HLSC621 Health Sciences Research: Animal Assited Therapy
Write a "literature review for a research question"
This lesson will cover the following topics
- Basic steps to conducting a systematic literature search
- List of useful and relevant electronic databases
Reviewing the relevant literature
“A research literature review is a systematic, explicit and reproductive method for identifying, evaluating, and synthesising the existing body of completed and recorded work produced by researchers, scholars, and practitioners.” (Fink, 2005) By reviewing the relevant literature, in addition to learning what is already known about the research question(s), the researcher will become familiar with problems that other investigators have faced, using various study methods. In an era of evidence based medicine, being able to search for relevant literature to answer a question is crucial. Computers and particularly the internet have revolutionised medical publishing. With thousands of research articles being published each year, bibliographic databases provide a way to search the archives of multiple journals from across the world. A bibliographic database is a repository of bibliographic or publication records. It provides an index of journal articles from multiple journals, and includes citations, abstracts and often a link to the full text. Databases are usually held electronically, so they can be updated regularly.
After you have selected your research questions, you would need to:
- Select search terms
- Select data resources
- Consult with a librarian regarding the search terms and search engines
- Run search terms
- Collate retrieved articles in a single library (i.e., EndNote)
- Screen for relevant literature, and finally
- Synthesise the results
Answer:
Introduction
The rising prevalence of dementia at the present times has drawn attention of health care researchers to find the best possible intervention that can manage dementia symptoms in a better way. Against this background, alternative form of therapies have been prominent as an effective form of therapy that can decrease severity of dementia symptoms. Animal assisted therapy have been long considered as a potential mode of therapy that can lead to beter outcomes for dementia patients. It was thought desirable to understand the effectiveness of animal-assisted therapy for dementia patients.
PICO question
The PICO question considered for conducting the systematic review is “Does animal-assisted therapy lead to better outcomes for dementia patient?”
Search Strategy
Databasases used- Medline, PubMed, Science Direct were searched for relevant articles addressing the PICO question. The databases provide up-to-date peer-reviewed journal articles.
Key words used- animal-assisted therapy, pet therapy, dog-assisted therapy, therapy, intervention, dementia patients, dementia
Search operations- AND and OR Boolean operations were used together with the key words
Inclusion criteria- Full text articles on the research topic published year 2013 onwards were considered for the study.
PRISMA flow diagram
Summary :
Bernabei et al., (2013) conducted a systematic literature review on the impact of animal-assisted interventions (AAI) on elderly dementia patients and different psychiatric disorders. A comprehensive literature search was done using PubMed database of the US National Library of Medicine and National Institutes of Health, PsycINFO and Embase. Effects of AAI was investigated for changes in behaviour, mood, and cognitive function of dementia patients. 18 articles were considered for dementia. From the review it was indicated that AAI has a positive influence on patients suffering from dementia. This is shown by a reduced extent of agitation. In addition, the patients showed improved quality and degree of social interaction. The researchers poined out that there was a scarcity of articles on impact of AAI on patient’s mood. Cognitive functions were also less assessed after AAI in articles. The results were a positive indication of better coping ability and communciaation among dementia patients. A striking finding of the study was that a pet robot gave encouraging results; however, it’s degree of effectiveness required further investigations.
Nordgren and Engstrom (2014) presented the results from a study that used dogs as a form of complement or alternative therapy to pharmacological treatment option for dementia patients. The study evaluated the effect of dog-assisted intervention on the psychological and behavioural symptoms of dementia residents during six months period. 33 residents from 8 nursing homes in Sweden took part in the study, and were divided into control group and intervention group. For assessing the effect of dog-assisted therapy, the Cohen-Mansfield Agitation Inventory (CMAI) and the Multi-Dimensional Dementia Assessment Scale (MDDAS) were used. Descriptive statistics were utilised for data analysis. In case of the intervention group, changes immediately after the intervention was not so much significance, and so was the result at three-month follow-up. However, after six months, the changes as compared to baseline values were statistically significant. It was concluded from the study that dog-assisted intervention provides an alternative treatment strategy that can be used for reducing behavioural symptoms in dementia patients. It was also pointed out that the place and value of the treatment option needs to be evaluated further. The researchers remarked that the influence of therapy dogs on symptoms of dementia must not be disregarded.
There is an increasing population of dementia patients across the globe whose quality of life is effected negatively due to cognitive impairments. Animal assisted therapy (AAT) is considered as a therapeutic activity for dementia patients so that their quality of life is improved. Pope et al., (2016) compared the effectiveness of animal-assisted treatment (AAT) with human interaction to understand their efficiacy of AAT on engagement and social behaviours of elderly patients suffering dementia in long term care facility. A randomised control cross-over experimental quantitative study was carried out. The participants were 44 dementia residents of a nursing facility of which 24 were female and 20 were male. Six dogs were used for engaging the participants. The data collection instruments were Social Behaviors checklist, Demographic and Pet History Questionnaire, Menorah Park Engagement Scale (MPES) and Cohen-Mansfield Agitation Inventory (CMAI). After allocation to groups, the participants had to go undertake two visits every week for two weeks to human interaction or animal therapy sessions. One week of no activity followed after which alternate therapies were provided. There results indicated that AAT had a remarkable impact on social behaviour as there was a positive impact. The result was indicated by fewer incidents when staff intervention was required. It was concluded that AAT coincides with the major goals of long term care settings in relation to dementia care as it improves socialisation among dementia patients.
An experimental study was conducted by Sollami et al., (2017) to understand whether pet therapy is an effective strategy for caring for the elderly patients in nursing home. Pet therapies are undertaken with the utilisation of influential involvement of any pet. At background of the study was the fact that a growing interest has been developed towards emotional and affective needs, more in association to relational therapies. Elderly patients, suffering from dementia feel depressed, unstimulated and are not able to communicate properly. The study had a longitudainal design that verified the effcetivness of pet therapy for bringing improvement in well-being of elderly patients in nursing care units. 28 patients with age above 60 years took part in the study that had dogs as the form of intervention whereby participants were made to physically interact with the animal. Patient aspects were measured in respect of anxiety, depression, loneliness, apathy and quality of life through different questionnaires. The results of the study confirmed a major reduction in the variables considered. A significant result was more prominent for quality of life. The inference drawn from the study was that pet therapy can have social and emotional impact of dementia patients, since it brings relief to patients and health care professionals alike.
Majic et al. had conducted a match case- controlled trial in the year 2013. This study had been popular due to the fact that it was a fist large sample study that not only showed the beneficial effects of animal assisted therapy in dementia but also has proved its efficacy over a prolonged period of time. The researchers have taken a control group where normal dementia treatment therapy had been provided and other intervention group where a combined therapy of animal assisted therapy as well as normal dementia therapy had been provided. A unique result was found where it was seen that in control group where only the regular therapy was provided, symptoms of dementia continued to worsen over a period of time. However, in the case of the intervention group where the combined therapy had been provided, it was seen that the conditions did not worsen but remained stable in the state as it was before. Hence, this experiment showed that both the therapies do not reduce the symptoms of dementia but the combined therapy helps in stabilising the effects and do not allow worsening of the symptoms as it was noticed in the control group where only the regular dementia care was provided. Therefore, this therapy has promising result on the future which can be used and further ventured by healthcare professionals and researchers for better results.
The works of Peterson et al. (2017) provides us with interesting information which indeed is one of the path-breaking strategies to treat dementia patients. The study shows the use of robotic pets in the treatment of dementia patient in the forms of assisted animal therapy in place of using real life pets. Managing and controlling real life patients along with managing the treatment interventions for dementia patients often become strenuous for the healthcare professionals and comprises of many negative aspects. Hence the introduction of robotic pets was done. This intervention was found to be extremely helpful in managing the symptoms of dementia and helped in providing a developed care for the patients. The intervention helped in decreasing the rates of stress as well as anxiety that often accompanies dementia patients who are exposed to different types of physical and mental threats when under treatment in healthcare centres. Not only that, this intervention also helped in the reduction of the use of psychoactive medications as well as pain medications in elderly clients which was indeed one of the most beneficial impacts in dementia care. Hence, modern healthcare centres should try to incorporate this technique in their practices to provide a high quality life in dementia patients.
Treatment of dementia patients with the help of animal assisted therapy also resulted in positive effects on the quality of lives of the patients. In this work which was conducted by researchers Nordgren and Engstrom in 2013, it was found that non pharmacological treatment of dementia with the help of animal assisted therapy was considered to be successful alternative intervention for dementia patients. It was found that the trained dog therapy brought out many memories in the dementia patients that resulted in development of happiness within the patients decreasing emotional, mental as well as physical stress. Training with certified therapy dogs helped in developing memory, communication and language, ability to solve problems, social commitment and others. It also resulted in developing balance and muscle strength, fine motor skills, grips ability and accuracy and also movement of the patients. Hence, this also supports the view of animal assisted therapy for dementia patients.
Conclusion:
The rising concern for the side effects of different medications used in dementia as well as due to the rising stress and complains of the nurses to cover the stressful treatments of dementia patients, an alternative therapy needed to be proposed. The modern day researchers are of the opinion that animal assisted therapy is highly efficient in tackling the various symptoms of dementia. Animal assisted therapy is believed by some authors to reduce stress and anxiety in the dementia patents. Many researchers suggest that it does not resolve any symptoms but helps in prevention of the worsening of the symptoms. Many researchers also suggest that robotic pets can also be used in place of traditional dogs as it will help in resolving the negative aspects of using animals in treatment of dementia patients. Many also suggest that they help in development of motor skill, communication, movement and others when patients are trained with such dogs. Therefore animal assisted therapy holds high level of chances of becoming one of the successful methods of treatment of dementia patients not only reducing the effects of dementia but also developing the quality of their lives.
References:
Bernabei, V., De Ronchi, D., La Ferla, T., Moretti, F., Tonelli, L., Ferrari, B., ... & Atti, A. R. (2013). Animal-assisted interventions for elderly patients affected by dementia or psychiatric disorders: a review. Journal of psychiatric research, 47(6), 762-773. URL” https://www.sciencedirect.com/science/article/pii/S0022395612003846
Gauthier, S., Albert, M., Fox, N., Goedert, M., Kivipelto, M., Mestre-Ferrandiz, J., & Middleton, L. T. (2016). Why has therapy development for dementia failed in the last two decades?. Alzheimer's & Dementia, 12(1), 60-64. URL: https://www.sciencedirect.com/science/article/pii/S1552526015030034
Maji?, T., Gutzmann, H., Heinz, A., Lang, U. E., & Rapp, M. A. (2013). Animal-assisted therapy and agitation and depression in nursing home residents with dementia: a matched case–control trial. The American Journal of Geriatric Psychiatry, 21(11), 1052-1059. URL: https://www.sciencedirect.com/science/article/pii/S1064748113001784
Nordgren, L., & Engström, G. (2014). Animal-assisted intervention in dementia: effects on quality of life. Clinical nursing research, 23(1), 7-19. URL: https://journals.sagepub.com/doi/abs/10.1177/1054773813492546
Nordgren, L., & Engström, G. (2014). Effects of dog-assisted intervention on behavioural and psychological symptoms of dementia: Lena Nordgren and Gabriella Engström present the results from a study that used dogs as an alternative or a complement to pharmacological treatments. Nursing older people, 26(3), 31-38. URL: https://journals.rcni.com/doi/abs/10.7748/nop2014.03.26.3.31.e517
Petersen, S., Houston, S., Qin, H., Tague, C., & Studley, J. (2017). The Utilization of Robotic Pets in Dementia Care. Journal of Alzheimer's Disease, (Preprint), 1-6. URL: https://content.iospress.com/articles/journal-of-alzheimers-disease/jad160703
Pope, W. S., Hunt, C., & Ellison, K. (2016). Animal assisted therapy for elderly residents of a skilled nursing facility. Journal of Nursing Education and Practice, 6(9), 56. URL: https://www.sciedu.ca/journal/index.php/jnep/article/view/8778
Sollami, A., Gianferrari, E., Alfieri, M., Artioli, G., & Taffurelli, C. (2017). Pet therapy: an effective strategy to care for the elderly? An experimental study in a nursing home. Acta Bio Medica Atenei Parmensis, 88(1-S), 25-31. URL: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/6281
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