Abstract
ContextPain is a primary reason individuals attend an Emergency Department (ED), and its management is a concern.ObjectivesChange in symptoms and physiologic variables at 3 time points pre-post a ten-minute St. John Ambulance therapy dog team visit compared to no visit in ED patients who experienced pain.Design, setting and participantsUsing a controlled clinical trial design, pain, anxiety, depression and well-being were measured with the Edmonton Symptom Assessment System (revised version) (ESAS-r) 11-point rating scales before, immediately after, and 20 minutes post- therapy dog team visit with Royal University Hospital ED patients participating in the study (n = 97). Blood pressure and heart rate were recorded at the time points. Control data was gathered twice (30 minutes apart) for comparison (n = 101). There were no group differences in age, gender or ethnicity among the control and intervention groups (respectively mean age 59.5/57.2, ethnicity 77.2% Caucasian/87.6%, female 43.6% /39.2%, male 56.4%/60.8%,).Intervention10 minute therapy dog team visit in addition to usual care.Main outcome measuresChange in reported pain from pre and post therapy dog team visit and comparison with a control group.ResultsA two-way ANOVA was conducted to compare group effects. Significant pre- post-intervention differences were noted in pain for the intervention (mean changeint. = -0.9, SD = 2.05, p = .004, 95% confidence interval [CI] = [0.42, 1.32], ηp2 = 04) but not the control group. Anxiety (mean changeint. = -1.13, SD = 2.80, p = .005, 95% CI = [0.56, 1.64], ηp2 = .04), depression (mean changeint. = -0.72, SD = 1.71, p = .002, 95% CI = [0.39, 1.11], ηp2 = .047), and well-being ratings (mean changeint. = -0.87, SD = 1.84, p < .001, 95% CI = [0.49, 1.25], ηp2 = .07) similarly improved for the intervention group only. There were no pre-post intervention differences in blood pressure or heart rate for either group. Strong responders to the intervention (i.e. >50% reduction) were observed for pain (43%), anxiety (48%), depression (46%), and well-being (41%).ConclusionsClinically significant changes in pain as well as significant changes in anxiety, depression and well-being were observed in the therapy dog intervention compared to control. The findings of this novel study contribute important knowledge towards the potential value of ED therapy dogs to affect patients’ experience of pain, and related measures of anxiety, depression and well-being.Trial registrationThis controlled clinical trial is registered with ClinicalTrials.gov, registration number NCT04727749.
Highlights
Significant pre- post-intervention differences were noted in pain for the intervention but not the control group
Anxiety, depression, and well-being ratings improved for the intervention group only
Significant changes in pain as well as significant changes in anxiety, depression and well-being were observed in the therapy dog intervention compared to control
Summary
Pain is both an emotional and a sensory experience that is unpleasant and specific to an individual [1, 2]. An ongoing concern with quality of care in Eds is that patient pain is inadequately managed, in part because of long wait times [5]. It is recognized that experiencing anxiety in the ED can negatively impact patients’ pain and the perception of wait times [6–8]. The ED setting has been linked as a contributor to patient pain. Common environmental stressors, such as constant bright lighting and noise levels [9, 10], may disrupt ED patients’ rest patterns. This can slow down the recovery process and prolong patients’ symptoms of pain [11, 12]. As waiting for extended periods of time is typical of the ED patient
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