Animal Visitation's Impact on Depression in Elderly Patients

This report analyzes the effectiveness of animal visitation as a therapeutic intervention for reducing depression in elderly patients. It begins with an introduction to animal visitation and its benefits, followed by a clinical question formulated using the PICO framework. The report outlines the search strategy employed, including the electronic databases used (Cochrane Library, PubMed Central, and CINAHL Plus) and the key search terms and inclusion/exclusion criteria. The core of the report comprises summaries and critical appraisals of three articles: "The Benefit of Pets and Animal-Assisted Therapy to the Health of Older Individuals," which explores the positive effects of animal interaction, "Psychosocial and Psychophysiological Effects of Human-Animal Interactions: The Possible Role of Oxytocin," which discusses the physiological mechanisms underlying these interactions, and "Animals in Healthcare Facilities: Recommendations to Minimize Potential Risks," which addresses the potential risks associated with animal visitation. The report concludes by summarizing the key findings and emphasizing the relevance of animal visitation in improving the mental health of elderly patients. This report highlights how animal visitation can be an effective intervention to reduce depression levels in elderly individuals. The report also evaluates the strengths, limitations, and the impact of findings from the articles.

Nursing: Animal Visitation

TABLE OF CONTENTS
INTRODUCTION ..........................................................................................................................3
CLINICAL QUESTION USING PICO STRATEGY ....................................................................3
Clinical Question: How is animal visitation effective in reducing depression in elderly
patients?.......................................................................................................................................3
SEARCH STRATEGY ...................................................................................................................4
Article 1- “the benefit of pets and animal-assisted therapy to the health of older individuals”......6
ARTICLE 2- “Psychosocial and Psychophysiological Effects of Human-Animal Interactions:
The Possible Role of Oxytocin”......................................................................................................8
ARTICLE 3- “Animals in Healthcare Facilities: Recommendations to Minimize Potential Risks”
........................................................................................................................................................10
CONCLUSION .............................................................................................................................11
REFERENCES..............................................................................................................................13
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INTRODUCTION
Animal visitation is a technique which is used by medical practitioners to aid the
recovery process of patients especially those who suffer from physical or mental disability. Often
there are situations when people who have to reside in the hospital for a long time experience
depression and loneliness because of the internal atmosphere. The use of animal visitation as a
remedial process helps in reducing this depression (Cevizci and et.al., 2013). This assessment
portrays three articles which provide evidence that animal visitation is quite effective in treating
depression amongst elderly patients. These three articles include “The Benefit of Pets and
Animal-Assisted Therapy to the Health of Older Individuals”, “Psychosocial and
Psychophysiological Effects of Human-Animal Interactions: The Possible Role of Oxytocin” and
“Animals in Healthcare Facilities: Recommendations to Minimize Potential Risks”.
CLINICAL QUESTION USING PICO STRATEGY
PICO framework is used in nursing practises for developing a clinical question which can
also be associated with health care. The abbreviation PICO is used for Patient, problem or
population, I for Intervention, C- Comparison, control or comparator and O for Outcome. For the
present study following are the attributes applicable as per the PICO framework:
P stands for The concerned population is elderly patients irrespective of their nature of suffering.
I stands for Intervention provided for treating elderly patients is animal visitation.
C stands for There is no comparison taken into consideration for this research.
O stands for Reduction of depression in elderly patients when provisioned animal visitation
(Kamioka and et. al., 2014).
The clinical question or health care related question developed according to this
framework is depicted as follows:
Research Question: How is animal visitation effective in reducing depression in elderly patients?
With growing developments in technology, medical science has evolved greatly. Modern
day civilisation holds cures for major disabilities and diseases that were a curse earlier. The
proposed clinical question depicts a new technique or intervention which is gaining popularity
due to its effectiveness. Animal visitation involves the use of animals especially dogs for making
the healing process of elderly patients faster (Murthy, R. and et. al., 2015).
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SEARCH STRATEGY
The essence of research is completely linked with the methodology that is adopted for
conducting the specific research. There are certain elements which need to be considered before
performing the study. Following elements determine the search strategy that was adopted to
analyse the clinical question developed from PICO framework.
Electronic Search:
The entire research work has been presented by accessing resources that are available
over the electronic libraries or databases. These are accessible through the internet and the
articles that are to be evaluated ahead are acquired through these sources. Following databases
were utilised for conducting the research of articles and journals with relevance to the topic.
Below are the database used for researching the present topic:
The Cochrane Library consists of different types of articles which are majorly associated with
health care and medical science. The articles and journals are provided by the collaboration
which exists between Cochrane and many other organisations (About Us, 2017).
PubMed Central is a kind of digital repository which provides wide variety of articles with
scholarly grade for the public with subject of biomedical sciences. This database consists of
more than 2.9 million articles which indicates towards a wide range of sources.
CINAHL Plus is known as Cumulative Index of Nursing and Allied Health Literature which is
one of the widest or largest database that consists of in-depth nursing research with about 5000
journals.
The above described databases were considered for performing searches and collecting
the respective articles of this study. It is important to get authentic information which is possible
only when there is valid and authentic platform to conduct the research.
Key Search Terms:
Key search terms are basically words or search elements that help in performing the
research more specifically and accurately. The topic of this research is animal visitation and its
effectiveness in reducing depression amongst elder patients has certain key search terms. The use
of such words and elements helps in reducing the redundancy errors which can hamper the
authenticity of information acquired. The following key search terms had been developed for this
comprehensive research and to acquire respective articles:
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Term 1 used are Animal Visitation, animal assisted therapy, Human animal interaction.
Term 2 used are Elderly, old.
Term 3 used are Depression, mental disorders.
Inclusion and Exclusion Criteria:
There has to be certain criteria which can be utilised for performing the research and
collecting the right journals and articles. This type of criteria are called exclusion and inclusion.
The accuracy and precision of research can be obtained only when there is proper elaboration of
the respective criteria and element that needs to be incorporated into the research. The articles for
the present topic i.e. Reduction of depression in elderly people through animal visitation had
following inclusion and exclusion criteria:
Inclusion criteria
The proposed research has been performed in English language. The Time period for selecting
the articles is from 2010-2017.The research is associated with animal visitation and animal
assisted therapy.
Exclusion criteria
No other language can be considered for the research. Articles and journals before 2010 would
bot be considered. Any information source other than the topic cannot be taken for consideration.
English language is considered as the primary language for conducting the research. It is
quite familiar with the researcher. The articles belonging to this particular language can only be
considered for research. Hence, it is considered as the inclusion criteria. With time, the
information collected over research is advanced by some other researchers with better findings.
Hence, it becomes important to consider a time period for selecting the articles and collecting the
information. The use of articles in the time period 2010 – 2017 is considered as the inclusion
criteria and articles before 2010 are excluded. Furthermore, the topic is “How is animal visitation
effective in reducing depression in elderly patients?”. This has to be the inclusion criteria and
any sort of article or journal beyond the boundaries of article are considered to be excluded.
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ARTICLE 1
Cherniack, E. P. and Cherniack, R. A., 2014, 'The Benefit of Pets and Animal-Assisted Therapy
to the Health of Older Individuals', Current Gerontology and Geriatrics Research, vol 2014. pp:
9.
Summary:
Innovation reached an advanced stage when medical practitioners involved the use of pet
assisted therapy or animal visitation in treating the health issues of elderly individuals. It is quite
unusual to think of an intervention which marks the use of pets (Bernabei and et. al., 2013). The
article enfolds this mysterious intervention and elaborates the benefits which further come up
when provided as a therapy to older individuals. The use of animals is mainly for depression and
schizophrenia. People experience social isolation when they suffer from a disease especially a
mental one. The consequences of this kind of isolation is increasing activity of depression and
lower indulgence towards livelihood experiences (Cherniack and Cherniack, 2014). Pets provide
great relief to feelings of isolation and cures boredom.
Through this article, the pets that are majorly considered as part of the therapy include
cats, dogs and birds. The potential benefits or advantages of using animals as an assistance has
positive effects on mental health (Cherniack and Cherniack, 2014). This is directly in relation
with depression. The evidence of this particular fact is provided by the findings of trials that
were conducted in two nursing homes of US. Additionally, another trial was conducted with
regards to patients suffering from dementia and fishes were used for therapeutic purpose for
them. About 62 elders were considered and the results depicted that people were able to socialise
in a better way as compared to those who were not the part of research. Several findings
directing towards the benefits of using pets in the research are also provided in the article.
Despite of these many advantages, the there is significant description of the harms of animals
when used in medical interventions. One major threat is bites and transfer of diseases from
animals to owners/patients (Cherniack and Cherniack, 2014).
Critical appraisal:
The authors have presented analytical data in context of the use of pets like cats, dogs,
animals, goats or fishes for assisting in the healing process of elderly patients that are suffering
from mental unhealthiness. It is commendable to state that there is practical elaboration of the
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facts which support the subject. However, there is no wide scale acceptance of use of pet animals
for improving the mental conditions of elderly patients. Despite of the drastic improvements and
benefits experienced by researchers in the condition of patients, there is a continuous threat that
canines might be dangerous for the patient itself in many ways. On the contrary, the article has
provided certain facts and figures of the investigative trials that were conducted in US for getting
knowledge about the subject.
Strengths and limitations:
The strength of this research work is there is great amount of information which is
sufficient enough to understand the diverse effects that come up with use of animal assisted
therapies. On the contrary, the research doesn't have in-depth understanding about the
consequences which can arise if a depressed elderly individual is subjected to animal assisted
therapy. Hence, the authors can consider better information depiction so that no particular aspect
is left unexplored.
Relevance and impact of findings:
The effect or benefits of animal visitation on the mental and psychological health of elder
patients has been depicted in the article “The Benefit of Pets and Animal-Assisted Therapy to the
Health of Older Individuals” (Cherniack and Cherniack, 2014). Through the information
acquired from the provided article, the clinical question and topic are quite justified. There is
significant reduction in the depression levels of elder people when they are provided animal
based intervention.
Research Terms:
The major research term which is used in this article is animal assisted intervention. It
refers to the intervention that involves the use of animals for helping humans in their daily chores
and activities. Holt, Johnson and Brenner (2015) accounted that psychiatric disorders and mental
patients are more benefited through use of animal assisted interventions.
ARTICLE 2
Beetz, A. and et. al., 2012, 'Psychosocial and psychophysiological effects of human-animal
interactions: the possible role of oxytocin', Clinical and Health Psychology, vol. 3, no. 234.
Summary:
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The use of animals in health and social care services was not so popular in the earlier
times like it is currently. This development has taken place in the past decade. There is a review
of 69 original studies that are completely based on the interactions of human beings with
animals. This is also referred as HAI i.e. Human-animal interactions (Beetz and et. al., 2012).
The patients suffering from mental health conditions suffer not only from the internal
consequences of their bodies but also get affected by certain barriers like societal beliefs, stress,
anxiety and the interpersonal interactions which exist between them and the associated people.
Through this article, the patients suffering from cardiovascular diseases and certain mental and
physical health disorders have been taken into consideration (Beetz and et. al., 2012).
Despite of the fact that animals cannot communicate their emotions and feelings, there
are large number of advantages provided by these kinds of interactions i.e. HAI. There are very
few evidences present in the form of researches which indicates towards the positive effects of
increasing animal interaction with humans that are suffering from mental and physical health
incapabilities (Bert, Gualano and Siliquini, 2016). However, the areas of application of animal
assisted therapies include stress management, improvements in the functioning of immune
system, reduction in fear and anxiety, etc. The major advantage which is acquired from this type
of interaction is the psychological and psychophysiological development visible in the elderly
individuals that are provided animal assisted therapy.
Oxytocin one of the key hormone system in the human body is released when the brain
experienced positive attributes (Cevizci and et.al. 2013). It is helpful for the patients to have
greater release of this particular hormone so that their recovery can be advanced. The trustful or
trustworthy relationships are much of contributor to this hormone. This article has presented the
effects of HAI on oxytocin and reduction in mental disorders and depression (Beetz and et. al.,
2012).
Critical appraisal:
The authors have well presented the research with broader classification of the subject.
The information acquired in this article is widely helpful in undermining the biological facts
which are associated with the introduction of animal assisted therapies (Beetz, and et. al., 2012).
Furthermore, there is effective elaboration of the facts and figures which are useful for the study
and reduces the barriers to understanding with clear communication. The authors have provided
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effective conclusion which indicates towards development of a thought process with regards to
animal assisted interactions.
Strengths and limitations:
The key strength of this research work is the accurate declaration of information and the
inclusion of diversified effects which are catered when human beings interact with animals on a
therapeutic basis. The use of this information is very much supportive and provides
authentication for the researcher to understand the application of AAT.
Relevance and impact of findings:
This article is largely relevant in contributing to the findings of the concerned research.
The impact of the findings acquired from the article is quite positive. A large number of facts
have been unveiled which further help in understanding the effect which animal-assisted
interventions can have on the psychological development of the patient. Elderly individuals will
be largely benefited if such type of therapeutic measure is introduced for their intervention (Fick,
2015).
Research Terms:
The major research terms associated with this article include animal assisted therapies,
human-animal interactions and oxytocin. Oxytocin is the hormone which is released in the
circulatory system when individuals experience trustworthy relationships and atmosphere (Fine,
2015). It is a kind of developmental hormone that helps in stimulating the recovery process. On
the other hand, the human-animal interactions are considered as basic interactions amongst
human beings and animals (Nordgren and Engström, 2014).
ARTICLE 3
Murthy, R. and et. al., 2015, 'Animals in Healthcare Facilities: Recommendations to Minimize
Potential Risks', Inspection Control and Hospitality Epidemiology, vol. 36, no. 5.
Summary:
Healthcare facilities are developed for providing assistance to the patients so that their
state of unhealthiness can be improved. The inclusion of animals in this set up was considered as
a senseless and unusual approach (Murthy and et. al., 2015). But right from the beginning of
time, pets have been of great use to human beings. The present article indicates the inclusion of
animals in healthcare facilities like care hospitals and ambulances. Patients that have sight
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impairment or are subjected to certain mobility based diseases are assisted by dogs. But the
major risk which orients with this kind of facilitation is transmission of diseases either directly or
indirectly. The article presents the risks which are associated with the patients when animals are
introduced in the healthcare system (Murthy and et. al., 2015).
The article is presented as a collection of practical opinions which have been acquired
after considering the healthcare epidemiology. A review of the policies and procedures which are
submitted by the healthcare facilities is also provided by the authors of this article. This includes
depiction of the animal-assisted programs and personal per visitation (Smits, Anisuzzaman and
Heerink, 2015). There is a basic difference between animal assisted activities and service
animals. This difference is the use of animals that are trained for general interventions but
service animals are specifically trained dogs that function individually (Pope, Hunt and Ellison,
2016). There is broad scale information provided in the article with regards to use in the
healthcare facilities with elaboration of facts and figures. Different types of animals and their
broad classification in terms of application has been discussed in the article (Murthy and et. al.,
2015).
Critical appraisal:
The authors have performed quite a well versed research with authentic information and
more analytical characteristics. The use of this information is largely helpful in areas which
aspire to use animals for further medical assistance to patients in a healthcare facility. However,
this broad information is not presented in a compact form. Despite of this fact, the authors are
able to communicate that inclusion of animals as a supportive element in the healthcare facility
will be largely beneficial in improving the situation.
Strengths and limitations:
The major strength of this article is the specific information that has been provided
regarding different types of animal groups and their application. Furthermore, there is quite
elaborate presentation of several researches which had been conducted by different authors with
regards to the subject so that animal assistance can be adopted. However, there is only direct
portrayal of the results obtained from the survey that was conducted to generate the response of
members of SHEA on Animal based healthcare facilities. There is no much description of impact
which occurs when there is increase in animal visitation for elderly people with depression.
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Relevance and impact of findings:
The findings of the survey that was conducted by authors of this article are quite helpful
in evaluating whether the inclusion of animal assisted techniques in healthcare facilities shall be
performed or not (Zsoldos, Sátori and Zana, 2014). The impact of these findings definitely helps
in generating an insight regarding the validity of clinical question formed before. Despite of the
fact that elderly patients with specific disabilities can be provided good care and support through
service animals, the article becomes quite less relevant (Sehr, Eisele-Hlubocky and Gaehle,
2013). The information of this article is helpful in understanding only the different aspects which
occur when aligning healthcare facilities with animal assistance.
Research Terms:
The research term associated with this article is Animals in HealthCare. This type of
inclusion is known as research based therapy and is gaining momentum because of the
innovative nature (Mayo-Wilson, Grant and Montgomery, 2014). There are different types of
animals i.e. service animals, therapy animals and emotional animals which are included in the
health care facilitation.
CONCLUSION
This research on the use of animal visitation in reduction of depression in the elderly
people is assisted by the informative evidences provided in the three articles “The Benefit of Pets
and Animal-Assisted Therapy to the Health of Older Individuals” (Cherniack and Cherniack,
2014), “Psychosocial and Psychophysiological Effects of Human-Animal Interactions: The
Possible Role of Oxytocin” (Beetz and et. al., 2012) and “Animals in Healthcare Facilities:
Recommendations to Minimize Potential Risks” (Murthy and et. al., 2015). The use of this
information has helped in gaining an understanding that when people suffer from mental disorder
like depression, the main thing they require is a company which is friendly and compassionate.
Animals have proven to be man's best friend since ages. The use of animal assisted therapies in
enhancing the recovery process for such socially isolated individuals is highly useful. From the
findings of these articles and cited resources, it can be inferred that the use of animal-assisted
therapies aids the intervention process.
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REFERENCES
Books and Journals
Bernabei, V. and et. al., 2013, 'Animal-assisted interventions for elderly patients affected by
dementia or psychiatric disorders: a review', Journal of psychiatric research, vol 47, no 6,
pp.762-773.
Bert, F., Gualano, M. R. and Siliquini, R., 2016, 'Animal assisted intervention: A systematic
review of benefits and risks', European Journal of Integrative Medicine', vol. 8, no 5, pp.695-
706.
Cevizci, S. and et.al. 2013, Animal Assisted Therapy and Activities in Alzheimer's Disease,
INTECH Open Access Publisher, Turkey.
Fick, J. L., 2015, Teachers' and principals' perceptions of animals as pets and animal-assisted
therapy in an educational setting, Sam Houston State University, Houston.
Fine, A. H. ed., 2015, Handbook on animal-assisted therapy: Foundations and guidelines for
animal-assisted interventions, Academic Press, United Stated of America.
Holt, S., Johnson, R. A. and Brenner, C., 2015, 'Animal assisted activity with older adult
retirement facility residents: The PAWSitive visits program', Activities, Adaptation & Aging, vol
39, No 4, pp.267-279.
Kamioka, H. and et. al., 2014, 'Effectiveness of animal-assisted therapy: A systematic review of
randomized controlled trials.'Complementary therapies in medicine, vol 22, no 2, pp.371-390.
Mayo-Wilson, E., Grant, S. and Montgomery, P., 2014, 'Preventive home visits for mortality,
morbidity, and institutionalization in older adults: a systematic review and meta-analysis', PloS
one, Vol 9,No 3, p.e89257.
Nordgren, L. and Engström, G., 2014, 'Animal-assisted intervention in dementia: effects on
quality of life', Clinical nursing research, vol. 23, No. 1, pp.7-19.
Pope, W. S., Hunt, C. and Ellison, K., 2016, 'Animal assisted therapy for elderly residents of a
skilled nursing facility', Journal of Nursing Education and Practice, Vol 6, no. 9, p.56.
Sehr, J., Eisele-Hlubocky, L. and Gaehle, K., 2013, 'Family pet visitation', AJN The American
Journal of Nursing, Vol. 113, no. 12, pp.54-59.
Smits, C., Anisuzzaman, S. and Heerink, M., 2015, 'Towards practical guidelines and
recommendations for using robotics pets with dementia patients', Canadian International Journal
of Social Science and Education, vol 3, pp.656-670.
Zsoldos, A., Sátori, Á. and Zana, Á., 2014, 'Impact of animal-assisted intervention on
rehabilitation of patients with spinal cord injury', Orvosi hetilap, Vol 155, no. 39, pp.1549-1557.
Article 1:
Cherniack, E. P. and Cherniack, R. A., 2014, 'The Benefit of Pets and Animal-Assisted Therapy
to the Health of Older Individuals', Current Gerontology and Geriatrics Research, vol 2014. pp:
9.
Article 2:
Beetz, A. and et. al., 2012, 'Psychosocial and psychophysiological effects of human-animal
interactions: the possible role of oxytocin', Clinical and Health Psychology, vol. 3, no. 234.
Article 3:
Murthy, R. and et. al., 2015, 'Animals in Healthcare Facilities: Recommendations to Minimize
Potential Risks', Inspection Control and Hospitality Epidemiology, vol. 36, no. 5.
Online
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About Us, 2017. [Online]. Available Through: <http://www.cochranelibrary.com/>. [Accessed
on 30th May, 2017].
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