Animal-Assisted Therapy for Hospitalized Heart Failure Patients

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Use of Animal-Assisted Therapy to Decrease Cardiopulmonary Pressures, Neurohormone Levels, and State Anxiety in Patients Hospitalized With Heart Failure

Conditions
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Heart Failure

Intervention / Treatment
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* Behavioral: Animal-assisted Therapy


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Animal-assisted Therapy|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Blood pressure |  |  | 
| heart rate |  |  | 
| pulmonary artery pressure |  |  | 
| pulmonary capillary wedge pressure |  |  | 
| right atrial pressure |  |  | 
| cardiac index |  |  | 
| systemic vascular resistance |  |  | 
| plasma levels of epinephrine |  |  | 
| plasma levels of norepinephrine |  |  | 
| state anxiety |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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animal-assisted therapy, dog hospital visit, heart failure