OP0256-PARE A PAW? YES, THANK YOU AN ANIMAL ASSISTED INTERVENTION (AAI) PILOT PROJECT FOR CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS (JIA)
Authors: U. Viora, P. Ponzio, M. T. Mascarino, B. Picco, P. Guiso, E. Battista, S. Martino, D. Montin, M. Dellepiane, G. Rosso
Journal: Annals of the Rheumatic Diseases (2020)

Background: Animal-Assisted Interventions (AAI) is the new way to indicate what was previously known as “Pet Therapy”, as activities can be done either with the conventional “pets” (dogs, cats and rabbits) or with horses and donkeys. Children with JIA have several problems in terms of adherence both due to the atavistic fear of the needle and due to nausea and vomiting - the most important side effects of Methotrexate – often since the 2-3 days before the assumption to immediately after it. Sure that animals can help children to forget this fear and to avoid the psycological conditions which enhance nausea, for the first time in Italy (and probably in Europe) it was designed a specific AAI program for these children. Objectives: To promote a general state of psycho-physical well-being in children and families about: manage of therapy; reduce discomfort and anxiety caused by entering hospital; improve self-esteem and the response to the stress generated by the execution of therapy and disease management; strengthen communication and socialization; stimulate the affective area through the activities of animal care. Methods: Dogs and cats are part of the recreational activities once a week in an equipped area in the OIRM Hospital (no alternative gateway was needed). Paediatric Rheumatologists selected two different groups of children: the first one (5 children in the pilot study) every 15 days; the second one (5 children) every month; the selection was made looking at the therapeutic scheme. Every session, one hour, has 3 clearly distinct stages: Welcome and organization : children say hello to dogs and cats, open the toolkits specifically designed for the intervention, express their state of mind and are encouraged to tell their own stories. Therapy: parents prepare and inject the drug to their children under medical or Health Professional control without discontinuation of the activities with animals. Play and socializing: children are involved in petting and other activities with animals; they are also involved in manipulative activities (design, puppets shows, modelling clay, animal care, ball retriving, etc). This step has the aim to relieve stress and discomfort due to medical procedures. Visual Analogic Scales (VAS) were part of the toolkit, to let the researchers evaluate the effects of the activity directly from the children experience. For the first time, we will control also the animal health status and wellness condition monitoring behavioural parameters and salivary cortisol level during each session. Results: The pilot project started in October 2019 and nowaday we closed 12 meetings, 4 on October, 4 on November, 3 on December and 2 on January, with the participation of 2 dogs (Golden and Labrador Retriever) and 1 cat (Devon Rex) in each one. All children love to play with animals, seek their closeness at the time of therapy and enjoy playing all together with the dogs; no one cry or refuse therapy and, since the third session, no one has nausea before, during or after the injection. Parents have reached a certain level of confidence: they stay quietly in the waiting room or go away to have a drink or to run an errand (it becomes a moment of relaxing for them too). Animals remain in healthy and wellness conditions during the activity. Conclusion: These preliminary data seem that AAI to be useful in helping patients in JIA to overcome some problems related to their pathology. Disclosure of Interests: UGO VIORA: None declared, Patrizia Ponzio: None declared, Maria Teresa Mascarino: None declared, Barbara Picco: None declared, Paolo Guiso: None declared, Eleonora Battista: None declared, Silvana Martino: None declared, Davide Montin Speakers bureau: Not relevant for the topic, Marta Dellepiane: None declared, Germana Rosso: None declared