1. The Animal-Assisted Therapy Program at Phoenix Children's Hospital:
A Journey Towards Evidence
Kathy A. Zeblisky, MLS, AHIP and Mary Lou Jennings, BS, MC,LPC
Methods
A single-arm design will be used to study the effect of an animal-
assisted therapy (AAT) interaction on salivary cortisol, salivary alpha-
amylase (sAA), oxygen saturation (O2), blood pressure (BP), heart rate
(HR) and energy levels in children in an acute care hospital. Saliva
samples and vitals will be taken before and after an AAT interaction of
five to ten minutes. Energy levels will be measured by Lansky scores.
Demographic data will be collected to describe sample characteristics.
Variables include gender, age, and dog in family.
Objectives
Our hospital’s animal-assisted therapy (AAT) program began in 2004. A
viable clinical question was identified in 2007 with librarian assistance.
Literature searches probed for validated, quantitative studies to
replicate. Initially anecdotally based, our program will now study
physiological variables and stress biomarkers hoping to prove or
disprove this hypothesis: AAT decreases stress and improves energy
levels in children.
AAT Program ImpactLibrarian Impact on AAT Program
Literature Searches Impact of Research on Program
Identify the
Clinical Study Question
 Literature searches were performed
over 10 years
 Challenge of terminology. Use of MLA
Bib-Kit and other resources such as
Delta Society™ (now Pet Partners)
 Challenge of database selection and
accessibility. Hospital librarians may
not have access to pertinent
databases
 Need to identify replicable studies in
our hospital setting
 Change in policy: Ability to bring your
own pet to the hospital
 Change in policy: Infection control
concerns were resolved
 Prompted the AAT Coordinator to
obtain additional training in study
design by participating in a Clinical
Scholars program
 Lack of quantitative studies to
replicate
 Need to benchmark
 Multiple literature searches over the
years identified a valid study to
replicate and the clinical question
 Protocol Title: The Effects of an Animal
Assisted Therapy Interaction on
Physiological Variables and Stress
Biomarkers of Children in an Acute
Care Setting
Background and Significance
Animals have been shown to have a positive effect on humans for
centuries. The effect of human-animal interaction has been more
rigorously researched in the last 40 years, showing a wide variety of
benefits from improved sleep to decreased risk of heart disease
(Anderson et al., 1992). Research on animal-assisted therapy (AAT) in
hospital settings has shown:
• improved blood pressure (Tsai et al., 2010)
• increased activity (Kaminski et al., 2002), and
• improved psychological well-being (Wu et al., 2002).
The AAT program has been taking registered therapy dog teams to
visit patients, and recording patients’ change in mood since 2005. Nine
years of data indicate a 93% positive change in mood of patients
during an AAT interaction. This new IRB-approved study will measure
the physiological effects of AAT during patient visits.
The physical therapist
has the patient brush
Bonita. To do this the
patient must sit up,
hold his balance, and
brush and stroke the
dog.
The occupational
therapist is having the
patient sit up next to
Marley, a Puli,
encouraging her to
use the right side of
her body affected by
traumatic brain injury
Gus the English Mastiff
with a patient who
needed to walk. The
patient was even able
to squat and pet Gus’s
paw after a walk.
Kahuna the Labrador
Retriever walking with
a patient and her
physical therapist
Distraction activity
with Labrador
Retriever Kahuna
More than 55,000 visits have been recorded
from 2005 through 2014, without any adverse events occurring.
References
Anderson WP, Reid CM, Jennings GL. Pet ownership and risk factors for cardiovascular disease. The Medical journal of Australia. 1992;157(5):298-301. PMID: 1435469.
Kaminski M, Pellino T, Wish J. Play and pets: The physical and emotional impact of child-life and pet therapy on hospitalized children. Children’s Healthcare.
2002;31(4):321-335.
Tsai C, Friedmann E, Thomas, SA. The effect of animal-assisted therapy on stress responses in hospitalized children. Anthrozoos. 2010;23(3):245-258
Wu AS, Niedra R, Pendergast L, McCrindle BW. Acceptability and impact of pet visitation on a pediatric cardiology inpatient unit. Journal of pediatric nursing.
2002;17(5):354-62. PMID: 12395303.
Initial Patient Results
The initial patient encounter was
postponed until March, 2015. Data
will be available regarding cortisol
levels when 3-4 patients have
participated in the study, targeted
by the end of May, 2015
All photos used
with permission.
Please see our videos:
http://www.cox7.com/cox/paws-that-heal
https://www.youtube.com/watch?v=mb2tv8jT6r8