Feasibility, efficacy, and safety of animal-assisted activities with visiting dogs in inpatient pediatric oncology

Abstract

Background: Childhood cancer entails a heavy burden for patients and their families. Recent advances in overall survival rates have increasingly brought long-term quality of life into focus. Animal-assisted activities (AAAs) have long been hypothesized to alleviate the burden on pediatric patients and their peers in the hospital setting. However, their use in inpatient pediatric oncology has been a sensitive issue mainly due to the fear of infections, resulting in a lack of studies. This study presents data on the feasibility, safety, and efficacy of AAAs from a single German center.

Methods: Between 2018 and 2022, 60 patients (median age = 10.3 years) diagnosed with malignancy and undergoing treatment were visited by an intervention dog (total visits = 100). Patients were screened for infections as per hospital policy, with additional microbiological testing performed based on symptoms. The dog was screened for human pathogens and zoonoses. Microbial data and hospitalizations were analyzed from two months prior to the first visit until two months after the last visit. Acceptance of being in the hospital, both with and without planned animal-assisted interventions and pre- and post-intervention state stress, were measured using a validated visual analogue scale (0-10).

Results: Patients benefited from AAAs, showing increased acceptance of being in the hospital (median: 7.25 vs. 4.50, P < 0.001) and decreased median state stress ratings one hour after the visit compared to one hour before the visit (1.00 vs. 4.25, P < 0.001). The intervention did not result in an increased number of infections or unplanned hospitalizations, and no zoonoses were detected. All microbial screening tests of the dog were negative.

Conclusions: AAAs with visiting dogs in inpatient pediatric oncology are feasible and safe. Although they hold promise for enhancing patients' well-being, further prospective studies are needed. Supplementary file 2 (MP4 240076 KB).

Keywords: Animal-assisted activities; Animal-assisted interventions; Animal-assisted therapy; Feasibility; Infection control; Inpatient pediatric oncology; Safety; Stress response; Therapy dog; Visiting dog.

Fig. 1

The self-rating of patients. a Patients with or without planned animal-assisted therapy intervention were asked how much they enjoyed coming to the hospital; b patients with dog visits were asked to rate the level of state stress one hour before and one hour after the visit. The box depicts 25th to 75th percentile and median. Whiskers represent all samples lying within 1.5 times the IQR. VAS visual analogue scale, IQR interquartile range