The Pet Therapy in Nursing Care

Nursing Care and Pet Therapy

What is Pet Therapy,Nursing Research on Pet Therapy,Earlier Studies About Pet Benefits,First Trial on Pet Dog,Animal Interaction and Children,Effectiveness of Animal Companionship,Benefits of Animal Championship,Outcomes of Study.

What is Pet Therapy

    Pet therapy (use of a companion animal to benefit the health of humans) has become a very popular intervention for a variety of clients, and many nurses as well as pet owners have become involved in its delivery. 

    While at the intuitive level pet therapy appears to be beneficial, there are relatively few scientific studies to support its effectiveness. This growing body of research on pet therapy has largely been generated by multidisciplinary scholars, of which nurses have been active participants.

Nursing Research on Pet Therapy 

    In general, the research on pet therapy generated by nurses falls into three distinct categories: research on the bio-physiological effects of pet therapy; research on the effects of companion animals in alleviating the distress of children undergoing painful procedures, and research on the effectiveness of companion animals for the elderly. 

    This review is divided into these three categories. Studies are included if at least one of the authors is a nurse.

Earlier Studies About Pet Benefits

    One of the earliest studies that demonstrated the health benefits of companion animals was coauthored by a nurse, Sue Ann Thomas (Friedmann, Katcher, Lynch, & Thomas, 1980). 

    A group of patients who had been admitted to either coronary care or intensive care units with diagnoses of myocardial infarction or angina pectoris were followed for 1 year after discharge. 

    At one year, 28% of the patients who did not own pets had died, but only 6% of the pet owners had died, caring for the animal was not a factor in the survival rate, and pet ownership was correlated with survival but not with the physiological severity of the disease. 

    Thomas also coauthored a subsequent study that demonstrated that the presence of a friendly animal could modify children's perceptions of an experimental situation and result in lower blood pressures while the children were resting and while they were reading (Friedmann, Katcher, Thomas, Lynch, & Messent , 1983).

First Trial on Pet Dog 

    The first controlled trial of the effect of interaction with a companion dog on blood pressure was published in Nursing Research in 1984 (Baun, Bergstrom, Langston, & Thomas, 1984). 

    Prior to this time, several investigators outside of nursing had released findings from non-experimental observations that seemed to indicate that petting a dog could lower blood pressure, but these studies were never published as scientific journal articles. Thus, the Nursing Research article became a landmark study in the fledgling field of the human animal bond. 

    The study used a within subject, repeated measures design to measure blood pressure (systolic, diastolic, and mean), heart rate, and respiratory rate across three protocols (interacting with a dog to whom the subject was attached, interacting with an unknown [control ] dog, and reading quietly). 

    There was a statistically significant difference among the three protocols. Interaction with a known dog resulted in greater decreases in BP than either interacting with the control dog, or reading quietly. 

    This study was the first to suggest that attachment to the animal played an integral role in the human's physiological responses to that animal. Subsequent nursing studies on hypertensives (Schuelke et al., 1991) and other subjects (Oetting, Baun, Bergstrom, & Langston, 1985) confirmed these findings.

Animal Interaction and Children

    Children and animals seem drawn to each other and several studies have explored the benefits of this relationship in the clinical setting. 

    In a study of the effects of the presence of a companion animal on physiological arousal and behavioral distress exhibited by preschool children during a routine physical examination, a within subject, time series design was used to study healthy children during two physical examinations, with and without a dog present, conducted in a behavioral laboratory (Nagengast, Baun, Megel, & Leibowitz, 1997). 

    Statistically significant differences were found with greater reductions in subjects' systolic and mean arterial pressure, heart rate, and behavioral distress when a dog was present.

    A follow up study was conducted on pre- school children attending a pediatric clinic using a two group, repeated measures design, in which the experimental group had a therapy dog present during their pediatric examination and the control group did not have the dog present (Hansen , Messinger, Baun, & Megel, 1999). 

    Physiological measures of blood pressure and finger temperature were not statistically significantly different between the dog and no dog groups but were found not to be good measures of physiologic arousal in this age group. Behavioral distress was statistically significantly less in the dog group versus the no-dog group. 

    These findings replicated those of Nagengast and colleagues (1997) and suggested that companion animals may be useful in a variety of health care settings to decrease procedure induced distress in children.

Effectiveness of Animal Companionship

    A third study evaluated the effectiveness of a companion animal on physiologic arousal and behavioral distress among children undergoing a dental procedure (Havener et al., 2001). A two group, repeated measures experimental design was used to study school age children undergoing procedures in a pediatric dental children. Half the children had the dog present during the procedure and half did not. 

    Children who initially verbalized distress on arrival at the clinic had decreased physiologic arousal during the time the child was on the dental table waiting for the dentist to arrive. Both of these studies demonstrated that a therapy dog could be used in clinical settings to alleviate procedural distress in children.

Benefits of Animal Championship

    The majority of studies of the benefits of companion animals have been conducted with the institutionalized elderly, both cognitively intact and cognitively impaired. One of the earliest landmark studies was conducted by nurses in the Veterans Administration system (Robb, Boyd, & Pristash, 1980). 

    At different times a wine bottle, a plant, or a caged dog were placed in the day room of a long-term care division and socially interactive behaviors were measured. Of the three stimulus objects, the caged puppy produced the most dramatic increase in social behavior.

    Two early studies addressed the effect of a dog on social interaction among nursing home residents, one on cognitively intact residents (Buelt, Bergstrom, Baun, & Langston, 1985) and the second on cognitively impaired residents (McArthur, Brunmeier, Bergstrom, & Baun, 1986). 

    Within subject, repeated measures designs were used in both studies to measure socially interactive behaviors, which increased in the presence of a dog although the majority of the behaviors were directed at the dog.

    Caged birds were placed in the rooms of elderly residents of skilled rehabilitation units, and before and after measures of depression, loneliness, and morale were completed on admission and after 10 days (Jessen, Cardiello, & Baun, 1997). 

    The experimental group (bird) had a significant decrease in depression but not in morale or loneliness compared to the control group (no bird). Results of this study supported the use of companion animals other than dogs to lessen the negative effects of hospitalization in institutionalized elderly.

    The use of a therapy dog with persons with Alzheimer's disease (AD) has resulted in increased socialization (Batson, McCabe, Baun, & Wilson, 1998; Churchill, Safaoui, McCabe, & Baun, 1999), improved social behaviors (Kongable, Stolley , & Buckwalter, 1990) and decreased agitation (Churchill et al.). 

    When a resident dog was introduced on an AD special care unit, the number of problem behaviors decreased and decreased remained across the entire 4 weeks of the study (McCabe, Baun, Speich, & Agrawal, 2002). 

    Residents of AD special care units increased nutritional intake, which continued over 6 weeks when aquariums were introduced into the dining rooms. This increased nutritional intake resulted in increased weight gain among the residents (Edwards & Beck, 2002).

Outcomes of Study

    From the studies cited above it is clear that quantity of research on the health benefits of companion animals has increased steadily and that nurses have been active investigators in a multidisciplinary field. 

    Published studies on human animal interactions generally have had significant findings and support the use of animals to benefit the health of humans. Thus, there is some support for pet therapy, although a lot more research on the health benefits of companion animals still needs to be conducted.