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American Journal of Critical Care. 2007;16: 575-585
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CE Article

Animal-Assisted Therapy in Patients Hospitalized With Heart Failure

By Kathie M. Cole, RN, MN, CCRN, Anna Gawlinski, RN, DNSc, Neil Steers, PhD and Jenny Kotlerman, MS. Kathie M. Cole is a clinical nurse III in the cardiac care unit, Anna Gawlinskiis the director of evidence-based practice and an adjunct professor, and Jenny Kotlermanis a statistician at the Medical Center and School of Nursing, University of California, Los Angeles. Neil Steers is an adjunct assistant professor at the David Geffen School of Medicine, University of California, Los Angeles.

Corresponding author: Kathie M. Cole, RN, MN (CNIII),UCLA Medical Center, 4W CCU (Rm 46220), Los Angeles, CA 90095 (e-mail: nskmc{at}mednet.ucla.edu).

Background Animal-assisted therapy improves physiological and psychosocial variables in healthy and hypertensive patients.

Objectives To determine whether a 12-minute hospital visit with a therapy dog improves hemodynamic measures, lowers neurohormone levels, and decreases state anxiety in patients with advanced heart failure.

Methods A 3-group randomized repeated-measures experimental design was used in 76 adults. Longitudinal analysis was used to model differences among the 3 groups at 3 times. One group received a 12-minute visit from a volunteer with a therapy dog; another group, a 12-minute visit from a volunteer; and the control group, usual care. Data were collected at baseline, at 8 minutes, and at 16 minutes.

Results Compared with controls, the volunteer-dog group had significantly greater decreases in systolic pulmonary artery pressure during (–4.32 mm Hg, P = .03) and after (–5.78 mm Hg, P = .001) and in pulmonary capillary wedge pressure during (–2.74 mm Hg, P = .01) and after (–4.31 mm Hg, P = .001) the intervention. Compared with the volunteer-only group, the volunteer-dog group had significantly greater decreases in epinephrine levels during (–15.86 pg/mL, P = .04) and after (–17.54 pg/mL, P = .04) and in norepinephrine levels during (–232.36 pg/mL, P = .02) and after (–240.14 pg/mL, P = .02) the intervention. After the intervention, the volunteer-dog group had the greatest decrease from baseline in state anxiety sum score compared with the volunteer-only (–6.65 units, P =.002) and the control groups (–9.13 units, P < .001).

Conclusions Animal-assisted therapy improves cardiopulmonary pressures, neurohormone levels, and anxiety in patients hospitalized with heart failure.

Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your understanding of the following objectives:
  1. Identify the physiological findings associated with advanced heart failure.
  2. Discuss the overall effects of animal-assisted therapy on cardiopulmonary pressures, neurohormonal levels, and anxiety in advanced heart failure patients who participated in this study.
  3. Describe the indications for further research in animal-assisted therapy that this study identifies.
To read this article and take the CE test online, visit www.ajcconline.org and click "CE Articles in This Issue." No CE test fee for AACN members.




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