Abstract From Florence Nightingale’s statements that patients should take care of animals through Dr. Levinson articles regarding his experiences that spurned research to this day into Animal-Assisted Therapy, patients have reaped the benefits. These benefits are both physiological as it relates to changes in the persons physical condition and psychosocial refers to changes in a person’s mental or emotional condition. Animals have the ability to continue to play an important part in the medical field. What is Animal Assisted Therapy and Does it Work?

While people love their pets this paper considers if animals have a larger therapeutic roll. Looking at the consumer spending on pets alone, one can get a sense of the importance we focus on them. The statistical report is that Americans had spent over $45 billion dollars in 2009 on their pets. Over 60% of U. S. households have pets. (American Pet Products Manufacturers Association 2009, 2010). Clearly pets are important in our lives. These animals can be more than just family pets; with the continued development of animal assisted therapy; they can have key roles in the medical field.

Animal Assisted Therapy (AAT) had been around for many years before it was identified with that name. Starting with Florence Nightingale one can find the use of animals assisting the medical professionals. Nightingale in 1860 noted, “A small pet animal is often an excellent companion for the sick, for long chronic cases especially. A pet bird in a cage is sometimes the only pleasure of an invalid confined for years to the same room. If he can feed and clean the animal himself, he ought always to be encouraged to do so. (Nightingale, 1898) Another time AAT type therapy was in use for treatment of psychiatric patients in 1919; the Secretary of the Interior advocated that dogs be incorporated in treatment of psychiatric patients (Burch, 1996). The next time that the use of AAT type treatment was documented was in 1943, when it was used by therapists working with recovering veterans (Hooker, Freeman & Stewart, 2002). Dog therapy made its integration into the mental health field in the early 1960’s. This was when an American child psychiatrist named Boris Levison had his personal dog in his office during a session.

The dog served as a conduit in getting the children who were Dr. Levinson patients to communicate with him while interacting with his dog. His writings on the subject initiated other child psychiatrists to put his theories into practices. (Starlifeservices, 2010). The researchers from the 1960’s onwards have continued to evaluate the role of animals in the therapeutic setting; there is still much to study and learn about how and why these types of interventions work for patients. (Levinson & Mallon, 1997)

There are at many different organizations in the U. S. that are training centers for the therapy animals; some large some small. One of the largest groups name is the Delta Society. The Delta Society is extremely well known group that is particular about their interpretation of Animal Assisted Therapy. This stems from an analysis of AAT by Beck and Katcher (1984, as cited in Fine 2006) “a clear distinction should be made between emotional response to animals, that is, their recreational use, and therapy.

It should not be concluded that any event that is enjoyed by the patients is a kind of therapy. ”  The Beck and Katcher are of the opinion that you dilute the AAT premise if you include all interaction with animals as actual therapy. More distinction needs to be made between the definition of the animal assisted types of programs and services. Kathleen LaJoie has proposed to make an identification system to coordinate the different types of programs.

Part of the Kathleen LaJoie’s findings were that there were twenty different definitions of AAT and twelve terms that related to the idea such as pet therapy, pet psychotherapy, pet-facilitated therapy, pet- facilitated psychotherapy, four-footed therapy, animal-assisted therapy, animal- facilitated counseling, pet-mediated therapy (2003, as cited in Fine 2006)  The Delta Society a large well known non-profit organization whose mission (Delta Society, 2010) “… is to help lead the world in advancing human health and well-being through positive interactions with animals.

We help people throughout the world become healthier and happier by incorporating therapy, service and companion animals into their lives. ” This group has an extremely rigid and structured definition of what constitutes an AAT animal. Delta’s definition, of AAT therapy animals must be have an assignment to a single person not generalized visitation to a hospital, or rehabilitation facility. The Delta Society refers to a general visitation dog as an Animal Assisted Activity (AAA) or visiting dog. The Delta Society existing definitions of AAA and AAT (Delta Society, 2010) as follows:

Animal assisted therapy: AAT is a goal directed intervention in which an animal that meets specific criteria is an integral part of the treatment process. AAT used at the direction of and/or delivered by a health/human services professional with specialized expertise, and within the scope of practice of his/her profession. AAT is designed to promote improvement in human physical, social, emotional, and/or cognitive functioning [cognitive functioning refers to thinking and intellectual skills]. AAT is provided in a variety of settings and may be group or individual in nature.

This process is documented and evaluated. Animal assisted activities: AAA provides opportunities for motivational, educational, recreational, and/or therapeutic benefits to enhance one? s quality of life. AAA is delivered in a variety of environments by specially trained professionals, paraprofessionals, and/or volunteers, in association with animals that meet specific criteria. Looking at the benefits of animal therapy it is necessary to identify physiological from psychosocial effects. The definition of physiological means that it relates to changes in the persons physical condition.

This therapy illustrates that a person’s blood pressure drops when they come into contact with animals. Yet, when greeting humans the same person’s blood pressure may elevate (Haggard, 1985). A study by Jenkins (1986, as cited in Fine 2006) found that stroking a companion animal could reduce the blood pressure. A study by Katcher, Friedmann, Beck, and Lynch (1983) found that blood pressures were lower in patients who sat and watched tropical fish in a tank then those patients that did not watch the fish. There was a notable drop in blood pressure beyond what of just resting in a chair produced.

Psychosocial refers to changes in a person’s mental or emotional condition. An increased level of physical exercise has been found in patients that participate in therapy animal treatment (Haggard 1985). The findings in Haggard (1985) was that the number of mediations that patients took, decreased as the patients interacted with a therapy dog. While the physiological effects are evident, there is evidence that the psychosocial effects of animal therapy are at the fore front of the study and research. The physiological effects prove to reduce stress, loneliness, grief, fear and pain. (Deliz, 2008).

The stated cause for these improvements was because the patients is not continually focusing on their own physical and mental deterioration. They begin to explore outside themselves. Patients open up a line of communication between themselves and therapist. A therapy animal becomes a conduit, as illustrated in Dr. Levinson research (Levinson & Mallon, 1997). The evidence that tactile therapy works better than prescription drugs and has no side effects or addiction issues (Daniels, 2008), should be incentive enough to make sure this model of therapy is useable to patients as an alternative.

It is necessary to note that while there have been studies done on AAT and AAA most of the information we have is based on anecdotal comments like the following: “People with enduring mental health issues already feel isolated from their families and former selves. Watching patients smile or well up with tears as they pet a dog is incredibly moving” (Daniels, 2008). Most of the studies and research that has been done on AAT was completed in the late 1990’s to early 2000’s. Though a number of smaller studies like the following have been completed more recently.

A small study to determine whether a 12-minute hospital visit by a therapy dog improved patients cardiopulmonary pressures, neurohormone levels and anxiety. The results compared the control group with the therapy dog group and a human visitor group. The measurements of the patients in the therapy dog group were significantly more improved in all three categories than either of the other groups in the study (Cole, Gawlinski, Steers & Kotlermanet, 2007). AAT and AAA can occur in a number of environments from hospitals to home health care. There is a number of benefits of AAT and AAA both physiological and psychosocial.

The importance of both of these different types of benefits has to be weighed against the objections or negatives. One common complaint is the possibility of infection. There is little research on this point but, infection control policies should be implemented when allowing pets to visit (Miracle, 2009). The benefits of having an animal visit a patient notes that there are many more positives than negatives. Considering this the benefits out weigh the potential risks. A nurse in the role of provider of care can encourage a number of behaviors that would promote the use of AAT with their patients.

A positive attitude toward the use of animals will help patients feel comfortable in attempting this new type of therapy. A nurse who is able to communicate to the patient the possible decreased need for medications such as pain, blood pressure or anxiety medications would have a better chance to encourage the use of this therapy. Help the client set goals with the use of therapy animal such as petting the animal for two minutes as this would help with the patients range of motion. The nurses ability to set the tone for use of AAT just by her relationship with the patient and their family.

A positive relationship has the ability to foster many adaptations to the patients health needs. As a coordinator of care the nurse the nurse could be the facilities advocate to introduce this therapy. Many nurses take the lead to coordinate setting up organizations that provide pet therapy with the facility patients that would most likely benefit. AAT not only can benefit the patient but the nurses can encourage the families of patients to interact as the ability to calm, reduce anxiety and fear isn’t just for patients. Nurses could introduce animal activities in waiting rooms so families can benefit.

Nurses with the ability to teach patients and families how to make the best of animal therapy with their own pets has the ability to continue the patients forward progression even in a home setting. As a Member of a profession nurses have larger picture responsibilities when it comes to their role in AAT. If a nurse decides that they want to be an advocate to introduce AAT into their facility they must make sure that the organization that will be providing the animals is certified in therapy animals. This makes sure that all the animals are both health and trained.

The implementation of infection control program is important for both the animals and people they come in contact with whether it is a patient, family or staff. The nurses ability to understand proper response to an emergency situation. This could be a health emergency on the part of the patient or animal that reacts to a situation unexpectedly. The nurses responsibility would be to demonstrate professional behavior no matter what the situation. Understanding AAT and AAA treatment is the initial step to being able to recommend it to patients.

This student has learned many things about how AAT and AAA works for patients. The fact that it can be more beneficial to patients then using some other forms of treatment so as a nurse, this student thinks it would be exciting to have the experience to see this type of therapy in action. This students believes that having the understanding of this type of therapy will make it easier to help future patients and families understand it’s benefits of the therapy. Animals have been and will continue to be our pets.

Now current research suggests they can also be a part of medical therapy. Animal use in the healthcare community runs a continuum from just simple companionship to documentation of physically dropping a patient’s blood pressure. The patients that are able to use the services of these animals gain benefits. Therapy animals can be part of our medical care plans for patients that can benefit from their visits. Each patient is different and will respond to different variations of animal therapy. Nurses can be ongoing advocates for animals in healthcare settings.

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