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Pet therapy and institutionalized elderly: A study on 144 cognitively unimpaired subjects
Abstract
The aim of this study was to assess whether a pet therapy program had a favorable effect on psychopathological status and perception of quality of life in cognitively unimpaired institutionalized elderly. Seven elderly rest homes in Veneto Region of Northern Italy participated in the project, which was conducted on 144 cognitively intact elderly residents (97 females and 47 males). The participants were randomly divided into three groups: 48 subjects were given a canary, 43 subjects were given a plant, and 53 subjects were given nothing. The observation period (t0-t1) lasted for 3 months. At time t0 and t1 participants were administered the mini mental state examination (MMSE) to assess their cognitive status, the LEIPAD II-Short Version (LEIPAD-SV), to gauge subjective perception of quality of life in the elderly, and the brief symptom inventory (BSI), for self-evaluation of the presence of psychopathological symptoms. At the end of the 3-month trial, tests were re-administered, without removing the experimental condition. Even if the group that received a plant seemed to benefit from the experience, they did not achieve the same positive results on BSI and quality of life subscales exhibited by the group that received a pet. This study reinforces the hypothesis that pet therapy may have a beneficial effect on the psychological well being of institutionalized elderly, in particular on aspects related to depressive symptoms and perception of quality of life.
... While Eyster (1984) presents Mugford and M'Comisky's (1975) results, we cannot build upon them without access to the full study. Although it is unfortunate that we could not locate this study for inclusion, one of the studies included in our review presents a very similar methodology (Colombo et al., 2006), the results of which we can present and analyze. Thus, we added two new references to our literature review, bringing the total number of articles included to six (see Fig. 1). ...
... Among the six included articles, four focused on older adults (Jessen et al., 1996;Holcomb et al., 1997;Colombo et al., 2006;Falk and Wijk, 2008), and two focused on individuals with different psychopathologies (Beck et al., 1986;Sahebalzamani et al., 2020). ...
... Jessen et al. (1996) provided 20 residents of a skills rehabilitation unit the opportunity to have a caged bird in their room for 10 days; the control group (n = 20) did not have this opportunity. Colombo et al. (2006) classified 144 participants into three groups in a nursing home setting: the first had a caged canary in their room, the second had a green plant in their room, and the third served as the control group without any animal or plant. The exposure duration was three months. ...
Animal-assisted therapy (AAT) practices have diversified following one of the earliest uses of animals in therapy, as described by Levinson (1962). Since the 1960s, evidence of the effectiveness of AAT can be found in the scientific literature across various populations. Different species of animals have been used for AAT, while literature reviews specific to dogs or horses can be found, there is currently no literature review that specifically focuses on bird-assisted treatments.
This study aims to conduct a comprehensive evaluation of the existing literature on bird-assisted treatments in diverse populations. We conducted a comprehensive search for the keywords “animal assisted therapy,” “animal assisted intervention,” “zootherapy,” “thérapie assistée par l’animal,” “intervention assistée par l’animal,” “zoothérapie,” “bird,” and “oiseau” in the PubMed, ScienceDirect, and PsycInfo databases, covering the period from 1975 to October 2023. A total of six articles were eligible for inclusion in our literature review, four on older individuals and two conducted within various psychiatric departments. These studies identified two distinct forms of interventions: individual and shared room cages. Irrespective of the intervention type, the primary findings demonstrated not only positive effects on depression levels and social well-being among older individuals but also favorable outcomes for psychopathological symptoms and social life among individuals with psychiatric disorders. The use of birds can be a strategy to implement AAT in institutional settings where managing larger animals or those requiring more complex care would be challenging. These results lead us to recommend bird-mediated interventions to promote well-being and reduce psychological distress among populations requiring this type of assistance.
... Interventions were described as pet encounter therapy, pet-facilitated therapy, pet-assisted living, animal assisted intervention, animal assisted therapy, animal assisted activity or simply dog visits/therapy. The majority of studies were from the USA (n = 11), and the remainder were conducted in Norway [64], Italy [59], South Africa [63], Australia [69], Spain [58,70] and Denmark [67,68]. Nine of the studies had a specific focus on residents living with dementia [58,60,61,64,66,67,68,69,70]. ...
... Nine of the studies had a specific focus on residents living with dementia [58,60,61,64,66,67,68,69,70]. The sample size of the studies were generally small, ranging from six [61] to 144 residents [59], with eleven of the studies involving less than 50 residents. Fifteen of the studies involved dogs as the intervention, one study involved cats [61], one study assessed in-room canaries [59], and one study reported on the effect of kitten and rabbit visits [62]. ...
... The sample size of the studies were generally small, ranging from six [61] to 144 residents [59], with eleven of the studies involving less than 50 residents. Fifteen of the studies involved dogs as the intervention, one study involved cats [61], one study assessed in-room canaries [59], and one study reported on the effect of kitten and rabbit visits [62]. Intervention duration varied from a one-off visit [61,62], to interventions of three to six weeks [57,63,66,67,71,72,73], longer interventions of 8-12 weeks [54,55,59,60,64,65,69,70] and in one study, nine months [58]. ...
Background:
There is some evidence to suggest that animal-assisted interventions can have beneficial impact for residents in long-term care, but the focus of the evidence has largely been on behavioural and psychosocial measured outcomes. Animals, either as companion animals or in the form of pet/animal-assisted therapy, may provide benefits in the form of social contact, as well as opportunities for sensory experiences and meaningful engagement not picked up by outcome tools. This review aimed to create a state-of-knowledge synthesis, bringing together qualitative and quantitative findings, on the impact of animal-human interaction on care home residents and care home staff.
Methods:
Fourteen databases were searched from inception to July 2020. Forward and backward citation chasing of included articles was conducted. Screening was undertaken independently by a team of reviewers. Thematic synthesis and meta-analysis were used to synthesise the qualitative and quantitative data.
Results:
Thirty-four studies, published in 40 articles (20 qualitative and 20 quantitative) were included. Five themes relating to resident wellbeing were identified in the qualitative evidence synthesis. These were animals as 'living beings', reminiscence and storytelling, caring (as 'doing' and 'feeling'), respite (from loneliness, institutionalisation, and illness), and sensory engagement. A sixth theme related to staff perceptions and wellbeing, and a seventh to animal health and wellbeing. Maintaining identity was identified as an overarching theme. The majority of randomised trials had small sample sizes and were rated as low quality, mostly showing no evidence of beneficial effect. There was, however, limited evidence of a positive effect of pet/animal interaction on outcomes of loneliness, anxiety and depression, supporting the themes of respite and sensory engagement.
Conclusions:
The presence of animals can significantly impact the health and wellbeing of some care home residents. Residents had meaningful relationships with animals and derived pleasure and comfort from them. Interacting with animals offered residents a way to maintain a sense of self in the care homes, and with support, residents with dementia could also express their identities. Facilitating residents to interact with animals as part of person-centred care may also help residents to feel 'at home' in the care home.
Trial registration:
PROSPERO registration no: CRD42017058201.
... The average of items rated "high quality (Y)" was 1.80 per paper. Only one study (Mountain et al., 2017) was evaluated as "high quality" in five of the six items; however, only two of the items (sequence generation in Rantanen et al. (2014) and incomplete outcome data in Colombo et al. (2006)) were evaluated as "high quality" in four studies. By item, the determination of "yes" was made for 40% of the papers for sequence generation, blinding of participants, and incomplete outcome data. ...
... Intervention content varied widely; no two studies used the same intervention. The intervention types were an isolation prevention program (Saito et al., 2012), outdoor activities (Rantanen et al., 2014), art therapy through participation in theater workshops (Moore et al., 2017), animal-assisted activity (Colombo et al., 2006), and an encounter group (Mountain et al., 2017). Three of the five interventions were group-based, and two studies provided individual interventions. ...
... It is problematic to mix active control groups and waitlist or TAU groups for quantitative convenience. Therefore, a meta-analysis was performed in four papers (Colombo et al., 2006;Mountain et al., 2017;Rantanen et al., 2014;Saito et al., 2012). Figure 2 shows the results of calculating the effect size. ...
Aging societies are a global problem, necessitating the promotion of well-being in healthy older adults. However, the evidence regarding psychological interventions in this population is unclear. Therefore, we conducted a systematic review and metaanalysis to clarify the effects of psychological interventions on the well-being of healthy older adults. A systematic literature search was performed using PubMed, PsycINFO, and CiNii. Included studies were randomized controlled trials of psychological interventions designed to improve psychological well-being in healthy older adults. The search yielded 1,047 articles, out of which five qualitative and four quantitative studies were selected. A meta-analysis was performed using a random effects model. We found a large effect size (Hedges’ g = 0.87) and heterogeneity among the studies ( I2 = 94.4%, τ2 = 0.556, p = 0.00). Most studies were evaluated as being of a low quality. There were five types of interventions: an isolation prevention program, outdoor activities, art therapy through participating in theater workshops, animal-assisted activity, and an encounter group. The results indicated that healthy older adults’ psychological well-being can be promoted through interventions. The evaluated studies had no theoretical commonality; however, all research involved interaction with other people or animals. Thus, we recommend increased interaction with people or animals to promote well-being in older adults. Heterogeneity is a limitation of the study, and there is a need for more high-quality studies on well-being in healthy older adults.
... In this sentid, Animal Assisted Therapy (TAA), also known as zootherapy, pet therapy and therapy facilitated by animals, aims to promote behavioral and organic changes in human patients with different types of disabilities and age groups through the use of animals of various species, both being constantly monitored by qualified health professionals and veterinarians (NORDGREN; ENGSTROM, 2012;CHERNIACK;CHERNIACK, 2014). In contrast, the Animal Assisted Activity (AAA) is characterized by promoting the animal's direct contact with the patient, aiming for entertainment and distractions, without necessarily having therapeutic actions involved (DOTTI, 2005). ...
... In this sentid, Animal Assisted Therapy (TAA), also known as zootherapy, pet therapy and therapy facilitated by animals, aims to promote behavioral and organic changes in human patients with different types of disabilities and age groups through the use of animals of various species, both being constantly monitored by qualified health professionals and veterinarians (NORDGREN; ENGSTROM, 2012;CHERNIACK;CHERNIACK, 2014). In contrast, the Animal Assisted Activity (AAA) is characterized by promoting the animal's direct contact with the patient, aiming for entertainment and distractions, without necessarily having therapeutic actions involved (DOTTI, 2005). ...
... Damon and May (1986) carried out a study with three elderly people over 78 years old, with Alzheimer's, aiming to analyze the benefits that dogs would provide to the elderly when they held the animals' collars for fifteen minutes, and in the meantime, anyone could approach of the dog petting him, even in the presence of the patient under observation; the researchers concluded that the dogs aroused courage and calm to socialize with other people in the institution, in addition to improving mood and communication, reducing behaviors of depression, aggression and agitation. Colombo et al. (2006) stated that elderly people who had contact with and cared for birds and plants for three consecutive months, in a nursing home in Italy, conferred psycho-cognitive benefits when compared to those who did not have such an opportunity. Edwards and Beck (2002) examined the influence of TAA in 62 elderly people with Alzheimer's, using aquarium fish, and observed that there was a significant increase in the food intake of these patients after the introduction of complementary therapy, delaying muscle loss that decreases the incidence of falls , prevents skin infections, decubitus ulcers and sepsis; in addition, they required less nutritional supplementation, which reduced treatment costs. ...
The main goal of Animal Assisted Therapy (TAA) and of the Animal Assisted Activity (AAA)
is to promote organic, behavioral and such sentimental changes in human healthy or patients
with different types of deficiencies and diseases, by the aid of animal of different species (cotherapists). Therefore, the importance of the correct selection of the co-therapists (mainly the
behavioral factor), as well the periodic health attestation, issued by the veterinary doctor. It is
clear that helps to control pain, sleep, appetite, stress, mood and aggression. Faced with the
numerous advantages described about this activities in improving the quality of life and survival
of patients, the purpose of the present final paper was to conduct a literary review emphasizing
the objectives of this therapies as complementary alternatives in human medicine and,
nevertheless, highlight the most commonly used animal species, type of selection and care with
co-therapists, besides the human patients benefited.
... Of the eight studies in this review that explored the benefit of animal companionship on late-life anxiety, four studies identified a positive effect (Colombo et al., 2006;Kanamori et al., 2001;Mossello et al., 2011;Sollami et al., 2017) and four studies found no effect (Feng et al., 2014;Ko et al., 2016;le Roux & Kemp, 2009;Parslow et al., 2005). For example, Colombo et al. (2006) found that residents who cared for a bird experienced significant improvements on anxiety on the Brief Symptom Inventory (BSI) (p < .05), ...
... Of the eight studies in this review that explored the benefit of animal companionship on late-life anxiety, four studies identified a positive effect (Colombo et al., 2006;Kanamori et al., 2001;Mossello et al., 2011;Sollami et al., 2017) and four studies found no effect (Feng et al., 2014;Ko et al., 2016;le Roux & Kemp, 2009;Parslow et al., 2005). For example, Colombo et al. (2006) found that residents who cared for a bird experienced significant improvements on anxiety on the Brief Symptom Inventory (BSI) (p < .05), including phobic anxiety (p < .05) ...
... The other studies found no effect of animal companionship on cognitive functioning (Coleman et al., 2002;Colombo et al., 2006;Kanamori et al., 2001;Mossello et al., 2011;Motomura, Yagi, & Ohyama, 2004;Stasi et al., 2004;Thodberg et al., 2016). Interestingly, Thodberg et al. (2016) observed that residents significantly deteriorated in cognitive impairment (MMSE) and other dementia related impairments, however, this effect was consistent across both the AAI and control conditions. ...
Objectives. The aim of this systematic literature review (SLR) was to investigate the effect of companion animals (whether simply as pets or used in more formal intervention approaches) on the physical and mental health of older adults (aged 60+).
Methods. The reviewers identified key search terms and conducted a systematic search of the PsycINFO and PubMed databases. The 70 articles reviewed were evaluated through tabular and thematic analysis.
Results. In 52 of the studies examined, companion animals positively contributed to the mental and/or physical health of older adults. With respect to mental health, involvement with a companion animal improved participant quality of life and effectively attenuated symptoms of depression, anxiety, cognitive impairment, and the behavioral and psychiatric symptoms of dementia (BPSD). In relation to physical health, marked increases in physical activity and improvements in blood pressure and heart rate variability were the only consistent physical health improvements observed from companion animal interactions.
Conclusions. Animal companionship can benefit the mental and physical health of older adults, although more and better controlled research on this topic is required.
Clinical Implications. Use of companion animals has the potential to be an effective treatment or adjunct therapy to improve the health status and quality of life of older individuals.
... Dentre os estudos avaliados, observou que apenas dois (Colombo et al., 2006;Vrbanac et al., 2013) utilizaram em sua amostra idosos sem comprometimento cognitivo. Os outros seis estudos (Berry et al., 2012;Moretti et al., 2011;Nordgren e Engström, 2012;Sellers, 2006;Travers et al., 2013) englobaram idosos com declínio cognitivo leve e demência de diferentes níveis (leve, moderada e severa). ...
... As intervenções realizadas nos estudos foram variadas. Colombo et al. (2006) randomizou os participantes em três grupos: idosos receberem um canário, juntamente, com a instrução de cuidá-lo, alimentá-lo e mantê-lo limpo; idosos que receberam uma planta; e idosos que não receberam nada. Os participantes foram avaliados antes e após a intervenção, que durou três meses, em relação ao funcionamento cognitivo, qualidade de vida e sintomas psicopatológicos. ...
... Somente as pesquisas de Nordgren e Engström (2012; 2014) utilizaram--se dos mesmos instrumentos (Quality of Life in Late-stage). Os outros instrumentos usados para avaliação da qualidade de vida foram o LEIPAD II -Short Version (Colombo et al., 2006), Quality of Life-AD (Travers et al., 2013) e Social Behavior Observation Checklist (Sellers, 2006 ...
Este é um artigo de acesso aberto, licenciado por Creative Commons Atribuição 4.0 Internacional (CC BY 4.0), sendo permitidas reprodução, adaptação e distribuição desde que o autor e a fonte originais sejam creditados. Resumo. O estudo objetivou investigar os efeitos da Terapia Assistida por Animais (TAA) na qualidade de vida em idosos por meio de uma revisão sistemática. Foi realizada a busca de artigos, por dois juízes, nas bases de dados indexadas na Medline, PsycINFO, Embase e Web of Science. Utilizaram-se as recomendações da Declaração Preferred Reporting Items for Systematic Reviews and Meta-Analyses para esta revisão. A partir de critérios de inclusão/ exclusão, foram recuperados e analisados oito artigos. Os estudos destacam que a TAA produz melhoria na qualidade de vida dos idosos, e os instru-mentos para essa avaliação foram diversificados. Conclui-se que a TAA afeta positivamente a qualidade de vida dos idosos. Palavras-chave: Terapia Assistida por Animais, qualidade de vida, idosos. Abstract. This study investigated the effects of Animal Assisted Therapy (AAT) on elderly quality of life through a systematic review. Articles were searched by two judges at Medline, PsycINFO, Embase, and Web of Science. This research was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After the criteria for inclusion and exclusion were applied, eight articles were selected and analyzed. The majority of studies found that AAT has positive effects on quality of life by the elderly, and different instruments were used for such evaluation. Finally, it can be concluded that AAT improves the quality of life among the elderly. A Terapia Assistida por Animais (TAA) consiste em intervenções desenvolvidas com o auxílio de um animal no processo terapêutico. Ela possui objetivos claros e definidos, poden-do ser utilizada na promoção da saúde física e mental, bem como na estimulação das funções cognitivas do paciente. Na TAA, o indivíduo beneficia-se do vínculo resultante da relação humano-animal, em formatos ou arranjos te-rapêuticos que podem ser individuais ou gru-pais (Domènec e Ristol, 2012; Dotti, 2005). Os animais que podem ser utilizados na TAA são inúmeros, desde escargot até elefantes (Burton, 2013). Estão disponíveis estudos cien
... Dentre os estudos avaliados, observou que apenas dois (Colombo et al., 2006;Vrbanac et al., 2013) utilizaram em sua amostra idosos sem comprometimento cognitivo. Os outros seis estudos (Berry et al., 2012;Moretti et al., 2011;Nordgren e Engström, 2012;Sellers, 2006;Travers et al., 2013) englobaram idosos com declínio cognitivo leve e demência de diferentes níveis (leve, moderada e severa). ...
... As intervenções realizadas nos estudos foram variadas. Colombo et al. (2006) randomizou os participantes em três grupos: idosos receberem um canário, juntamente, com a instrução de cuidá-lo, alimentá-lo e mantê-lo limpo; idosos que receberam uma planta; e idosos que não receberam nada. Os participantes foram avaliados antes e após a intervenção, que durou três meses, em relação ao funcionamento cognitivo, qualidade de vida e sintomas psicopatológicos. ...
... Somente as pesquisas de Nordgren e Engström (2012; 2014) utilizaram--se dos mesmos instrumentos (Quality of Life in Late-stage). Os outros instrumentos usados para avaliação da qualidade de vida foram o LEIPAD II -Short Version (Colombo et al., 2006), Quality of Life-AD (Travers et al., 2013) e Social Behavior Observation Checklist (Sellers, 2006 ...
O estudo objetivou investigar os efeitos da Terapia Assistida por
Animais (TAA) na qualidade de vida em idosos por meio de uma revisão
sistemática. Foi realizada a busca de artigos, por dois juízes, nas bases de
dados indexadas na Medline, PsycINFO, Embase e Web of Science. Utilizaram-
-se as recomendações da Declaração Preferred Reporting Items for Systematic
Reviews and Meta-Analyses para esta revisão. A partir de critérios de inclusão/
exclusão, foram recuperados e analisados oito artigos. Os estudos destacam
que a TAA produz melhoria na qualidade de vida dos idosos, e os instrumentos
para essa avaliação foram diversificados. Conclui-se que a TAA afeta
positivamente a qualidade de vida dos idosos.
... Moreover, research has pointed to underlying mechanisms that may explain how integrating animals in the therapeutic process can have additive positive effects (Beetz, Uvnäs-Moberg, Julius, & Kotrschal, 2012). Numerous studies indicate that the presence of an animal leads to reduced fear (e.g., Barker, Pandurangi, & Best, 2003;Cole, Gawlinski, Steers, & Kotlerman, 2007;Hoffmann et al., 2009;Lang, Jansen, Wertenauer, Gallinat, & Rapp, 2010), promotes calmness (Crowley-Robinson, Fenwick, & Blackshaw, 1996;Perkins, Bartlett, Travers, & Rand, 2008), and improves mood and prosocial behaviors (e.g., Banks & Banks, 2005;Colombo, Buono, Smania, Raviola, & De Leo, 2006;Marr et al., 2000;Nathans-Barel, Feldman, Berger, Modai, & Silver, 2005). Furthermore, interacting with animals is associated with stress buffering effects on a behavioral (Hansen, Messinger, Baun, & Megel, 1999) and physiological level (e.g., Beetz et al., 2011;Cole et al., 2007;Handlin et al., 2011;Odendaal & Meintjes, 2003). ...
... Furthermore, in nursing home residents with dementia and depressive symptoms, an increase in depression over time was prevented if treatment-as-usual was combined with AAT in comparison to treatment as usual alone (Majić, Gutzmann, Heinz, Lang, & Rapp, 2013). Other studies found reduced depressive symptoms in residents of a long-term care facility (Le Roux & Kemp, 2009), older institutionalized adults without cognitive impairment (Colombo et al., 2006;Jessen, Cardiello, & Baun, 1996), and college students (Folse, Minder, Aycock, & Santana, 1994). In summary, existing studies give promising findings regarding the treatment of depression with animal-assisted therapy. ...
... The remaining studies on this topic include five at level 2b (Colombo et al., 2006;Friedmann et al., 2015;LeRoux & Kemp, 2009, Travers et al., 2013Zisselman et al., 1996), seven at 2c (Colby & Sherman, 2002;Francis et al., 1985;Holcomb et al., 1997;Lutwack-Bloom et al., 2005;Moretti et al., 2011;Mossello et al., 2011;Stasi et al., 2004), and four at 4 (Barker, Pandurangi, & Best, 2003;Kumasaka et al., 2012;Phelps et al., 2008;Prosser et al., 2008). ...
... The majority of these remaining studies report results linking AAI to a decrease in depression in older adults. For example, in one study 144 cognitively intact older adults were randomly assigned to one of three experimental conditions for a period of three months: a canary, a plant, and nothing (Colombo et al., 2006). Pre-and post-intervention measures showed a significantly greater improvement in scores for the canary group than the plant group or the no-treatment group, for both depression and quality of life, with the largest impact on depression. ...
Research on the impact of companion animals in the lives of older adults is considered from two perspectives: pet ownership and in animal-assisted interventions (AAI). This paper first presents a discussion of potential theoretical explanations of the impact of animals on human health and wellbeing among older adults, and then provides a systematic review and evaluation of existing research on the topics of human–animal interaction (HAI) and physical health and exercise, depression and anxiety, and loneliness and social functioning. Each of the studies in this review (n = 145) are rated according to modified Oxford Center for Evidence Based Medicine (OCEBM) levels and the role of theory, in conceptualizing the study or interpreting outcomes, is discussed. The quality of evidence for each topical area of HAI and aging research is summarized, and recommendations are made for future research directions that will increase our knowledge of the relationship between HAI and health outcomes for older adults in different settings.
... CAT research in healthcare settings has centered around improving both subjective and objective measurements related to patient health and well-being. Subjective measurements have included self-reported mood, anxiety, stress, and pain [3][4][5][6][7][8][9][10]. Barker et al. demonstrated how this canine-human interaction significantly reduced self-reported anxiety among patients with mood and psychotic disorders compared to patients who received human only recreation group sessions [2]. ...
... Subjective measurements have included self-reported mood, anxiety, stress, and pain [3][4][5][6][7][8][9][10]. Barker et al. demonstrated how this canine-human interaction significantly reduced self-reported anxiety among patients with mood and psychotic disorders compared to patients who received human only recreation group sessions [2]. Other neuropsychiatric studies have found similar benefits of CAT in reducing depression among nursing home patients [3], improving social interactions and communication in children with autism [4], and reducing post-operative pain in children following surgery [5]. Furthermore, Raina et al. demonstrated that pet ownership in geriatric populations led to improved performance of activities of daily living (ADLs) over a one-year longitudinal study [6]. ...
... Las interacciones humano-perro han mostrado su efecto sobre la proximidad emocional y sentimientos de apego en interacciones habituales con animales de compañía, así como también en IAA (Díaz Videla et al., 2015b). Respecto de estas últimas, algunas investigaciones mostraron una clara disminución de síntomas asociados con depresión y sentimientos de soledad, con incrementos en el bienestar psicológico (Banks & Banks, 2002;Colombo, Dello Buono, Smania, Raviola, & De Leo, 2006) y reducción en los niveles de ansiedad (Le Roux & Kemp, 2009). En pacientes psiquiátricos hospitalizados, un estudio mostró que estos tenían menores niveles de ansiedad luego de una sesión de terapia asistida con perros, mientras que una sesión recreativa con perros solo evidenció el mismo efecto para los pacientes con trastornos del estado de ánimo (Barker & Dawson, 1998). ...
... Desde esta perspectiva, la interacción con un perro de terapia impacta profundamente en la percepción de la calidad de vida. Los resultados de diversos estudios han reflejado una amplia mejoría en este aspecto, teniendo un efecto beneficioso sobre su bienestar psicológico, particularmente en ancianos institucionalizados ( Zarebski et al., 2000;Colombo et al, 2006;Berry et al., 2012). ...
Las Intervenciones Asistidas por Animales son utilizadas como una forma de terapia complementaria desde hace poco más de cincuenta años. Se revisan las publicaciones científicas sobre investigaciones empíricas que hayan empleado perros en el trabajo psicoterapéutico, principalmente con adultos mayores, tomando como guía el enfoque multimodal de Lazarus. En base a este modelo, se proponen intervenciones asistidas con perros que pueden resultar potencialmente beneficiosas para esta población. Se destaca la relevancia del enfoque multimodal para el diseño de intervenciones y programas terapéuticos.
... Ce travail de thèse avait pour but premier de tester l'hypothèse que la thérapie assistée par l'animal pourrait être considérée comme une approche nonpharmacologique apportant la preuve de son efficacité dans le traitement des symptômes psychologiques et comportementaux de la démence. Cette hypothèse était basée sur l'existence de bénéfices constatés sur la santé humaine, au travers de différents types de contacts et relations aux animaux domestiques (Barker & Wolen, 2008 ;Bernabei et al., 2013 ;Budge, Spicer, Jones, & George, 1998 ;Cherniack & Cherniack, 2014 ;Coakley & Mahoney, 2009 ;Colombo et al., 2006 ;Friedmann et al., 2000 ;Majić et al., 2013 ;Matuszek, 2010 ;Maujean, Pepping, & Kendall, 2015b ; Stasi et al., 2004). A ce jour, les mécanismes sous-jacents les plus fréquemment proposés, tels que la théorie du support social (Collis & McNicholas, 1998), l'hypothèse de la biophilie (Gullone, 2000 ;Wilson, 1984), la réponse émotionnelle (Vining, 2003), pour tenter d'expliquer la nature des bienfaits de la thérapie assistée par l'animal, ne font toujours pas consensus dans le domaine, auprès des auteurs et chercheurs. ...
... Les observations de notre étude vont dans le sens de recherches publiées sur l'apport de la TAA auprès des personnes âgées démentes présentant des SPCD associés (G. Colombo et al., 2006;Motomura et al., 2004). ...
Les symptômes psychologiques et comportementaux de la démence (SPCD) sont fréquents et peuvent concerner jusqu’à 90 % des patients atteints de la maladie d’Alzheimer. Considérant l’efficacité limitée et l’ampleur des effets secondaires observés avec les traitements psychotropes en France, la majorité des directives existantes soulignent l’importance de la recherche clinique sur la maladie d’Alzheimer et une amélioration de l’évaluation des approches non pharmacologiques (ANP). En 2016, Le recours à la médiation animale, comme prise en soins, en établissements d’hébergement pour personnes âgées dépendantes (EHPAD) est de plus en plus fréquent. Nous avions montré les bienfaits de cette ANP sur l'apathie dans la maladie d'Alzheimer et avons souhaité en démontrer son efficacité. Notre étude évalue et mesure, principalement à l’aide de l’Inventaire Neuropsychiatrique version Equipe soignante (NPI-ES), comment la présence du chien dans la psychothérapie des malades Alzheimer est associée à des niveaux de SPCD chez des femmes et des hommes, âgés en moyenne de 85 ans qui vivent en institution. Nous nous sommes concentrés sur le bien-être et la construction d’émotions positives de la personne âgée démente, en particulier sur la revalorisation de l’estime de soi, la stimulation, la remobilisation et le maintien des capacités cognitives préservées, comme base thérapeutique possible dans l’association de la présence du chien avec la diminution significative des SPCD.
... Pet therapy for the residents of elderly rest homes showed reduction in depression and improvement in the perception of quality of life (49). AAA for elderly patients with dementia also showed reduction in depression and improved perception of quality of life (50). ...
... However, the impact of horses, aquatic animals, and other animals showed more variability. Despite the use of various animals in contemporary interventions, including horses (Tseng et al., 2013;Collado-Mateo et al., 2020;Prieto et al., 2022), dolphins (Dilts, 2008;Matamoros et al., 2022), cats (Goleman et al., 2012), and birds (Colombo et al., 2006), therapy dogs have emerged as the most widely used, historically established, and effective therapeutic animals (Chandler, 2001). ...
The impact of companion animals on human psychological health has garnered widespread attention. Research demonstrates that companion animals contribute positively in various ways, including reducing depression, anxiety, stress, and fostering positive emotions in humans. Recent studies have revealed significant changes in the activity levels of human emotion-related cortical areas (such as the frontal cortex and amygdala) and neurotransmitter (e.g., oxytocin, cortisol) secretion due to interaction with companion animals. However, research in this domain is still in a nascent stage, with many unknowns in the cognitive neural mechanisms involved. This paper proposes that to understand the cognitive mechanisms through which companion animals affect human psychological health, we need to examine changes in emotional cognitive processing. It aims to uncover the neurological underpinnings of how companion animals enhance human psychological well-being from the perspective of brain connectivity. This approach is expected to provide theoretical support and direction for future research and practical applications in this field.
... A variety of animals, from horses to dolphins, have been used in animal therapy, but dogs have become mainstream in recent years [2][3][4][5]. Specific effects of animal therapy have been reported, including decreased progression of depression [2,6,7], stabilization of blood pressure [8,9], and increased motivation to socialize [10][11][12]. In expectation of these effects, many hospitals and facilities have introduced dog visits, and the demand for these services has been increasing. ...
In recent years, therapy dogs in medical and assisted living facilities have become popular in Japan, and the demand for such dogs has increased. However, some owners have their dogs take this test, which evaluates the dog’s talent, without understanding what is required of the test. The system needs to teach owners in an understandable way whether their dog is suitable to become a therapy dog so that the owners can determine if their dog is ready to be tested. Therefore, we suggest that easy at-home testing is likely to encourage dog owners to apply for their dog to take the aptitude test. If more dogs take the test, more therapy dogs can be born. The purpose of this study was to identify the personality traits of therapy dogs that pass the aptitude test by using the Canine Behavior Assessment and Research Questionnaire (C-BARQ). The C-BARQ was administered to dogs that previously passed the aptitude test for therapy training at the Hokkaido Volunteer Dog Association, assessing their behavioural displays. A factor analysis was conducted for each questionnaire item, and a total of 98 items were analyzed. Data were collected from the results of 110 dogs encompassing 30 dog breeds, with the most common breeds including Labrador Retrievers, Golden Retrievers, and Toy Poodles. Factor analysis revealed that 14 extracted factors should be evaluated. Given these personality traits and the fact that breed and age did not influence aptitude, we believe that a variety of dogs have the potential to become therapy dogs.
... Multiple studies have reported physiological components to human-dog attachments. Dogs have been shown to have beneficial effects on the mental health, quality of life, and well-being of wounded warriors (19,20), nursing home residents (21,22), and institutionalized people (23). The human-animal bond can be particularly strong for individuals who are psychologically vulnerable (24). ...
Objective:
This work aimed to assess the therapeutic and economic benefits of service dogs versus emotional support dogs for veterans with posttraumatic stress disorder (PTSD).
Methods:
Veterans with PTSD (N=227) participating in a multicenter trial were randomly assigned to receive a service or emotional support dog; 181 veterans received a dog and were followed up for 18 months. Primary outcomes included overall functioning (assessed with World Health Organization Disability Assessment Scale II [WHODAS 2.0]) and quality of life (Veterans RAND 12-Item Health Survey [VR-12]). Secondary outcomes included PTSD symptoms (PTSD Checklist for DSM-5), suicidal ideation, depression, sleep quality, health care costs and utilization, medication adherence, employment, and productivity.
Results:
Participants paired with a dog had a mean±SD age of 50.6±13.6 years (range 22-79), and most were male (80%), White (66%), and non-Hispanic (91%). Adjusted linear mixed repeated-measures models indicated no difference between the two groups on WHODAS 2.0 or VR-12 scores. Participants with service dogs had a 3.7-point greater reduction in PTSD symptoms versus participants with emotional support dogs (p=0.036). No reduced health care utilization or cost was associated with receiving a service dog. Veterans with service dogs had an increase of 10 percentage points in antidepressant adherence compared with those with emotional support dogs (p<0.01).
Conclusions:
Both groups appeared to benefit from having a service or emotional support dog. No significant differences in improved functioning or quality of life were observed between the groups. Those in the service dog group had a greater reduction in PTSD symptoms and better antidepressant adherence, improvements that should be explored further.
... This trend has led several researchers to study the potentially beneficial effect of pet exposure on the health and longevity of their owners. As a result, a plethora of observational studies on physical (Curl et al. 2016;Mičková et al. 2019;Parslow et al. 2005;Raina et al. 1999;Taniguchi et al. 2018) or mental health (Colombo et al. 2006;Enmarker et al. 2015;Friedmann et al. 2011;Garrity et al. 1989;Parslow et al. 2005;Powell et al. 2019;Raina et al. 1999;Taniguchi et al. 2018), with exposures spanning from in utero (Xu et al. 2020) and early life (Casas et al. 2013), to late years (Scheibeck et al. 2011), make up the literature. ...
With pet ownership on the rise, millions of individuals are exposed to this environmental exposure. Although the subject has been largely studied, more evidence is needed to clarify the potential association of pet ownership with human health. The aim of this research is to study the potential association of pet exposure (any pet, cat, dog, bird, fish) with all-cause, cardiovascular and cancer mortality of older ( ≥ 50 years) European residents. To this end, a total of 23,274 participants from the Survey of Health Ageing and Retirement in Europe (SHARE) were employed (median follow-up 119 months). All-cause mortality (5163 events), as well as cardiovascular (CVD) (1832 events), and cancer mortality (1346 events) were examined using Cox Proportional Hazards models for their relation with pet exposure at baseline. Stratified analyses were also performed by gender and for single or multi-person households. No significant association was observed for any of the pets with all-cause mortality on the whole sample and the fully adjusted models. In stratified analyses, bird exposure significantly increased the risk of all-cause mortality in women [Hazard Ratio ( HR ) = 1.23 ; 95% CI 1.04–1.44] as well as women living alone ( HR = 1.38 ; 95% CI 1.02–1.85). Cause-specific models revealed an increased risk of death for women bird owners for causes other than cancer and CVD ( HR = 1.40 ; 95% CI 1.05–1.99). In conclusion, bird ownership may be negatively associated with survival of older women in Europe.
... Despite these potential benefits of pet ownership, few studies have investigated the benefits of owning pets among communitydwelling older adults (Hughes et al., 2020;Albright et al., 2022). Most research investigating such relationships has focused on the therapeutic effects of animal-assisted therapy in patients with memory disorders (Kanamori et al., 2001;Bono et al., 2015) or those who need care in nursing homes (Stasi et al., 2004;Colombo et al., 2006). These studies investigated very coarse, global measures of cognition via measures like the Mini-Mental Status Exam (MMSE) and showed mixed results. ...
Human-animal interactions that stem from pet ownership have a wide range of benefits for social, emotional, and physical health. These factors also tend to improve cognition. Following this logic, owning a pet could indirectly enhance cognitive and brain health through mechanisms like improvements in well-being, socialization, and decreased stress. In the present study, cross-sectional data were drawn from the Alabama Brain Study on Risk for Dementia in which 95 participants aged 20–74 were recruited. Specifically, 56 adults were pet-owners and 39 adults were not pet-owners. Multivariate analyses revealed that pet ownership was related to higher levels of cognition and larger brain structures, and these effects were largest in dog owners. The most consistent cognitive relationships were found with better processing speed, attentional orienting, and episodic memory for stories, and with dorsal attention, limbic, and default mode networks. Moreover, we show that owning a pet can reduce one’s brain age by up to 15 years. Pet ownership was not related to indirect factors including social, emotional, and physical health. We found also that older adults’ brain health benefited from owning more than one pet versus owning one or fewer pets. These findings indicate that pet ownership, especially dog ownership, may play a role in enhancing cognitive performance across the adult lifespan, which could in turn influence protection against age-related cognitive decline.
... Additionally, analysis of hospital records indicated that patients who participated in AAT had reduced pain (Ichitani & Cunha, 2016;Stoffel & Braun, 2006), increased relaxation and calmness (Stoffel & Braun, 2006), and better attitudes during the AAT sessions (Stoffel & Braun, 2006). Dogs have been shown to have beneficial effects in the mental health, quality of life, and well-being of wounded warriors (Beck, et al., 2012;Mills & Hall, 2014), nursing home residents (Colombo, et al., 2006;Friedmann, et al., 2015), and institutionalized people such as those in prisons (Wells, 2019). Additionally, the presence of a dog has been correlated to a reduction in depression (Lentino, et al., 2012;Putney, 2013), fear and anxiety (Beetz, et al., 2012;Beetz, 2017;Putney, 2013), and aggression (Beetz, et al., 2012;Beetz, 2017). ...
Full text available from: https://www.research.va.gov/REPORT-Study-of-Costs-and-Benefits-Associated-with-the-Use-of-Service-Dogs-Monograph1.pdf
Objectives. Determine whether overall disability and quality of life of Veteran participants in treatment for PTSD are improved by the provision of service dogs relative to provision of emotional support dogs.
Design. Multicenter parallel, two-arm, randomized clinical trial with Veteran participants diagnosed with PTSD assigned 1:1 to either a service dog or an emotional support dog. Randomization was conducted centrally by the study coordinating center using the computer-generated Interactive Touch Tone Randomization System (ITTRS).
Setting. Three VA medical centers: Atlanta VA Medical Center (Atlanta, GA) Iowa City Veterans Affairs Health Care System (Iowa City, IA), and VA Portland Health Care System (Portland, OR).
Participants. 227 Veteran participants were randomized and fulfilled study requirements, of which 181 were paired with a study dog.
Intervention. After randomization to either the service dog intervention or emotional support dog intervention, an observation period of at least three months duration began; during this period both the study team and the participants were blinded to the type of dog to which the participant had been randomized. Dog type assignment disclosure to the participant and the study team occurred upon completion of the observation period. Participants were paired with either service dogs or emotional support dogs per assignment and followed for 18 months.
Main outcome measures. Overall disability (WHO-DAS 2.0) and quality of life (VR-12). Secondary outcomes included PTSD symptoms (PCL-5), suicidal ideation (C-SSRS), depression (PHQ-9), sleep (PSQI) and anger (DAR).
Results. 227 participants were randomized to either the service dog intervention (n=114) or emotional support dog (n=113) intervention. 46 participants terminated prior to pairing; (n=17) participants assigned to the service dog intervention versus (n=29) participants assigned to the emotional support dog intervention. 97 participants were paired with a service dog; 84 participants were paired with an emotional support dog. 9 participants paired with a service dog terminated after pairing; 19 participants paired with an emotional support dog terminated after pairing. Participants paired with a dog were on average 50.6 years old (SD=13.6; range 22-79), mostly male (80.1%), white (66.3%), and non-Hispanic (91.2%). After adjusting for baseline score, center, and gender, the linear mixed repeated measures (LMRM) model for WHO-DAS 2.0 (disability) showed no statistical difference between the two intervention groups nor did the mixed models for quality of life (VR-12) show statistical differences between the two groups for either PCS (physical health) or MCS (mental health). Of the secondary outcome measures, only PCL-5 (PTSD symptoms) using the adjusted LRMR model showed a statistically significant difference between intervention groups. Participants receiving the service dog intervention had a 3.7-point improvement (lower score=less symptoms of PTSD) in the PCL-5 total score over time as compared to the emotional dog intervention. Contrasts testing for a difference in the service dog group versus the emotional support dog group for suicidal ideation and behavior (per C-SSRS) did not show a significant difference between groups across time, however, it did show a difference between groups at 18 months with the service dog group having fewer suicidal behaviors and ideation. In both groups, WHO-DAS 2.0 scores at 18 months decreased (less disability) from scores at 3 months post pairing; improvement in VR-12 MCS also showed some improvement over time in both groups. Descriptive statistics for sleep and anger also showed a decline in scores (improvement) over time in both groups. Serious Adverse Events (SAE) and adverse events (AE) were compared across groups. None of the SAEs in either group were dog related. All AEs occurred in the emotional support dog group.
Conclusions. While both groups appeared to have experienced some benefit, an improvement in overall disability and quality of life among Veteran participants with PTSD was not observed with the provision of a service dog relative to provision of an emotional support dog. Among secondary outcome measures, participants paired with a service dog experienced a reduction in the severity of PTSD symptoms (PCL-5) compared to participants paired with an emotional support dog, and had fewer suicidal behaviors and ideations, particularly at 18 months post- pairing.
... Another study defined walking with a dog as the control intervention, while the experimental intervention had participants train dogs to be more suitable for adoption (Syzmanski et al., 2018). Other examples of such specific factors of an animal were the sound of an animal (Park et al., 2019), proximity to an animal Vandagriff et al., 2021), or taking care of another living being (Colombo et al., 2006). We also found that a minority of studies defined novelty as a non-specific factor. ...
Research on animal-assisted interventions (AAIs) has increased massively in the last few years. But it is still not clear how AAIs work and how important the animal is in such interventions. The aim of this systematic review was to compile the existing state of knowledge about the working mechanisms of AAIs. We searched 12 major electronic databases for previous AAI studies with active control groups. Of 2001 records identified, we included 172 studies in the systematic review. We extracted previously published hypotheses about working mechanisms and factors that have been implicitly considered specific or non-specific in AAI research by categorizing control conditions using content analysis. We analyzed the categories using descriptive statistics. We found that 84% of the included studies mentioned a hypothesis of working mechanisms, but 16% did not define specific hypotheses. By analyzing their control conditions, we found that in most controlled studies, the animal or the interaction with the animal was implicitly considered as a specific factor for the effects of the AAI. Non-specific factors such as therapeutic aspects, social interactions, or novelty have also been controlled for. We conclude that AAI research still cannot answer the question of how and why AAIs work. To address this important research gap, we suggest using component studies with innovative control conditions and results from placebo research to address both the specific and non-specific, contextual factors of AAIs to disentangle its mechanisms.
Systematic Review Registration
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=158103, identifier: CRD42020158103.
... Researchers in Italy studied the effects of interaction with a canary, compared to a plant or no intervention for 144 residents in a nursing home. Researchers found a statistically significant number of individuals who interacted with the canary bird reported quality of life improvements on the LEIPAD II-Short Version (Colombo, et al. 2006). The available research of the power of avian AAI was incorporated by the first author into academic projects and then into fieldwork. ...
Occupational Deprivation has been a present risk [ER1] for people in inpatient hospital settings such as Skilled Nursing Facilities (SNF) during the Coronavirus Disease 2019 (COVID-19) pandemic restrictions. Clients have described their days as “boring” and “unfulfilling.” Clients experiencing extended in-patient hospitalization, who already might experience great interruptions to their treasured roles, routines, and occupations, were further restricted from recreational and social opportunities usually present in those settings. This work describes the translation of the animal assisted intervention evidence base to an occupational therapy student-developed program at a SNF to address this deficit. A vibrant avian therapy partner gave moments of joy for clients whose activities were heavily restricted during widespread social isolation of the COVID-19 containment efforts. Connections to performance skills in the Occupational Therapy Practice Framework (AOTA, 2020). are discussed
... The results suggest that HAI is associated with decreases in depressive symptoms. Additional studies with older adults living within care facilities provide evidence that caring for an animal (in these studies, a bird) is associated with less depressive symptoms [157,158]. Similarly, Barker et al. [159] found that, among patients waiting for a psychiatric procedure, those who interacted with an animal reported significantly lower levels of fear and anxiety in comparison to patients within a control group. ...
There is a paucity of research exploring how relationships with household pets may impact maternal mental health. We are unaware of any study to date that has examined associations between individuals’ relationships with their pets and psychological adjustment in the perinatal period. Using a biobehavioral lens, this paper provides a narrative overview of the literature on perinatal mental health and human–animal interaction (HAI). We focus on the role of social relationships, stress, and stress reduction in relation to perinatal mental health; the role of HAI in perceptions of social support, stressors, and stress reduction; and gaps in empirical knowledge concerning the role of HAI in perinatal mental health. Finally, we integrate contemporary biobehavioral models of perinatal mental health and HAI (i.e., Comprehensive Model of Mental Health during the Perinatal Period and the HAI–HPA Transactional Model) to propose a new conceptual framework that depicts ways in which HAI during the perinatal period may influence maternal and child health and wellbeing. To our knowledge, this is the first paper to consider the role of HAI in biobehavioral responses and mental health during the perinatal period. We conclude with recommendations for future research and improved perinatal care.
... [25][26][27] Several observational case series have demonstrated that animal interactions increased positive social behaviors, increased weight gain, reduced mood disturbances and agitation, and resulted in longer conversations with therapists. [28][29][30] Many nursing researchers have qualitatively observed that animals relieve loneliness and boredom, promote social interactions, add variety to the lives of the geriatric population, act as a surrogate for human interaction, disrupt antisocial behaviors, provide a cardiovascular mortality benefit, and improve overall quality of life. [31][32][33][34] Apart from psychological well-being, numerous studies have shown that animals positively affect the physiological health of individuals or a target population. ...
Critical illness has lasting consequences on the mind and the body. Acute sequelae include a decline in the cognitive function of the brain, known as delirium. Increased interest in improving outcomes for ICU survivors without an increased incidence of delirium has started an array of non-pharmacologic interventions in many countries. One such intervention is animal-assisted intervention (AAI). As the role of animals in human healing is being recognized, there is an increasing need for formal and professionally-directed therapies. There have been no reviews focusing exclusively on AAIs in critical care to alleviate delirium. This review aimed to identify the cause of delirium in the ICU and ascertain the effect of animal-human interaction on critically ill patients. There is emerging evidence that AAI improves the efficacy of critical care provided to the patients regarding primary symptomatology and secondary factors by improving engagement and retention.
... Auch ergotherapeutische Effekte waren zu verzeichnen (Schervier-Vogt 2013,Julius 2013, Berry et al. 2012, Hohmann 2012, Pedersen et al. 2011, Frömming 2006, Crowley-Robinson et al. 1996. Effekte wurden selbst dann gemessen, wenn Tiere nur auf einem Bildschirm oder aus einem Fenster betrachtet wurden, Colombo et al. 2006).Peluso et al. (2018) wiesen mit mehreren Studien die Wirkungen tiergestützter Aktivitäten auf ältere Menschen mit Demenzerkrankungen und psychiatrischen Problemen nach, die in stationären Einrichtungen leben oder behandelt werden. Dabei verbesserten sich soziale und kommunikative Fähigkeiten und das Wohlbefinden der Patienten und Patientinnen. ...
In Europa werden vermehrt soziale Dienstleistungen auf landwirtschaftlichen Betrieben angeboten. Seit einigen Jahren gibt es erste Ideen, solche Angebote auch für alte Menschen zu schaffen. Damit könnten Lücken der Daseinsvorsorge in kleinen Siedlungseinheiten geschlossen werden und (kleinere) landwirtschaftliche Betriebe bekämen eventuell zusätzliche Einkommensmöglichkeiten. Die Aufrechterhaltung einer vielfältigen Agrarstruktur ist von besonderem gesellschaftlichem Interesse, weil sie sowohl Auswirkungen auf Landschaftsstrukturen und damit Biodiversität hat als auch als Ressource der Versorgung mit Nahrungsmitteln besonders schützenswert ist.
Zumindest in Deutschland sind jedoch sowohl das Sozial- als auch das Gesundheitssystem in jeder Hinsicht von der Agrarstruktur getrennt. Die sektorübergreifende Entwicklung von innovativen Konzepten kann somit zu Problemen in der Passung führen und es muss geprüft werden, inwieweit diese zunächst pragmatische erscheinende Idee einer Kombination von Landwirtschaft und Vorsorgeeinrichtungen für alte Menschen in die Realität umgesetzt werden kann.
Im Rahmen des F-&E-Vorhabens „Lebensabend im Dorf. Seniorenangebote auf landwirtschaftlichen Betrieben“ (VivAge, 2016-2019) untersuchten Wissenschaftlerinnen und Wissenschaftler der HAWK Hochschule Hildesheim/Holzminden/Göttingen daher, welche Chancen sich aus Angeboten landwirtschaftlicher Betriebe ergeben. Dabei wurden drei Perspektiven eingenommen und jeweils spezifische Fragen entwickelt:
1. Perspektive der Landwirtinnen und Landwirte: Wie können soziale Angebote wirtschaftlich rentabel gestaltet werden? Welche (bürokratischen) Hindernisse gibt es und welche Unterstützungs- oder Beratungsangebote brauchen Landwirtinnen und Landwirte?
2. Perspektive der Seniorinnen und Senioren: Wie kann eine hohe Qualität der Dienstleistungen sichergestellt werden? Verleiht die Anbindung an einen landwirtschaftlichen Betrieb den Dienstleistungen eine Qualität, die an anderer Stelle nicht in dieser Ausformung erreicht werden kann?
3. Perspektive der ländlichen Entwicklung und Daseinsvorsorge: Sind soziale Dienstleistungen auf landwirtschaftlichen Betrieben eine Möglichkeit, den Versorgungsbedarf älterer Dorfbewohnerinnen und Dorfbewohner zu decken?
Um diese Fragen zu beantworten, wurde eine systematische Recherche durchgeführt. Dabei wurde zum einen über Online-Materialien und Gesprächen mit Expertinnen und Experten erarbeitet, wie viele Angebote es in Deutschland gibt, die auf landwirtschaftlichen Betrieben mit der Zielgruppe Seniorinnen und Senioren stattfinden. Um die Rahmenbedingungen für andere Strukturen erarbeiten zu können, wurde diese Recherche um Informationen zu anderen europäischen Ländern ergänzt, in denen Angebote für Seniorinnen und Senioren auf landwirtschaftlichen Betrieben zum Zeitpunkt der Antragstellung für das F-&E-Vorhaben VivAge bekannt waren. Zudem wurde wissenschaftliche Literatur gesichtet, die für die Fragestellung von Interesse war. Die intensiven Recherchen wurden um eine methodengeleitete Analyse von acht bestehenden Angeboten in Deutschland ergänzt. Dazu dienten Betriebsbesuche, bei denen neben Teilnehmenden Beobachtungen Interviews mit Seniorinnen, Senioren, Landwirtinnen und Landwirten durchgeführt wurden. Die zuvor genannten Arbeitsschritte dienten als Grundlage für die Entwicklung von vier theoretischen Modelle, aus denen heraus abschließend Leitfäden zur Umsetzung entwickelt wurden.
... 11,13 Animal mediation reduces depressive symptoms and thus improves the quality of life of elderly Alzheimer patients. 11,14,15,16,17,18 Introducing an animal, including providing a stable and calm environment, allows people to "care about something," and be "distracted" and thus build and maintain self-esteem. 13,19,20,21,22 The presence of an animal could also reduce behavioral disorders (aggression, wandering or shouting) in patients with Alzheimer's disease 19,23,24,25,26,27 In addition, several authors have shown an improvement in cognitive capacities in patients with dementia after activity sessions with an animal. ...
Background
Increasing numbers of scientific studies have dealt with the benefits of animal assisted intervention programs (AAI). Although many positive effects have been identified, there are still few AAI programs in nursing homes. To date, no study has investigated special the difficulties in implementing such a program.
The aim of this study was to explore the representations of this type of program among caregivers.
Methods
This qualitative study was conducted between January and June 2019. Psychologists conducted 11 interviews with people working in nursing homes. The sample was based on different professions and on the fact that participants had already been involved in an IAA program.
Results
The results were organized according to two main themes: brakes and levers. The results show that the brakes were raised quickly before the implementation of the project, but once the project had been implemented, the perceived beneficial effects multiplied and all those interviewed mentioned the benefits of animals. More than half of the caregivers interviewed mentioned animals as a lever, facilitating contact with elderly people suffering from dementia. Setting up a project upstream enhanced the success of this type of program.
Conclusion
The benefits perceived by the people interviewed are consistent with the scientific literature. The obstacles mentioned for implementing this type of program can be reduced by a rigorous and well-thought-out project.
... The programme was developed by the study's primary investigator, an animal-assisted psychotherapist, and a professor from the Graduate School of Health & Complementary Medicine at the Wonkwang University. In previous studies, programme length ranged from 3 days to 12 weeks, [22][23][24] but based on the participating hospitals' availability, we set the length of this study at 8 weeks. The effects of the intervention were assessed at weeks 4 and 8. ...
Aim
The purpose of this study was to investigate the psychological and behavioural effects of animal‐assisted therapy on cognitive function, emotional state, problematic behaviours, and activities of daily living among older adults with dementia.
Methods
A nonequivalent control group pretest and post‐test study design was used in this study. Twenty‐eight participants—14 in the intervention group and 14 in the control group—were recruited from two hospitals in Gyeonggi Province, South Korea, between February and April 2015. The intervention group received two 60‐min sessions of animal‐assisted therapy weekly for 8 weeks, while the control group received conventional care. The cognitive function, emotional state (mood, depression), activities of daily living, and problematic behaviours of the two groups were compared at three points (before the study, at week 4, and at week 8).
Results
The results showed significant group‐by‐time interactions of cognitive function (P < 0.001), mood status (P < 0.001), depressive symptoms (P < 0.01), degrees of activities of daily living (P < 0.001), and problematic behaviours (P < 0.001). There were no significant group differences, but significant time differences were observed in cognitive function (P < 0.001), mood status (P < 0.05), degrees of activities of daily living (P < 0.01), and problematic behaviours (P < 0.05).
Conclusion
The findings of the study suggest the adoption of animal‐assisted therapy in the daily care of older adults with dementia for improving their psychological and behavioural problems.
... Research offering support of animal-assisted therapy among older adults is growing, and studies have documented benefit for the use of animal-assisted therapy among those with dementia (Travers, Perkins, Rand, Bartlett, & Morton, 2013), older adults with mental illness (Moretti et al., 2011), and older adults living in long-term care facilities (Colombo, Buono, Smania, Raviola, & De Leo, 2006). Benefits of companion animals, such as dogs and cats, have been established especially in various health-care settings to "reach" individuals who have a reduced capacity to interact with others (Bachi & Parish-Plass, 2017;Barker, Vokes, & Barker, 2019). ...
The purpose of this study was to explore participants’ perceived benefits of equine-assisted psychotherapy and to understand if older adults with functional or cognitive impairment found meaning and purpose in their interactions with horses. This study employed a mixed methods study design with a concurrent triangulation approach. The findings from our study suggest that those impacted with functional or cognitive impairment can meaningfully engage in EAGALA model of equine-assisted psychotherapy and demonstrate the ability to find purpose from their experience. Their perceived benefits were not limited to their interactions with horses but instead wide-ranging, including positive influences from their peers, the outdoor environment associated with equine-assisted activities, and the increased level of social interactions through reminiscence. Social workers can serve a vital role in the use of equine-assisted psychotherapy among older adults, and equine-assisted psychotherapy may hold less stigma than traditional talk therapy to the older adult population.
... AAI efficacy research conducted in health care facilities has produced mixed results. Some evidence supports benefits of AAI associated with reduced anxiety (Barker & Dawson, 1998) and fear (Barker, Pandurangi, & Best, 2003) in hospitalized psychiatry patients, less depression among nursing home patients (Colombo, Buono, Smania, Raviola, & De Leo, 2006), reduced pain perception in pediatric patients (Sobo, Eng, & Kassity-Krich, 2006), improved cardiovascular function in congestive heart failure patients (Cole, Gawlinski, Steers, & Kotlerman, 2007), reduced pain and increased patient satisfaction following joint replacement surgery (Harper et al., 2015), and reduced pain medication use following joint replacement (Havey, Vlasses, Vlasses, Ludwig-Beymer, & Hackbarth, 2014). Benefits have also extended to health care professionals whose salivary and serum cortisol levels significantly declined after as little as five minutes of AAI (Barker, Knisely, McCain, & Best, 2005). ...
Animal assisted interventions (AAI) have been shown to improve patient outcomes in some healthcare settings. Flexible cystoscopy, while minimally invasive, is associated with patient-reported pain, fear, and anxiety. Few techniques have been found to improve these adverse effects associated with cystoscopy. The purpose of this study was to extend existing research on AAI in outpatient settings to investigate the effectiveness of AAI in reducing patient distress associated with outpatient cystoscopy. Ninety-five patients (average age 55.5) were prospectively enrolled and randomized to receive one 15-minute AAI prior to cystoscopy (n=46), or cystoscopy performed per standard protocol (n=49). Distress was measured by Visual analogue scales (VAS) for fear, anxiety, and stress, systolic blood pressure, and heart rate at 3 time points: prior to intervention/prior to cystoscopy, following intervention/prior to cystoscopy, and following intervention/following cystoscopy. Pain was assessed by VAS post-cystoscopy. There were no significant differences between the AAI and control groups in changes in systolic blood pressure, heart rate, fear and pain between any time points. There were significant between-group differences in changes in anxiety and stress prior to cystoscopy with greater reductions found in anxiety and stress following AAI. The greater reductions in stress associated with AAI were maintained after cystoscopy. This is the first study to investigate the effectiveness of AAI in reducing distress associated with cystoscopy. More research is needed to determine if AAI is a viable method for improving patient outcomes associated with this and other outpatient procedures.
... Prior work on designing robots for older adults with mental health issues suggests that it may be appropriate to use robot companions in lieu of pet therapy [29,30]. Pet therapy has had success as a treatment for older adults with depression [31,32], but pets require a high level of care that mental and physical issues sometimes prevent. In prior participatory design studies with older adults with depression, several participants lost access to their pets during the study due to deteriorating health [15]. ...
As healthcare turns its focus to preventative community-based interventions, there is increasing interest in using in-home technology to support this goal. This study evaluates the design and use of socially assistive robots (SARs) and sensors as in-home therapeutic support for older adults with depression. The seal-like SAR Paro, along with onboard and wearable sensors, was placed in the homes of 10 older adults diagnosed with clinical depression for one month. Design workshops were conducted before and after the in-home implementation with participating older adults and clinical care staff members. Workshops showed older adults and clinicians sawseveral potential uses for robots and sensors to support in-home depression care. Long-term in-home use of the robot allowed researchers and participants to situate desired robot features in specific practices and experiences of daily life, and some user requests for functionality changed due to extended use. Sensor data showed that participants’ attitudes toward and intention to use the robot were strongly correlated with particular Circadian patterns (afternoon and evening) of robot use. Sensor data also showed that those without pets interacted with Paro significantly more than those with pets, and survey data showed they had more positive attitudes toward the SAR. Companionship, while a desired capability, emerged as insufficient to engage many older adults in long-term use of SARs in their home.
... It was seen that AAT benefit the patients by increasing their social behavior and interaction. Colombo et al., (2006) conducted a study on elderly residents of an institution. It was observed that there was a reduction in depression and improvement in quality of life when caring for a canary for a period of 3 months. ...
The aim of this study is to find out the effect of human and animal bond on emotional regulation and level of depression. From ages the relationship has been formed between humans and animals based on work, sports and companionship. These animals affect us in lot of ways and they become important part of our family portraits. To see this, sample was taken of 60 adolescents (18-25) out of which, 30 who owned the pet and 30 who did not own the pet, by using Emotional regulation questionnaire (ERQ) and Beck's depression inventory (BPI). The result shows no significant correlation among pet owners and non-pet owners. Thus, other factors also play a major role and further research needs to be done.
... One recent study even found that older adults who owned a pet were nearly two times more likely than non-pet own- ers to have suffered depression at some point in their lives, although the authors indicated that it was impossible to determine the directionality of the relationship between depression and pet ownership (Mueller, Gee, & Bures, 2018). Studies of older adults residing in institutional care have proven equally conflicting, with some reporting lower levels of depression as a response to ani- mal-assisted interventions (Colombo, Dello Buono, Smania, Raviola, & De Leo, 2006;Friedmann, Galik, Thomas, Hall, Chung, & McCune, 2015;Le Roux & Kemp, 2009;Moretti et al., 2011;Travers, Perkins, Rand, Bartlett, & Morton, 2013;Virues-Ortega, Pastor-Barriuso, Castellote, Poblacion, & de Pedro-Cuesta, 2013), but others showing no significant effect of such schemes (Phelps, Miltenberger, Jens, & Wadeson, 2008;Thodberg et al., 2015). ...
Since the late 1970s, scientific evidence has accumulated showing that pet ownership can have positive effects on people’s physical and mental wellbeing. This paper reviews the current state of affairs regarding the relationship between companion animals and human health, focusing on both the physical and psychological health outcomes related to human–animal interactions. Although designed to set the general scene on the link between animals and human wellbeing, research specific to older adults is highlighted where relevant. A particular emphasis is placed on disorders prevalent in modern-day society, notably cardiovascular disease and depression. The possible mechanisms by which companion animals might be able to enhance human wellbeing and quality of life are discussed, focusing on routes including, amongst others, the provision of companionship, social lubrication, and improvements to physical fitness. The role of the social bonding hormone, oxytocin, in facilitating attachment to our pets and the implications for human health is also discussed. Inconsistencies in the literature and methodological limitations are highlighted throughout. It is concluded that future human–animal interaction experiments should aim to account for the confounding variables that are inherent in studies of this nature.
... Several studies suggest that it can positively impact on stress [65,66], in particular for highly stressed or socially isolated individuals. Interacting with a pet has been reported to reduce anxiety [67,68] and depression [69][70][71] and to enhance the quality of life [71][72][73]. ...
Recently, there has been a rising interest in service dogs for people with epilepsy. Dogs have been reported as being sensitive to epileptic episodes in their owners, alerting before and/or responding during or after a seizure, with or without specific training. The purpose of this review is to present a comprehensive overview of the scientific research on seizure-alert/response dogs for people with epilepsy. We aimed to identify the existing scientific literature on the topic, describe the characteristics of seizure-alert/response dogs, and evaluate the state of the evidence base and outcomes. Out of 28 studies published in peer-reviewed journals dealing with this topic, only 5 (one prospective study and four self-reported questionnaires) qualified for inclusion according to PRISMA guidelines. Reported times of alert before seizure varied widely among dogs (with a range from 10 seconds to 5 hours) but seemed to be reliable (accuracy from ≥70% to 85% according to owner reports). Alerting behaviors were generally described as attention-getting. The alert applied to many seizure types. Dogs mentioned as being seizure-alert dogs varied in size and breed. Training methods differed between service animal programs, partially relying on hypothesized cues used by dogs (e.g., variations in behavior, scent, heart rate). Most studies indicated an increase in quality of life and a reduction in the seizure frequency when living with a dog demonstrating seizure-related behavior. However, the level of methodological rigor was generally poor. In conclusion, scientific data are still too scarce and preliminary to reach any definitive conclusion regarding the success of dogs in alerting for an impending seizure, the cues on which this ability may be based, the best type of dog, and associated training. While these preliminary data suggest that this is a promising topic, further research is needed.
... También son varios los estudios que han resaltado los beneficios de la interacción humano-animal en la dimensión psicológica: destacando que los animales tienen la capacidad de actuar como un instrumento o herramienta viva, que puede aplicarse para provocar cambios positivos en la autopercepción y el comportamiento de las personas [9]; señalando que los animales proporcionan una fuente ilimitada de amor, afecto y compañerismo y que esta relación puede alcanzar el eterno ideal: el amor que dura siempre [10] [11]; aportando una reducción del estrés en los propietarios cuando las mascotas están presentes [12]; reduciendo la ansiedad [13]; mejorando la depresión y la calidad de vida [14] [15]; mejorando la motivación y la ilusión por la vida [16]; y, por último, proporcionando una mejora del equilibrio intraemocional, de la vitalidad, de la extroversión social y del estado de alerta [17]. ...
INTRODUCCIÓN. En varios estudios se ha desvelado que las relaciones entre humanos y animales pueden jugar un papel importante en el desarrollo socioemocional de los niños OBJETIVO. El presente estudio pretende identificar la relación existente entre la variable dependiente empatía y las variables independientes actitudes hacia las mascotas, trato hacia las mascotas y tener o no tener mascota, en un grupo de preadolescentes. MÉTODO. Se presenta un estudio de tipo ex post facto. Se han aplicado tres cuestionarios: El Interpersonal Reactivity Index en su versión castellanizada, El Pet Attitude Scale - Modified y El Children´s Treatment of Animals Questionnaire. RESULTADOS. Hemos constatado que existen relaciones de covariación entre algunas de las variables estudiadas lo que nos ha permitido proponer una serie de cuatro modelos causales y decidir cuál de ellos obtiene los mejores indicadores de bondad de ajuste. DISCUSIÓN Y CONCLUSIONES. El contacto con animales en el hogar ejerce influencia sobre el desarrollo de la empatía en los niños.
... Th ese benefi ts are particularly important for older adults (Banks & Banks, 2002;Cherniack & Cherniack, 2014). Reductions in blood pressure (Wright, Kritz-Silverstein, Morton, Wingard, & Barrett-Connor, 2007), decreased depressive symptoms (Orlandi et al., 2007), enhanced social interactions (Bernstein, Fried-mann, & Malaspina, 2000), and improved mental health (Colombo, Buono, Smania, Raviola, & De Leo, 2006) have been attributed to pet contact. Further, animals may be incorporated in physical therapy programs, such as dog walking or animal brushing, to increase participation in targeted activities aimed at restoring or promoting physical function and mobility (Abate, Zucconi, & Boxer, 2011). ...
Pets are encountered in nursing homes and although they provide health benefits to individuals, they are also a source of health risks. The current study aimed to determine the frequency and types of animals in nursing homes, perceived benefits, and content of policies addressing health risks. Ninety-five administrators from unique nursing homes in Ohio completed an online survey addressing perceived benefits and risks of animals and policies in place. Animals were permitted in 99% of nursing homes, with dogs (95%), cats (85%), birds (71%), fish (55%), and farm animals (40%) most frequently reported. Respondents perceived animal interactions resulted in high health benefits for residents. Most facilities (70/75; 93%) reported having an animal policy, yet important gaps were frequently identified in the content of policies. Most respondents (75%) did not report health and safety concerns with animals in facilities. Best practice guidelines and policies should be developed and implemented in nursing homes to address requirements for different animal ownership models, range of animal species, and staff knowledge. [Journal of Gerontological Nursing, xx(x), xx-xx.].
In diagnostic, therapeutic, and nursing contexts, touch is a prerequisite for successful treatment. Compared to other everyday touches, these touches represent exceptional situations in the lives of both patients and the professionals performing the touches.
Social touches can be distinguished from necessary touches that serve a medical or nursing purpose. These social touches, which often occur spontaneously, fulfill social or emotional functions and can have a calming, comforting, or stress-reducing effect. It is possible to use social touches specifically for these effects in medical and nursing contexts.
The chapter informs about emotional, social, and ethical aspects of touch, placebo effects through touch, embodiment effects, effects of pets and animal-assisted therapy, and the effects of loneliness and touch deprivation on health.
This chapter introduces animal-assisted therapy as a discipline—after presenting the past and the current state, the focus is primarily on the necessary further development of this discipline. As a basis, the exact definition of animal-assisted therapy is discussed first, and correct terms are introduced in this context. For further understanding of this field, an overview of the various effective factors and the history of animal-assisted therapy is provided. In the next step, using my own work method as an example, a further development of animal-assisted therapy is described, which takes new paths and addresses ethical questions.
The COVID-19 pandemic placed older adults at a disproportionate risk of experiencing social isolation and loneliness and subsequent reduced wellbeing. Evidence suggests companion animals may have the capacity to provide social support, reduce loneliness, and improve wellbeing in older adults. Using a cross-sectional design and online/phone semi-structured survey methodology, this qualitative study explored how companion animal ownership impacted the subjective wellbeing of 177 (89.8% female) older adult companion animal owners aged 65–84 years (M = 70.72, SD = 4.5) during the COVID-19 pandemic in Australia. A template thematic analysis indicated older adult companion animal owners perceived their companion animals to provide mental, social, and physical wellbeing benefits during the pandemic. Participants found providing care for their companion animals offered a light-hearted reprieve from pandemic fears while bringing a crucial sense of motivation and purpose to their days. Participants considered that their companion animals provided “COVID-safe” tactile comfort, social support, and companionship, while older adults also found pleasure forming attachments with wild animals during the pandemic, a novel finding in companion animal research. Our findings suggest that older adults facing barriers to companion animal ownership, including those living in retirement villages, residential aged care facilities, and hospital settings, may gain mental health benefits from forming attachments with wild animals, without being burdened with the sole responsibility of providing full time care for a companion animal. Furthermore, our findings provide evidence to support the creation of two novel theoretical mechanisms of human–animal interactions for further investigation: the motivation and purpose theory and the reprieve theory.
Kapitel enthält: emotionale, soziale und ethische Aspekte von Berührungen; Placeboeffekte; Embodiment; Haus- und Therapietiere; Einsamkeit. - Abstract: Im medizinischen Kontext können von erforderlichen Berührungen, die einem medizinischen oder pflegerischen Zweck dienen, soziale Berührungen unterschieden werden. Diese, oft spontan auftretenden Berührungen, erfüllen soziale oder emotionale Funktionen. Soziale Berührungen können beruhigend, tröstend, angst-, schmerz- oder stressreduzierend wirken. Es besteht somit die Möglichkeit, soziale Berührungen im medizinischen oder pflegerischen Kontext gezielt zu diesen Zwecken einzusetzen.
This meta-analysis was conducted to determine the effect of animal-assistant therapy on the quality of life of older adults. This research systematically searched electronic databases (CINAHL, Cochrane Central, Medline/PubMed, Web of Science, Science Direct, and the National Thesis Centre and ULAKBİM of the Council of Higher Education) for studies published between April – June 2021. Seven studies with experimental design were used, three were quasi-experimental and four were randomly controlled studies. The total sample size in the meta-analysis was 375 (experimental group: 177 and control group: 198). The mean duration of animal-assistant therapy was 38.5 ± 12.4 min. Animal-assistant therapy had a significant effect on the quality of life of older adults (mean difference: -4.59 p: 0.03, Z:2.23). Therefore, animal assistant therapy is an effective method to improve older adults’ quality of life.
Meeting the physical and emotional needs of a therapy animal requires knowledge of species-typical behaviors. Though to ensure optimal welfare, an awareness of perceptive abilities and signs of stress and fear is necessary to avoid negative emotional states. This information can help those utilizing AAI to select appropriate species for patients and with the implementation of management practices to ensure the welfare of therapy animals. In order to provide a biological perspective on behavior, a review of emotional processing and memory is provided. The intention was to serve as a reminder that every experience shapes perception and for therapy animals every AAI should be perceived as positive. Lastly, training of therapy animals and reinforcement of appropriate and desired behaviors should be positive as it is more effective and humane than punitive methods, such as positive punishment. Learning the behavioral and social needs of a species will undoubtedly provide useful information to safeguard the welfare of therapy animals.
Adults over the age of 65 now represent a substantially larger proportion of the US population than ever before and the percentage of older adults is on the rise. Advancing age is commonly associated with a number of mental and physical health risks including reduced social networks, and increased risk of mortality and morbidity. As the population of older adults increases so will the demand on the health care system which makes it increasingly important to find ways to support healthy or successful aging. This chapter discusses the potential of companion animals to address, at least in part, this growing concern. This chapter will summarize some of the key research findings suggesting that companion animals may play a role in promoting healthy active aging and will briefly discuss the physical and mental health benefits associated with pet ownership or with the simple act of interacting with a companion animal.
Animal-assisted therapy (AAT) is one of the non-pharmacological and complementary interventions. AAT has been practiced for many years and now a lot of progress are being made. However, the effect of AAT on social interaction is not well understood. The purpose of this meta-analysis was to present the best available evidence regarding the effects of AAT on social interaction including blood pressure, cognitive function, and communication. Researchers searched seven electronic databases for relevant articles published between 1984 and 2014. Data were collected using inclusion and exclusion criteria. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used to evaluate the quality of the identified articles.Six RCTs and three pseudorandomized controlled trial published within 1995-2011 with 281 participants had extractable data. The result of the meta-analysis indicated that AAT had an effect on increasing communication. The results were not statistically for blood pressure and cognitive function. There are a number of promising indications, in view of the limited number and quality of studies and the variation in results among studies. This review highlights the need for additional well-designed trials to draw conclusions that are more robust.
In diesem Kapitel wird die tiergestützte Therapie als Disziplin vorgestellt – wobei nach einer Vorstellung der Vergangenheit und des Ist-Zustandes der Fokus vor allem auf die notwendige Weiterentwicklung dieser Disziplin gelegt wird. Als Grundlage wird hierzu zunächst die genaue Definition von tiergestützter Therapie besprochen und es werden korrekte Begriffe in diesem Zusammenhang eingeführt. Zum weiteren Verständnis dieses Fachbereiches folgt ein Überblick über die verschiedenen Wirkfaktoren und über die Entstehungsgeschichte der tiergestützten Therapie. Im nächsten Schritt wird dann am Beispiel meiner eigenen Arbeitsweise eine Weiterentwicklung der tiergestützten Therapie beschrieben, die neue Wege geht und sich ethischer Fragestellungen annimmt.
Background:
Dementia is a chronic condition which progressively affects memory and other cognitive functions, social behaviour, and ability to carry out daily activities. To date, no treatment is clearly effective in preventing progression of the disease, and most treatments are symptomatic, often aiming to improve people's psychological symptoms or behaviours which are challenging for carers. A range of new therapeutic strategies has been evaluated in research, and the use of trained animals in therapy sessions, termed animal-assisted therapy (AAT), is receiving increasing attention.
Objectives:
To evaluate the efficacy and safety of animal-assisted therapy for people with dementia.
Search methods:
We searched ALOIS: the Cochrane Dementia and Cognitive Improvement Group's Specialised Register on 5 September 2019. ALOIS contains records of clinical trials identified from monthly searches of major healthcare databases, trial registries, and grey literature sources. We also searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), CINAHL (EBSCOhost), ISI Web of Science, ClinicalTrials.gov, and the WHO's trial registry portal.
Selection criteria:
We included randomised controlled trials (RCTs), cluster-randomised trials, and randomised cross-over trials that compared AAT versus no AAT, AAT using live animals versus alternatives such as robots or toys, or AAT versus any other active intervention.
Data collection and analysis:
We extracted data using the standard methods of Cochrane Dementia. Two review authors independently assessed the eligibility and risk of bias of the retrieved records. We expressed our results using mean difference (MD), standardised mean difference (SMD), and risk ratio (RR) with their 95% confidence intervals (CIs) where appropriate.
Main results:
We included nine RCTs from 10 reports. All nine studies were conducted in Europe and the US. Six studies were parallel-group, individually randomised RCTs; one was a randomised cross-over trial; and two were cluster-RCTs that were possibly related where randomisation took place at the level of the day care and nursing home. We identified two ongoing trials from trial registries. There were three comparisons: AAT versus no AAT (standard care or various non-animal-related activities), AAT using live animals versus robotic animals, and AAT using live animals versus the use of a soft animal toy. The studies evaluated 305 participants with dementia. One study used horses and the remainder used dogs as the therapy animal. The duration of the intervention ranged from six weeks to six months, and the therapy sessions lasted between 10 and 90 minutes each, with a frequency ranging from one session every two weeks to two sessions per week. There was a wide variety of instruments used to measure the outcomes. All studies were at high risk of performance bias and unclear risk of selection bias. Our certainty about the results for all major outcomes was very low to moderate. Comparing AAT versus no AAT, participants who received AAT may be slightly less depressed after the intervention (MD -2.87, 95% CI -5.24 to -0.50; 2 studies, 83 participants; low-certainty evidence), but they did not appear to have improved quality of life (MD 0.45, 95% CI -1.28 to 2.18; 3 studies, 164 participants; moderate-certainty evidence). There were no clear differences in all other major outcomes, including social functioning (MD -0.40, 95% CI -3.41 to 2.61; 1 study, 58 participants; low-certainty evidence), problematic behaviour (SMD -0.34, 95% CI -0.98 to 0.30; 3 studies, 142 participants; very-low-certainty evidence), agitation (SMD -0.39, 95% CI -0.89 to 0.10; 3 studies, 143 participants; very-low-certainty evidence), activities of daily living (MD 4.65, 95% CI -16.05 to 25.35; 1 study, 37 participants; low-certainty evidence), and self-care ability (MD 2.20, 95% CI -1.23 to 5.63; 1 study, 58 participants; low-certainty evidence). There were no data on adverse events. Comparing AAT using live animals versus robotic animals, one study (68 participants) found mixed effects on social function, with longer duration of physical contact but shorter duration of talking in participants who received AAT using live animals versus robotic animals (median: 93 seconds with live versus 28 seconds with robotic for physical contact; 164 seconds with live versus 206 seconds with robotic for talk directed at a person; 263 seconds with live versus 307 seconds with robotic for talk in total). Another study showed no clear differences between groups in behaviour measured using the Neuropsychiatric Inventory (MD -6.96, 95% CI -14.58 to 0.66; 78 participants; low-certainty evidence) or quality of life (MD -2.42, 95% CI -5.71 to 0.87; 78 participants; low-certainty evidence). There were no data on the other outcomes. Comparing AAT using live animals versus a soft toy cat, one study (64 participants) evaluated only social functioning, in the form of duration of contact and talking. The data were expressed as median and interquartile ranges. Duration of contact was slightly longer in participants in the AAT group and duration of talking slightly longer in those exposed to the toy cat. This was low-certainty evidence.
Authors' conclusions:
We found low-certainty evidence that AAT may slightly reduce depressive symptoms in people with dementia. We found no clear evidence that AAT affects other outcomes in this population, with our certainty in the evidence ranging from very-low to moderate depending on the outcome. We found no evidence on safety or effects on the animals. Therefore, clear conclusions cannot yet be drawn about the overall benefits and risks of AAT in people with dementia. Further well-conducted RCTs are needed to improve the certainty of the evidence. In view of the difficulty in achieving blinding of participants and personnel in such trials, future RCTs should work on blinding outcome assessors, document allocation methods clearly, and include major patient-important outcomes such as affect, emotional and social functioning, quality of life, adverse events, and outcomes for animals.
This study compared the impact of therapy and activity groups on two matched groups of 8 and 9 psychiatric inpatients. Daily sessions of the groups were held for 11 wk. in identical rooms except for the presence of caged finches in one of the rooms. The patients were evaluated before and after the sessions using standard psychiatric rating scales. The group who met in the room that contained animals (a cage with four finches) had significantly better attendance and participation and significantly improved in areas assessed by the Brief Psychiatric Rating Scale. Other positive trends indicated that the study should be replicated with larger samples and modified to increase interactions with the animals.
The findings of this study confirm the independent importance of social factors in the determination of health status. Social data obtained during patients' hospitalization can be valuable in discriminating 1-year survivors. These social data can add to the prognostic discrimination beyond the effects of the well-known physiological predictors. More information is needed about all forms of human companionship and disease. Thus, it is important that future investigations of prognosis in various disease states include measures of the patient's social and psychological status with measures of disease severity. The phenomenon of pet ownership and the potential value of pets as a source of companionship activity or attention deserved more careful attention that that recorded in the literature. Almost half of the homes in the United States have some kind of pet. Yet, to our knowledge, no previous studies have included pet ownership among the social variables examined to explain disease distribution. Little cost is incurred by the inclusion of pet ownership in such studies, and it is certainly by the importance of pets in the lives of people today and the long history of association between human beings and companion animals. The existence of pets as important household members should be considered by those who are responsible for medical treatment. The need to care for a pet or to arrange for its care may delay hospitalization; it may also be a source of concern for patients who are hospitalized. Recognition of this concern by physicians, nurses, and social workers may alleviate emotional stress among such patients. The therapeutic uses of pets have been considered for patients hospitalized with mental illnesses and the elderly. The authors suggest that patients with coronary heart disease should also be included in this consideration. Large numbers of older patients with coronary heart disease are socially isolated and lonely. While it is not yet possible to conclude that pet ownership is beneficial to these patients, pets are an easily attainable source of psychological comfort with relatively few risks.
Animal-assisted therapy involves interaction between patients and a trained animal, along with its human owner or handler, with the aim of facilitating patients' progress toward therapeutic goals. This study examined whether a session of animal-assisted therapy reduced the anxiety levels of hospitalized psychiatric patients and whether any differences in reductions in anxiety were associated with patients' diagnoses.
Study subjects were 230 patients referred for therapeutic recreation sessions. A pre- and posttreatment crossover study design was used to compare the effects of a single animal-assisted therapy session with those of a single regularly scheduled therapeutic recreation session. Before and after participating in the two types of sessions, subjects completed the state scale of the State-Trait Anxiety Inventory, a self-report measure of anxiety currently felt. A mixed-models repeated-measures analysis was used to test differences in scores from before and after the two types of sessions.
Statistically significant reductions in anxiety scores were found after the animal-assisted therapy session for patients with psychotic disorders, mood disorders, and other disorders, and after the therapeutic recreation session for patients with mood disorders. No statistically significant differences in reduction of anxiety were found between the two types of sessions.
Animal-assisted therapy was associated with reduced state anxiety levels for hospitalized patients with a variety of psychiatric diagnoses, while a routine therapeutic recreation session was associated with reduced levels only for patients with mood disorders.
Animal visitation programs have been used in a wide variety of clinical settings with predominantly positive outcomes reported anecdotally. However, there is also a growing body of research investigating the effects of these interventions. Developing and conducting rigorous studies of animal interventions can be a complex and challenging process, The purpose of this article is to identify and discuss several issues arising with this type of research and to posit suggestions for avoiding pitfalls.
Many studies have suggested that health and social benefits may be derived from pet ownership or visitation upon interaction levels within severely mentally ill populations. The study featured in this article aimed to examine further this relationship while attempting to control for the effects of an extraneous variable (the human dog handler) using an A-B-C-A reversal design. The article concludes that the presence of a pet does, indeed, promote social interactions within a long-stay psychiatric population.
This study was undertaken to assess the therapeutic roles of pet mascots on a hospital ward with total-care elderly patients
and to explore the logistics of pet maintenance. Staff (N = 19) on a ward where feline mascots had been kept over two years
were interviewed. Mascots were observed to stimulate patient responsiveness, give patients pleasure, enhance the treatment
milieu, and act as a form of reality therapy. Further research is suggested.
The bond between human and pet depends on their commonality as animals and their mutual need for attachment. Under abnormal circumstances of developmental frustration a human may displace an overdetermined need for attachment to the pet. The attachment relationship is pathological because of its defensive purpose, and its interruption can create enduring psychiatric reactions. The paper details the developmental determinants for this interaction.
A study of volunteers in three nursing homes revealed that their role had several unexpected consequences for institutional residents and for the volunteers themselves. The research, carried out in geriatric facilities in upstate New York, focused on community members and college students working in a pet therapy program, through which they brought companion animals to various institutions on a weekly basis. Visiting people and pets re-created an aura of domesticity for residents who had been cut off from homes and families by age and illness. Consonant with this domestic perception by residents was the self-image that volunteers developed of their role: most came to see themselves as family and friends to patients rather than as visitors, strangers, or adjunct staff. Volunteering, however, was an emotionally demanding experience that some people handled more successfully than others. While certain individuals found the costs of this unexpected intimacy to be too high, others discovered significant rewards in what one person called its 'selfish altruism.' Several factors were found to mediate how volunteers felt about what they did, and whether or not they continued with their work over a long period of time. These variables included: (a) the motives that people had for becoming volunteers, (b) their prior experience doing this kind of work, (c) their career orientations, and current family and living situation, and (d) the image that they had of the elderly in general and nursing homes in particular.
Behavior modification training, like veterinary medicine, is an exacting science, requiring a knowledge of not only wild avian behavior, but of child and adult human behavior as well. It is important to note that absolutely any changes in a bird's or its owner's environment may trigger a vast assortment undesirable behaviors. Some behavior problems are simple, but most have multiple causes and each of those causes must be determined and corrected before a high rate of success is evident. As in veterinary medicine, some birds respond to general "shotgun" techniques; however, parrots are intelligent and complex creatures. They consider themselves an integral part of their human "flock" and respond as such. Most commonly seen negative behaviors can be altered, at least to some extent, and, in most cases, they can be alleviated completely. Yelling at the bird, striking it, or any other type of confrontational behavior modification technique is virtually useless and can actually worsen most situations. A high percentage of success involves extensive history taking, an understanding of human and wild animal flock behavior, and the time to create a complete program for each individual and its owner.
The literature now contains more than 1000 references to the use of a variety of animals in therapy. The terms used include Pet Therapy, Pet Assisted Therapy, Pet Facilitated Therapy. They reflect lack of agreement as to the role and effectiveness of animal use. Most are anecdotal descriptive studies lacking in scientific methodology. There are almost none in the psychiatric literature despite repeated claims of effectiveness in treating mental and emotional illness. This paper provides a review for the psychiatrist. It describes the development and use of rating scales to generate numerical values for statistical analysis, from videotaped observations of pet therapy sessions. Blind ratings yielded high inter-rater correlations. Although a pilot study, the results indicate the feasibility of designing definitive studies to evaluate the claims of animal enthusiasts. Valuable insights were gained which help to clarify the respective roles of animals and therapists.
Twelve (N = 12) Alzheimer's (AD) residents of a Special Care Unit in a large midwest Veterans' Home were observed for the effects of the presence of a pet dog on eight social behaviors: smiles, laughs, looks, leans, touches, verbalizations, name-calling, and others. Observations took place on three separate occasions (absence of dog, temporary presence of the dog, and permanent placement of the dog) in both group and individual settings. The results showed that the presence of the dog increased the number of total social behaviors of the AD clients, but no differences were found in behaviors between the temporary and permanent placement of the dog.
Pets can provide companionship, affection, and psychosocial stimulus for elderly people in a program that is planned and supervised by professionals who are knowledgeable about both the humans and the animals and who are clear about the goals to be achieved. Ineffective programs, or programs with negative effects, have developed when the proponents assumed that any pet would be good for elderly persons either living alone or in a residential center. A much-needed aspect of any people-pet program is the collection, analysis, and reporting of social data to provide a better information base for planning the use of pets in a therapeutic setting.
The human/animal relationship exhibited by the elderly and their pets has limitations as well as potentials. The functions of a pet as a companion and social facilitator in pet-facilitated psychotherapy include serving as a cotherapist for facilitation of rapport, providing companionship, substituting for close interpersonal relationships (ie, significant others), enhancing the health status of a variety of target groups, increasing opportunity for sensory stimulation, and providing emotional support and a sense of well-being. Available information was limited because few studies have been replicated, data were not validated, and previous studies were restricted mainly to institutionalized or therapeutic environments. Implications for future research include use of animals for companionship and to promote the physical, social, and emotional health of the elderly.
Synopsis
This is an introductory report for the Brief Symptom Inventory (BSI), a brief psychological self-report symptom scale. The BSI was developed from its longer parent instrument, the SCL-90-R, and psychometric evaluation reveals it to be an acceptable short alternative to the complete scale. Both test-retest and internal consistency reliabilities are shown to be very good for the primary symptom dimensions of the BSI, and its correlations with the comparable dimensions of the SCL-90-R are quite high. In terms of validation, high convergence between BSI scales and like dimensions of the MMPI provide good evidence of convergent validity, and factor analytic studies of the internal structure of the scale contribute evidence of construct validity. Several criterion-oriented validity studies have also been completed with this instrument
Interactions with companion animals have been shown to have socializing and calming effects for Alzheimer's patients in an institutional setting. Sixty-four Alzheimer's patients living in the private home were studied, through medical records and information provided by caregivers, to determine what effect association with a companion animal had on the progression of cognitive decline and the manifestation of concomitant noncognitive symptoms. Prevalence of episodes of verbal aggression and anxiety was reported less frequently in 34 patients who were exposed to companion animals compared with patients who were not exposed. Significantly fewer mood disorders were reported in patients who were attached to their pets compared with patients who were not attached. There was no significant difference in the rate of cognitive decline between pet-exposed and nonexposed patients as measured by three standard indices. This study lends preliminary support to the belief that interaction with pets can aid in tempering feelings of agitation and aggression in Alzheimer's patients.
Italian community norms for the Brief Symptom Inventory (BSI) in the elderly are presented on 462 subjects. Means do not substantially differ from previously published US norms for the elderly. Higher scores were found in women and in subjects with social or distressing somatic conditions.
This study was conducted to determine the effect of the presence and absence of a dog on the frequency and types of social interactions among nursing home residents during a socialization group. Point sampling was used to evaluate the behaviors of 36 male nursing home residents at a Veterans Administration Medical Center under two conditions, Dog Present and Dog Absent. A significant difference in verbal interactions among residents occurred with the dog present, F(1, 69) = 4.92, p < .05. These findings are consistent with existing literature, thus providing further evidence of the value of Animal Assisted Therapy programs as an effective medium for increasing socialization among residents in long-term care facilities. Because an increase in social interactions can improve the social climate of an institution and occupational therapists frequently incorporate group process into their treatment, the therapeutic use of animals can become a valuable adjunct to reaching treatment goals.
The purpose of this study was to evaluate the effects of pet therapy on geriatric psychiatry inpatients. A demonstrable impact could lead to more widespread or targeted use of animal companionship programs for hospitalized older persons.
The study design was a randomized, parallel-group control treatment trial with pretreatment and posttreatment measures. Fifty-eight subjects with chronic age-related disabilities who were patients of the Wills Eye Hospital Geriatric Psychiatry Unit were assigned to a pet therapy intervention group or an exercise control group for 1 hr a day for 5 consecutive days. Every subject was blindly evaluated with the Multidimensional Observation Scale for Elderly Subjects (MOSES) before and after the intervention week.
No significant differences in MOSES scores were found between or within groups before and after the interventions. There was a nonsignificant tendency for subjects who received the pet intervention to have less irritable behavior after treatment. However, women with dementia who received either pet therapy or exercise intervention had improved irritable behavior scores after treatment.
This pilot study demonstrates the need for further research on animal-assisted interventions with hospitalized elderly persons. Differential improvement in women with dementia also requires further investigation.
To assess effects of a companion bird on the depression, morale, and loneliness of 40 older adults in a skilled rehabilitation unit, self-reported measures of depression, loneliness, and morale were completed on admission and 10 days later. With the presence of a companion bird the experimental group (n = 20) showed a significant decrease in depression but none in morale or loneliness from the control group (n = 20) who were without a bird. Use of a companion bird may lessen negative effects of change of residence for older adults.
To ascertain the effects of animal-assisted therapy on hospitalized adolescents.
Thirty adolescents hospitalized in a 16-bed psychiatric unit. Data collection included patient journals, interviews with 15 patients, and anecdotal notes from observations and staff reports. The ethnographic method was used for data analysis.
Categories identified from the data include the dog as a component of the milieu, as friend, and as therapist. The dog served as a catalyst for interactions, and often had human qualities ascribed to him by the adolescents.
This study provides new information that can enhance patient care.
To explore research that lends credibility to the therapeutic use of animals in health care. By integrating research from other disciplines and applying it to nursing, the art of nursing is fostered through the creative application of knowledge to practice.
Positive physiological and psychological benefits have been linked to the presence of companion animals. For example, researchers suggest that decreases in blood pressure, heart rates, and stress levels, as well as increases in emotional well-being and social interaction are benefits of the human-animal bond.
Compiling what has been learned in earlier scientific studies provides direction for future research in nursing to enhance nursing knowledge and expand nursing theory to improve care. Further investigation is necessary to clarify the concepts of animal assisted therapy (AAT) to build a body of useful knowledge for practice.
The purpose of this systematic overview was to summarize research findings on strategies for managing the behavioural symptomatology associated with dementia of the Alzheimer type. A search of the published and unpublished literature resulted in 265 articles, 45 of which were judged to be relevant. Using validity criteria, 1 article was judged to be strong, 6 moderate, 20 weak, and 18 poor. Strategies such as planned walking, pet therapy, an attention-focusing program, functional skills training, music, and visual barriers demonstrated promising results in improving: (a) aggressive, agitated, and disruptive behaviours, (b) social interaction, (c) self-care ability, (d) day-night disturbances, or (e) wandering. The findings indicate that there is existing research, although in its infancy, to support the use of strategies for managing the behavioural symptomatology associated with dementia of the Alzheimer type.
To examine whether companion animals or attachment to a companion animal was associated with changes in physical and psychological health in older people and whether the relationships between physical and psychological health and human social networks were modified by the presence or absence of a companion animal.
A 1-year longitudinal study with standardized telephone interview data collected at baseline and repeated at 1-year
Wellington County, Ontario, Canada
An age- and sex stratified random sample (baseline n = 1054; follow-up n = 995) of noninstitutionalized adults aged 65 and older (mean age = 73, SD +/- 6.3)
Social Network Activity was measured using a family and non-family social support scale, participation in an organized social group, involvement in the affairs of the social group, the practice of confiding in others, feelings of loneliness, and the perceived presence of support in a crisis situation. Chronic conditions were measured as the current number of selected health problems. Pet ownership was assessed by the report of owning a dog or a cat and the Lexington Attachment to Pets Scale score. Physical health was assessed as the ability to perform Activities of Daily Living (ADLs). Psychological health was measured as a summed score comprising the level of satisfaction regarding one's health, family and friend relationships, job, finances, life in general, overall happiness, and perceived mental health. Sociodemographic variables assessed include subject age, sex, marital status, living arrangements, education, household income, and major life events.
Pet owners were younger, currently married or living with someone, and more physically active than non-pet owners. The ADL level of respondents who did not currently own pets deteriorated more on average (beta = -.270, P = .040) than that of respondents who currently owned pets after adjusting for other variables during the 1-year period. No statistically significant direct association was observed between pet ownership and change in psychological well-being (P > .100). However, pet ownership significantly modified the relationship between social support and the change in psychological well-being (P = .001) over a 1-year period.
The results demonstrate the benefits of pet ownership in maintaining or slightly enhancing ADL levels of older people. However, a more complex relationship was observed between pet ownership and an older person's well-being.
Animal Facilitated Therapy (AFT) is the therapeutic use of the human-animal bond to improve a patient's physical and emotional health. It is an emerging treatment modality that is gaining acceptance among medical practitioners and healthcare administrators. Medical care has traditionally focused on the clinical well-being of the patient. But it is now widely recognized that emotional health is an integral part of physical health. Many patients have unmet psychological and emotional needs that affect their ability to heal and to maintain health. Because some animals have the capacity for interrelationships with people, companion animals can provide an adjunct to traditional therapies. For many patients, particularly those having long-term disabilities, the interaction with an animal fills important emotional needs which can improve mental and physical health. AFT often works when other therapeutic modalities have failed. It gives health professionals an alternative method for reaching patients who are depressed or who have withdrawn from social intercourse. AFT can be used in a variety of situations and settings. Programs are often staffed by trained volunteers and can be implemented and maintained at a relatively low cost. Marketing Animal Facilitated Therapy must focus on creating awareness about the health benefits derived from the human-animal bond, stimulating demand for animal therapy programs in healthcare settings, and generating funding for operating expenses and replication of services.
This paper describes the structure and function of a program of animal therapy used with hospitalized psychiatric patients as part of a comprehensive therapy milieu. It begins with identification of some common psychological needs of psychiatric patients and continues with a discussion of ways in which therapeutic recreation programs such as this can address these common needs and facilitate their development in psychotherapy. In addition, potential modifications are explored as a means of adapting the principles of this model to accommodate the resources of virtually any mental health or recreational therapy program.
A sound theoretical basis supported by scientifically measured physiological parameters is needed to gain medical support for animal-assisted therapy. Six neurochemicals associated with a decrease in blood pressure were measured in humans (n=18) and dogs (n=18) before and after positive interaction. Results (P<.05) indicated that in both species the neurochemicals involved with attention-seeking or attentionis egens behavior have increased. This information can be used as a rationale for animal-assisted therapy.
Pet therapy is a centuries-old treatment approach. The new news is that pet therapy is now being validated via scientific and anecdotal data proving its effectiveness. This article shows that pet therapy is worth considering for the care plan of persons with dementia.
Nature-based therapy (NBT) has been incorporated into the practice of many medical and mental health professions. Occupational therapists, physical therapists, nurses, social workers, psychologists, and to a lesser extent, speech-language pathologists have used NBT practices as a complementary means of treating a variety of physical, emotional, and cognitive disorders. This article includes a description of NBT and the three types that comprise the practice and a review of the literature demonstrating the use of NBT in the general population and, more specifically, with individuals with neurogenic communication disorders. It concludes with a discussion of directions for future research of NBT.
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Using Atlantic bottlenose dolphin to increase cognition of mentally retarded children
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La valutazione della qualità di vita nella popolazione anziana: utilizzo del LEIPAD, versione breve (LEIPAD-Short Version)
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LEIPAD-Short Version (SV), a Short Instrument to Measure Self-perceived Functions and Well-being in the Elderly
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at the end of the three-month trial, tests (MMSE, BSI, LEIPAD-SV) were re-administered, without changing the experimental conditions. Overall results (test scores obtained at time t0 and time t1 were processed and compared by means of Student's t test, chi square and variance analysis
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At time t1, i.e., at the end of the three-month trial, tests (MMSE, BSI, LEIPAD-SV) were re-administered, without changing the experimental conditions. Overall results (test scores obtained at time t0 and time t1 were processed and compared by means of Student's t test, chi square and variance analysis. Research data were processed using SPSS statistical software (1997).
Benefits of pet therapy in dementia. Home Health Nurs
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Pet-facilitated therapy as adjunctive care for home hospice patient: A human service program design to promote quality of life
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Therapeutic value of cage birds with old people
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Pet-facilitated therapy as adjunctive care for home hospice patient: A human service program design to promote quality of life
- Fried
La valutazione della qualità di vita nella popolazione anziana: utilizzo del LEIPAD, versione breve (LEIPAD- Short Version)
- Scocco