Heart Failure
Conditions
Keywords
animal-assisted therapy, dog hospital visit, heart failure
Brief summary
Effects of complementary therapies on heart failure, a leading cause of hospitalization, are unknown. Animal-assisted therapy improves physiological and psychosocial variables in healthy and hypertensive subjects. The purpose of this study was to determine whether a 12-minute hospital visit with a therapy dog improves hemodynamics, lowers neurohormone levels, and decreases state anxiety in patients hospitalized with heart failure.
Detailed description
Context: Effects of complementary therapies on heart failure, a leading cause of hospitalization, are unknown. Animal-assisted therapy improves physiological and psychosocial variables in healthy and hypertensive subjects. Objectives: To determine whether a 12-minute hospital visit with a therapy dog improves hemodynamics, lowers neurohormone levels, and decreases state anxiety in patients hospitalized with heart failure. Design, Setting, Participants: A 3-group (volunteer-dog team, volunteer only, and control) randomized repeated-measures experimental design was used in 76 adult patients with advanced heart failure hospitalized between November 2001 and July 2004. Longitudinal analysis was used to model differences among the 3 groups at 3 time points. Interventions: One group received a 12-minute visit from a volunteer with a therapy dog, another group received a 12-minute visit from a volunteer, and the control group received usual care, at rest. Data were collected at baseline, 8 minutes after the intervention started, and 16 minutes (4 minutes after intervention ended). Main Outcome Measures: Blood pressure, heart rate, pulmonary artery pressure, pulmonary capillary wedge pressure, right atrial pressure, cardiac index, systemic vascular resistance, plasma levels of epinephrine and norepinephrine, and state anxiety. Results: Compared with the control group, patients visited by a volunteer-dog team showed significantly greater decreases in pulmonary artery pressure during (5.34, P = .003) and after (5.78, P = .001) the intervention, pulmonary capillary wedge pressure during (3.09, P = .02) and after (4.31, P = .002) the intervention, and epinephrine (17.54, P = .04) and norepinephrine (240.14, P = .02) levels during the intervention. After the intervention, patients visited by the volunteer-dog team showed the greatest decrease in state anxiety over patients visited by a volunteer only (6.65, P = .003) and the control group (9.13, P \< .0001). Conclusions: Animal-assisted therapy improves cardiopulmonary pressures, neurohormone levels, and anxiety in patients hospitalized with heart failure.
Interventions
BEHAVIORALAnimal-assisted Therapy
Sponsors
Pet Care Trust
University of California, Los Angeles
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* diagnosis of heart failure requiring medical management with an indwelling pulmonary artery catheter * age between 18 and 80 years * ability to read, write, and speak English * mental status: alert and oriented to person, place, and time * SVR greater than 1200 dyne · sec · cm-5 at least once within 12 hours from the start of data collection
Exclusion criteria
* SVR less than 1200 dyne · sec · cm-5 * allergies to dogs * immunosuppression, defined as a white blood cell count of less than 4500 cells/mm3 * infection as determined by an elevated white blood cell count exceeding 11,000 cells/mm3 * body temperature greater than 38ºC * decreased level of consciousness
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| heart rate | — |
| pulmonary artery pressure | — |
| Blood pressure | — |
| pulmonary capillary wedge pressure | — |
| right atrial pressure | — |
| cardiac index | — |
| systemic vascular resistance | — |
| plasma levels of epinephrine | — |
| plasma levels of norepinephrine | — |
| state anxiety | — |
Countries
United States
Outcome results
None listed