the use of a soft animal toy. The studies evaluated 305 participants with dementia. One study used horses and the remainder used dogs as the therapy animal. The duration of the intervention ranged from six weeks to six months, and the therapy sessions lasted between 10 and 90 minutes each, with a frequency ranging from one session every two weeks to two sessions per week. There was a wide variety of instruments used to measure the outcomes. All studies were at high risk of performance bias and unclear risk of selection bias. Our certainty about the results for all major outcomes was very low to moderate. Comparing AAT versus no AAT, participants who received AAT may be slightly less depressed after the intervention (MD -2.87, 95% CI -5.24 to -0.50; 2 studies, 83 participants; low-certainty evidence), but they did not appear to have improved quality of life (MD 0.45, 95% CI -1.28 to 2.18; 3 studies, 164 participants; moderate-certainty evidence). There were no clear differences in all other major outcomes, including social functioning (MD -0.40, 95% CI -3.41 to 2.61; 1 study, 58 participants; low-certainty evidence), problematic behaviour (SMD -0.34, 95% CI -0.98 to 0.30; 3 studies, 142 participants; very-low-certainty evidence), agitation (SMD -0.39, 95% CI -0.89 to 0.10; 3 studies, 143 participants; very-low-certainty evidence), activities of daily living (MD 4.65, 95% CI -16.05 to 25.35; 1 study, 37 participants; low-certainty evidence), and self-care ability (MD 2.20, 95% CI -1.23 to 5.63; 1 study, 58 participants; low-certainty evidence). There were no data on adverse events. Comparing AAT using live animals versus robotic animals, one study (68 participants) found mixed effects on social function, with longer duration of physical contact but shorter duration of talking in participants who received AAT using live animals versus robotic animals (median: 93 seconds with live versus 28 seconds with robotic for physical contact; 164 seconds with live versus 206 seconds with robotic for talk directed at a person; 263 seconds with live versus 307 seconds with robotic for talk in total). Another study showed no clear differences between groups in behaviour measured using the Neuropsychiatric Inventory (MD -6.96, 95% CI -14.58 to 0.66; 78 participants; low-certainty evidence) or quality of life (MD -2.42, 95% CI -5.71 to 0.87; 78 participants; low-certainty evidence). There were no data on the other outcomes. Comparing AAT using live animals versus a soft toy cat, one study (64 participants) evaluated only social functioning, in the form of duration of contact and talking. The data were expressed as median and interquartile ranges. Duration of contact was slightly longer in participants in the AAT group and duration of talking slightly longer in those exposed to the toy cat. This was low-certainty evidence. AUTHORS' CONCLUSIONS We found low-certainty evidence that AAT may slightly reduce depressive symptoms in people with dementia. We found no clear evidence that AAT affects other outcomes in this population, with our certainty in the evidence ranging from very-low to moderate depending on the outcome. We found no evidence on safety or effects on the animals. Therefore, clear conclusions cannot yet be drawn about the overall benefits and risks of AAT in people with dementia. Further well-conducted RCTs are needed to improve the certainty of the evidence. In view of the difficulty in achieving blinding of participants and personnel in such trials, future RCTs should work on blinding outcome assessors, document allocation methods clearly, and include major patient-important outcomes such as affect, emotional and social functioning, quality of life, adverse events, and outcomes for animals.
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Affiliation(s)
- Nai Ming Lai
- Taylor's UniversitySchool of MedicineSubang JayaMalaysia
| | | | - Siok Shen Ng
- Hospital MelakaPharmacy Resources and Information Centre (PRIC)Jalan Mufti Haji‐KhalilMelakaMelakaMalaysia75400
- Monash University MalaysiaJeffrey Cheah School of Medicine and Health SciencesJalan Lagoon SelatanBandar SunwaySelangorMalaysia47500
| | - Shir Ley Tan
- Calvary North Adelaide HospitalHPS PharmaciesAdelaideSouth AustraliaAustralia
| | - Nathorn Chaiyakunapruk
- College of Pharmacy, University of UtahDepartment of PharmacotherapySalt Lake CityUtahUSA84112
| | - Fiona Stanaway
- University of SydneySydney School of Public Health, Faculty of Medicine and HealthEdward Ford Building A27SydneyNSWAustralia2042
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Owners' Attitudes toward Their Companion Dogs Are Associated with the Owners' Depression Symptoms-An Exploratory Study in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193567. [PMID: 31554230 PMCID: PMC6801548 DOI: 10.3390/ijerph16193567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/21/2019] [Accepted: 09/23/2019] [Indexed: 11/17/2022]
Abstract
Background: Various health benefits from the ownership of companion dogs have been studied from a One Health perspective. However, the preventive effects on depression are unclear, with inconsistent results across studies. We hypothesized that heterogeneity among owners would be related to the mixed results. Specifically, the difference in the strength of the bond between the owners and their companion dogs would modify the effect of dog ownership. As an exploratory study, we compared the depression symptoms of the owners with favorable attitudes toward their dogs, with those of the owners with unfavorable attitudes, to investigate the potential effect modification of owners' attitudes on the association between the ownership and depression symptom. Methods: We conducted a web-based questionnaire survey of 654 19- to 39-year-old adults who had companion dogs in Seoul, South Korea, where a major health burden is depression among young adults. We measured the owners' attitudes toward their dogs using the modified Pet Attitude Scale (PAS-M) and their depression symptoms using the short version of the Center for Epidemiologic Studies depression scale (CESD-10). Demographic and socioeconomic factors were measured to adjust for the association between attitude and depression symptoms. Multivariate logistic regression models were used in this study. Results: The owners who had less favorable attitudes toward their dogs (lower PAS-M scores) tended to have depression symptoms. The direction and significance were maintained either when the PAS-M variable was used as a continuous variable (odds ratio (OR) for one score increase in PAS-M was 0.95 (95% confidence interval (CI) = 0.94-0.96)) or as a categorical variable (OR for lower PAS-M was 3.19 (95% CI = 2.28 -4.47)). Conclusion: We found a positive significant association between owners' depression symptoms and unfavorable attitudes toward their dogs, although causal direction could not be determined. Future studies should investigate the potential causal link.
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Menna LF, Santaniello A, Amato A, Ceparano G, Di Maggio A, Sansone M, Formisano P, Cimmino I, Perruolo G, Fioretti A. Changes of Oxytocin and Serotonin Values in Dialysis Patients after Animal Assisted Activities (AAAs) with a Dog—A Preliminary Study. Animals (Basel) 2019; 9:E526. [PMID: 31382576 PMCID: PMC6721151 DOI: 10.3390/ani9080526] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/18/2019] [Accepted: 08/01/2019] [Indexed: 12/27/2022] Open
Abstract
Our study aimed to measure the levels of serotonin and oxytocin in patients affected by end-stage renal disease (ESRD), undergoing dialysis and participating in a program of animal-assisted activities (AAAs) with a dog. Ten patients with comparable levels of ESRD were enrolled. A blood sample was taken before the start of the study in order to establish basal levels. Eleven meetings were held once a week for 3 months during the last hour of dialysis, and blood samples were collected before and after AAAs. Two more meetings, one month apart from each other, were held two months later without the dog but with the same veterinarian zootherapist. Blood was drawn at the beginning and at the end of each meeting. The samples were then processed for the measurement of serotonin and oxytocin, and data obtained were analysed using analysis of variance with mixed effect models. The results show an increasing level of both serotonin and oxytocin between subsequent meetings with the dog and an increasing trend of inter-intervention levels. Overall, the results suggest that AAAs lead to modifications of serotonin and oxytocin levels, which are also accompanied by behavioural changes of patients.
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Affiliation(s)
- Lucia Francesca Menna
- Departments of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy
| | - Antonio Santaniello
- Departments of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy
| | - Alessia Amato
- Departments of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy
| | | | | | - Mario Sansone
- Electrical Engineering and Information Technology Federico II University of Naples, 80125 Naples, Italy
| | - Pietro Formisano
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Ilaria Cimmino
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Giuseppe Perruolo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Alessandro Fioretti
- Departments of Veterinary Medicine and Animal Productions, Federico II University of Naples, 80134 Naples, Italy
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