Animal Assisted Therapy

Jennifer EdgellKimberly Holden

Vanessa Gonzolez-LopezAmy Wirick

Over the past several years Animal Assisted Therapy (AAT) has gained widespread support and application.

It is an interdisciplinary approach to care that can promote quality of life and positive health benefits.

Those in our group have a love for animals and have noticed a therapeutic effect in our own lives.

We wanted to prove, through research and evidence that animals have a place in healthcare.

(Young and Koopsen, 2011)

Why are we interested?

Does Animal Assisted Therapy improve healthcare outcomes?”

Question

Animal-assisted therapy (AAT) is a therapeutic patient interaction with a domestic “pet-type” animal that is not one’s own pet. (Nahm, et al., 2010)

Animals that can be used in AAT include: dogs, cats, horses, rabbits, guinea pigs, ferrets.

Pet therapy dates as far back as 1699 and was first used in the U.S. in the 1940’s. (Parshall, 2003)

Definition and History

Study Therapy Dogs in the Emergency Department

This study was done to examine acceptance by staff and patients of a therapy dog in the emergency department.

Setting: a large, Midwest, urban teaching hospital. 2 therapy dogs were used. Quincy, a mixed-breed Labrador retriever, and Brinkley, a Burmese Mountain Dog.

Participants: 125 patients (included actual patients and their visitors), and 105 staff members. All were older than 18 years of age.

Circumstances: Patients were asked if they would like a visit from the therapy dog. People could then pet the dog, have the dog do tricks, talk about the dog, and sometimes throw a treat to the dog.

Methods: Immediately after visits by a therapy dog in a University Hospital ED, all available ED staff, patients, and their visitors were invited to complete a survey. The survey asked about the respondent’s attitudes toward dogs in general, and about dogs in the ED.

87 patients and 73 staff visited with the therapy dog. 93% of the patients and 95% of the staff thought that

therapy dogs should visit the ED. Four patients and one staff member felt the therapy

dog could be dangerous. Eleven patients and 11 staff members strongly

agreed that therapy dogs made the ED less sanitary. 8.6 % of the staff and 4.2% of the patients worried

that the TD interfered with the work of the ED.

Results

This is the first study of AAT in an ED. Acceptance by patients and staff was excellent. The specific benefits of AAT in EDs should be further studied.

Conclusions

Introduction: This study was done to see if a 12 minute visit in the hospital by a therapy dog improved hemodynamic measures, lowered neuro-hormone levels, and decreased anxiety in patients with heart failure.

Setting: A cardiac care unit and a cardiac observation unit.

Participants: “76 patients with a diagnosis of admitted to

the cardiac care unit or cardiac observation unit” (Cole, Gawlinski, Steers & Kolterman, 2007, p. 577) Certain criteria for participation were required.

Study: Animal-assisted therapy in patients hospitalized with heart failure

Methods: A group of heart failure patients was randomly placed in 3 groups. One group received a visit from a volunteer with a dog for 12 minutes, another group received a visit from a volunteer for 12 minutes and a control group received the usual care. Data was collected three times; a baseline was established, then at 8 and 16 minutes. Each group was evaluated 3 times.

Data collection procedures: Randomly selected patient were assigned to 3 groups. Patients in the experiment group were received a visit from a volunteer and dog. The dogs were not controlled for and included 1 extra large, 6 large, 5 medium and 2 small dogs. Patients in the volunteer only group received a visit from a volunteer-only. Patients in the control group were asked to lie quietly. For all groups data was collected immediately before the visit, 8 minutes after the intervention started and at 16 minutes, which was 4 minutes after the visit ended.

Methods and Data Collection Procedures

Compared to the control group, the volunteer-dog group had significant decreases in systolic pulmonary artery pressure and pulmonary capillary wedge pressure during and after the visit.

Compared to the volunteer-only group, the volunteer-dog group had decreases in epinephrine levels and in norepinephrine levels during and after the visit.

After the visit, the volunteer-dog group had the greatest decrease in anxiety compared with the volunteer-only and the control groups.

Conclusions: In patients hospitalized with heart failure, AAT improved cardiopulmonary pressures, neuro-hormone and levels of anxiety.

Results and Conclusions

Introduction: Fibromyalgia is an often disabling widespread chronic pain condition affecting about 2–3% of adults in the Americas and Europe, with no currently available curative treatment. (Marcus, Berstein, Constantin, Kunkel, Breurer & Hanlon, 2012

Setting: An outpatient pain clinic setting Participants: 133 participants were part of this study. All

participants were > than 18 yrs old and had a diagnosis of fibromyalgia.

Circumstances: The study wanted to look at the advantages of having a therapy dog present in a pain clinic waiting room.

Purpose: The idea was to determine if the therapy dog would have a positive impact on the patient’s levels of pain, stress, fatigue and anxiety levels.

Study:Pain Medicine Impact of Animal

Assisted therapy for outpts with Fibromyalgia

Methods of Data Collection and Conclusions

Participants were divided into two groups. They were randomly selected to either be in a group that would sit in a clinic waiting room with a therapy dog present and the control group would sit in a waiting room without the therapy dog present. The participants of the dog therapy group were introduced to the dog handler and the therapy dog. Participant interaction with the therapy dog averaged 12 minutes.

All participants were asked to fill out a survey before and after their appointments. The surveys asked them to rate their levels of anxiety, pain, stress and fatigue.

Overall, pain severity was significantly reduced after a brief therapy dog visit, with clinically meaningful pain relief reported in 34% of fibromyalgia patients after the dog visit vs 4% in the waiting room control. (Marcus et al., 2012)

Introduction: The primary objective of this review is to synthesize the existing literature on the use of animal-assisted therapy and activity (AAT/A) as complementary treatment among people living with chronic disease and to discuss the possible application of this practice among children living with HIV.

Methods: Relevant databases were searched between March 10 and April 11, 2011, using the words: animal assisted therapy or treatment and chronic conditions or diseases. Thirty-one articles were found and 18 followed the inclusion and exclusion criteria.

definition of AAT for the purpose of this review was: any type of regular interaction with animals with the intention of creating positive behavioral, emotional or physical changes related to chronic disease.

Study:

Natural healers: a review of animal assisted therapy and activities as complementary treatment for chronic conditions

A Literature Review

According to the results of this integrative review, three areas were identified the first area was the social effects of AAT/A

---- Animal visitation was reported as both a good distraction and normalizing experience of the hospital environment for the children. ----AAT increased social interaction in an occupational therapy program for children with autism spectrum disorders. ----Adults with various medical conditions have also been reported to benefit from working with therapy animals socially, emotionally and psychologically. the second area was the physical effects of AAT/A ----several of the studies showed a decrease in anxiety during hospital stays in children and provided pain relief described to be comparable to the child taking acetaminophen.

Results

The third area was the perspective of caregivers. ----Staff was open to having AAT in place but were originally concerned with safety and infection risk. ---- After implementation, staff reported feeling more open to the program and that the animals created a friendlier atmosphere.

Conclusions: * the potential benefits of implementing more AAA/T programs in medical centers and hospitals are numerous. * more research must be done to determine the function AAA/T may have in complementary therapy for chronic conditions in children and adults.

Results and Conclusions

There are many potential benefits for the use of Animal Assisted Therapy and Activities.

More research and clinical trials need to be conducted to prove these benefits occur.

Conclusions and Implications for Practice

Young and Koopsen(2011) along with the authors of the articles we reviewed listed many benefits of AAT. Among those are stress reduction, alleviating loneliness, reducing anxiety, instilling a sense of responsibility, reduction of depression and ongoing comfort. There were physiologic benefits as well, such as lowering heart rate and blood pressure. As nurses providing holistic care to individuals, we have come to understand through this project the importance animals can add to traditional therapies.

Cole, K. M., Gawlinski, A., Steers, N., & Kolterman, J. (2007, November). Animal-assisted

therapy in patients hospitalized with heart failure. Am J Crit Care, 16(6), 575-585.

Marcus, D.A., Bernsteirn, C.D., Constantine, J.M., Kurkel, F.A. (2012). Impact of Animal

Assisted Therapy for Outpatients with Fibromyalgia. Pain Medicine. Wiley

Periodicals,

Inc. Retrieved from http

://onlinelibrary.wiley.com.libcat.ferris.edu/doi/10.1111/j.1526-

4637.2012.01522.x/full

Nahm, N., Lubin, J., Lubin, J., Bankwitz, B. K., Castelaz, M., Chen, X., Shackson, J. C.,

Aggarwal,

M. N., Totten, V. Y., (2010). Therapy dogs in the emergency department.

Western Journal of Emergency Medicine. 13(4), 363-365.

References

Parshall, D. (2003). Research and reflection: animal-assisted therapy in mental

health settings. Counseling And Values, 48(1), 47-56.

Reed,R., Ferrer, L., Villegas, N., (2012). Natural healers: a review of animal assisted

therapy and activities as complementary treatment for chronic conditions.

Rev. Latino-Am. Enfermagem May.-June;20(3):612-18

www.eerp.usp.br/rlae

Young, C., Koopsen, C., (2011) Spirituality, Health, and Healing An Integrative

Approach. (2nd Edition) Sudbury: MA . Jones and Bartlett Publishers

References