Evaluating the Effects of Animal Therapy on Anxiety in Pediatric Dental Patients

评估动物疗法对小儿牙科患者焦虑的影响

• 批准号: 10649010
• 负责人: Laura Anne Jacox
• 金额: $ 15.41万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2025-07-14
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10649010
• 关键词: Adult; Adverse event; Affect; Age; Anesthesia procedures; Animals; Anxiety; Appointment; Arousal; Behavior; Behavioral; Biometry; Canis familiaris; Caregivers; Caring; Cessation of life; Child; Childhood; Clinical Trials; Code; Collaborations; Computer software; Data; Data Analyses; Dementia; Dental; Dental Anxiety; Dental Care; Dentistry; Dentists; Devices; Diagnostic; Discipline; Elderly; Emergent care; Emotional; Ensure; Evaluation; Exhibits; Facial Pain; Faculty; Fright; Funding; Future; Galvanic Skin Response; General Anesthesia; Health; Heart Diseases; Heart Rate; Hormones; Hospitalization; Hydrocortisone; Individual; Infection; Inpatients; Intervention; Intravenous; Lead; Learning; Licensing; Literature; Malignant Neoplasms; Measurement; Measures; Medical; Methodology; Minor; Movement; Nervous System Trauma; Oral; Oral health; Outcome; Outpatients; Pain; Parents; Pathological anxiety; Patient Self-Report; Patients; Pediatric Dentistry; Perception; Persons; Physiological; Population; Preventive treatment; Protocols documentation; Public Health; Qualifying; Quality of life; Questionnaires; Randomized; Risk; Salivary; Sampling; Sedation procedure; Stress; Surveys; Techniques; Testing; Therapeutic; Therapeutic Intervention; Toothache; Training; Visit; Work; active control; adverse event risk; age group; alpha-amylase; animal efficacy; animal-assisted therapy; anxiety management; anxiety reduction; cohort; comparison control; expectation; experience; health care settings; health related quality of life; improved; innovation; novel; pain perception; pediatric patients; pharmacologic; protocol development; randomized, clinical trials; response; restraint; saliva sample; sedative; self-reported anxiety

ABSTRACT. Dental anxiety (DA) affects a striking 50-80% of adults and 6-22% of children. Individuals affected by DA often exhibit disruptive behavior and avoidance of dental care, leading to major adverse health outcomes, including increased rates of decay, pain, extractions, infections, emergent care and even hospitalization. DA frequently develops in childhood due to traumatic experiences and can lead to lifelong DA. Behavioral management techniques aimed at improving dental experiences must be employed during childhood to avoid these sequelae. For patients with severe anxiety and decay, pharmacological interventions may be used. However, sedatives and general anesthesia are frequently met with caregiver objections, as they carry low risks for adverse events, including neurological injury and death. Animal-Assisted Therapy (AAT) with a trained therapy dog has been used widely as a non-pharmacologic behavior guidance approach in numerous medical settings. Though in its nascent stages in dentistry, the novel use of AAT in a pediatric population holds promise for behavior management, reducing anxiety, mitigating pain, and creating positive associations. Furthermore, our data from 800 patients and parents confirm a pervasive desire for canine AAT in dentistry. The objective of this study is to evaluate whether AAT alleviates stress and improves perceptions during pediatric dental care. We hypothesize that AAT significantly alleviates biometric and self-reported measures of anxiety and pain in pediatric dental patients (with relative measure improvements of >20%). We propose to evaluate effects of AAT on objective measures of stress and pain during preventative treatment using salivary stress hormones, heart rate, sweat response, and observational coding data (Aim 1) along with patients' perceptions of dental pain, anxiety, and future visits with validated questionnaires (Aim 2). As part of an ongoing randomized clinical trial, data are collected from patients (age 4-7 years) randomized to a short AAT protocol, a long AAT protocol and an active control with a dental exam and cleaning (N=180, 60 per group). Altogether, data generated from these aims will be used to measure the impact of AAT on pediatric dental patients to guide implementation. This secondary data analysis project will generate results on feasible, rapidly implementable protocols for AAT use in dentistry to mitigate DA and improve experiences, to reduce dental avoidance and its significant health sequelae. Our interdisciplinary team is uniquely qualified to conduct the proposed work as we have the innovative methodologies, RCT patient data and samples, BLS2 facilities, and expertise to achieve our aims. This application includes collaboration between experienced and junior faculty across multiple disciplines to ensure the rigor and translatability of our findings.

抽象的。 牙科焦虑症 (DA) 影响着 50-80% 的成年人和 6-22% 的儿童。经常受到 DA 影响的个人 表现出破坏性行为和回避牙科护理，导致重大不良健康后果，包括 腐烂、疼痛、拔牙、感染、紧急护理甚至住院率增加。经常DA 由于创伤经历而在童年时期形成，并可能导致终生 DA。行为管理 必须在儿童时期采用旨在改善牙科体验的技术，以避免这些问题 后遗症。对于严重焦虑和衰弱的患者，可以使用药物干预。然而， 镇静剂和全身麻醉经常遭到护理人员的反对，因为它们的风险较低 不良事件，包括神经损伤和死亡。经过训练有素的动物辅助治疗 (AAT) 狗已被广泛用作许多医疗环境中的非药物行为指导方法。 尽管 AAT 在牙科领域还处于起步阶段，但在儿科人群中的新应用有望为 行为管理，减少焦虑，减轻疼痛，并建立积极的联系。此外，我们的 来自 800 名患者和家长的数据证实了牙科领域对犬类 AAT 的普遍渴望。此举的目的 该研究旨在评估 AAT 是否可以减轻儿科牙科护理期间的压力并改善认知。我们 假设 AAT 显着减轻生物特征和自我报告的焦虑和疼痛测量 儿科牙科患者（相对测量改善 >20%）。我们建议评估以下措施的影响 AAT 使用唾液应激激素进行预防性治疗期间压力和疼痛的客观测量， 心率、出汗反应和观察编码数据（目标 1）以及患者对牙科的看法 通过经过验证的问卷来了解疼痛、焦虑和未来就诊（目标 2）。作为正在进行的随机临床的一部分 试验中，数据收集自随机接受短 AAT 方案、长 AAT 方案的患者（4-7 岁） 以及进行牙科检查和清洁的主动对照组（N=180，每组 60 人）。总而言之，数据生成自 这些目标将用于衡量 AAT 对儿童牙科患者的影响，以指导实施。 该二次数据分析项目将为 AAT 提供可行且可快速实施的协议结果 在牙科中的使用可减轻 DA 并改善体验，减少牙科回避及其对健康的重大影响 后遗症。我们的跨学科团队具有独特的资格来开展拟议的工作，因为我们拥有 创新方法、RCT 患者数据和样本、BLS2 设施以及实现我们目标的专业知识。 该应用程序包括跨多个学科的经验丰富和初级教师之间的协作 确保我们研究结果的严谨性和可翻译性。