animal-assisted therapy for hospitalized heart failure patients

Conditions: Heart Failure

Summary: effects of complementary therapies on heart failure, a leading cause of hospitalization, are unknown. animal-assisted therapy improves physiological and psychosocial variables in healthy and hypertensive subjects. the purpose of this study was to determine whether a 12-minute hospital visit with a therapy dog improves hemodynamics, lowers neurohormone levels, and decreases state anxiety in patients hospitalized with heart failure.

context: effects of complementary therapies on heart failure, a leading cause of hospitalization, are unknown. animal-assisted therapy improves physiological and psychosocial variables in healthy and hypertensive subjects. objectives: to determine whether a 12-minute hospital visit with a therapy dog improves hemodynamics, lowers neurohormone levels, and decreases state anxiety in patients hospitalized with heart failure. design, setting, participants: a 3-group (volunteer-dog team, volunteer only, and control) randomized repeated-measures experimental design was used in 76 adult patients with advanced heart failure hospitalized between november 2001 and july 2004. longitudinal analysis was used to model differences among the 3 groups at 3 time points. interventions: one group received a 12-minute visit from a volunteer with a therapy dog, another group received a 12-minute visit from a volunteer, and the control group received usual care, at rest. data were collected at baseline, 8 minutes after the intervention started, and 16 minutes (4 minutes after intervention ended). main outcome measures: blood pressure, heart rate, pulmonary artery pressure, pulmonary capillary wedge pressure, right atrial pressure, cardiac index, systemic vascular resistance, plasma levels of epinephrine and norepinephrine, and state anxiety. results: compared with the control group, patients visited by a volunteer-dog team showed significantly greater decreases in pulmonary artery pressure during (5.34, p = .003) and after (5.78, p = .001) the intervention, pulmonary capillary wedge pressure during (3.09, p = .02) and after (4.31, p = .002) the intervention, and epinephrine (17.54, p = .04) and norepinephrine (240.14, p = .02) levels during the intervention. after the intervention, patients visited by the volunteer-dog team showed the greatest decrease in state anxiety over patients visited by a volunteer only (6.65, p = .003) and the control group (9.13, p \< .0001). conclusions: animal-assisted therapy improves cardiopulmonary pressures, neurohormone levels, and anxiety in patients hospitalized with heart failure.

Eligibility criteria:
inclusion criteria: * diagnosis of heart failure requiring medical management with an indwelling pulmonary artery catheter * age between 18 and 80 years * ability to read, write, and speak english * mental status: alert and oriented to person, place, and time * svr greater than 1200 dyne · sec · cm-5 at least once within 12 hours from the start of data collection exclusion criteria: * svr less than 1200 dyne · sec · cm-5 * allergies to dogs * immunosuppression, defined as a white blood cell count of less than 4500 cells/mm3 * infection as determined by an elevated white blood cell count exceeding 11,000 cells/mm3 * body temperature greater than 38ºc * decreased level of consciousness

Keywords: animal-assisted therapy dog hospital visit heart failure