Pet therapy in the emergency department and ambulatory care: A systematic review and meta‐analysis

Abstract

Background: Pet therapy, or animal-assisted interventions (AAIs), has demonstrated positive effects for patients, families, and health care providers (HCPs) in inpatient settings. However, the evidence supporting AAIs in emergency or ambulatory care settings is unclear. We conducted a systematic review to evaluate the effectiveness of AAIs on patient, family, and HCP experience in these settings. Methods:We searched (from inception to May 2020) Medline, Embase, Cochrane CENTRAL, PsycINFO, and CINAHL, plus gray literature, for studies assessing AAIs in emergency and ambulatory care settings on: (1) patient and family anxiety/distress or pain and (2) HCP stress. Screening, data extraction, and quality assessment were done in duplicate with conflicts adjudicated by a third party. Random-effects metaanalyses are reported as mean differences (MDs) or standardized mean differences (SMDs) and 95% confidence intervals (CIs), as appropriate. Results:We included nine randomized controlled trials (RCTs; 341 patients, 146 HCPs, 122 child caregivers), four before-after (83 patients), and one mixed-method study (124 patients). There was no effect across three RCTs measuring patient-reported anxiety/distress (n = 380; SMD = -0.36, 95% CI = -0.95 to 0.23, I 2 = 81%), while two before-after studies suggested a benefit (n = 80; SMD = -1.95, 95% CI = -2.99 to -0.91, I 2 = 72%). Four RCTs found no difference in measures of observed anxiety/distress (n = 166; SMD = -0.44, 95% CI = -1.01 to 0.13, I 2 = 73%) while one before-after study reported a significant benefit (n = 60; SMD = -1.64, 95% CI = -2.23 to -1.05).Three RCTs found no difference in patient-reported pain (n = 202; MD = -0.90, 95% CI = -2.01 to 0.22, I 2 = 68%). Two RCTs reported positive but nonsignificant effects on HCP stress. Conclusions:Limited evidence is available on the effectiveness of AAIs in emergency and ambulatory care settings. Rigorous studies using global experience-oriented (or patient-identified) outcome measures are required.

The Impact of Therapy Dogs on Anxiety and Emotional Management in the Pediatric Emergency Department

“…Additionally, in a survey study performed in 2012 amongst patients and staff in an emergency department, 87.8% of patients and 92% of staff were in approval of therapy dog presence in the ED for both adult and pediatric patients (22) . A recent systematic review was completed to examine the effect of animal assisted therapy on patients, families, and healthcare workers within general emergency departments, nding limited existing literature and supporting the need for further studies in the emergency department setting (23) .…”

Animal-Assisted Intervention and Health Care Workers’ Psychological Health: A Systematic Review of the Literature

“…In healthcare, companion animals have recently been increasingly used in the workplace to provide emotional support for people living with disabilities [49], but there is little empirical research on the effects of these programs on HCWs. To better understand the potential role of pets in healthcare settings, Gaudet et al [56] conducted a meta-analysis on the potential benefits of pet presence in alleviating stress among HCWs, patients, and parents/caregivers. Their findings were inconsistent due to some incongruence between qualitative and quantitative studies, so no clear conclusion could be drawn about the benefits of keeping pets in this particular occupational setting.…”