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Randomized Controlled Trial
. 2024 Jan;27(1):75-82.
doi: 10.1089/jpm.2023.0091. Epub 2023 Sep 25.

Impact of Animal-Assisted Interaction on Anxiety in Children With Advanced Cancer and Their Caregivers

Anne Byrd Mahoney  1 , Terrah Foster Akard  2 , Brittany A Cowfer  3 , Mary S Dietrich  2   4 , Jennifer L Newton  5 , Mary Jo Gilmer  2
Affiliations
Randomized Controlled Trial

Impact of Animal-Assisted Interaction on Anxiety in Children With Advanced Cancer and Their Caregivers

Anne Byrd Mahoney et al. J Palliat Med. 2024 Jan.

Abstract

Background: Pediatric patients with advanced cancer and their caregivers have unique psychosocial needs. Anxiety often worsens throughout treatment for both patients and parents, and, if undertreated, can cause suffering. Animal-assisted interaction (AAI) incorporates animals into patient care in a structured manner for the purpose of therapeutic benefit. Objective: To evaluate feasibility of incorporating AAI into patient care and to assess AAI effectiveness in decreasing patient and caregiver anxiety in pediatric patients with advanced cancer, defined by relapsed or refractory disease. Design: Randomized controlled study. Setting/Subjects: Participants were children (n = 19) and parents (n = 21) who were randomized to AAI group or usual care (UC) group. Measures: Participants completed weekly measures to assess anxiety, including the 20-question State-Trait Anxiety Inventory (STAI). Results: Our results demonstrated feasibility of the use of AAI in children with advanced cancer. While they did not reveal a significant difference in anxiety scores over the four sessions in either group, parents randomized to the AAI group had lower STAI State subscores at initial visit in comparison to the UC group. The difference in initial STAI State anxiety scores for caregivers may indicate a positive effect of AAI in reducing anxiety surrounding appointments through anticipation of seeing a therapy dog. Conclusion: Further research is needed to determine the effectiveness of AAI in pediatric patients with advanced cancer and their caregivers, but results are promising that participation in AAI may lessen caregiver anxiety. Clinical Trial Registration Number is: NCT03765099.

Keywords: animal-assisted interaction; pediatric cancer; pediatric palliative care.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
Consort diagram. Thirty-one patients and their caregivers were approached to either receive AAI intervention or UC. One family was excluded due to reported fear of dogs. In the AAI group, one family was lost to follow up for unknown reason. Of the remaining 14 participating families, 9 children and 10 caregivers met analysis criteria with completion of at minimum four STAI surveys. In the UC group, four families were lost to follow up; one due to insufficient time to complete surveys, one due to moving away, and two for unknown reasons. Of the remaining 11 participating families, 10 children and 11 caregivers met analysis criteria with completion of at minimum 4 STAI surveys. AAI, animal-assisted interaction; STAI, State-Trait Anxiety Inventory; UC, usual care.
FIG. 2.
FIG. 2.
STAI-CH State subscores of child participants across four sessions in UC groups and AAI groups.
FIG. 3.
FIG. 3.
STAI State subscores of adult participants across four sessions in UC groups and AAI groups.
See this image and copyright information in PMC

References

    1. National Cancer Institute. Childhood Cancers. 2022. Available from: https://www.cancer.gov/types/childhood-cancers [Last accessed: January 30, 2023].
    1. Collins JJ, Byrnes M, Dunkel I, et al. . The measurement of symptoms in children with cancer. J Pain Symptom Manage 2000;19(5):363–377; doi: 10.1016/s0885-3924(00)00127-5 - DOI - PubMed
    1. Weaver MS, Heinze KE, Kelly KP, et al. . Palliative care as a standard of care in pediatric oncology. Pediatr Blood Cancer 2015;62 Suppl 5(Suppl 5):S829–S833; doi: 10.1002/pbc.25695 - DOI - PMC - PubMed
    1. Badr H. Psychosocial interventions for patients with advanced cancer and their families. Am J Lifestyle Med 2016;10(1):53–63; doi: 10.1177/1559827614530966 - DOI - PMC - PubMed
    1. Hechler T, Blankenburg M, Friedrichsdorf SJ, et al. . Parents' perspective on symptoms, quality of life, characteristics of death and end-of-life decisions for children dying from cancer. Klin Padiatr 2008;220(3):166–174; doi: 10.1055/s-2008-1065347 - DOI - PubMed

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