Animal Assisted Interactions With Animal Robot During PT/OT in the ICU
Condition: Pediatric ALL; Critical Illness; Physical Therapy Modalities; Occupational Therapy; Animal Assisted Therapy
MeSH terms: Critical Illness
Study type: Interventional

Summary: 
      The purpose of this study is to:

        1. Establish the feasibility and acceptability of a therapeutic robot, Paro, for critically
           ill patients admitted to the Pediatric Intensive Care Unit

        2. Explore safety considerations related to infection control [participant
           hospital-acquired infection (HAI) rates, screening for the presence of microbial
           contamination with real-time ATP testing

        3. Examine the therapeutic effect of Paro on patient psychological variables, physiological
           variables, and sedative and analgesic medication requirements.
    

Detailed description: 
      Admission to the PICU can be an extremely upsetting experience for children of all ages. In
      addition to physical symptoms such as pain, thirst and fatigue, patients in the PICU also
      experience a multitude of psychological symptoms. Symptoms like anxiety, spells of terror,
      social isolation, disturbed sleeping patterns, restlessness, fear, confusion and loss of
      control are exacerbated in the PICU because patients often have limited mobility, decreased
      capacity to communicate, and rely on healthcare providers for survival.

      Large doses of sedative and analgesic medications are administered by nursing staff to help
      alleviate distressing symptoms. Overuse of sedative medications can cause a sequela of
      adverse effects, and therefore, recent recommendations call for reducing sedative use as much
      as possible. To minimize the overwhelming symptom burden of acute critical illness and
      promote lasting psychological well-being during recovery, it is imperative to identify
      effective non-pharmacological interventions that decrease psychological distress, but do not
      alter level of alertness during acute critical illness. Established evidence supports the use
      of a variety of non-pharmacological approaches that can be easily applied as adjuncts to
      sedative and analgesic medications in order to reduce dependence on these medications. Animal
      assisted interactions (AAI) are a promising integrative approach that can be used as an
      adjunct to sedative and analgesic medications in order to improve psychological symptoms and
      promote comfort, relaxation, and positive mood in critically ill patients.

      AAI are interventions that intentionally incorporate animals as part of a therapeutic process
      to promote human health, learning, and well-being. Domestic and farm animals such as dogs,
      cats, birds, equines, guinea pigs, rabbits, llamas, sheep, goats, and pigs are predominantly
      featured in AAI programs. Animals can be simply observed, touched, held, and petted, or more
      actively integrated into specific therapy activities such as brushing with different tools to
      exercise range of motion and fine motor coordination and tandem walking with the animal to
      encourage exercise. Recent literature indicates that AAI can improve reality orientation and
      attention span, eliminate the sense of isolation, reduce stress and anxiety, enhance
      communication, promote positive social interactions, and enhance overall quality of life. The
      use of AAI in the ICU has the potential to engage patients, family members, and healthcare
      staff in an innovative, holistic approach to symptom management.
    

Intervention name(s): PARO therapy seal
Intervention type(s): Device
Intervention description(s): PARO, a baby harp seal, is an advanced interactive, therapeutic medical robot developed by AIST, a leading Japanese industrial automation pioneer. It allows the documented benefits of animal therapy to be administered to patients in environments such as hospitals and extended care facilities where live animals present treatment or logistical difficulties.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Robot; Animal Assisted Interaction; Critical Care; Rehabilitation