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Outcomes of a controlled trial with visiting therapy dog teams on pain in adults in an emergency department

By B. Carey, C. A. Dell, J. Stempien, S. Tupper, B. Rohr, E. Carr, M. Cruz, S. Acoose, P. Butt, L. Broberg, L. Collard, L. Fele-Slaferek, C. Fornssler, D. Goodridge, J. Gunderson, H. McKenzie, J. Rubin, J. Shand, J. Smith, J. Trask, K. Ukrainetz, S. Meier

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Abstract

Context
Pain is a primary reason individuals attend an Emergency Department (ED), and its management is a concern.

Objectives
Change in symptoms and physiologic variables at 3 time points pre-post a ten-minute St. John Ambulance therapy dog team visit compared to no visit in ED patients who experienced pain.

Design, setting and participants
Using a controlled clinical trial design, pain, anxiety, depression and well-being were measured with the Edmonton Symptom Assessment System (revised version) (ESAS-r) 11-point rating scales before, immediately after, and 20 minutes post- therapy dog team visit with Royal University Hospital ED patients participating in the study (n = 97). Blood pressure and heart rate were recorded at the time points. Control data was gathered twice (30 minutes apart) for comparison (n = 101). There were no group differences in age, gender or ethnicity among the control and intervention groups (respectively mean age 59.5/57.2, ethnicity 77.2% Caucasian/87.6%, female 43.6% /39.2%, male 56.4%/60.8%,).

Intervention
10 minute therapy dog team visit in addition to usual care.

Main outcome measures
Change in reported pain from pre and post therapy dog team visit and comparison with a control group.

Results
A two-way ANOVA was conducted to compare group effects. Significant pre- post-intervention differences were noted in pain for the intervention (mean changeint. = -0.9, SD = 2.05, p = .004, 95% confidence interval [CI] = [0.42, 1.32], ηp2 = 04) but not the control group. Anxiety (mean changeint. = -1.13, SD = 2.80, p = .005, 95% CI = [0.56, 1.64], ηp2 = .04), depression (mean changeint. = -0.72, SD = 1.71, p = .002, 95% CI = [0.39, 1.11], ηp2 = .047), and well-being ratings (mean changeint. = -0.87, SD = 1.84, p < .001, 95% CI = [0.49, 1.25], ηp2 = .07) similarly improved for the intervention group only. There were no pre-post intervention differences in blood pressure or heart rate for either group. Strong responders to the intervention (i.e. >50% reduction) were observed for pain (43%), anxiety (48%), depression (46%), and well-being (41%).

Conclusions
Clinically significant changes in pain as well as significant changes in anxiety, depression and well-being were observed in the therapy dog intervention compared to control. The findings of this novel study contribute important knowledge towards the potential value of ED therapy dogs to affect patients’ experience of pain, and related measures of anxiety, depression and well-being.

Date 2022
Publication Title PLoS One
Volume 17
Issue 3
Pages e0262599
ISBN/ISSN 1932-6203
DOI 10.1371/journal.pone.0262599
Author Address Department of Sociology, University of Saskatchewan, Saskatoon, Canada.College of Medicine, University of Saskatchewan, Saskatoon, Canada.Quality, Safety & Standards, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada.Faculty of Nursing University of Calgary, Calgary, Alberta, Canada.School of Indigenous Social Work, First Nations University of Canada, Saskatoon, Saskatchewan, Canada.Emergency Services, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada.College of Arts & Science, University of Saskatchewan, Saskatoon, Canada.Saskatchewan Centre for Patient Oriented Research, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.College of Nursing & Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.Veterinary Microbiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.Clinical Analyst, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada.St. John Ambulance, Saskatoon, Saskatchewan, Canada.Clinical Research Professional Clinical Trial Support Unit, University of Saskatchewan, Saskatoon, Canada.
Additional Language English
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Tags
  1. Animals
  2. Dogs
  3. Emergency
  4. Females
  5. Hospitals
  6. Humans
  7. Males
  8. open access
  9. Pain
  10. therapy animals
Badges
  1. open access