Department of Mental Health and Social Work, Middlesex University, London, UK.
School of Social Work and Social Policy, University of Strathclyde, Glasgow, UK.
Int J Older People Nurs. 2020 Sep;15(3):e12320. doi: 10.1111/opn.12320. Epub 2020 May 11.
To comprehensively review studies on dog-assisted interventions (DAIs) among older people in residential long-term care facilities (RLTCFs) and to provide an overview of their interventions, outcomes and methodological quality.
We searched 18 electronic databases to identify English articles (published January 2000-December 2019) reporting on well-defined DAIs targeting older adults (≥65 years) in RLTCF. Data were extracted by two independent reviewers. Descriptive statistics were produced for quantitative studies, with key themes identified among qualitative studies. Where possible, estimates were pooled from randomised controlled trials using random effects meta-analyses.
Forty-three relevant studies (39 quantitative; 4 qualitative) were identified. The majority of quantitative studies were assessed as low-quality according to the MMAT criteria (n = 26, 67%). Almost half of the quantitative studies (n = 18, 46%) found no significant changes over time or between groups across outcomes measured. The most salient intervention effects included improved social functioning (n = 10), reduced depressive symptoms (n = 6) and loneliness (n = 5). A random-effects meta-analysis revealed a medium effect in favour of DAT on reducing depressive or loneliness symptoms (pooled SMD: 0.66, 95%CI 0.21-1.11; I = 50.5; five trials), relative to treatment as usual. However, compared to treatment as usual, no overall effect of DAI on activities of daily living was detected (p = .737). Key themes from qualitative studies included (a) animals as effective transitional objects, (b) the therapeutic value of pets and (c) the significance of the care environment and stakeholders in facilitating DAI.
The findings of this review indicate that while DAI has value for older people in RLTCF, challenges remain in accurately measuring its impact to provide a stronger evidence-base. Standardisation of DAI service design, delivery and evaluation is required for future research and practice in providing holistic care for older adults.
全面综述住宅长期护理机构（RLTCF）中老年人参与犬辅助干预（DAI）的研究，并概述其干预措施、结果和方法学质量。
我们检索了 18 个电子数据库，以确定 2000 年 1 月至 2019 年 12 月期间发表的针对 RLTCF 中老年人（≥65 岁）的明确定义的 DAI 报告的英文文章。由两名独立评审员提取数据。对定量研究进行描述性统计，对定性研究确定主要主题。在可能的情况下，使用随机效应荟萃分析从随机对照试验中汇总估计值。
共确定了 43 项相关研究（39 项定量研究；4 项定性研究）。根据 MMAT 标准，大多数定量研究被评估为低质量（n=26，67%）。近一半的定量研究（n=18，46%）发现，在测量的结果方面，没有随时间或组间的显著变化。最显著的干预效果包括改善社会功能（n=10）、减轻抑郁症状（n=6）和孤独感（n=5）。一项随机效应荟萃分析显示，DAI 对减轻抑郁或孤独症状具有中等效果（合并 SMD：0.66，95%CI 0.21-1.11；I=50.5；五项试验），与常规治疗相比。然而，与常规治疗相比，未发现 DAI 对日常生活活动的总体影响（p=0.737）。定性研究的主要主题包括：（a）动物作为有效的过渡对象，（b）宠物的治疗价值，（c）护理环境和利益相关者在促进 DAI 方面的重要性。
本综述的结果表明，尽管 DAI 对 RLTCF 中的老年人具有价值，但在准确衡量其影响以提供更有力的证据基础方面仍存在挑战。为了为老年人提供全面护理，未来的研究和实践需要对 DAI 服务设计、交付和评估进行标准化。
