The aim of this phenomenological qualitative study was to capture and understand the essence of the lived experiences of individuals after participating in equine facilitated psychotherapy (EFP). In that the experiences of participants after exposure to EFP have not previously been examined, this study adds to the literature on this innovative therapy. Theoretical viewpoints on animal assisted therapy and solution-focused brief therapy (SFBT) were explored, as well as how the SFBT methodology compares to techniques used in EFP. Using interviews, the study involved capturing participants' experiences by collecting their descriptions of their involvement with EFP, identifying the specific experiences they noted, ascertaining what the participants did with these experiences, and discerning themes or patterns in the interview data. A purposive sample of 10 adults who had participated in EFP participated in interviews, the data from which were analyzed by hand coding. Analysis showed improved quality of life with improvements in overall well-being and in participants' relationships. The findings of this research study may lead to additional research in this area and may promote the establishment of consistent techniques in EFP, proper credentialing of those who use EFP, and applicable regulatory standards. By exploring the lived experiences of individuals who have participated in EFP, providers may be able to delve more deeply into the curative factors that may be at work with this type of therapy.

No description available.

Children with neurodevelopmental disorders (NDDs) tend to experience restricted social participation and therefore require support in this area. Animal assisted interventions (AAIs) offer a complementary or alternative intervention approach for those children. This research aimed at investigating the literature on AAIs in relation to the social participation of children with NDDs. A systematic literature review was conducted in four databases. Based on the PICO framework, search strings and inclusion/exclusion criteria were defined, resulting in the inclusion of eleven articles from seven countries. The selected articles were assessed for quality and data was extracted with the help of an extraction protocol. The majority of research concerned children with autism spectrum disorder, in the context of school, occupational therapy, and other health care and therapy settings. Social participation was assessed primarily through measures of frequency and initiation of social behaviors and interactions. Results of the studies were mixed, with a trend toward a positive effect of AAIs on social participation. Overall, most evidence was found for animal assisted therapy including dogs. The research reflected a lack of protocol for animal-assisted interventions and a need for a clear definition of social participation across research and practice. However, in relation to the International Classification of Functioning, Disability, and Health – Children and Youth version (ICF-CY), AAIs seem to offer a treatment approach that can target several factors simultaneously instead of putting a focus on body functions only. Although this research could not draw any straightforward conclusions, there is clearly an indication that AAIs have a positive potential to impact the social participation of children with neurodevelopmental disorders. / Kinder mit neurologischen Entwicklungsstörungen erfahren oft Einschränkungen in ihrer sozialen Teilhabe und benötigen daher Unterstützung in diesem Bereich. Tiergestützte Interventionen bieten in diesem Fall einen ergänzenden oder alternativen Interventionsansatz. Das Ziel dieser Studie war es, die Literatur über tiergestützte Interventionen in Bezug auf die soziale Teilhabe von Kindern mit neurologischen Entwicklungsstörungen zu untersuchen. Mit Hilfe von vier Datenbanken wurde eine systematische Übersichtsarbeit durchgeführt. Basierend auf dem PICO-Modell wurden Suchbegriffe sowie Einschluss- und Ausschlusskriterien festgelegt, woraufhin elf Artikel aus sieben Ländern in die Arbeit aufgenommen wurden. Die ausgewählten Artikel wurden auf ihre Qualität geprüft und Daten wurden mit Hilfen eines Extraktionsprotokolls gesammelt. Die meisten Studien betrafen Kinder mit Autismus-Spektrum-Störungen, und wurden im Kontext von Schule, Ergotherapie und anderen Gesundheits- und Therapieeinrichtungen durchgeführt. Die soziale Teilhabe wurde in erster Linie durch Messungen der Häufigkeit und der Initiierung von sozialem Verhalten und sozialer Interaktionen bewertet. Die Ergebnisse der Studien waren gemischt, zeigten jedoch die Tendenz einer positiven Wirkung von tiergestützten Interventionen auf die soziale Teilhabe. Insgesamt wurden hauptsächlich Belege für die tiergestützte Therapie mit Hunden gefunden. Die Forschungsergebnisse spiegeln den Mangel an einem einheitlichen Interventionsprotokoll für tiergestützte Interventionen und die Notwendigkeit einer klaren Definition der sozialen Teilhabe in Forschung und Praxis wider. In Bezug auf die internationale Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit – Kinder- und Jugendversion, scheinen tiergestützte Interventionen jedoch einen Behandlungsansatz zu bieten, der an mehreren Faktoren gleichzeitig ansetzen kann, anstatt sich nur auf Körperfunktionen zu konzentrieren. Obwohl im Rahmen dieser Studie keine eindeutigen Schlussfolgerungen gezogen werden konnten, gibt es eindeutige Hinweise darauf, dass tiergestützte Interventionen das Potenzial haben, die soziale Teilhabe von Kindern mit neurologischen Entwicklungsstörungen zu beeinflussen.

The purpose of this qualitative study was to investigate the experience and knowledge from the implementation of animal-assisted therapy as a health-promoting method in nursing homes. This study used a qualitative method with an inductive approach. To collect data, four semi-structured interviews were conducted. The respondents of this study were selected by a meaningful sampling method. The inclusion criteria were that the nursing homes currently used or had used therapeutic animals. The collected data was analyzed with a content analysis. The results were presented in continues text with quotes from the respondents to validate the findings. The main findings of the study displayed that the reasoning behind the respondent’s willingness to implement animal-assisted therapy in nursing homes was that they had previous positive experience with the effects of therapeutic animals. The respondents highlighted that they experienced that the implementation of therapeutic animals was met with few difficulties.  The conclusion of the study was that nursing homes were dependent on receiving therapeutic animals in form of donations to implement them. Lack of funding may be an underlying factor why therapeutic animals have not been implemented to a greater extent in other nursing homes, despite the health-promoting effects previous studies show. / Syftet med denna kvalitativa studie var att undersöka upplevelser och erfarenheter av implementering av terapidjur som en hälsofrämjande metod på äldreboenden. En kvalitativ metod med en induktiv ansats användes för studien. För att samla in data genomfördes fyra individuella semistrukturerade intervjuer. Urvalet av respondenter till studien gjordes genom ett meningsfullt urval. Inklusionskriteriet för urvalet var att respondenterna hade använt eller använde sig av terapidjur på äldreboendet. För att analysera data genomfördes en innehållsanalys där ett kodningsschema tillämpades. I innehållsanalysen identifierades sex kategorier vilka formades utifrån respondenternas svar. Resultatet presenterades i flytande text med stärkande citat från respondenterna. Resultatet visade att respondenterna hade erfarenheter av en variation av terapidjur; mjukis- och robotdjur, terapihundar, höns, marsvin, kaniner, häst och orm. Huvudresultatet för studien visade att bakgrunden till respondenternas vilja att implementera terapidjur på äldreboenden var att de erhöll kunskap och erfarenheter av de effekter som terapidjur kan ge. Att det ansågs som att något saknades på äldreboenden när det inte fanns terapidjur samt att det bedömdes vara ett behov hos de boende. Möjligheterna för att implementera terapidjur var tack vare bidragande ekonomiska resurser. I sin helhet upplevdes få svårigheter av respondenterna om att implementera terapidjur. Slutsatsen för studien var att äldreboendena var i stor utsträckning beroende av att få terapidjur i form av bidrag för att implementera dem. Brist på bidrag kan vara en bakomliggande faktor till att terapidjur inte har implementerats i större utsträckning på andra äldreboenden, trots de hälsofrämjande effekterna tidigare forskning visar. Denna studie belyser de fördelar som kan upplevas i samband med terapidjur och hur en implementering av terapidjur kan antas. I takt med en ökad livslängd bland befolkningen finns det ett behov av ytterligare hälsofrämjande metoder, där terapidjur är en väl anpassad hälsofrämjande metod för äldres hälsa och ett hälsosamt åldrande.

<p> There has been substantial growth in recent decades in the variety and popularity of roles for dogs assisting humans in professional therapeutic partnerships. Simultaneously, increasingly rigorous research has repeatedly demonstrated the effects of professional human-canine partnerships in remedying important issues of public health among several at-risk populations. Yet, despite these areas of growth, mechanisms of action and predictors of efficacy in the field of human-animal interaction (HAI) remain poorly understood, and the role of human diversity has been rarely discussed. Thus, the present dissertation examines potential mechanisms and diverse predictors in two distinct samples of professional human-canine partnerships, while building the impetus to explore diversity in the HAI field as a whole. For the first three studies (Chapters 2-4), the selected samples of professional human-canine partnerships include military veterans working with psychiatric service dogs to mediate their symptoms of PTSD and healthcare professionals in pediatric hospitals working with facility dogs to benefit their patients. Following the introduction in Chapter 1, the objective of Chapters 2-3 was to examine primary human outcomes in the selected professional canine partnerships. In a crosssectional study of N=198 military veterans with PTSD, Chapter 2 compared PTSD symptom severity between n=112 veterans with service dogs and n=86 veterans on the waitlist to receive service dogs in the future. Next, in a cross-sectional study of N=130 healthcare professionals in pediatric hospitals, Chapter 3 compared job-related well-being and mental health of n=65 professionals working with facility dogs to n=65 working without. Findings suggested benefits to the mental health and well-being of both military veterans with PTSD and pediatric healthcare professionals, which were significantly associated with their professional canine partnerships. Subsequently, the objective of Chapter 4 was to explore how variances within a specific professional canine partnership may suggest predictors and potential mechanisms for the observed human outcomes. Thus, in a longitudinal study of N=82 veterans with PTSD and their service dogs, Chapter 4 explored associations of veterans’ outcomes with veteran-service dog demographics and interactions. Results suggested components of the human-canine partnership which might explain observed human outcomes, including social connections, a calming influence, and strong humananimal bonds. </p>

<p>The attached document contains the dissertation of Clare Jensen, including descriptions of all procedures used in the associated research studies.</p>

Bakgrund: Hästunderstödd terapi, HUT, är en sedan länge existerande vårdform för allehanda besvär. Evidensen för HUT som vårdverktyg har framtill nyligen dock varit svag, men allt fler studier har visat att HUT är en effektiv träningsform för balans och gångförmåga hos barn och ungdomar med CP-skador, förmågor som är tätt förknippade med människors livskvalitet. En diagnos som är lik CP och ofta ger liknande symtom är stroke. Trots likheterna mellan stroke och CP finns inte alls samma mängd evidens för effekten av HUT vid stroke som vid CP. Samtidigt råder det brist på effektiv strokerehabilitering i vissa delar av Sverige. Det är därför av intresse att utvärdera huruvida HUT kan vara ännu ett verktyg att använda vid just strokerehabilitering. Syfte: Att systematiskt granska forskningen och gradera evidensen för effekten av HUT på balans, gångförmåga och livskvalitet hos patienter som tidigare drabbats av en stroke. Metod: Systematisk litteraturstudie av randomiserade kontrollerade studier Resultat: Åtta studier hittades och de visade en förbättrande effekt av HUT på de undersökta områdena. Fem av studierna var av tillräckligt hög kvalitet för att graderas via GRADEstud. Graderingen visade att evidensvärdet var mycket låg för effekt av HUT på gångförmåga, låg för effekt av HUT på livskvalitet, och måttligt hög för effekt av HUT på balans.  Konklusion: På grund av begränsat antal studier och begränsade mätmetoder i dem kan ingen fast slutats dras, mer forskning behövs för att svara på frågeställningarna. / Background: Horse-Assisted Therapy, HAT, has since a long time been used as a health-care-tool for an assorted group of problems. The evidence for HAT as a health-care-tool has until recently been weak, however an increasing number of studies has shown HAT to be an effective way to train balance and gait in children and youths with cerebral palsy, abilities that are closely linked to a persons quality of life. A diagnosis that is similar to CP and often gives similar symptoms is stroke. Despite the similarities between stroke and CP there is far less evidence for the effects of HAT on stroke than there is for that on CP. At the same time some parts of Sweden are lacking in0 ways to rehabilitation-train after a stroke, therefore it is of interest to evaluate whether HAT can be yet another tool to use in stroke-rehabilitation.  Purpose: To systematically review and evaluate the evidence for the effect of Horse-Assisted Therapy on balance, gait and quality of life in patients who earlier has suffered a stroke.  Result: Eight studies were found and showed that HAT has an enhancing effect on the examined values. Five studies were of high enough quality to be graded using GRADEstud. The evidence grading showed a very low evidence grade for the effect of HAT on gait, low for the effect on quality of life, and moderately high for the effect on balance.  Conclusion: Due to a limited number of studies, and limitations in the ways to measure the effect no conclusion can be drawn, more research is needed in order to answer the issues in question.

Bakgrund: Ungefär 130 000–150 000 personer i Sverige lider idag av demenssjukdomar och varje år insjuknar ytterligare ca 20 000–25 000 personer i sjukdomen. Demenssjukdomar innebär en progressiv försämring av kognitiva funktioner, vilket medför symtom som minnesstörningar, rumsliga oförmågor, nedsatta språkförståelser, förlust av inlärda funktioner, nedsatta praktiska förmågor samt beteendeförändringar. Inom omvårdnad av personer med demenssjukdom ska sjuksköterskor utgå ifrån personcentrerad vård som innebär att omvårdnad ska anpassas till personers behov. Enligt nationella riktlinjer är djurassisterade insatser en alternativ omvårdnadsåtgärd som kan användas som verktyg i den personcentrerade vården. Syfte: Syftet var att kartlägga hur personer med demenssjukdom påverkas av djurassisterade insatser. Metod: En allmän litteraturöversikt som inkluderade artiklar av både kvalitativ och kvantitativ metod. Resultat: Djurassisterade insatser hade påverkan på personer med demenssjukdom avseende fysiska funktioner, psykisk hälsa och inom kommunikation. Djuren motiverade till rörelse och aktiviteter, lockade fram positiva känslor, lindrade oro och ångest samt främjade verbal och icke-verbal kommunikation. Genom att använda djurassisterade insatser som oberoende omvårdnadsåtgärd främjades möjligheten för personer med demenssjukdom att erhålla en personcentrerad vård. Slutsats: Djurassisterade insatser påvisade positiv påverkan på personer med demenssjukdom och kan således utgöra ett alternativ av oberoende omvårdnadsåtgärd som kan tillämpas inom personcentrerad vård och omvårdnad. / Background: Approximately 130 000–150 000 people in Sweden are suffering from dementia, and an additional 20 000–25 000 people are diagnosed with the disease yearly. Dementia causes a progressive deterioration of cognitive abilities causing symptoms such as memory disorders, spatial incapacities, language impairment, loss of learned functions, impaired practical skills, and behavioral changes. In nursing people with dementia, nursing should be based on person-centered care, meaning nursing should be based on the individual's needs. According to national guidelines, animal-assisted intervention is an independent nursing intervention, which can be used as a tool within person-centered care. Aim: The aim was to identify how people with dementia are affected by animal-assisted interventions. Method: A general literature review, which included articles of both qualitive and quantitative approaches. Results: People with dementia were affected by animal-assisted interventions in areas such as physical functions, psychological health, and communication. The animals motivated movement and activities, evoked positive emotions, relieved anxiety and promoted verbal and non-verbal communication. Animal-assisted interventions enhanced the possibilities for person-centered care. Conclusion: People with dementia were positively affected by animal-assisted interventions. Animal-assisted intervention is an independent nursing intervention, which can be applied within person-centered care and within nursing.

A sizeable number of U.S. veterans of all ages experience post-traumatic stress disorder (PTSD) which can impact their quality of life; physically, mentally and socially. Consequences of PTSD are associated with physical and emotional disabilities, including ideation of self-harm and even suicide. Increasingly, animal-assisted therapies (AAT) are used to treat PTSD and other physical and behavioral conditions in veterans. Over the decades, AATs have used dogs, cats, horses, and dolphins among other animals. The purpose of this integrative review is to examine the use of AAT focusing on canine assisted therapy (CAT) among veterans diagnosed with PTSD. The methodology involved database searches, including MEDLINE, PubMed, PsychInfo, EBSCOhost, along with textbooks and popular media published from 2000 to 2016. Associated with the lack of more recent research, relevant articles published before 2000 were included in the review. Search terms included, ‘veterans,’ ‘service dogs,’ ‘service animals,’ ‘animal-assisted therapy,’ ‘canine therapy,’ ‘PTSD,’ ‘post-traumatic stress disorder,’ ‘psychiatric,’ ‘U.S. veterans,’ ‘equine therapy,’ ‘horse therapy,’ ‘pet therapy,’ and ‘military veterans.’ A total of ten relevant studies were identified which focused on the use of AAT among veterans diagnosed with PTSD. Different populations diagnosed with PTSD and other behavioral and psychiatric health conditions using AAT were examined as well. These articles were read, analyzed, and synthesized. Results of the review offer some support that AAT has psychological, physiological and psychosocial benefits for some populations across the lifespan with various diagnoses. Consistent and conflicting findings along with gaps in the literature are highlighted. Limitations and implications for nursing practice, research, policy and education also are noted in this thesis.

Sweden is often seen as a welfare state where children can grow up in safe circumstances. However, social support for children who are at risk of social exclusion has been shown to be lacking. Animal-assisted therapy (AAT) is an alternative intervention within the field of social work, though it is still in its infancy. Existing research evidence suggests that AAT can generate positive results, especially for individuals who have low engagement in other types of treatment. This study examines how AAT is used within the field of social work with children and young people. Seven professionals who employ AAT in their work with children and young people were interviewed. The interviews were interpreted through Antonovsky’s theory Sense of Coherence (SOC). Results show that the animal is seen to increase motivation for the child to partake in the treatment. The therapeutic alliance that is created through the presence of the animal can be helpful in increasing the child’s SOC and the surrounding environment can also play a significant part.