Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 22
Filter
3.
Psychiatr Serv ; 74(8): 790-800, 2023 08 01.
Article in English | MEDLINE | ID: mdl-36718602

ABSTRACT

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.


Subject(s)
Animal Assisted Therapy , Stress Disorders, Post-Traumatic , Veterans , Adult , Aged , Animals , Dogs , Female , Humans , Male , Middle Aged , Young Adult , Antidepressive Agents , Health Surveys , Quality of Life , Service Animals , Stress Disorders, Post-Traumatic/therapy , Stress Disorders, Post-Traumatic/psychology , Therapy Animals , Veterans/psychology
4.
Arch Phys Med Rehabil ; 104(2): 237-244, 2023 02.
Article in English | MEDLINE | ID: mdl-35917950

ABSTRACT

OBJECTIVE: To investigate the association between Service Dog Training Program (SDTP) participation and mental health care utilization. DESIGN: Retrospective cohort study. SETTING: Outpatient rehabilitation clinic at a large military treatment facility. PARTICIPANTS: Military Health System beneficiaries who attended at least 1 SDTP session at a large military treatment facility (N=597). SDTP program enrollment records identified participants. INTERVENTION: The SDTP, a unique application of animal-assisted therapy, is intended to improve the mental and cognitive health for individuals with war-related trauma. MAIN OUTCOME MEASURES: Negative binomial regression calculated the associations between the SDTP participation rate and 2 mental health care utilization outcomes: mental health encounter days and psychotropic medication months' supply. RESULTS: Most of the 597 participants were male, enlisted service members, and aged 25-34 years. Approximately 46% had a posttraumatic stress disorder diagnosis, 21% had a traumatic brain injury diagnosis, 47% had an opioid prescription, and 58% had a sleep aid prescription pre-SDTP participation. Participation was categorized into low (≤1 sessions), medium (>1 and ≤2 sessions), and high (>2 sessions) monthly participation. In adjusted analysis, high monthly SDTP participation was associated with 18% fewer post-SDTP mental health encounter days (rate ratio [RR], 0.82; 95% confidence interval [CI], 0.68-0.96) than low monthly SDTP participation. High monthly SDTP participation was also associated with a 22% fewer post-SDTP psychotropic prescription months' supply (RR, 0.78; 95% CI, 0.64-0.95) than low monthly SDTP participation in adjusted analysis. CONCLUSIONS: Results suggest that participants who attend more than 2 SDTP sessions monthly encounter mental health care differently post SDTP than participants who attended 1 or fewer monthly sessions. Adjunct therapies, such as the SDTP, may offer patients a nonstigmatizing way to engage in mental health care.


Subject(s)
Animal Assisted Therapy , Stress Disorders, Post-Traumatic , Male , Humans , Animals , Dogs , Female , Retrospective Studies , Service Animals , Stress Disorders, Post-Traumatic/psychology , Patient Acceptance of Health Care
5.
PLoS One ; 17(9): e0273913, 2022.
Article in English | MEDLINE | ID: mdl-36048784

ABSTRACT

Previous studies have suggested positive effects of mindfulness on inhibitory control (stopping behaviour). However, scarce previous studies suggest the relationship may depend on context. We provide first evidence that inhibitory control is challenged when perceiving attractive faces, especially when being mindful. Specifically, we investigated the relationship between mindfulness and inhibitory control and the moderating role of a social reward context (being exposed to attractive opposite sex faces). Participants (n = 50) between 18-43 years old (M = 25, SD = 5.4) filled out questionnaires assessing standard demographic variables and dispositional mindfulness. Subsequently, they performed a Go/No-go task with a neutral condition and attractive faces condition. Results showed that inhibitory control was challenged in the attractive condition relative to the neutral condition, p = 0.019. Dispositional mindfulness was negatively correlated with inhibitory performance, but only in the attractive faces condition (r = -0.32, p = 0.024). Results did not support a moderating role of gender. Finally, though post-hoc, higher mindfulness was associated with reduced perceived attractiveness of presented faces (r = -0.33, p = 0.019). However, the relationship between mindfulness and reduced inhibitory control could not be explained by mindfulness associated reduced attractiveness. Taken together, results show that mindfulness challenges inhibitory control when perceiving attractive faces. This implies that mindfulness interventions aimed at enhancing inhibitory control, may not render the desired effect in a context of being exposed to attractive faces. Though certainly plausible, it remains an open question whether results generalize to other reward contexts as well.


Subject(s)
Mindfulness , Adolescent , Adult , Animals , Humans , Mindfulness/methods , Personality , Reward , Service Animals , Surveys and Questionnaires , Young Adult
6.
PLoS One ; 17(9): e0274960, 2022.
Article in English | MEDLINE | ID: mdl-36129950

ABSTRACT

Psychiatric assistance dogs for military veterans with posttraumatic stress disorder (PTSD) currently make up over 19% of assistance dog partnerships globally. We conducted a systematic review of the literature relating to these partnerships, with specific aims to (1) summarize their characteristics, (2) evaluate the quality of existing evidence, and (3) summarize outcomes. A total of 432 records were independently screened (Cohen's kappa = 0.90). Of these, 41 articles (29 peer-reviewed publications and 12 unpublished dissertations) met inclusion criteria. Data extraction was conducted to address the research aims, including a meta-analysis (quantitative outcomes) and meta-synthesis (qualitative outcomes). All peer-reviewed publications on the topic of psychiatric assistance dogs for veterans with PTSD were published within the last five years. The majority of included articles were quantitative (53%), 41% were qualitative, and 6% employed mixed methods. Mean methodological rigor scores were 80% for peer reviewed articles and 71% for dissertations, where higher scores represent more rigorous methodology. Quantitative articles reported significant improvements in the domains of PTSD severity, mental health, and social health. Impacts on physical health and global quality of life appear inconclusive. Meta-analysis (9 articles) revealed that partnership with an assistance dog had a clinically meaningful, significant, and large effect on PTSD severity scores (g = -1.129; p<0.0001). Qualitative meta-synthesis identified two third order constructs: (1) Impact on the individual: mental & physical health and (2) Impact beyond the individual: building relationships & connection. This synthesis of increasingly prevalent research on assistance dogs for veterans with PTSD provides support for the impact of this complementary and integrative health intervention on PTSD symptom severity, and signs of meaningful improvements in adjacent domains including mental and social health. Gaps between quantitative and qualitative findings, along with the need to report greater demographic detail, highlight key opportunities for future research.


Subject(s)
Stress Disorders, Post-Traumatic , Veterans , Animals , Dogs , Humans , Mental Health , Quality of Life , Service Animals , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Veterans/psychology
7.
PLoS One ; 17(7): e0269186, 2022.
Article in English | MEDLINE | ID: mdl-35895599

ABSTRACT

Psychiatric service dogs are an emerging complementary intervention for posttraumatic stress disorder (PTSD). Initial evidence suggests that partnership with a service dog may be related to less PTSD symptom severity. However, it remains unclear how or why this might occur. To address this gap, we conducted a longitudinal investigation of 82 post-9/11 military members or veterans and their PTSD service dogs to (1) evaluate service dog characteristics as potential predictors of efficacy, (2) assess dog and human characteristics as potential predictors of veteran-dog bond, and (3) explore potential mechanisms for mental health outcomes. Aim 1 results demonstrated that most service dog characteristics did not predict veterans' mental health outcomes, but lower service dog excitability was associated with less PTSD symptom severity at follow-up. Aim 2 results showed that closer dog-veteran relationships were associated with less excitable dog temperament. Aim 3 results indicated that worse mental health at follow-up was associated with greater use of the specifically trained PTSD service dog task to initiate a social greeting ("make a friend"), whereas better mental health was related to less use of dominance-based training methods, lower perceived emotional/logistical costs of service dog partnership, and closer veteran-dog relationships. More frequent use of the trained service dog task to signal when someone approaches from behind (cover/watch back) was associated with greater anxiety, but less PTSD symptom severity. Overall, veterans spent an average of 82% of their time with service dogs (assessed via Bluetooth proximity between dog collar and veteran smartphone), and most frequently asked their service dogs to perform the trained task for calming their anxiety (calm/comfort anxiety). The present study provides subjective and objective metrics of the heterogeneity among veteran-service dog dyads while also suggesting which of the assessed metrics might be potential mechanisms involved in the intervention.


Subject(s)
Animal Assisted Therapy , Military Personnel , Stress Disorders, Post-Traumatic , Veterans , Animal Assisted Therapy/methods , Animals , Dogs , Humans , Military Personnel/psychology , Service Animals , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Veterans/psychology
8.
Eur J Psychotraumatol ; 13(1): 2062997, 2022.
Article in English | MEDLINE | ID: mdl-35572392

ABSTRACT

Background: Benefits and challenges associated with service dogs for veterans with posttraumatic stress disorder (PTSD) may extend beyond veterans to their families. Objective: The purpose of the current study is to evaluate the impact of veterans' PTSD service dogs on spouses and families in a parallel-group, longitudinal design with assessments at baseline and three months follow-up. Method: A total of 88 United States military veteran spouses completed a survey composed of multiple standardized measures at baseline and three months later. In the intervention group (n = 48), veterans received service dogs shortly after baseline while the waitlist control group (n = 40) did not. Results: Linear regression analyses demonstrated significantly lower caregiver satisfaction, higher caregiver burden and higher participation in life activities among spouses who had service dogs in their homes compared to those on the waitlist. Though not significant, small effect sizes were present among additional measures. Conclusion: Results suggest that although previous literature demonstrates service dogs may offer significant improvements for veterans, spouses and children may not experience those same benefits. Clinicians should consider how to prepare veteran spouses and families for integrating service dogs into their home. Future studies should explore family-focused approaches for service dog integration, defining an optimal strategy for the benefit of the entire family. HIGHLIGHTS: Though service dogs may improve wellbeing for veterans with posttraumatic disorder, families of veterans may not experience those same benefits. Researchers and clinicians should consider how to best prepare veteran families for integrating service dogs into their homes.Though posttraumatic stress disorder (PTSD) service dogs are trained specifically for veterans, recent studies have demonstrated that their impact may go beyond veterans themselves (McCall, Rodriguez, Wadsworth, Meis, & O'Haire, 2020; Nieforth, Craig, Behmer, MacDermid Wadsworth, & O'Haire, 2021). PTSD service dogs may provide both benefits and challenges for veteran families.


Antecedentes: Los beneficios y desafíos asociados con los perros de asistencia para veteranos con trastorno de estrés postraumático (TEPT) pueden extenderse más allá de los veteranos a sus familias. Objetivo: El propósito del estudio actual es evaluar el impacto de los perros de asistencia en el TEPT de cónyuges y familias de veteranos en un diseño longitudinal de grupos paralelos con evaluaciones al inicio y a los tres meses de seguimiento. Método: Un total de 88 cónyuges de veteranos militares de los Estados Unidos completaron una encuesta compuesta por múltiples medidas estandarizadas al inicio y tres meses después. En el grupo de intervención (n = 48), los veteranos recibieron perros de asistencia poco después del inicio, mientras que el grupo de control en lista de espera (n = 40) no lo hizo. Resultados: Los análisis de regresión lineal demostraron una satisfacción del cuidador significativamente menor, una mayor carga del cuidador y una mayor participación en las actividades de la vida entre los cónyuges que tenían perros de asistencia en sus hogares, comparado con los que estaban en la lista de espera. Aunque no significativos, pequeños tamaños de efecto estuvieron presentes entre las medidas adicionales. Conclusión: Los resultados sugieren que aunque la literatura previa demuestra que los perros de asistencia pueden ofrecer mejorías significativas para los veteranos, es posible que las cónyuges y sus hijos no experimenten los mismos beneficios. Los clínicos deben considerar cómo preparar a las cónyuges y familias de veteranos para integrar perros de asistencia en sus hogares. Los estudios futuros deberían explorar enfoques centrados en las familias para la integración del perro de asistencia, definiendo una estrategia óptima para el beneficio de toda la familia.


Subject(s)
Animal Assisted Therapy , Military Personnel , Stress Disorders, Post-Traumatic , Veterans , Animal Assisted Therapy/methods , Animals , Dogs , Humans , Service Animals , Stress Disorders, Post-Traumatic/therapy
10.
Complement Ther Clin Pract ; 48: 101590, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35439705

ABSTRACT

The objective of this study was to investigate the day-to-day experiences of positive and negative emotions among partners of veterans assigned service dogs for posttraumatic stress disorder (PTSD). As part of a larger clinical trial, a total of N = 87 partners of post-9/11 veterans with PTSD were recruited from a nonprofit service dog provider and participated in an ecological momentary assessment (EMA) protocol. The sample included partners of veterans who received a PTSD service dog after baseline (n = 48, treatment group) and partners of veterans on the waitlist for a service dog (n = 39, control group). Data were collected twice daily for two weeks at baseline and again at follow-up three months later, for approximately 56 assessments per participant (28 at baseline, 28 at follow up). Participants completed an average of 84% of questionnaires at baseline (n = 23.6) and 86% (n = 24.1) at follow-up. A total of 3780 EMA questionnaires were collected among partners for this analysis. Data were analyzed using a generalized linear mixed model. Three months following baseline, partners of veterans with service dogs reported statistically significant higher levels of positive emotions than the control partners (p = .01, d = 0.39) with small-to-medium effect sizes for each individual positive emotion. No statistically significant differences were reported for negative emotions (p = .77, d = 0.21). This study quantitatively identifies higher levels of positive emotion in partners who are cohabitating with a PTSD service dog compared to those partners who remained on the waitlist. Given the influence that positive emotions have on well-being and coping, findings suggest that the influence of service dogs may go beyond veterans to influence their cohabitating partners.


Subject(s)
Emotions , Service Animals , Spouses , Stress Disorders, Post-Traumatic , Veterans , Animals , Dogs , Ecological Momentary Assessment , Humans , Spouses/psychology , Stress Disorders, Post-Traumatic/therapy , Veterans/psychology
11.
Health Soc Care Community ; 30(6): e4113-e4121, 2022 11.
Article in English | MEDLINE | ID: mdl-35352418

ABSTRACT

Autism assistance dogs (AADs) increase safety for children with autism and their families. Autism assistance dogs can also decrease familial stress and the isolation which families may experience due to fear for their child's safety and judgement from others within the community. Currently there is a paucity of literature on parents' experiences of AADs. Therefore, this study aimed to develop a rich understanding of parents' experiences of owning an AAD. A mixed methods design was utilised, with a qualitative descriptive design and the use of occupational mapping. Eight families were recruited through an Australian AAD programme and participated in semi-structured in-depth interviews throughout 2017. The interviews were analysed thematically. Mobility in the community before and after introduction of the dog was measured using occupational mapping. Families plotted on Google Map printouts the places they frequented before and after placement of their dog. Five major themes emerged from the analysis of the interviews: freedom through restraint; expanding our world; a calming/sensory tool (AAD); "at the end of the day they're dogs"; and, friendship and personal growth. The occupational maps demonstrated a median increase of 8.5 more places and 20.50 km further travelled from home after having the dog for over a year. Families with an AAD experienced an expanded world for the child and their family. Families experienced freedom in the places they could go, decreased isolation due to the safety which the dog provides. Occupational mapping supported the qualitative data, showing increased mobility and decreased isolation of the family. The paradox of freedom through restraint is a new and key finding which requires further exploration. The results provide support for funding and increased awareness of AAD programmes. Future longitudinal comparative studies are needed to explore the long-term impact of AADs on the child and family.


Subject(s)
Autistic Disorder , Humans , Dogs , Animals , Service Animals , Australia , Parents , Emotions , Qualitative Research
12.
Psychol Trauma ; 14(3): 376, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35175084

ABSTRACT

Reports an error in "Expectations versus experiences of veterans with posttraumatic stress disorder (PTSD) service dogs: An inductive conventional content analysis" by Leanne O. Nieforth, Kerri E. Rodriguez and Marguerite E. O'Haire (Psychological Trauma: Theory, Research, Practice, and Policy, Advanced Online Publication, Feb 25, 2021, np). In this article, the length of time in which service dogs had been paired with Veterans was reported incorrectly in the third paragraph under the "Participants" heading of the "Methods" section whereby the sentence "Participants with a service dog had received their PTSD service dog an average of 51.5 months prior to participating in the study (range = 3-121.7 months, SD = 33.3)." should have read "Participants with a service dog had received their PTSD service dog an average of 20.9 months prior to participating in the study (range = 1.2-46.23 months, SD = 13.18)." All versions of this article have been corrected. (The following abstract of the original article appeared in record 2021-21569-001.) Objective: The objective of this study was twofold: to describe the benefits and drawbacks of a posttraumatic stress disorder (PTSD) service dog from the perspective of Veterans with service dogs and to compare these reports to the expectations of Veterans who were on a waitlist for a PTSD service dog. Method: A total of 128 U.S. post-9/11 Veterans with PTSD were recruited from a nonprofit service dog provider (K9s for Warriors), including n = 69 with a PTSD service dog and n = 59 on the waitlist. Participant responses to open-ended survey questions were analyzed with conventional content analysis and classified into 214 codes across six subthemes, creating three larger themes. A subset (20%) of the data was independently coded to establish interrater reliability (Cohen's κ = .804). Frequency data were used to compare theme and subtheme prevalence between groups. Results: Veterans' experiences and expectations were centered on the effects the service dogs had on Veteran mental health, human-dog interaction, and the associated drawbacks. Although the majority of Veterans reported benefits from their service dogs, the findings revealed that Veterans on the waitlist more frequently mentioned benefits than those with a service dog. Study findings suggest that the drawbacks expected from service dogs differ from the drawbacks experienced. Conclusion: Understanding expectations versus experiences provides critical information for mental health professionals who are informing Veterans on individualized interventions for PTSD. This knowledge will enable professionals to temper expectations and educate Veterans on specific benefits and drawbacks so that they have a more rounded view of PTSD service dogs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Animal Assisted Therapy , Stress Disorders, Post-Traumatic , Veterans , Animals , Dogs , Humans , Motivation , Reproducibility of Results , Service Animals , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Veterans/psychology
13.
Psychol Trauma ; 14(3): 347-356, 2022 Mar.
Article in English | MEDLINE | ID: mdl-33630635

ABSTRACT

[Correction Notice: An Erratum for this article was reported in Vol 14(3) of Psychological Trauma: Theory, Research, Practice, and Policy (see record 2022-33825-001). In this article, the length of time in which service dogs had been paired with Veterans was reported incorrectly in the third paragraph under the "Participants" heading of the "Methods" section whereby the sentence "Participants with a service dog had received their PTSD service dog an average of 51.5 months prior to participating in the study (range = 3-121.7 months, SD = 33.3)." should have read "Participants with a service dog had received their PTSD service dog an average of 20.9 months prior to participating in the study (range = 1.2-46.23 months, SD = 13.18)." All versions of this article have been corrected.] Objective: The objective of this study was twofold: to describe the benefits and drawbacks of a posttraumatic stress disorder (PTSD) service dog from the perspective of Veterans with service dogs and to compare these reports to the expectations of Veterans who were on a waitlist for a PTSD service dog. Method: A total of 128 U.S. post-9/11 Veterans with PTSD were recruited from a nonprofit service dog provider (K9s for Warriors), including n = 69 with a PTSD service dog and n = 59 on the waitlist. Participant responses to open-ended survey questions were analyzed with conventional content analysis and classified into 214 codes across six subthemes, creating three larger themes. A subset (20%) of the data was independently coded to establish interrater reliability (Cohen's κ = .804). Frequency data were used to compare theme and subtheme prevalence between groups. Results: Veterans' experiences and expectations were centered on the effects the service dogs had on Veteran mental health, human-dog interaction, and the associated drawbacks. Although the majority of Veterans reported benefits from their service dogs, the findings revealed that Veterans on the waitlist more frequently mentioned benefits than those with a service dog. Study findings suggest that the drawbacks expected from service dogs differ from the drawbacks experienced. Conclusion: Understanding expectations versus experiences provides critical information for mental health professionals who are informing Veterans on individualized interventions for PTSD. This knowledge will enable professionals to temper expectations and educate Veterans on specific benefits and drawbacks so that they have a more rounded view of PTSD service dogs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Animal Assisted Therapy , Stress Disorders, Post-Traumatic , Veterans , Animals , Dogs , Humans , Motivation , Reproducibility of Results , Service Animals , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Veterans/psychology
14.
J Consult Clin Psychol ; 89(6): 551-562, 2021 Jun.
Article in English | MEDLINE | ID: mdl-34264702

ABSTRACT

Though popular across many audiences, engagement with a service dog has undergone limited empirical evaluation as a complementary or alternative treatment for posttraumatic stress disorder (PTSD). The present study took advantage of a service dog training intervention underway in a Department of Veterans Affairs residential PTSD treatment program to perform a within-subjects comparison of a range of phenotypic markers. The present report considers negative and positive affect, assessed throughout the day, contrasting weeks when participants were or were not accompanied by their service dog. Fifty-four veterans were studied for 2-6 weeks. Negative and positive affect were sampled five times per day using items from the Positive and Negative Affect Schedule. Participants also wore a single-patch ECG/activity recorder and slept on beds recording sleep actigraphically. Linear mixed effects regression was employed to estimate the effect of the presence of service dog on momentary affect in the context of other presumable influences. Missing data were managed using methods applicable to random and nonrandom missingness. In this sample, the presence of a service dog was associated with reduced negative and increased positive affect, with both effects diminishing over time. Only negative affect was associated with time in residential treatment, and only positive affect was associated with concurrent heart rate, activity, and the interaction of activity and prior-night actigraphic sleep efficiency. These results concur with prior reports of reduced PTSD symptomology in association with the presence of a service dog, and with the distinct neurocircuitries underlying defensive and appetitive emotion and motivation. Limitations derive from the artificial environment and brief duration of study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Animal Assisted Therapy/methods , Residential Treatment/methods , Service Animals , Stress Disorders, Post-Traumatic/therapy , Veterans/psychology , Adult , Affect , Animals , Dogs , Heart Rate , Humans , Inpatients , Linear Models , Male , Middle Aged , Sleep
15.
Eur J Psychotraumatol ; 12(1): 1934789, 2021.
Article in English | MEDLINE | ID: mdl-34262669

ABSTRACT

Background: Clinical guidelines recommend a phase-based approach to treatment for complex post-traumatic stress disorder (CPTSD), yet little is known about what interventions are being offered and which may be effective in the final 'reintegration' phase. Objective: To systematically review literature on reintegration interventions for CPTSD, describing the nature and effectiveness of interventions. Method: We searched four electronic databases (Medline, PsycINFO, Embase, and PTSDpubs) for interventions aiming to facilitate reintegration for participants with probable CPTSD. We had two aims: firstly, to describe the interventions and secondly, to describe their effectiveness as measured through measures of reintegration, PTSD and/or disturbances in self-organization (DSO), or qualitative data describing changes experienced. Results are presented using narrative synthesis. Results: Fifteen studies met our inclusion criteria. Interventions included yoga, exercise, use of service dogs, residential treatment, education, self-defence and patient research involvement. Overall study quality was low, as assessed by critical appraisal tools. Of the six studies including a control group, two reported a statistically significant improvement in the measure of reintegration between the intervention and control group, four studies reported a statistically significant difference in the measure of PTSD symptoms, but none reported any significant differences between intervention and control groups in DSO. Of all eight quantitative studies, three reported a statistically significant difference in the reintegration measure pre- to post-intervention for the intervention group, five a statistically significant improvement in the measure of PTSD symptoms, and three a significant difference in the DSO measure. From eight studies reporting qualitative date we synthesized themes into eight categories, within which facilitation of connection with others was the most commonly reported benefit. Conclusions: The interventions outlined may facilitate reintegration, however, research in this area is still in its infancy and quality research is lacking. Further research is needed to establish whether reintegration interventions enhance treatment for CPTSD.


Antecedentes: Las guías clínicas recomiendan un enfoque basado en fases para el tratamiento del trastorno de estrés postraumático complejo (TEPTC), aunque se sabe poco acerca de las intervenciones que se ofrecen y cuáles pueden ser efectivas en la fase final de 'reintegración'.Objetivo: Revisar la literatura en forma sistemática acerca de intervenciones de reintegración para el TEPTC, describiendo la naturaleza y efectividad de las intervenciones.Método: Para las intervenciones cuyo objetivo era facilitar la reintegración de los participantes con probable TEPTC, buscamos en cuatro bases de datos electrónicas (Medline, PsycINFO, Embase, y PTSDpubs). Teníamos dos objetivos: en primer lugar, describir las intervenciones y, en segundo lugar, describir su efectividad medida a través de mediciones de reintegración, TEPT y/o alteraciones en la auto-organización (DSO en sus siglas en ingles), o datos cualitativos que describieran los cambios experimentados. Los resultados se presentan mediante síntesis narrativa.Resultados: Quince estudios reunieron nuestros criterios de inclusión, La intervenciones incluían yoga, ejercicio, uso de perros de servicio, tratamiento residencial, educación, autodefensa y la implicación del paciente en la investigación. La calidad del estudio en general fue baja, según la evaluación de las herramientas de evaluación críticas. De los seis estudios que incluyeron un grupo control, dos reportaron una mejoría estadísticamente significativa en la medición de la reintegración entre la intervención y el grupo control, cuatro estudios reportaron una diferencia estadísticamente significativa en la medición de los síntomas de TEPT, pero ninguno reportó alguna diferencia significativa en los síntomas DSO entre los grupos de intervención y control. De los ocho estudios cuantitativos, tres reportaron una diferencia estadísticamente significativa en la medición de la reintegración pre y post intervención para el grupo con intervención, cinco una mejoría estadísticamente significativa en la medición de los síntomas de TEPT, y tres una diferencia significativa en la medición de los síntomas DSO. De los ocho estudios que reportaron datos cualitativos los sintetizamos por temas en ocho categorías, dentro de las cuales la facilitación de la conexión con otros fue el beneficio más comúnmente reportado.Conclusiones: Las intervenciones descritas pueden facilitar la reintegración, sin embargo, la investigación en esta área aún está dando sus primeros pasos y se carece investigación de calidad. Se necesita más investigación para establecer si las intervenciones de reintegración mejoran el tratamiento para el TEPTC.


Subject(s)
Exercise , Service Animals , Stress Disorders, Post-Traumatic/therapy , Yoga , Animals , Dogs , Humans , Residential Facilities , Stress Disorders, Post-Traumatic/classification , Treatment Outcome
16.
J Hosp Infect ; 115: 5-9, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33940092

ABSTRACT

This study explored the bacterial transmission between patients and dogs during dog-assisted therapy (DAT). Twenty children (55% girls) with a median age of 7 years (range 3-17 years) were included. Two dogs assisted and the conditions were more restricted hygienically with dog 2. Samples from child and dog were collected and cultured before and after each DAT visit. The results showed that dog 1 transmitted bacteria repeatedly to the children. No bacteria were transmitted with dog 2. In conclusion, exchange of bacteria can occur between dog and child during DAT, but it can be reduced by simple infection control measures.


Subject(s)
Animal Assisted Therapy , Animals , Bacteria , Child , Dogs , Humans , Service Animals
18.
J Small Anim Pract ; 62(4): 286-292, 2021 04.
Article in English | MEDLINE | ID: mdl-33496345

ABSTRACT

OBJECTIVES: To investigate if maternal folic acid supplementation (5 mg) is associated with a reduction of cleft palates, umbilical hernias, stillbirths and caesarean sections in a guide dog breeding colony. MATERIALS AND METHODS: Labrador retrievers, golden retrievers and Labrador/golden Crosses from the breeding colony of a professional guide dog training organisation were eligible for inclusion. Dams in the treatment group (n = 137) received 5 mg oral folic acid supplementation daily from the start of pro-oestrous through day 40 of gestation. A historical control group (n = 134) was selected from the previous calendar year for comparison. A logistic regression model identified the relative risk of disease (cleft palates, umbilical hernias, stillbirths and caesarean sections) for puppies whose dams did or did not receive folic acid supplementation. RESULTS: A total of 1917 puppies (890 control, 1027 treatment; from 294 litters) were produced during the entire study period, with 994 puppies (494 control, 500 treatment; from 144 litters) born to the subset of dams (n = 72) who produced litters during both the control and treatment periods. All 95% highest posterior densities of relative risk included 1.0, failing to detect differences between the treatment and control groups on incidence rate of cleft palate (control: 2.25%; treatment: 2.34%), umbilical hernias (control: 1.91%; treatment: 3.12%), stillbirths (control: 3.26%; treatment: 2.92%) and caesarean sections (control: 1.45%; treatment: 1.28%). CLINICAL SIGNIFICANCE: There was no observable reduction of cleft palate, umbilical hernia, stillbirth or caesarean section associated with folic acid supplementation during pregnancy in the study colony. For a domestic dog cohort with a low tendency of hereditary malformations, such as this study colony, 5 mg dietary folic acid supplementation should not be expected to drastically improve or eradicate these diseases.


Subject(s)
Dog Diseases , Stillbirth , Animals , Cesarean Section/veterinary , Dietary Supplements , Dog Diseases/drug therapy , Dog Diseases/epidemiology , Dog Diseases/prevention & control , Dogs , Female , Folic Acid , Pregnancy , Service Animals , Stillbirth/veterinary
19.
Article in English | MEDLINE | ID: mdl-32887269

ABSTRACT

Animal-assisted therapy (AAT) is a non-pharmacological therapy aimed at people with physical and/or mental disabilities. Therefore, it is necessary to carry out interventions that guarantee its benefits for patients while also avoiding the risk of zoonoses due to contact with the animals or their mucous membranes. The present study aimed to detect the occurrence of Pasteurella multocida in the oral cavity of dogs attending a "dog educational centre" and training for AAT interventions. In addition, some of the potential predictable factors of infection (i.e., age, sex, breed, and living conditions) were analyzed. In total, 25/200 dogs examined (12.5%; 95% confidence interval = 8.4-18.1%) were positive for P. multocida, as confirmed by PCR. Sex, breed, and living conditions were risk factors associated with P. multocida as revealed by the logistic regression analysis. Specifically, cross-bred female dogs living prevalently outdoors were significantly associated with the presence of P. multocida (p < 0.05). This study represents the first epidemiological survey of the prevalence of P. multocida in the oral cavity of dogs involved subsequently in AAT interventions, highlighting the potential risk of P. multocida infection in patients, often belonging to risk categories (e.g., children, the elderly, and immunocompromised individuals). Therefore, healthcare guidelines could be suggested to integrate the current literature related to the health check of dogs involved in AAT. In this way, it could be ensured that, even with bodily contact during AAT, the risk of pathogen transmission by the co-therapist dog can be avoided.


Subject(s)
Animal Assisted Therapy , Pasteurella Infections , Pasteurella multocida , Aged , Animals , Child , Dogs , Female , Humans , Male , Mouth , Pasteurella multocida/isolation & purification , Risk Assessment , Service Animals/microbiology , Zoonoses
20.
Psychogeriatrics ; 20(4): 510-521, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32065698

ABSTRACT

This systematic review investigated evidence for the effectiveness of trained assistance dogs as an intervention and support for people with dementia. Peer-reviewed articles were retrieved from multiple databases (SCOPUS, Web of Science, and Google Scholar). Reference lists of the articles retrieved were also screened to identify key authors for inclusion. Articles were subject to a quality review, and the results synthesised to address the research questions. Both qualitative and quantitative data were reported. There was evidence of the potential positive effects of dog-assisted interventions in relation to mood, prosocial behaviours, activities of daily living and/or quality of life, cognitive impairment and symptoms specific to dementia, and existential functions. However, the form and quality of the studies varied considerably. It was concluded that further research is needed, particularly for those with younger onset dementia (YOD), for whom there were no specific studies available. Attention needs to be given to establishing adequate-sized samples and designs incorporating control groups. Research would benefit from employing mixed-methods, allowing for the triangulation of qualitative and quantitative data. For deteriorating conditions such as the dementias, studies need to be conducted over time. Furthermore, given the important place family members play in the lives of those with dementia, the effects of dog-assisted interventions on the wider family should also be considered.


Subject(s)
Activities of Daily Living , Dementia , Service Animals , Animals , Dementia/therapy , Dogs , Family , Humans , Quality of Life
SELECTION OF CITATIONS
SEARCH DETAIL