Psychological benefits and potential pathogen transmission in hospitalized pediatric oncology patients receiving therapy dog visits: a randomized controlled trial

接受治疗犬就诊的住院儿科肿瘤患者的心理益处和潜在病原体传播：一项随机对照试验

• 批准号: 9322093
• 负责人: Jessica Chubak
• 金额: $ 21.07万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9322093
• 关键词: Adverse event; Alaska; Americas; Animals; Anxiety; Biometry; Cancer Patient; Canis familiaris; Caring; Child; Child Psychology; Clinical Trials; Controlled Study; Data; Distress; Emotional; Ensure; Epidemiology; Evidence based program; Future; Goals; Hand; Hand functions; Happiness; Health; Healthcare; Hospitalized Child; Hospitals; Idaho; Immune system; Infection; Infection prevention; Inpatients; Intervention; Knowledge; Length of Stay; Malignant Childhood Neoplasm; Malignant Neoplasms; Measures; Medical; Medical center; Mental Health; Methods; Microbiology; Montana; National Institute of Child Health and Human Development; Nosocomial Infections; Outcome; Pacific Northwest; Pain; Patient Outcomes Assessments; Patient risk; Patients; Pediatric Hospitals; Pediatric Oncology; Pilot Projects; Population; Populations at Risk; Prospective Studies; Provider; Publishing; Randomized; Randomized Controlled Trials; Research; Research Activity; Risk; Safety; Societies; Standardization; Stress; Surveys; Testing; Therapeutic Intervention; United States; Veterinary Medicine; Visit; Washington; Work; aged; arm; cancer care; clinical practice; coping; design; effective intervention; efficacy study; evidence base; experience; high risk; improved; instrument; microbial; named group; pathogen; primary outcome; programs; prospective; psychologic; psychosocial; satisfaction; secondary outcome; transmission process; treatment as usual

PROJECT SUMMARY Strategies to improve the psychological health of children with cancer are greatly needed. Pediatric oncology patients are a special population because of their often long and frequent hospital stays and because of their compromised immune systems. Pilot data suggest that therapy dog visits can reduce distress in this population. However, concerns about risk of infection are barriers to implementing animal-assisted activities (AAA) programs in pediatric oncology settings. No efficacy studies, let alone rigorous randomized controlled trials, have been published on AAA for pediatric oncology inpatients. And no prospective studies have measured pathogen transmission associated with AAA in any setting. The proposed study will rigorously test whether therapy dog visits reduce distress, lower treatment-related anxiety, increase happiness, and improve satisfaction with hospital care in hospitalized children with cancer (Aim 1). This study will also contribute to knowledge about the safety of therapy dog visits by determining whether these visits increase microbial levels on patients’ hands (Aim 2), which could increase infection risk. A randomized controlled trial of 40 pediatric oncology patients (aged 6-17) will be conducted at Seattle Children’s Hospital, a large, quaternary-care medical center in the Pacific Northwest that serves Washington, Alaska, Montana, and Idaho. Patients will be randomized 1:1 to usual care or to the intervention, which will consist of twice-weekly therapy dog visits. Distress and other psychological health outcomes after each visit, at discharge, and 2 weeks post discharge will be assessed using patient surveys with standardized, validated instruments. Microbial levels will be assessed by culturing patients’ hands using a standard method. Rigorous methods for clinical trials (e.g., allocation concealment, intent-to-treat analyses) will be employed to ensure high quality results. This study will provide hospitals and care providers with information needed to make evidence-based decisions about offering therapy dog visits to pediatric oncology inpatients. If this study demonstrates therapy dog visits can improve the psychological health of pediatric oncology inpatients without transmitting pathogens, evidence-based programs could improve cancer-care experiences for children nationwide. If therapy dog visits improve psychological health but transmit pathogens that remain on children’s hands, further research can evaluate strategies to reduce this risk. If therapy dog visits do not reduce distress for pediatric oncology inpatients, future studies can adapt and tailor “active ingredients” from other AAA interventions in other settings. Thus, findings from the proposed study are expected to have a large impact on clinical practice and future AAA research. The proposed study directly responds to the National Institute of Child Health and Human Development’s goal of stimulating rigorous research on animal-assisted interventions for special populations.

项目摘要 非常需要提高癌症儿童心理健康的策略。小儿肿瘤学 患者是特殊人口，因为他们经常长时间住院，并且由于他们的 免疫系统受损。试点数据表明，治疗狗的探访可以减少这种情况 人口。但是，对感染风险的担忧是实施动物辅助活动的障碍 （AAA）小儿肿瘤学环境中的程序。没有效率研究，更不用说严格的随机控制 试验已发表在AAA的儿科肿瘤学住院患者上。并且没有前瞻性研究 在任何情况下，测量与AAA相关的病原体传播。拟议的研究将严格测试 治疗狗的访问是否减轻了困扰，降低治疗相关的焦虑，增加幸福感并改善 对住院儿童癌症儿童的医院护理满意（AIM 1）。这项研究也将有助于 通过确定这些访问是否会增加微生物水平，了解治疗狗访问的安全性 在患者的手上（AIM 2），这可能会增加感染风险。 40个小儿的随机对照试验 肿瘤学患者（6-17岁）将在西雅图儿童医院进行，这是一个大型的第四纪护理 西北太平洋的医疗中心为华盛顿，阿拉斯加，蒙大拿州和爱达荷州提供服务。患者会 将1：1随机分配给通常的护理或干预措施，其中包括每周两次治疗狗的访问。 每次访问，出院和出院后2周后，遇险和其他心理健康成果 将使用具有标准化的，经过验证的工具的患者调查进行评估。微生物水平将是 使用标准方法通过文化患者的手评估。严格的临床试验方法（例如， 分配隐藏，意图对治疗分析）将被雇用以确保高质量的结果。这项研究会 为医院和护理提供者提供有关提供循证决策所需的信息 治疗狗探访儿科肿瘤学住院患者。如果这项研究表明治疗狗的访问可以改善 小儿肿瘤学住院患者的心理健康，没有传播病原体，基于证据 计划可以改善全国儿童的癌症护理经历。如果治疗狗的访问有所改善 心理健康，但仍保留在儿童手上的病原体，进一步的研究可以评估 降低这种风险的策略。如果治疗狗的访问不会减少儿科肿瘤学住院患者的困扰，则 未来的研究可以从其他环境中其他AAA干预措施中适应和量身定制“主动侵害”。那， 拟议研究的发现预计将对临床实践和未来AAA产生重大影响 研究。拟议的研究直接回应了国家儿童健康与人类研究所 发展的目标是刺激对特殊人群的动物辅助干预措施进行严格研究。