Animal-assisted activities/therapy (AAA/T) is a highly effective form of psychotherapy intervention that has not only been shown to aid stress and depression, but provide a sense of companionship that can combat feelings of isolation. It is a cheap yet effective way to maximize health outcomes for our hospital patients.

Psychotherapies are needed because patients are prone to comorbidities such as stress, anxiety, and depression. For instance, major depression is three to five times higher in oncology patients than the general population (Miller, 2008).

These comorbidities can have negative effects on the patient’s health outcome due to their immunosuppressive effects and decreased treatment adherence, leading to slowed recovery, and increased mortality and cancer recurrence rates (Miller, 2008; Reiche, 2004; Mystakidou, 2005).

The Joint Commission on Accreditation of Healthcare Organizations has also noted the importance of such holistic health care, recognizing the importance of emotional health on disease recovery (Clark, 2003). To achieve a maximum health outcome for our patients, we need to address comorbidities with psychotherapies, such as AAA/T. 

AAA/T has been shown to be beneficial for reducing stress, improving moods and energy level, decreased perceived pain, and decreasing anxiety. The soothing effect of petting a dog has been shown to increase salivary immunoglobulin concentration, demonstrating the resulting immune function boost (Charnetski, 2004).

In addition to reversing the immunosuppressive effects of depression, stress, and anxiety, AAA/T can improve patient outcome by increasing willingness to adhere to treatment through decreasing perceived pain and increasing perceived energy levels. 

Despite fears of allergies, phobias, and zoonotic infections, AAA/T does not need to be harmful to patients as long as proper guidelines are in place (Lefebvre and Golab, 2008). Most of these fears arose from studies in hospitals where infection control guidelines were almost entirely absent.

Prescreening patients and having designated routes in and out of the hospital avoid issues of allergies and phobias. Zoonotic infection transmission is limited by high standards of hygiene, animal training, and limited, controlled interaction between the patient and the AAA/T dog.

There are measures in the protocol to prevent zoonotic disease transmission by fecal and fecal-oral routes, surface contact, saliva, bites and blood, and external parasites. The protocol at Duke’s AAA/T program adheres to and exceeds the guidelines for safety and infection control as laid out by Lefebvre and the committee in the American Journal of Infection Control (2008).

Animal-assisted activity/therapy is an important tool for hospitals and clinics to achieve the best possible health outcome for their patients. By using appropriate infection control guidelines, we can utilize this beneficial therapy without increased risk to our patients. 

References

Charnetski, C. J., Riggers, S., Brennan, F. X. (2004) Effect of petting a dog on immune system Function. Psychological Reports, 95, 1087-1091.

Clark, P. A., Drain, M., Malone, M. P. (2003) Addressing patients’ emotional and spiritual needs. Joint Commission Journal on Quality and Safety, 29 (12), 659-670.

Lefebvre, S. L., Peregrine, A.S., Golab, G.C., Gumley, N.R., Waltern-Toews, D., Weese, J. S. (2008) A veterinary perspective on the recently published guidelines for animal-assisted interventions in health-care facilities. Public Veterinary Medicine: Public Health, 233 (3), 394-402.

Lefebvre, S. L., Golab, G. C., Christensen E., Castrodale, L., Aureden, K., Bialachowski, A., Gumley, N., Robinson, J., Peregrine, A., Benoit, M, Card, M L., Horne, L. V., & Weese, J. S. (2008). Guidelines for animal-assisted interventions in health care facilities. American Journal of Infection Control, 36(2), 78-85.

Miller, A. H., Ancoli-Israel, S., Bower, J. E., Capuron, L, Irwin, M. R. (2008) Neuroendocrine-Immune mechanisms of behavioral comorbidities in patients with cancer. Journal of Clinical Oncology, 26 (6), 971-982.

Mystakidou, K., Tsilika, E., Parpa, E., Katsouda., E., Galanos, A., Vlahos, L. (2005) Assessment of anxiety and depression in advanced cancer patients and their relationship with quality of life. Quality of Life Research 14, 1825-1833.

Passik, S. D., Dugan, W., McDonald, M., Rosenfeld, B., Theobald, D. E., Edgerton, S. (1998) Oncologists’ recognition of depression in their patients with cancer. Journal of Clinical Oncology, 16(4), 1594-1600.

Reiche, E., Nunes, S., Morimoto, H. (2004) Stress, depression, the immune system, and cancer. Psychological features of cancer, 5, 617-625.