Sim Shu Qing, Liu Zhiwei, Wu Zishuo, Wang Sian, Nisa Claudia
Division of Social Sciences, Duke Kunshan University, Kunshan, China.
Duke University, Duke Global Health Institute, Durham, USA.
BMC Complement Med Ther. 2025 Aug 12;25(1):303. doi: 10.1186/s12906-025-04955-2.
Due to the high prevalence of mental health issues among university students worldwide, canine-assisted therapy (CAT) has emerged as a potential intervention to reduce student stress and anxiety. This study systematically reviews and meta-analyzes the effects of CAT on reducing stress and anxiety levels among university students.
Following the PRISMA 2020 guidelines, we conducted a systematic search across multiple databases (APA PsycINFO, PubMed, Duke Libraries, CNKI, Wanfang, and Google Scholar) for randomized controlled trials published in English and Chinese. Only studies incorporating professionally trained dogs and handlers were included. Two reviewers (SS and ZL) independently extracted data, and the risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Effect sizes (Hedges' g) were pooled using a random-effects meta-analysis to account for the anticipated clinical and methodological heterogeneity. Subgroup analyses were conducted to explore moderators such as intervention duration, baseline stress levels, and control condition types. Publication bias was evaluated using funnel plots, Egger's test, and trim‑and‑fill analysis.
Of 290 identified studies, 15 met the inclusion criteria and 14 were included in the meta-analysis. The meta-analysis yielded a statistically significant overall effect size of g = -0.67 (p <.001), indicating a moderate reduction in stress and anxiety among university students receiving CAT. Forest plots revealed effect sizes ranging from approximately - 1.34 to -0.13 across studies. Although substantial heterogeneity was observed, subgroup analyses showed that CAT was significantly more effective for students with high baseline stress and anxiety levels. Funnel-plot asymmetry suggested possible bias, but Egger's test was non‑significant. Trim‑and‑fill analysis imputed two missing studies, adjusting the pooled effect to g = -0.59, indicating the findings remain robust.
CAT demonstrates promise in alleviating stress and anxiety among university students. Despite methodological variations and potential publication bias, the findings suggest that CAT may offer a feasible and accessible approach to enhancing mental well-being within university environments. Further studies are necessary to examine factors influencing methodological diversity and refine the integration of CAT within university settings.
由于全球大学生心理健康问题的高患病率，犬辅助疗法（CAT）已成为一种潜在的干预措施，以减轻学生的压力和焦虑。本研究系统地回顾并荟萃分析了CAT对降低大学生压力和焦虑水平的影响。
遵循PRISMA 2020指南，我们在多个数据库（APA PsycINFO、PubMed、杜克大学图书馆、中国知网、万方和谷歌学术）中进行了系统检索，以查找以英文和中文发表的随机对照试验。仅纳入了包含专业训练的犬和训练员的研究。两名评审员（SS和ZL）独立提取数据，并使用Cochrane偏倚风险2工具评估偏倚风险。使用随机效应荟萃分析汇总效应量（Hedges' g），以考虑预期的临床和方法学异质性。进行亚组分析以探索干预持续时间、基线压力水平和对照条件类型等调节因素。使用漏斗图、Egger检验和修剪填充分析评估发表偏倚。
在290项已识别的研究中，15项符合纳入标准，14项纳入荟萃分析。荟萃分析得出的总体效应量在统计学上具有显著意义，g = -0.67（p <.001），表明接受CAT的大学生的压力和焦虑有适度降低。森林图显示各研究的效应量范围约为-1.34至-0.13。尽管观察到显著的异质性，但亚组分析表明，CAT对基线压力和焦虑水平较高的学生更有效。漏斗图不对称表明可能存在偏倚，但Egger检验不显著。修剪填充分析推算出两项缺失研究，将合并效应调整为g = -0.59，表明研究结果仍然稳健。
CAT在减轻大学生压力和焦虑方面显示出前景。尽管存在方法学差异和潜在的发表偏倚，但研究结果表明，CAT可能为改善大学环境中的心理健康提供一种可行且可及的方法。有必要进一步研究影响方法学多样性的因素，并完善CAT在大学环境中的整合。
