'Dr Dog' Eases Emergency Patients' Anxiety, Pain

Megan Brooks

March 17, 2022

A 10-minute visit with a therapy dog leads to clinically significant reductions in pain and anxiety and improved well-being in patients attending the emergency department (ED), results of a randomized controlled trial show.

"This did not occur among those that did that not visit with a therapy dog. This gives us confidence in the intervention," study investigator James Stempien, MD, provincial head of emergency medicine, University of Saskatchewan (Usask), in Saskatoon, Canada, told Medscape Medical News.

"We have also seen benefit for the staff that get to interact with the dogs as well. The cost is minimal, thanks to our wonderful therapy dog volunteer teams; the result is priceless," he added.

The study was published online March 9 in PLOS ONE.

A Welcome Distraction

The study builds on previous results from uncontrolled studies by the same researchers.

One was a survey of waiting ED patients that showed that most wanted to visit with a therapy dog. The other was a brief questionnaire administered before and after a therapy dog visit in the ED that showed that the visit increased patients' perceived comfort levels and decreased their distress levels.

"The dogs were also considered by patients to be a welcome distraction from the stressful ED environment. A controlled trial was the natural next step," Colleen Dell, PhD, research chair, One Health and Wellness, at USask, and co-founder of the PAWS Your Stress program, told Medscape Medical News.

The study was conducted at the Royal University Hospital in Saskatoon ― the first ED in Canada to introduce therapy dogs to improve the experience of waiting patients.

Pain, anxiety, depression, and well-being were measured with the revised Edmonton Symptom Assessment System (ESAS-r) 11-point rating scales before, immediately after, and 20 minutes after a therapy dog visit for 97 patients (mean age, 56; 44% women). Blood pressure and heart rate were also recorded at those time points.

The same data were obtained twice (30 minutes apart) in 101 control patients (mean age, 57; 39% women) who didn't visit with the therapy dog in the ED.

There was a statistically significant main, albeit small, effect of the therapy dog visit on participants' ratings of pain, anxiety, and depression, the researchers report.

Patients who visited with the therapy dog had significantly lower ratings afterward for all three measures than peers in the control group.

Participants in the therapy dog group also rated their well-being as significantly better after interacting with the dog and its handler than those in the control group.

There was no main effect of the therapy dog visit on blood pressure or heart rate.

"I definitely think this is something hospitals should pursue. The incorporation of therapy dogs for patient support has been a great success in other areas of the hospital, supporting pediatric patients in hospital, for example," said Stempien.

The ED can be a "scary place for most people. People tend to visit the ED on the worst day of their life, either for them or a loved one. To have support in the form of a therapy dog is something welcome that most people can relate to. Interacting with a therapy dog can make the ED visit a little calmer," he added.

Unique Research

Reached for comment, Kara Rauscher, LCSW, interim director of behavioral health for Nashville CARES in Tennessee, noted that "much of the research on animal-assisted interventions have been qualitative in nature.

"The data from this controlled clinical trial enhance the pool of research that supports the efficacy of animal-assisted interventions. Further, there are opportunities to replicate this study in other EDs to strengthen our understanding of the potential benefits of these programs," said Rauscher.

Part of her work with Nashville Cares, an AIDS service organization, has been agency-wide implementation of trauma-informed care with a focus on staff wellness.

"That includes bringing in therapy dogs for staff to spend time with during the workday; anecdotally, our staff reported a reduction in stress and improvements in mood," Rauscher said.

Funding for the study was provided by the Royal University Hospital. Stempien, Dell, and Rauscher have disclosed no relevant financial relationships.

PLoS One. Published online March 9, 2022. Full text

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