Canine-Assisted Therapy (CAT): A nurse-initiated program to reduce patients’ perception of pain and anxiety at a critical access hospital

Background/Purpose: The use of animals to promote or improve human health and wellbeing has a long history. However, it is yet to be recognized and accepted as either a complementary therapy or integrated into mainstream healthcare. Even though studies have reported the benefits of animal-assisted therapy, critics dispute results, citing that personal beliefs about the value of companion animals as pets are insufficient as a basis for claims about the possible psychological and physical health benefits of interacting with animals. Hospitalized patients encounter stressors that impact their experience and recovery. Studies have shown that the presence of animals has a positive effect on human physiology, including blood pressure and heart rate. The literature confirms the positive impact of ca-nine-assisted therapy (CAT) during routine inpatient admissions such as; reduction in length of stay, increased patient mobility, and increased patient satisfaction. Understanding the benefits, nurses at a rural critical access hospital decided to implement a CAT program that would foster a culture of health and benefit the patients in the community they serve. CAT has been utilized in several settings, yet no study has assessed its effectiveness on reducing pain and anxiety at a critical access setting. The purpose of this study was to explore the effects of CAT on inpatients’ perception of pain and anxiety. Methods: We conducted a quasi-experimental design with a pre and post intervention survey to measure symptom changes in response to CAT. Adult inpatients who met the criteria for CAT were invited to participate. The Wong-Baker Pain scale (WBPS) and Numerical Pain Scale (NPS) along with the Faces Anxiety Scale (FAS) were assessed pre and post each CAT session. Participants decided how long they wanted to spend with the therapy dog, which was as little as 5 minutes to as much as 15 minutes. Results: A total of 50 inpatients participated in the study. Paired-samples t-tests were conducted to compare their pre and post CAT perception of pain as well as pre and post CAT perception of anxiety levels. The results showed a statistically significant decrease in the pain levels pre CAT (M=2.58, SD=2.82) and post CAT (M=1.52, SD=2.17); t(49)=4.90, p=.000, cohen’s d = 0.692. The 95% CI for the difference in pain levels was 0.625 to 1.495. Additionally, the results for anxiety show a statistically significant decrease in the anxiety level pre-therapy (M=2.40, SD=1.34) and post-therapy (M=1.38, SD=0.64); t(49)=6.36, p=.000, cohen\u27s d = 0.899. The 95% CI for the difference in anxiety levels was 0.698 to 1.342. The study results strongly suggest that CAT is effective in reducing patients’ perception of pain and anxiety. Implications for Nursing: In light of increasing regulation and concern regarding the use of opioid pain medications, other interventions need to be examined and utilized to assist patients with pain and anxiety. Nurses are in a perfect position to advocate for alternative interventions. CAT provided a significant reduction in pain and anxiety and is a therapeutic intervention that rural critical access hospitals can implement. Critical access hospitals should consider incorporating CAT as an alternative modality, in addition to, current medical treatments to increase patient satisfaction while decreasing pain and anxiety