Measuring stress and immune response in healthcare professionals following interaction with a therapy dog: a pilot study

Animal-Assisted Stress Management for Veterinary Staff

High levels of stress have a detrimental impact on veterinary staff, negatively influencing their mental health and contributing to high rates of suicide. Veterinary social workers are tasked with providing interventions to reverse these consequences and support the professional's health and well-being. Twenty-one veterinary staff participated in a study to evaluate the impact of animal-assisted support. Over three months, participants attended one or two therapy dog visits per month, interacting with therapy dogs for a minimum of 10 minutes each session. Pre- and postmeasures of blood pressure, heart rate, and self-reported stress were taken at each session. A measure to assess compassion fatigue and satisfaction was administered at the end of each session, and at the conclusion of the study participants' thoughts about the visits from the therapy dogs were assessed. Significant reductions in systolic and diastolic blood pressure were found as well as significantly lower ratings of self-reported stress. Additionally, participants looked forward to these visits stating they made them happy, helped them feel better, and took their mind off their troubles. Considering the growing utilization of therapy dogs, this timely study adds to the body of evidence, highlighting the benefits of animal-assisted interventions with veterinarian staff.

Human physiological responses to different types of human-dog interactions: A randomised crossover study

Previous studies of human-dog interventions vary in terms of type of interaction, which is rarely quantified, leading to contradictory findings and limited comparability. To uncover the influence of different types of interactions, the present study investigated if it was possible to detect differences in immediate physiological measurements of healthy humans during different standardised types of interaction with a dog. Thirty-three healthy participants (women = 25, men = 8, >18 years) were exposed to four different test situations with standardised types of interaction intensity with a dog in random order: no dog present (CONTROL), looking at a dog (VISUAL), petting a dog (TACTILE) or performing tricks with a dog (ACTIVE). Each test situation lasted 10 min with a 30-min break between each. Heart rate (HR), heart rate variability (HRV) and skin conductance (tonic level (SCL) and peak counts (SCR)) were continuously recorded. Blood pressure (BP) and salivary cortisol (s-cortisol) were measured before and after each test situation. Linear Mixed Models were applied. HR, HRV, BP, SCL and SCR increased with increased interaction with the dog (for all: p < 0.001). HRV increased with decreased HR (p = 0.002), increased SCL (p = 0.027), and SCR (p < 0.001) depending on the type of interaction. Generally, s-cortisol increased with increased HR (p = 0.042), SCL increased with increased SCR (p < 0.001), and SCR increased with increased HRV (p = 0.013), depending on type of interaction. The physiological measurements HR, HRV, BP, SCL and SCR are influenced by different types of dog interaction, and thus it is important to quantify and report the type of interaction in human-dog interaction studies. (ClinicalTrials.gov ID:NCT04696419).

Dog-assisted physiotherapy in amyotrophic lateral sclerosis: a randomized controlled pilot study

BACKGROUND

Animal-assisted therapy (AAT) is an intervention in which the animal acts as a co-therapist. It has been mainly used in the context of patients with dementia, showing positive effects on psychological symptoms, but its potential as a physiotherapy treatment for patients with neuromuscular disorders, amyotrophic lateral sclerosis (ALS) in particular, has not yet been investigated.

AIM

The aim of the study was to evaluate the impact of AAT, specifically of dog-assisted therapy, on motor functions and psychological status in patients with ALS.

DESIGN

This study was a randomized controlled pilot study.

SETTING

The study was carried out at the Rehabilitation Unit NEuroMuscular Omnicenter (NEMO) of Arenzano, Genoa.

POPULATION

Sixty hospitalized ALS patients were enrolled.

METHODS

All patients ran a regular two-weeks neurorehabilitation program twice a day. For three days a week, in place of the morning traditional treatment, the AAT group performed a rehabilitation session with a simultaneous interaction with the therapy-dog, while the control group performed a traditional rehabilitation session. The outcome measures were the Timed Up and Go Test, the Short Physical Performance Battery (SPPB), the Six Minutes Walk Test, the Ten Meters walking Test and the Hospital Anxiety and Depression Scale.

RESULTS

Both groups showed an amelioration in motor scales. However, SPPB subscales as well as HADS scores showed a statistically significant improvement only in the AAT group (P values from <0.0001 to 0.0004). Additionally, across almost all motor and psychological measures, post-treatments values were significantly better for the AAT group (P values from <0.0001 to 0.01).

CONCLUSIONS

The obtained results not only suggest that AAT is comparable to traditional physiotherapy treatments, but also evidence that this type of treatment has greater beneficial effects on motor and psychological symptoms in patients with ALS.

CLINICAL REHABILITATION IMPACT

This study provides first evidence that AAT is a powerful rehabilitation strategy in patients with ALS, improving both motor and psychological symptoms, and therefore possibly ameliorating quality of life.

Oxytocin levels and self-reported anxiety during interactions between humans and cows

Introduction

Positive social interactions with farm animals may have therapeutic benefits on humans by increasing brain oxytocin secretion, as inferred from circulating oxytocin levels. The aim of this observational study was to investigate acute changes in human plasma oxytocin levels and state anxiety associated with interactions with dairy cows.

Methods

Data were collected from 18 healthy female nursing students who performed stroking and brushing of an unfamiliar cow for 15 min. Blood samples were drawn before entering the cowshed (T1, baseline), and after 5 (T2) and 15 (T3) min of interaction with a cow. At T1 and T3, the students filled out the Norwegian version of the Spielberger State-Trait Anxiety Inventory-State Subscale (STAI-SS).

Results

Across participants, no significant changes in average plasma oxytocin concentration were detected between time points (p>0.05). There was, however, a modest decline in the STAI-SS scores between T1 and T3 (p=0.015) and a positive correlation between the change in individual level of state anxiety between T1 and T3 and the change in OT concentration of the same individual between T2 and T3 (p = 0.045).

Discussion

The results suggest that friendly social interactions with cows are beneficial in lowering state anxiety, but any relationship with release of OT into the circulation was complex and variable across individuals. The acute reduction in state anxiety lends support to the value of interacting with farm animals in the context of Green Care for people with mental health challenges.

Pet ownership and maintenance of cognitive function in community-residing older adults: evidence from the Baltimore Longitudinal Study of Aging (BLSA)

Pet ownership has been associated with reduced deterioration in physical health as older adults age; little research focused on deterioration in cognitive function. We examine the relationship of pet, dog, cat ownership, and dog walking to changes in cognitive function among 637 generally healthy community-dwelling older adults (185 pet owners) aged 50-100 years (M = 68.3, SD = 9.6) within the BLSA. Cognitive assessments every 1-4 years over 1-13 years (M = 7.5, SD = 3.6) include the California Verbal Learning (Immediate, Short, Long Recall); Benton Visual Retention; Trail-Making (Trails A, B, B-A); Digit Span; Boston Naming (Naming); and Digit Symbol Substitution (Digit Symbol) Tests. In linear mixed models, deterioration in cognitive function with age was slower for pet owners than non-owners (Immediate, Short, Long Recall; Trails A,B,B-A; Naming; Digit Symbol); dog owners than non-owners (Immediate, Short Recall; Trails A,B; Naming; Digit Symbol); and cat owners than non-owners (Immediate, Short, Long Recall; Naming), controlling for age and comorbidities. Among dog owners (N = 73) walkers experienced slower deterioration than non-walkers (Trails B, B-A; Short Recall). All ps ≤ 0.05. We provide important longitudinal evidence that pet ownership and dog walking contribute to maintaining cognitive function with aging and the need to support pet ownership and dog walking in design of senior communities and services.

Can Interacting with Animals Improve Executive Functions? A Systematic Review

There has been growing interest in the potential benefits of using human-animal interactions to improve executive functions: cognitive processes that allow individuals to plan, solve problems, and self-regulate behaviour. To date, no comprehensive review has been conducted. The purpose of this study was to evaluate existing literature, adopting broad inclusion criteria. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 16 papers were identified from peer-reviewed literature. Additional papers were identified from grey literature, including 6 dissertations and 1 thesis. A review of these 23 studies found that human-animal interactions and executive functions are investigated in three main ways: (1) exploring the potential benefits of the human-pet relationship, (2) exploring the impact of an animal's presence during administration of executive function tests, and (3) evaluating the efficacy of animal-assisted services (e.g., animal-assisted therapy) on executive functions. Five of the included studies reported a significant improvement across all measured domains of executive functions, but effect sizes were underreported. Comparatively, 9 studies reported mixed findings, d = 0.32-0.55, while 8 studies reported no significant results. The overall rigour of the research was limited, with great heterogeneity between the study methodologies and outcome measures used. It is recommended that future studies utilise high-quality research methodologies through the use of randomisation, pre- and postmeasures, and appropriate control conditions, where possible.

Lower Emotional Exhaustion among Employees Is Associated with Intentional Incorporation of Animals into Residential Care Settings

Secondary effects of animal-integrated programming on residential care center (RCC) staff and organizational culture are not well understood. We explored emotional exhaustion among RCC employees both in facilities that incorporated animals and those that did not incorporate animals into the therapeutic environment. We conducted a survey throughout a large midwestern RCC system in the United States to determine relationships between organizational culture, emotional exhaustion, and the intentionality by which animals were incorporated into programming. Data were analyzed by examining associations between variables of interest using chi-square or t-tests, and linear mixed-effects modeling was used to identify potential confounding effects due to differences in children served within RCCs. Staff from RCCs that used animals intentionally reported lower emotional exhaustion (p = 0.006), and higher average workplace safety (p = 0.024) and psychological safety (p < 0.001). Integrating animals into RCC programming is associated with elements of a strong organizational culture. It is possible that animal-integrated programming has a positive impact on the facility culture and workforce, and/or that RCCs with strong pre-existing cultures are more likely to use animal-integrated programming.

Understanding the Role of Therapy Dogs in Human Health Promotion

Dogs may provide humans with a range of physical, mental and social benefits. Whilst there is growing scientific evidence of benefits to humans, there has been less focus on the impact to canine health, welfare and ethical considerations for the dogs. The importance of animal welfare is increasingly acknowledged, indicating that the Ottawa Charter should be extended to include the welfare of non-human animals supporting the promotion of human health. Therapy dog programmes are delivered across a variety of settings including hospitals, aged care facilities and mental health services, highlighting the important role they play in human health outcomes. Research has shown that that there are biomarkers for stress in humans and other animals engaged in human-animal interactions. This review aims to assess the impact of human-animal interactions on therapy dogs engaged in providing support to human health. While challenging, it is paramount to ensure that, within the framework of One Welfare, the welfare of therapy dogs is included, as it is a key factor for future sustainability. We identified a range of concerns due to the lack of guidelines and standards to protect the wellbeing of the dogs engaged in these programmes. Extension of the Ottawa Charter to include the welfare of non-human animals with leveraging through a One Welfare approach would promote animal and human health beyond current boundaries.

Effects of human and animal-assisted skills training on oxytocin und cortisol levels in patients with borderline personality disorder

OBJECTIVE

Borderline Personality Disorder (BPD) is characterised, among other symptoms, by emotional instability and difficulties in regulating proximity to significant others. Many with BPD have difficulties in establishing a trustful therapeutic relationship, which often develop before a background of adverse childhood experiences with caregivers. One way to facilitate therapeutic interaction in psychotherapy incorporates pet animals as "door openers". No study exists, however, that has examined the effect of animal-assisted versus human-guided skills training on neurobiological correlates of affiliation and stress regulation, i.e. oxytocin and cortisol.

METHODS

Twenty in-patients diagnosed with BPD were recruited to participate in an animal-assisted skills-training. Another 20 in-patients participated in a human-guided skills-training. Salivary samples of both groups were taken for determining oxytocin and cortisol before and immediately after 3 therapeutic sessions at least one week apart from one another. In addition, borderline symptom severity (BSL-23), impulsivity (BIS-15), alexithymia (TAS-20), and fear of compassion (FOCS) were determined by self-rating questionnaires before and after the 6-week interventions.

RESULTS

Both therapeutic interventions led to a significant reduction in cortisol and an (non-significant) increase in oxytocin, respectively. Importantly, there was a statistically significant interaction between changes in cortisol and oxytocin, independent of group. Both groups further showed clinical improvement as measured using the above-listed questionnaires.

CONCLUSION

Our findings suggest that both animal-assisted and human-guided interventions have measurable short-term effects on affiliative and stress hormones, with no approach being superior to the other in this regard.

Longitudinal associations between allostatic load, pet ownership, and socioeconomic position among U.S. adults aged 50

It is hypothesized that pets provide benefits to human health by buffering the deleterious effects of stress, but varying exposure to chronic stress via social position is rarely considered in these conceptual and empirical models. Allostatic load is an index of biological and physical measures that represents cumulative wear and tear on the body via chronic stress exposure. In this study, we use the 2006-2016 waves of the Health and Retirement Study, a nationally representative, longitudinal panel survey of adults aged 50+ in the United States, to test whether and to what extent pet ownership has an impact on allostatic load, and whether pet ownership moderates the effects of socioeconomic position on allostatic load. Linear mixed effects regression models revealed that pet owners had significantly lower allostatic load scores than those who do not own pets; however, after adjusting for socioeconomic position (i.e., wealth, education, race, ethnicity, gender, marital status), the effect of pet ownership was no longer significant. We estimated a series of models stratified by sociodemographic groups to test moderation effects. Among those who had a high school education, pet owners had lower allostatic load scores, whereas among those who had attended some college, pet owners had higher scores. Among those who were aged 80+, pet owners had higher scores than those who did not own pets. These findings suggest that the magnitude of the effect of pet ownership on allostatic load may not be sufficient to counteract experiences of high chronic stress as experienced by lower-status groups. Supporting the human-animal bond may contribute to improving older adult population health if paired with efforts to address the underlying causes of population health disparities.

Can dogs serve as stress mediators to decrease salivary cortisol levels in a population of liberal arts college undergraduate students?

The steroid hormone cortisol can be used to measure physiological stress in humans. The hypothalamic-pituitary-adrenal (HPA) axis synthesizes cortisol, and a negative feedback cycle regulates cortisol depending on an individual's stress level and/or circadian rhythm. Chronic stress of college undergraduate students is associated with various adverse health effects, including anxiety and depression. Reports suggest that stress levels have risen dramatically in recent years, particularly among university students dealing with intense academic loads in addition to COVID-19 pandemic-related uncertainty. The increasing rate of mental illness on college campuses necessitates the study of mediators potentially capable of lowering stress, and thus cortisol levels. Research on mediation techniques and coping mechanisms have gained traction to address the concerning levels of stress, including the employment of human-animal interaction sessions on college campuses. In this study, human-canine interaction as a stress mediation strategy for undergraduate students was investigated. We measured salivary cortisol levels in 73 college undergraduate students during a 60-min interaction period with a dog to determine whether human-canine interactions are effective in lowering cortisol levels and potentially reducing chronic stress typical of undergraduate students. Our results indicate that a human-canine interaction for 60 min is an effective method for significantly reducing salivary cortisol and stress levels among undergraduate college students. These findings support the expansion of animal visitation programs on college campuses to help students manage stress.

Psychophysiological mechanisms underlying the potential health benefits of human-dog interactions: A systematic literature review

While the symbiotic nature of human-dog relationships and perceived benefits to human health have attracted much scientific interest, the mechanisms through which human-dog interactions may confer health benefits to humans are still poorly understood. The aim of this systematic literature review was to synthesize evidence of physiological changes associated with human-dog interactions with relevance to human health. Electronic databases were systematically searched (PubMed, MEDLINE with full text, Scopus, PsycINFO, CINAHL Plus with Full Text, and Web of Science Core Collection) for relevant studies. Of the 13,072 studies identified, 129 met the inclusion criteria, with approximately half being randomized trials (Level 2) based on the Oxford Centre for Evidence Based Medicine level system. Measures employed to study human physiological changes associated with human-dog interactions most commonly involved cardiac parameters and hormones, with negligible research of brain activity. The main positive findings were increases in heart rate variability and oxytocin, and decreases in cortisol with human-dog interactions. These physiological indicators are consistent with activation of the parasympathetic nervous system (PNS) and oxytocinergic system (OTS), and down-regulation of hypothalamic-pituitary-adrenal (HPA) axis activity. These results provide evidence of specific pathways through which human-dog contact may confer health benefits, likely through relaxation, bonding, and stress reduction. However, these findings should be interpreted contextually due to limitations and methodological differences. Previous research using other biological variables was limited in quantity and quality, thus impeding firm conclusions on other possible mechanisms. Further research is needed in some psychophysiological domains, particularly electroencephalography, to better understand central nervous system (CNS) effects. The findings of this review have implications for human-dog interactions to positively affect several stress-sensitive physiological pathways and thus confer health benefits. This supports their incorporation in various clinical, non-clinical, and research settings to develop evidence-based interventions and practices for cost-effective and efficacious ways to improve human health.

Reactivation of a Hospital-Based Therapy Dog Visitation Program during the COVID-19 Pandemic

This study examined human−animal interactions during the reactivation of a hospital-based therapy dog program during the COVID-19 pandemic. Data were collected from human−dog interactions at an academic medical center in Virginia. Interaction length, participant role, age group (pediatric or adult), and observed gender were recorded. Handler adherence to human and animal safety protocols (donning personal protective equipment (PPE), using hand sanitizer, and limiting visit length) was measured. Observations from 1016 interactions were collected. t-tests and analysis of variance were conducted. Most visit recipients were healthcare workers (71.69%). Patients received longer visits than other participants (F(4880) = 72.90, p = <0.001); post hoc Bonferroni analyses (p = 0.05/4) showed that patients, both adult (M = 2.58 min, SD = 2.24) (95% C.I = 0.35−1.68) and pediatric (M = 5.81, SD = 4.38) (95% C.I. 3.56−4.97), had longer interaction times than healthcare workers (M = 1.56, SD = 1.92) but not visitors (p = 1.00). Gender differences were not statistically significant (t(552) = −0.736), p = 0.462). Hand sanitizer protocols were followed for 80% of interactions. PPE guidelines were followed for 100% of visits. Most interactions occurred with healthcare workers, suggesting that therapy dog visits are needed for this population. High adherence to COVID-19 safety protocols supports the decision to reactivate therapy animal visitation programs in hospitals. Challenges to safety protocol adherence included ultra-brief interactions and crowds of people surrounding the dog/handler teams. Program staff developed a “buddy system” mitigation strategy to minimize departures from safety protocols and reduce canine stress.

Can dogs reduce stress levels in school children? effects of dog-assisted interventions on salivary cortisol in children with and without special educational needs using randomized controlled trials

Prolonged or excessive stress negatively affects learning, behavior and health across the lifespan. To alleviate adverse effects of stress in school children, stressors should be reduced, and support and effective interventions provided. Animal-assisted interventions (AAI) have shown beneficial effects on health and wellbeing, however, robust knowledge on stress mediation in children is lacking. Despite this, AAIs are increasingly employed in settings world-wide, including schools, to reduce stress and support learning and wellbeing. This study is the first randomized controlled trial to investigate dog-assisted interventions as a mediator of stress in school children with and without special educational needs (SEN) over the school term. Interventions were carried out individually and in small groups twice a week for 20 minutes over the course of 4 weeks. We compared physiological changes in salivary cortisol in a dog intervention group with a relaxation intervention group and a no treatment control group. We compared cortisol level means before and after the 4 weeks of interventions in all children as well as acute cortisol in mainstream school children. Dog interventions lead to significantly lower stress in children with and without special educational needs compared to their peers in relaxation or no treatment control groups. In neurotypical children, those in the dog interventions showed no baseline stress level increases over the school term. In addition, acute cortisol levels evidenced significant stress reduction following the interventions. In contrast, the no treatment control group showed significant rises in baseline cortisol levels from beginning to end of school term. Increases also occurred in the relaxation intervention group. Children with SEN showed significantly decreased cortisol levels after dog group interventions. No changes occurred in the relaxation or no treatment control groups. These findings provide crucial evidence that dog interventions can successfully attenuate stress levels in school children with important implications for AAI implementation, learning and wellbeing.

Lack of Effects of the Presence of a Dog on Pain Perception in Healthy Participants-A Randomized Controlled Trial

Animal-assisted interventions (AAIs) have been shown to be effective in the treatment of pain. Studies suggest that relationships with animals can have comparable qualities to relationships with humans and that this enables animals to provide social support. Further, the presence of an animal can strengthen the therapeutic alliance between patients and treatment providers. This suggests that the analgesic effects of AAI might be mediated by social support from an animal or by strengthening the alliance between the patient and the treatment provider. To test these assumptions, we examined the effects of the presence of a dog on experimentally induced pain in a pain assessment and a pain therapy context. Hundred thirty-two healthy participants were randomly assigned to the conditions “pain,” “pain + dog,” “pain + placebo,” or “pain + placebo + dog.” We collected baseline and posttreatment measurements of heat-pain tolerance and the heat-pain threshold and of the corresponding subjective ratings of heat-pain intensity and unpleasantness as well as of participants' perceptions of the study investigator. The primary outcome was heat-pain tolerance. The presence of the dog did not influence the primary outcome (“pain” vs. “pain + dog”: difference = 0.04, CI = −0.66 to 0.74, p = 0.905; “pain + placebo” vs. “pain + placebo + dog”: difference = 0.43, CI = −0.02 to 0.88, p = 0.059). Participants did also not perceive the study investigator to be more trustworthy in the presence of the dog (“pain” vs. “pain + dog”: difference = 0.10, CI = −0.67 to 0.87, p = 0.796; “pain + placebo” vs. “pain + placebo + dog”: difference = 0.11, CI = −0.43 to 0.64, p = 0.695). The results indicate that the mere presence of a dog does not contribute to pain reduction and that the analgesic effects of AAI that previous studies have found is not replicated in our study as AAI did not increase perceived social support and had no effect on the alliance between the participant and the treatment provider. We assume that the animal most likely needs to be an integrated and plausible part of the treatment rationale so that participants are able to form a treatment-response expectation toward AAI.

Clinical Trial Registration: This study was preregistered as a clinical trial on www.clinicaltrials.gov (Identifier: NCT0389814).

Animal-Assisted Intervention and Health Care Workers’ Psychological Health: A Systematic Review of the Literature

Healthcare settings have recently increased the use of companion animals in the workplace to provide emotional support to people with disabilities, but there is limited empirical research on the effects of these programs on healthcare workers. However, it is reasonable to speculate that Animal-Assisted Interventions (AAIs) may have positive effects on health care workers (HCWs) by buffering the negative effects of work-related stress and other occupational psychosocial risk factors. The aim of this review was to examine the beneficial effects of AAIs on the psychological well-being of HCWs. A systematic review was conducted in December 2021 to gain insight into the positive effects of pets on HCWs in the workplace. Searches were conducted in the following databases: Scopus, PubMed/Medline, Web of Science, and Google Scholar, including studies between 2001 and December 2021, and 12 articles were included in the review. The results indicate that implementing the AAI program in a busy clinic is feasible and that the program is accepted by medical professionals because of the immense psychological benefits it provides. However, the healthcare professionals disliked the experimental design that forced them to leave their workplaces at a certain time.

Perspectives on facility dogs from pediatric hospital personnel: A qualitative content analysis of patient, family, and staff outcomes

An increasing number of children's hospitals feature full-time resident facility dogs, which are specially trained to work alongside pediatric healthcare professionals to improve the patient experience. This qualitative study aimed to describe the role that facility dogs play in the lives of patients, families, and hospital staff. A total of N = 73 pediatric healthcare professionals that worked with 46 facility dogs across 17 children's hospitals in the US completed a set of open-ended questions in an online survey. Responses were analyzed via a conventional thematic analysis and organized into themes and sub-themes. Facility dogs were described to benefit pediatric healthcare professionals' daily lives through improving stress and wellbeing, staff relationships, and job-related morale. Negative impacts included increased burdens and responsibilities in the workplace. Facility dogs were also described to benefit patients and families by helping build rapport, providing a comforting presence and positive resource, and normalizing the hospital environment. In conclusion, facility dog programs were found to be a promising complementary intervention to benefit both staff as well as and patients and families. Future research is warranted to examine short-term and long-term implications of facility dog programs for staff, patient, and family wellbeing.

Animal-Assisted Interventions in Intensive Care Delirium: A Literature Review

Critical illness has lasting consequences on the mind and the body. Acute sequelae include a decline in cognitive function known as delirium. Increased interest in improving outcomes for intensive care unit survivors without a high incidence of delirium has initiated a focus on an array of nonpharmacologic interventions in many countries. One such intervention is animalassisted intervention. As the role of animals in human healing is being recognized by clinicians, need is increasing for formal and professionally directed therapies. This review ascertains the effect of interaction with animals on critically ill patients. Emerging evidence indicates that animal-assisted intervention improves the efficacy of critical care regarding primary symptoms and secondary factors of delirium.

Understanding the impact of dog ownership on autistic adults: implications for mental health and suicide prevention

Mental health problems and suicide are more frequent in autistic adults than general population. Dog ownership can improve human well-being. This study aimed to generate a framework of well-being outcomes for dog-related activities in autistic adults and compare it to the framework generated for a general adult population. Thirty-six autistic dog owners (18–74 years old, 18 males) from diverse UK regions were interviewed and transcripts thematically analysed. 16.7% reported that their dogs prevented them from taking their own lives, mainly due to the dog's affection and the need to care for the animal. Close dog-owner interactions (e.g., cuddling, walking, dog's presence) were the most frequent activities improving emotions/moods and life functioning, whereas routine-like activities (e.g., feeding the animal) particularly enhanced life functioning. Well-being worsening was mainly linked to dog behaviour problems, dog poor health/death and obligations to the dog. Despite some negatives associated with ownership, having a dog could improve the well-being of many autistic adults and assist suicide prevention strategies in this high-risk group. The framework was consistent with that generated previously, indicating its robustness and the potential opportunity to focus on dog-related activities rather than the vague concept of “ownership” when considering the impact of ownership on well-being.

Effect of animal assisted interactions on activity and stress response in children in acute care settings

Objective

Determine the effects of animal assisted interactions (AAI) on activity and stress response in pediatric acute care settings.

Design

Randomized treatment control design.

Setting

Inpatient pediatric acute care units (PICU, CVICU and Hematology/Oncology).

Patients

Eighty pediatric inpatients (49% male) age 2–19 years.

Intervention

The AAI experimental group patients interacted with therapy dog teams for 5–10 min and the comparison group patients continued their current activity without an AAI visit.

Measurement and results

Salivary cortisol, activity level, and mood were assessed before and after AAI. AAI was associated with a decrease in cortisol levels and increases in mood and activity.

Conclusion

AAI benefits children in pediatric acute care units.

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AAI effects activity and stress response in pediatric acute care settings

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AAI is associated with decreased cortisol levels and increased mood and activity

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Benefits may influence mobility, recovery and post-discharge psycho-social outcomes

Human-Animal Interaction and Perinatal Mental Health: A Narrative Review of Selected Literature and Call for Research

There is a paucity of research exploring how relationships with household pets may impact maternal mental health. We are unaware of any study to date that has examined associations between individuals' relationships with their pets and psychological adjustment in the perinatal period. Using a biobehavioral lens, this paper provides a narrative overview of the literature on perinatal mental health and human-animal interaction (HAI). We focus on the role of social relationships, stress, and stress reduction in relation to perinatal mental health; the role of HAI in perceptions of social support, stressors, and stress reduction; and gaps in empirical knowledge concerning the role of HAI in perinatal mental health. Finally, we integrate contemporary biobehavioral models of perinatal mental health and HAI (i.e., Comprehensive Model of Mental Health during the Perinatal Period and the HAI-HPA Transactional Model) to propose a new conceptual framework that depicts ways in which HAI during the perinatal period may influence maternal and child health and wellbeing. To our knowledge, this is the first paper to consider the role of HAI in biobehavioral responses and mental health during the perinatal period. We conclude with recommendations for future research and improved perinatal care.

Did Dog Domestication Contribute to Language Evolution?

Different factors seemingly account for the emergence of present-day languages in our species. Human self-domestication has been recently invoked as one important force favoring language complexity mostly via a cultural mechanism. Because our self-domestication ultimately resulted from selection for less aggressive behavior and increased prosocial behavior, any evolutionary or cultural change impacting on aggression levels is expected to have fostered this process. Here, we hypothesize about a parallel domestication of humans and dogs, and more specifically, about a positive effect of our interaction with dogs on human self-domestication, and ultimately, on aspects of language evolution, through the mechanisms involved in the control of aggression. We review evidence of diverse sort (ethological mostly, but also archeological, genetic, and physiological) supporting such an effect and propose some ways of testing our hypothesis.

Depression, anxiety and stress during the COVID-19 pandemic: results from a New Zealand cohort study on mental well-being

OBJECTIVES

The COVID-19 pandemic has caused unprecedented disruption to daily life. This study investigated depression, anxiety and stress in New Zealand (NZ) during the first 10 weeks of the COVID-19 pandemic, and associated psychological and behavioural factors. It also compares the results with a similar cross-sectional study in the UK.

DESIGN

Cross-sectional study.

SETTING

NZ community cohort.

PARTICIPANTS

N=681 adults (≥18 years) in NZ. The cohort was predominantly female (89%) with a mean age of 42 years (range 18-87). Most (74%) identified as NZ European and almost half (46%) were keyworkers. Most were non-smokers (95%) and 20% identified themselves as having clinical risk factors which would put them at increased or greatest risk of COVID-19.

MAIN OUTCOME MEASURES

Depression, anxiety, stress, positive mood and engagement in health behaviours (smoking, exercise, alcohol consumption).

RESULTS

Depression and anxiety significantly exceeded population norms (p<0.0001). Being younger (p<0.0001) and most at risk of COVID-19 (p<0.05) were associated with greater depression, anxiety and stress. Greater positive mood, lower loneliness and greater exercise were protective factors for all outcomes (p<0.0001). Smoking (p=0.037) and alcohol consumption (p<0.05) were associated with increased anxiety. Pet ownership was associated with lower depression (p=0.006) and anxiety (p=0.008). When adjusting for age and gender differences, anxiety (p=0.002) and stress (p=0.007) were significantly lower in NZ than in the UK. The NZ sample reported lower perceived risk (p<0.0001) and worry about COVID-19 (p<0.0001) than the UK sample.

CONCLUSIONS

The NZ population had higher depression and anxiety compared with population norms. Younger people and those most at risk of COVID-19 reported poorer mental health. Interventions should promote frequent exercise, and reduce loneliness and unhealthy behaviours.

The effects of facility dogs on burnout, job-related well-being, and mental health in paediatric hospital professionals

AIMS AND OBJECTIVES

To examine the effect of working with a facility dog on paediatric healthcare professionals' work-related burnout, job perceptions and mental health.

BACKGROUND

Due to their roles caring for ill children and distressed families, paediatric healthcare professionals often experience substantial depression and burnout. According to prior research, facility dogs in children's hospitals may provide significant benefits to paediatric patients. However, their potential effects on healthcare professionals have been minimally explored.

DESIGN

A cross-sectional design was used in adherence to the STROBE checklist.

METHOD

Among 130 participants, n = 65 paediatric healthcare professionals working with a facility dog were compared to n = 65 control participants matched on age, gender identity, job position category and pet ownership. Hierarchical regression assessed the effect of working with a facility dog on standardised self-report measures of work-related burnout, job perceptions and mental health.

RESULTS

For work-related burnout, working with a facility dog was associated with higher perceived personal accomplishment, but had no effect on emotional exhaustion. With respect to job perceptions, working with a facility dog was associated with more positive job descriptions and lower intention to quit, but not with perceptions about co-workers or workplace social support. Finally, in relation to mental health, working with a facility dog was associated with more positive emotions, better perceived mental health and less depression, but had no effect on anxiety.

CONCLUSION

Findings suggest that facility dogs may be related to several benefits for healthcare professionals' work-related burnout, job perceptions and mental health, but that they do not influence all components of these areas.

RELEVANCE TO CLINICAL PRACTICE

The present research functions to inform personnel in paediatric hospitals with existing facility dog programmes on the scope of their effects, in addition to shaping the expectations of hospitals considering the addition of a facility dog programme.

Canine-Assisted Interventions in Hospitals: Best Practices for Maximizing Human and Canine Safety

Canine-assisted interventions (CAI) are becoming more popular in hospital settings, representing a crucial intersection between animals, veterinary medicine, and society. However, standardized policies and procedures to minimize risk and maximize benefit to vulnerable humans and protect therapy dog welfare are lacking, posing a challenge to safe practice. Few intervention programs are evaluated to document efficacy compounding the potential risk. This paper presents a rationale for CAI in hospitals and describes the evidence, issues, and challenges to establishing and maintaining safe and effective programs for humans and animals. Recommendations are made for best practices based on the existing scientific evidence and a model program in place in a major medical center for 19 years. Scientific and practical implications are considered.

Dogs Supporting Human Health and Well-Being: A Biopsychosocial Approach

Humans have long realized that dogs can be helpful, in a number of ways, to achieving important goals. This is evident from our earliest interactions involving the shared goal of avoiding predators and acquiring food, to our more recent inclusion of dogs in a variety of contexts including therapeutic and educational settings. This paper utilizes a longstanding theoretical framework- the biopsychosocial model- to contextualize the existing research on a broad spectrum of settings and populations in which dogs have been included as an adjunct or complementary therapy to improve some aspect of human health and well-being. A wide variety of evidence is considered within key topical areas including cognition, learning disorders, neurotypical and neurodiverse populations, mental and physical health, and disabilities. A dynamic version of the biopsychosocial model is used to organize and discuss the findings, to consider how possible mechanisms of action may impact overall human health and well-being, and to frame and guide future research questions and investigations.

Terapia ocupacional assistida por cães: uma revisão de escopo da literatura brasileira

Resumo Terapeutas ocupacionais têm praticado a Terapia Assistida por Animais (TAA) incorporando cães em suas intervenções. A produção de conhecimento nacional sobre a Terapia Ocupacional Assistida por Cães foi analisada por meio de uma revisão de escopo. Esta investigação buscou obter respostas sobre quais populações têm sido focalizadas na Terapia Ocupacional Assistida por Cães no Brasil, quais os objetivos e resultados terapêuticos, de que forma o cão atuou neste processo, qual o treinamento necessário aos cães e qual a formação requerida ao terapeuta ocupacional para realizar tal terapia. A busca ocorreu nos periódicos nacionais de Terapia Ocupacional e na biblioteca Scielo.br por meio de descritores e critérios de inclusão. Não foram encontrados estudos da terapia ocupacional tendo cães como assistentes, mas sim sobre o cuidar de animais como uma ocupação humana e um papel ocupacional (n=4). Um estudo referiu a terapia ocupacional como uma das profissões que, no contexto estrangeiro, realiza a terapia assistida por cães com pessoas com deficiência e/ou sequelas físicas ou mentais, sendo os objetivos e resultados terapêuticos de reabilitação física ou cognitiva. A revisão revela que a produção nacional é incipiente, sobretudo se comparada à literatura estrangeira, que relata sobre a Terapia Ocupacional Assistida por Cães e informa sobre as populações, objetivos e resultados terapêuticos, a formação e competências necessárias ao terapeuta e o treinamento requerido ao cão. Reafirma-se a necessidade de estudos e de produção de conhecimento nacional para o embasamento teórico e diretrizes para a prática da Terapia Ocupacional Assistida por Cães no Brasil.

Animal-assisted therapy on happiness and life quality of chronic psychiatric patients living in psychiatric residential care homes: a randomized controlled study

BACKGROUND

Psychiatric patients who live in psychiatric residential care homes may often feel a loss of autonomy, decision making, and participation in social activities. They usually have few or no visitors and also do not have any purpose for living. Animals may increase the happiness and quality of life of psychiatric patients. This study aimed to evaluate the effects of Animal-Assisted Therapy (AAT) on happiness and quality of life of chronic psychiatric patients living in psychiatric residential care homes in Tehran, Iran.

METHODS

This randomized controlled trial was conducted with 70 males with a chronic psychiatric disorder who were living in psychiatric residential care homes in Tehran, Iran, in 2016. The patients were randomly selected and divided into animal therapy intervention group and control group. Patients in the intervention group received animal-therapy with a bird for eight weeks. Patients in the control group received no intervention. The Oxford Happiness Inventory evaluated all patients pre and post-intervention. To evaluate life quality, the Wisconsin Quality of Life Index was used. Data were statically analyzed using SPSS Ver.19.0. ANCOVA with pretest statistical control. The significance level was set as p < 0.05.

RESULTS

The mean age in both control and intervention groups were 47.12 and 45.82 years, and the mean age of illness onset for both control and intervention groups was 18.94 and 16.83 years, respectively. The result of this study showed that happiness in the intervention group had significantly increased (p < 0.001). The results also showed that the quality of life in four sub-domains increased significantly.

CONCLUSION

To bring happiness to chronic psychiatric patients living in psychiatric residential care homes is essential and may result in returning them to society and healthy life. The results of this study showed that AAT was helpful for chronic psychiatric patients living in psychiatric residential care homes and not only made them happy but also increased their quality of life.

TRIAL REGISTRATION

This was registered in Iranian Registry of Clinical Trials (IRCT) (clinical trial code: IRCT20101013004922N4. Registered 2018-08-19. Retrospectively registered, https://www.irct.ir/trial/32390.

Assessment of dental anxiety in children between 5 and 10 years of age in the presence of a therapy dog: a randomized controlled clinical study

PURPOSE

Children are often afraid to visit a dentist. Dental anxiety is a worldwide issue and a barrier to successful treatment outcome. Pet therapy, especially through dogs, has been demonstrated to be beneficial in reducing anxiety. In today's generation, where dopamine is prevalent, attention is hijacked, and children are tethered to screens-this research on animal-assisted therapy outlines the impact on children undergoing simple dental procedures, and to evaluate its use in long-term behavior management, and child and parental acceptance of this technique.

METHODS

One hundred and two children between five and 10 years of age and requiring simple dental procedures were selected randomly and divided into two groups. In Group A, dental treatment was carried out in the presence of a therapy dog, and in Group B (the control group), dental treatment was carried out in a regular dental setup. Anxiety levels were evaluated by pulse rate and anxiety rating scale. Prior to exiting the room, the parents were asked to rate the child's interaction with therapy dogs.

RESULTS

According to an independent t test, reduction in anxiety was highly significant (p < 0.001).

CONCLUSION

Animal-assisted therapy is an effective behavior management strategy.

The Impact of a 20-Minute Animal-Assisted Activity Session on the Physiological and Emotional States in Patients With Fibromyalgia

OBJECTIVE

To study the direct physiological and emotional impact of an animal-assisted activity (AAA) session (a form of complementary and integrative medicine) in patients with fibromyalgia (FM).

PATIENTS AND METHODS

The study population consisted of 221 participants with FM who were attending Mayo Clinic's Fibromyalgia Treatment Program between August 5, 2017, and September 1, 2018. This was a randomized controlled trial. Participants were randomly assigned to either the treatment group (a 20-minute session with a certified therapy dog and handler) or the control group (a 20-minute session with a handler only). To gain a better understanding of the direct physiological and emotional effects of AAA in patients with FM, we used multiple noninvasive physiologic-emotional biomarkers, including salivary cortisol and oxytocin concentrations, tympanic membrane temperatures, and various cardiac parameters, in addition to standardized pain and mood-based questionnaires.

RESULTS

Results show a decrease in heart rate, an increase in heart rate variability, an increase in well-being survey scores, an increase in salivary oxytocin, and subsequent tympanic membrane temperature changes, suggesting that participants in the treatment group were in a more positive emotional-physiologic state as a result of the AAA session compared with the control group.

CONCLUSION

Our results suggest that a 20-minute therapy dog visit in an outpatient setting can significantly and positively impact the physical and mental health of patients with FM.

Randomized Trial of Therapy Dogs Versus Deliberative Coloring (Art Therapy) to Reduce Stress in Emergency Medicine Providers

OBJECTIVE

Cognitive stress during shift work contributes to burnout in emergency department (ED) workers. We hypothesize that if physicians and nurses interact with a therapy dog for 5 minutes while on ED shift, both their perceived and their manifested stress levels will decrease.

METHODS

In this single-center, prospective, randomized controlled clinical trial (NCT03628820), we tested the effectiveness of therapy dogs versus coloring a mandala and versus no intervention (control) on provider stress. Consenting emergency medicine physicians and nurses provided three self-reported assessments of stress and saliva samples at the start (T1), at the middle (T2), and near the end (T3) of shift. Thirty minutes prior to T2, participants were randomized to either interacting with a therapy dog or coloring for 5 minutes; controls had neither. Stress was assessed on visual analog scale (VAS, 0-100 mm) and with salivary cortisol (Salimetrics) and the modified Perceived Stress Scale (mPSS-10). To assess potential change in participant behavior, patients of providers in either group were asked to complete an internally derived survey of empathic behaviors displayed by providers at T1 and T3.

RESULTS

We enrolled 122 providers (n = 39 control, n = 40 coloring, n = 43 dog); 48% were residents, and 60% enrolled on an evening shift. At T1, mean (±SD) VAS score was not different between groups (18.2 [±17.8] mm). At T3, VAS tended to increase with coloring (24.5 mm), remain unchanged in controls (20 mm), and decreased slightly with dogs (13.6 mm, p = 0.018 vs. coloring, Tukey's post hoc). Salivary cortisol levels were consistently highest at the beginning of each providers' shift and were significantly decreased versus control in both the dog and the coloring groups (p < 0.05, Tukey's). We observed no difference between groups for the mPSS-10 nor in patient reported survey of empathic behaviors.

CONCLUSION

This randomized controlled clinical trial demonstrates preliminary evidence that a 5-minute therapy dog interaction while on shift can reduce provider stress in ED physicians and nurses.

Effects of Animal-Assisted Activity on Mood States and Feelings in a Psychiatric Setting

BACKGROUND: Research has shown that animal-assisted activity (AAA) effectively improves physiological, psychological, emotional, and social well-being in various environments. AIMS: To identify how AAA affects mood states and feelings among both patients and staff on inpatient psychiatric units. METHODS: This study used a quasi-experimental, pre-/posttest design with nonequivalent comparison groups. Quantitative data were collected using the Visual Analog Mood Scale. Demographic data, with an open-ended question, were obtained postsessions. RESULTS: Significant changes were observed pre- and postexposure to AAA sessions with a therapy dog. Negative moods decreased, and positive moods increased as measured by the Visual Analog Mood Scale. Content analysis identified themes of feeling happy, feeling relaxed, and feeling calm. CONCLUSIONS: This research expands scientific evidence associated with AAA by identifying changes in mood states and feelings among individuals in a psychiatric setting.

A Systematic Literature Review of Animal-Assisted Interventions in Oncology (Part II): Theoretical Mechanisms and Frameworks

Animal-assisted interventions (AAIs) can improve patients' quality of life as complementary medical treatments. Part I of this 2-paper systematic review focused on the methods and results of cancer-related AAIs; Part II discusses the theories of the field's investigators. Researchers cite animal personality, physical touch, physical movement, distraction, and increased human interaction as sources of observed positive outcomes. These mechanisms then group under theoretical frameworks such as the social support hypothesis or the human-animal bond concept to fully explain AAI in oncology. The cognitive activation theory of stress, the science of unitary human beings, and the self-object hypothesis are additional frameworks mentioned by some researchers. We also discuss concepts of neurobiological transduction connecting mechanisms to AAI benefits. Future researchers should base study design on theories with testable hypotheses and use consistent terminology to report results. This review aids progress toward a unified theoretical framework and toward more holistic cancer treatments.

Distraction-focused interventions on examination stress in nursing students: Effects on psychological stress and biomarker levels. A randomized controlled trial

BACKGROUND

Nursing students all over the world experience high levels of stress with negative impacts on their health, emotional state and performance.

AIM

This study aimed to investigate the effects of distraction-focused interventions on examination stress and anxiety in nursing students.

METHODS

A randomized controlled, parallel trial design was conducted from January to June 2016. After baseline measurement, 72 participants were randomized to one of the following groups (n = 18 each): (i) animal-assisted therapy; (ii) music therapy; (iii) mandala painting; (iv) control group. Outcomes of all groups in terms of stress-reduction were compared by measuring self-reported perceived stress (STAI-State and visual analogue stress scale) and salivary biomarker levels (Cortisol and Immunoglobulin A).

RESULTS

Fifty-seven complete data sets (n = 12-16 for each group) were analysed. All distraction-focused interventions showed stress and anxiety reduction in everyday school situations. By contrast, on days with examinations, stress reductions did not reach statistical significance in regard to self-reported psychological stress. At the same time, interventions resulted in significantly decreased levels of stress biomarkers (P < .001).

CONCLUSIONS

Our preliminary findings suggest positive but situation-dependent effects of distraction-focused interventions in academic settings. Further research should investigate the complex relationship between physiological and psychological stress parameters.

Animal-Assisted Intervention Improves Pain Perception in Polymedicated Geriatric Patients with Chronic Joint Pain: A Clinical Trial

Chronic joint pain is associated to an increase in the consumption of medication and decrease in life quality in elderly people, which requires developing non-pharmacological treatments. The aim of this study was to evaluate the effectivity of a group intervention, based on animal-assisted therapy and applied to elderly people with chronic joint pain and polymedication, regarding the decrease of chronic pain, use of analgesics and improvement of life quality. A randomized controlled trial, two arms and open-label was conducted in a Primary Health Center. Twelve weekly sessions of kinesitherapy; in the EG, these exercises were performed with the additional assistance of the therapy dog. A total of 52 participants (22 Control Group (CG), 30 EG), average age 77.50 (±7.3), women 90.4%. A significant reduction on post-intervention values of pain β = −0.67(−1.27, −0.08), p = 0.03 and pain induced insomnia β = −0.53(−1.01, −0.05), p = 0.03 was found in EG for increasing baseline values. Animal-assisted therapy leads to an additional reduction in the perception of pain and pain induced insomnia in individuals with higher baseline severity. The presence of the dog improves the attachment to intervention and the satisfaction of the participants.

Children's Relationship With Their Pet Dogs and OXTR Genotype Predict Child-Pet Interaction in an Experimental Setting

Human-animal interaction (HAI) research has increasingly documented the important role of pet dogs in children's lives. The quality of interaction between children and their pet dogs, however, is likely influenced by individual differences among children as well as their perceived relationship with their pet dog. Ninety-seven children aged 7-12 years and their pet dogs participated in a laboratory protocol during which the child solicited interaction with their dog, from which time petting and gazing were recorded. Children reported on their perceived relationship with the pet dog via interview. Children provided saliva samples, from which a polymorphism in the oxytocin receptor, OXTR rs53576, which has long been implicated in social behavior, was genotyped. The results showed that OXTR genotype and children's perceived antagonism with the pet dog predicted the amount of petting, but not gazing, between children and their pet dogs. This research adds to the growing body of HAI research by documenting individual differences that may influence children's interactions with animals, which is key to research related to pet ownership and understanding factors that may impact therapeutic interventions involving HAI.

Therapy Dogs as a Crisis Intervention After Traumatic Events? - An Experimental Study

Animal-assisted therapy has been proposed as a treatment adjunct for traumatized patients. In animal-assisted crisis response, dogs are used directly after a traumatic event to reduce stress and anxiety. However, to date there are few controlled studies investigating the effects of therapy dogs on PTSD symptoms and to our knowledge there is no study investigating the effects of a therapy dog intervention directly after a traumatic event. In this study, 60 healthy female participants were randomly assigned to one of three groups: after exposure to a “traumatic” film clip (trauma-film paradigm), one group of participants interacted with a friendly dog for 15 min, another group of participants watched a film clip showing a person interacting with a friendly dog and the last group was instructed to relax. Participants who had interacted with the dog after the film reported lower anxiety levels, less negative affect, and more positive affect after the intervention as compared to the other two groups. However, the participants who interacted with the dog showed a smaller decrease in physiological arousal after the traumatic film clip compared to both other groups. There were no differences in intrusion symptoms between the three groups. Our results show that dogs are able to lessen subjectively experienced stress and anxiety after a “traumatic” stress situation.

The Relationship between Pet Ownership, Social Support, and Internalizing Symptoms in Students from the First to Fourth Year of College

Internalizing symptoms are prevalent in students as they enter and complete college. Considering research suggesting mental health benefits of pet ownership, this study explores the relationship between pet ownership, social support (SS), and internalizing symptoms (IS) in a cohort of students across their 4-year college experience. With no differences at college entry, students growing up with pets had greater IS through the fourth year, and greater SS through the third year, than those without pets. Currently living with a pet, gender, SS and personality predicted IS in the fourth year. Females experiencing higher IS in their first year are more likely to live with pets in their fourth year, and fourth year females living with pets or greatly missing absent pets have higher IS than females without pets or missing pets less. Findings suggest a unique relationship between IS in female students and their pet relationships not seen in males.

Levels of Nature and Stress Response

A growing number of studies have shown that visiting green spaces and being exposed to natural environments can reduce psychological stress. A number of questions concerning the effects of natural environments on levels of stress remain including, "Are activities engaged in natural environments more or less beneficial at reducing stress when compared to those done in more urban settings?" This study examined this question from the perspective of "levels of nature". That is, data on levels of stress were collected from three sites, one site having wilderness-like characteristics, a second site representing a municipal-type park, and a third site representing a built environment (indoor exercise facility) within a city. Data were generated using biophysical markers (cortisol and amylase) and a psychological measure within a pre- and post-visit format. Findings suggest that visiting natural environments can be beneficial in reducing both physical and psychological stress levels, with visitors to a natural environment reporting significantly lower levels of stress than their counterparts visiting a more urbanized outdoor setting or indoor exercise facility.

Impact of an animal-assisted therapy programme on physiological and psychosocial variables of paediatric oncology patients

The objective of this study was to propose an intervention and safety protocol for performing animal-assisted therapy (AAT) and evaluating its efficacy in children under outpatient oncological treatment based on psychological, physiological, and quality of life indicators for the children and caregivers. The sample consisted of 24 children diagnosed with leukaemia and solid tumours (58% girls with a mean age of 8.0 years) who underwent an AAT programme consisting of three 30-min sessions in an open group. Two dogs (one Labrador retriever and one golden retriever) were used, and activities such as sensory stimulation, gait training, and socialization were conducted. The exclusion criteria were severe mental problems, inability to answer the questions included in the instruments used, allergy to animals, unavailability/lack of interest, isolation precaution, surgical wound, use of invasive devices, ostomy, no current blood count for evaluation, neutropaenia, infection, fever, diarrhoea, vomiting, respiratory symptoms at the beginning of the intervention or 1 week before the intervention, hospitalization or scheduled surgery, and non-completion of the AAT programme. The variables analysed using validated self or other evaluations were stress, pain, mood, anxiety, depression, quality of life, heart rate, and blood pressure. A quasi-experimental study design was used. We observed a decrease in pain (p = 0.046, d = –0.894), irritation (p = 0.041, d = –0.917), and stress (p = 0.005; d = –1.404) and a tendency towards improvement of depressive symptoms (p = 0.069; d = –0.801). Among the caregivers, an improvement was observed in anxiety (p = 0.007, d = –1.312), mental confusion (p = 0.006, d = –1.350), and tension (p = 0.006, d = –1.361). Therefore, the selection criteria and care protocols used for the AAT programme in the oncological context were adequate, and the programme was effective.

Animal-Facilitated Therapy Program: Outcomes from Caring Canines, a Program for Patients and Staff on an Inpatient Surgical Oncology Unit

BACKGROUND

Animal-facilitated therapy (AFT) is a complementary medicine intervention. To the authors' knowledge, no study has investigated the benefits of an AFT program in an adult surgical oncology setting.

OBJECTIVES

The purpose of this study is to assess the effects of an AFT program on patients and staff on a surgical oncology unit.

METHODS

A quasiexperimental design was used for the patient group, and a pre-/post-test design was used for the staff group. The intervention involved the AFT program being fully integrated on a surgical inpatient unit. Outcomes included patient-reported symptoms and quality-of-life (QOL) outcomes for patients, as well as professional QOL for staff.

FINDINGS

QOL indicators improved for all patients, and the level of energy at follow-up was significantly higher in the AFT group after adjusting for baseline. For staff, compassion satisfaction was high and burnout was low.

The feasibility of brief dog-assisted therapy on university students stress levels: the PAwS study

BACKGROUND

Pet therapy is becoming increasingly popular and is used in a variety of ways from encouraging communication in older adults to improving wellbeing in those with serious mental illness. Increasingly Universities have been offering pet therapy to students in an effort to reduce stress. However, little evidence currently exists to support the effectiveness of reducing measurable stress levels after a standalone drop-in unstructured session. The University of Sheffield's Counselling Service works in partnership with Guide Dogs for the Blind to give students access to calm, well-trained animals for informal group stress relief.

AIMS

To assess the feasibility of implementing and evaluating unstructured group interventions with a Guide Dog in training within the university student population.

METHODS

One hundred and thirty-one students who attended pet therapy at the University Counselling Service were recruited on a voluntary basis to take part in the research. Stress, measured on the state trait anxiety inventory, and blood pressure were taken before and after a 15-min intervention.

RESULTS

All measures showed a statistically significant reduction immediately after the intervention.

CONCLUSION

Short interactions with a Guide Dog in training appear to reduce stress in University students. A controlled study is required to investigate further.

Effects of Animal-assisted Activities on Biobehavioral Stress Responses in Hospitalized Children: A Randomized Controlled Study

PURPOSE

This study assessed the effectiveness of animal-assisted activities (AAA) on biobehavioral stress responses (anxiety, positive and negative affect, and salivary cortisol and C-reactive protein [CRP] levels) in hospitalized children.

DESIGN AND METHODS

This was a randomized, controlled study.

METHOD

Forty-eight participants were randomly assigned to receive a 10-minute AAA (n=24) or a control condition (n=24). Anxiety, positive and negative affect, and levels of salivary biomarkers were assessed before and after the intervention.

RESULTS

Although increases in positive affect and decreases in negative affect were larger in the AAA condition, pre- and post-intervention differences between the AAA and control conditions were not significant. In addition, pre- and post-intervention differences between the conditions in salivary cortisol and CRP were not statistically significant. Baseline levels of anxiety, cortisol, and CRP had a significant and large correlation to the corresponding post-intervention measures. Scores on the Pet Attitude Scale were high but were not associated with changes in anxiety, positive affect, negative affect, or stress biomarkers.

CONCLUSIONS

Although changes were in the expected direction, the magnitude of the effect was small. Future randomized controlled trials with larger recruitment are needed to determine the effectiveness of AAAs in reducing biobehavioral stress responses in hospitalized children.

PRACTICE IMPLICATIONS

Nurses are positioned to recommend AAA as a beneficial and safe experience for hospitalized children.

A Review of the Benefits of Nature Experiences: More Than Meets the Eye

Evidence that experiences of nature can benefit people has accumulated rapidly. Yet perhaps because of the domination of the visual sense in humans, most research has focused on the visual aspects of nature experiences. However, humans are multisensory, and it seems likely that many benefits are delivered through the non-visual senses and these are potentially avenues through which a physiological mechanism could occur. Here we review the evidence around these lesser studied sensory pathways—through sound, smell, taste, touch, and three non-sensory pathways. Natural sounds and smells underpin experiences of nature for many people, and this may well be rooted in evolutionary psychology. Tactile experiences of nature, particularly beyond animal petting, are understudied yet potentially fundamentally important. Tastes of nature, through growing and consuming natural foods, have been linked with a range of health and well-being benefits. Beyond the five senses, evidence is emerging for other non-visual pathways for nature experiences to be effective. These include ingestion or inhalation of phytoncides, negative air ions and microbes. We conclude that (i) these non-visual avenues are potentially important for delivering benefits from nature experiences; (ii) the evidence base is relatively weak and often based on correlational studies; and (iii) deeper exploration of these sensory and non-sensory avenues is needed.

The Buffer Effect of Therapy Dog Exposure on Stress Reactivity in Undergraduate Students

Stress is an insidious health risk that is commonly reported among university students. While research suggests that dog exposure may facilitate recovery from a stress response, little is known about the buffer effect of dog exposure on the stress response to a future stressor. This study examined whether interaction with a therapy dog could reduce the strength of the physiological stress response when exposed to a subsequent stressor. Sixty-one university students were randomly assigned to either a therapy dog (TD, n = 31) or a no-dog control (C, n = 30) group. The stress response was measured by electrodermal activity (EDA) in response to the Paced Auditory Serial Addition Test (PASAT). Participants also completed questionnaires that assessed pet attitude, general stress levels, and affect. Analyses of covariance (ANCOVAs) showed that increase in EDA was significantly more pronounced in the C group than in the TD group (p < 0.01). Pet attitudes did not modulate the buffer effect of therapy dog exposure. Results suggest that therapy dog exposure may buffer the stress response in university students, which has implications for the promotion of a viable stress management program on university campuses.