Bakgrund: Demens är den fjärde största folksjukdomen i Sverige. Ofta behandla demens med läkemedel för Behavioural and Psychological Symtoms in Dementia (BPSD) som ger olika biverkningar. Det finns ett stadigt samband mellan umgänge med djur och livskvalitet där termer som återhämtning, trivsel och stressreduktion räknas in. Alternativa metoder som djur i omvårdnaden av personer med demens bör därför övervägas för att förbättra dementas livskvalitet. Syfte: Att beskriva forskning om djur i omvårdnad av personer med demens och hur det kan förbättra deras livskvalitet. Metod: En litteraturöversikt där resultatet var baserat på tio vetenskapliga artiklar hämtade från databaserna Cinahl, Pubmed, Psychinfo och Web of Science publicerade mellan 2011-2016. Nio av artiklarna var kvantitativa, en var kvalitativ. Resultat: Deltagarnas emotionella och kognitiva status påverkades av umgänge med djur. Glädje var en känsla som uppstod och som sedan resulterade i att deltagarna log. Depression och nedstämdhet påverkades i en positiv riktning i flera studier där djur implementerats i omvårdnaden, motivation till att delta i aktiviteter och genomföra dagliga sysslor likaså. Slutsats: Djur i omvårdnaden hade en positiv inverkan hos personer med demens och att livskvaliteten främjades genom att djur, främst hundar, förbättrade olika faktorer hos personer med demens. / Background: Dementia is the fourth largest national disease in Sweden. Dementia is often treated with medications for Behavioural and Psychological Symtoms in Dementia (BPSD) giving different side effects. There is a firm link between socializing with the animals and quality of life where terms such as recovery, wellbeing and stress reduction are included. Alternative methods such as animals in the care of people with dementia should be considered to improve the demented quality of life. Aim: To describe research on animals in the care of people with dementia and how it can improve their quality of life. Methods: A literature review in which the outcome were based on ten scientific articles from the databases Cinahl, Pubmed, Psychinfo and Web of Science published between 2011-2016. Nine of the articles had a quantitative approach, one had a qualitative approach. Results: The participants' emotional and cognitive status were influenced by association with animals. Joy was a feeling that arose which resulted in that the participants smiled. Depression and depressed moods were affected in a positive direction in several studies in which animals were implemented in the care, motivation to participate in activities and carry out daily chores as well. Conclusion: Animals in the care had a positive effect in people with dementia and the quality of life encouraged by animals, mainly dogs, improved various factors in people with dementia. / <p></p><p></p><p></p>

Bakgrund: Bandet mellan hund och människa har visat sig vara betydelsefullt och det har redan tidigt visats att de har hälsofrämjande effekter på människor. Sjuksköterskans roll innefattar att främja hälsa och om hundar kan göra detta så talar det för att det finns utrymme för dem att användas i vården. Syfte: Syftet med denna litteraturöversikt är att undersöka hur hundar kan användas i vården och vilka effekter de har på patienter. Metod: Denna studie är utformad som en litteraturöversikt. Författarna har sökt efter vetenskapliga artiklar som svarar på syftet via databaserna Cinahl COMPLETE och PubMed. Författarna valde tolv artiklar till resultatet som analyserades genom att författarna läste dem både separat och gemensamt samt identifierade teman och subteman. Resultat: Analysen avseende användning av hundar i vården resulterade i två teman: Aktivitet och Närvaro. Temat Aktivitet beskriver hur hundar används i aktiviteter som är specifikt utformade för ett syfte. Temat Närvaro beskriver hur man har använt hundar som sällskap, där aktiviteten inte varit styrd men man har sett fördelar med bara hundens närvaro. Analysen avseende effekten hundar i vården har på patienter resulterade i tre teman: Fysisk hälsa, Psykisk hälsa samt Patientdeltagande. Dessa beskriver effekter som hundarna har haft på patienter. Dessa har uteslutande varit positiva. Diskussion: Litteraturöversiktens styrkor och svagheter med tillvägagångssättet i metoden diskuteras under Metoddiskussion. Under Resultatdiskussion diskuteras resultaten som har varit övervägande positiva för användningen av hundar i vården men i vissa fall var resultatet svagt. / Background:The bond between humans and dogs has shown to be important. Early studies have shown that they have health-promoting benefits on humans. The nurse’s role includes promoting health and if dogs can do so then that would suggest that we should use them in clinical care. Aim: The aim of this literature review is to investigate how dogs can be used in clinical care and what effects they have on patients. Method: This study was designed as a literature review. The authors searched for scientific articles which addressed the aim of the study, by using the databases Cinahl COMPLETE and PubMed. The contents of the articles were then analysed by reading them both individually and jointly and themes and subthemes were identified. Results: The analysis regarding the use of dogs in clinical care resulted in two themes: Activity and Presence. The theme Activity describes how dogs were used to carry out activities that were specifically designed for a particular purpose. The theme Presence describes how dogs have been used as company, where the activities were not particularly structured but the dogs had a positive impact just by being present. The analysis regarding the effect dogs in clinical care have on patients resulted in three themes: Physical health, Psychological health and Participation. These describe the effects that the dogs have had on patients. These were exclusively positive. Discussion: The strengths and weaknesses of the method of this review are discussed in the section Method discussion. In the section Results discussion, the results are discussed. They have been primarily positive to the use of dogs in clinical care; however, in some cases the results were faint.

Background:Animal-assisted interventions (AAI) first came about in the US in the 1960s and was primarily used in child psychiatry. Since then it has evolved and spread to other countries and to other disciplines in health care. In Sweden AAI is used in some institutions for people living with dementia and is a popular feature among the residents. The purpose of the study is to examine if there are reasons for the use of AAI as a non-pharmacological treatment to promote the quality of life of people living with dementia. Methods: The study is a systematic literature review. 13 articles were used to answer the purpose. Results: The compilation of the studies shows that several positive effects appear when using AAI of people with dementia. This applies to several elements of the concept of quality of life which are improved. However, the number of people participating in the studies are small, and many of the results are not statistically significant. Conclusion: AAI appears to be a very popular feature in the care of people with dementia and for those who enjoy being in the company of animals, it may be a way to raise the perceived quality of life. More research with larger groups of participants are needed to obtain more reliable results.

SAMMANFATTNING Bakgrund: Demens är en folksjukdom som blir allt större i och med att befolkningen växer och människorna blir äldre. Detta kostar samhället enorma summor pengar eftersom dessa utsatta människor är i konstant behov av vård. Därför krävs effektiva och billiga hjälpmedel för att stärka den nuvarande vården av människor med demens idag. Djuren har levt nära människan väldigt länge och har varit till stor nytta genom tiderna genom att både ha agerat som arbetskraft och som sällskap. Syfte: Syftet med den här studien var att utforska betydelsen av djurs inverkan på personer med demens välbefinnande genom att undersöka interaktionen mellan människor och djur. Metod: En litteraturstudie användes. 12 originalartiklar valdes från databaserna Pubmed, CINAHL och Google Scholar som sedan lästs, granskats och bearbetats till fyra olika resultatkategorier. Joyce Travelbee’s teori användes som teoretisk ram. Resultat: Fyra kategorier av betydelsen av djurs inverkan på välbefinnandet identifierades: Positiv effekt, förändring av negativa psykologiska beteende, ingen eller obetydlig effekt och ökad fysisk aktivitet/balans. Genom att låta personer med demens få umgås med sällskapsdjur kontinuerligt visar sig ha en god effekt på social interaktion, ökad kognitiv förmåga och psykologiska problem såsom aggression, ängslan, oro och stress. Det finns också tecken på att sessioner med hundar även kan förstärka balansen genom att inspirera personerna till att gå och röra på sig mer än vad de gjorde innan interventionen. Slutsats: Närvaron av djur tenderar att ha en positiv inverkan på äldre personer med demenssjukdom. Även om mer forskning i ämnet behövs så kan ändå sällskapsdjur användas inom hälso- och sjukvården för att tillfälligt uppmuntra, aktivera och bidra med glädje och livslust i vardagen. / ABSTRACT Background: Dementia is a disease that is increasing as the population grows and people around the world gets older. This costs society enormous amount of money because these vulnerable people are in constant need of care. This requires effective and inexpensive means of assistance to strengthen the current care of people with dementia today. The animals have lived close to the human being for a long time and have been very useful of all time both by acting as labor and as company. Purpose: The purpose of this study was to explore the significance of the animal influences on person with dementia´s well-being through the interaction between human beings and animals. Methods: A literature study was used. 12 original articles were selected from the databases PubMed, CINAHL, and Google Scholar, which then were read, reviewed and analyzed to the four categories of results. Joyce Travelbee’s theory was used for the theoretical frame. Results: The four categories of the importance of animal influences in well-being were; positive effect, changing of negative psychological behavior, none or insignificant effect and increased physical activity or balance. By allowing people with dementia to socialize with pets continuously proves to have a good effect on social interaction, increased cognitive ability and psychological problems such as aggression, anxiety, worry and stress. There are also signs that sessions with a therapy dog can enhance balance by inspiring people to walk and mobilize themselves more than what they did before the intervention. Conclusion: The presence of animals tends to have a positive impact on older people with dementia. Although more research is needed on the subject, one can still use pets within healthcare to temporarily encourage, activate and to bring joy and happiness in everyday life.

Companion animals play a pivotal role in typical human development. It remains unknown how animals affect individuals with developmental disabilities. Based on the knowledge that companion animals help typically developing individuals, this research examined the effects of human-animal interactions on individuals with developmental disabilities. Human-animal interactions are based on the Biophilia hypothesis, an assertion that an emotional and beneficial relationship exists between humans and nature, in which there is an “innate tendency to focus on life and lifelike processes.” These are the shared, dynamic associations between people and animals, and the effects of those relationships on health and well-being. Sparse research exists, and the field and literature is scattered among various disciplines. In the first article in this work I examined and synthesized literature related to the effects of human-animal interaction on individuals with developmental disabilities, including companion animals and more formal animal-assisted therapy. In the second article in this work I examined, via direct observation, video recording, and Individualized Education Plan goal attainment, whether animal-assisted therapy (here, occupational therapy intervention incorporating a trained therapy dog) affected playfulness during routine occupational therapy sessions with children with developmental disabilities. Finally, in the third article I examined whether occupational therapy incorporating animal-assisted therapy changed participation during routine occupational therapy treatment sessions with children with developmental disabilities. Children with disabilities often exhibit impairments in play and participation, and enhancing these areas is likely to further their functional ability. The constructs of play and participation are significant in the lives of children with developmental disabilities, and a foundation of pediatric occupational therapy practice. Together they comprise two of the eight “Areas of Occupation” in the Occupational Therapy Practice Framework. The effects of incorporating animal-assisted therapy into occupational therapy are not well documented, although other disciplines have found animal-assisted therapy to be an effectual intervention. Human-animal interaction scholars have called for evidence-based effectiveness studies. This research responded to that call, examining the effectiveness of animal-assisted therapy from a functional perspective not yet addressed in the literature.

The thesis titled "Use of animal assisted therapy for the hospitalized children" deals with the theoretical background of animal assisted therapy as a supporting method in complex rehabilitation and its practical use during the visits of volunteers with their dogs and its influence to the health of children in hospital care. In the available literature are often described the positive effects of the animal assisted therapy onto the mental and physical condition of the person, the impact on improving communication as well as other factors in the social life of the client. The main focuse of my work is whether these effects can be observed (noticed) even in the short term or even after a single visit of the dog. Using quantitative and qualitative methods, I have tried to describe this impact and possibly uncover additional benefits that can be attributed to the visits of the volunteers with a dog at pediatric hospital.

The aim of this thesis is to determine the influence of assisted therapy of dogs and horses for people with musculoskeletal disabilities and sensory impairments. The operational objective is to define the status and position of a therapy with the assistance of a dog and a horse in the context of the complex rehabilitation of a client. The theoretical part concentrates on the issues of zootherapy and zooasistance as supportive methods for easing muscle spasms, the development of fine and gross motor skills, development of verbal and nonverbal communication and development of orientation in space. In the research part of the thesis there are used qualitative techniques of data collection (history and observation), all rounded off by grounded theory. By the carried out research there were found positive manifestations in both the social and psychological areas, as well as in the areas of communication and development of fine and gross motor skills of children with disabilities.

Thesis advisor: Aimee Seiler / In the effort to take responsibly and effect positive change in the lives of our children, we must begin by identifying and applying the most effective methods to help them overcome obstacles to mental and emotional well-being. In conjunction with a limited number of quantitative studies, anecdotal evidence suggests that animal-assisted therapies and activities promote positive outcomes for children who have been physically abused and who have developed behavioral and emotional disorders. Chapter one will address the current state of the research on the impact of physical abuse on children's physical, social and emotional beings. Understanding what we know about what abused children must cope with, chapter two will examine service provision under the current system known as the continuum of care. Finally, chapter three will introduce animal assisted therapy and illustrate the ways in which it can strengthen and support services that are already in place for children who are struggling with behavioral and emotional disorders that result from physical abuse. Before the argument for including animal assisted programs as a supplement to services currently provided can be made, this therapeutic approach deserves to be appropriately standardized and evaluated. Allocating more resources to research that will develop the breath and depth of knowledge in the field of animal assisted therapy is a necessary step in improving the quality of care. / Thesis (BA) — Boston College, 2004. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Education, Lynch School of. / Discipline: College Honors Program.

The purposeof the study was to investigate whether occupational therapists find that therapy dogs can affect the relationship with the client and client´s participation in activity. The methodused was a qualitative study with ten participants who were contacted via recommendations and via the social network Facebook. The questions concerned the occupational therapists' experience of working with therapy dogs and their experiences of whether the therapy dog ​​can be a tool to help create relationship with the client and motivate for activity. The resultshowed that the experience was predominantly positive and that the therapy dog ​​made the client contact stronger. The occupational therapists experienced that they could go further in their interventions with the help of the dog and that the clients opened up more and were more motivated to participate in activities when the dog was present. It also showed that education, planning, goal setting and journaling were important to demonstrate the effect of therapy dogs. Conclusion:The result showed positive situations in which the therapy dog ​​was an aid for the occupational therapists' success in the intervention. The study showed that contact with the client was strengthened with the help of the therapy dog ​​and that the motivation to participate in activities increased. / Syftet med studien var att undersöka omarbetsterapeuter upplever att terapihundarkan påverkarelationen till klienten samtklientensdelaktighet i aktivitet. Metodensom användes var en kvalitativ studie med tiodeltagare som kontaktades via rekommendationer och via det sociala nätverket Facebook. Frågorna berörde arbetsterapeuternas upplevelse kring att arbeta med terapihund och deras erfarenheter om huruvida terapihunden kan vara ett hjälpmedel för att hjälpa till att skapa relation till klienten och motivera till aktivitet. Resultatetvisade att erfarenheterna var övervägande positiva och att terapihunden gjorde att klientkontakten blev starkare. Arbetsterapeuterna upplevde att de kunde komma längre i sina interventioner med hjälp av hunden och att klienterna öppnade upp sig mer och var mer motiverade till att delta i aktiviteter närhunden var närvarande.Det visade också att utbildning, planering, målsättning och journalföring var viktigt för att visa på terapihundarnas effekt.Slutsats: Resultatet visade positiva situationer där terapihunden varit ett hjälpmedel för arbetsterapeuternas framgång i interventionen. Studien visade att kontakten till klienten stärktes med hjälp av terapihunden och att motivationen att delta i aktiviteter ökade

Existem diversos relatos anedóticos de casos de sucesso em terapia para crianças com autismo onde foi inserido um cão como co-terapeuta. Além destes relatos algumas poucas pesquisas apoiam a eficiência da Terapia Assistida por Animais (TAA) para melhorar habilidades sociais de pessoas com autismo. No entanto quais aspectos do comportamento do cão são responsáveis por este resultado, permanecem obscuros. A presente pesquisa é parte de um estudo que visou testar os benefícios da introdução de um cão na terapia com crianças autistas. Foram observadas as interações entre crianças com autismo severo (4 meninos e 2 meninas de 8-14 anos) e cães, durante a TAA estruturada com procedimento de operante-livres, com interesse na iniciativa de início e término de contato. Realizamos 20 sessões em blocos com e sem cão. Todas as sessões foram filmadas. Foram analisadas as filmagens da primeira e da última sessão com cão (sessão 7 e sessão 20) avaliando: a frequência de aproximação, o tempo perto (ao alcance do braço), o tempo longe, o contato físico, sorrisos e vocalizações. Usamos um índice desenvolvido pelo etólogo Robert Hinde: % Aproximação devida à Criança (ApC) - % de Afastamento devida à Criança (AfC). Os cães permaneceram perto das crianças durante a maior parte do tempo (81% na primeira sessão e 99% na última). Houve mudança de tolerância por parte das crianças que não se tornaram aproximadoras, mas menos afastadoras (%ApC - %AfC: -12% na primeira sessão para -1% na última). Observações qualitativas mostraram diminuição no contato negativo com o cão e aumento no engajamento nas atividades propostas. Os cães, merecedores do título Canis empathicus, pareciam perceber pistas sobre como se comportar numa sessão, permanecendo à disposição da criança mesmo quando estas não respondiam e nem os incentivavam. A mudança de comportamento das crianças pode ter ocorrido devido a emoções positivas suscitadas pelo cachorro. Especialmente notável foi a mudança no comportamento de L.S., que nas primeiras sessões ficava de costas para a terapeuta, num canto da sala, e ao final brincava com o cão e interagia com a terapeuta. Nossos resultados podem ser uma pista para o sucesso da inserção de um cão em Terapia Assistida por Animais, para indivíduos com transtorno autista: abriu-se uma janela de oportunidades de aprendizagem / There are many anecdotal reports of successful cases in therapy for children with autism, where a dog was inserted as co-therapist. In addition to these reports a few studies support the effectiveness of Animal Assisted Therapy (AAT) to improve social skills of people with autism. However, which aspects of the dog behavior are responsible for this result remain unclear. This work is part of a study of the benefits of introducing a dog in the therapy of autistic children. We observed interactions between children with severe autism (4 boys and 2 girls from 8-14 years old) and dogs during TAA structured free-operant procedure, with interest in the start and end of contact. Twenty (20) sessions were conducted in blocks with and without the dog. All sessions were video taped. We analyzed the recordings of the first and last sessions with the dog (session 7 and session 20) evaluating: the frequency of approach and the length of time close (within arm\'s reach), length of time away from physical contact, smiles and vocalizations. We used an index developed by the ethologist Robert Hinde: % of Approach due to the Child (ApC ) - % of distancing due to the Child (AfC). The dog remained close to the children during most of the time (81% in the first session and 99% in the last one). There was a change in the tolerance of children who have not become approachable, however less distant (ApC % - % AfC: -12 % in the first session to -1% in the last one). There was also a decrease in negative contact to the dog by the child and the emergence of the behavior of engaging in proposed activities. The dogs, deserving the title Canis empathicus, seem to perceive clues on how to behave in a session, remaining available to the children even when they do not respond nor encourage them. Changes in the children\'s behavior may be due to positive emotions raised by the dog. Especially notable was the change in the behavior of L.S., who during the first sessions stood with its back to the therapist, in a corner of the room, and at the end played with the dog and the therapist. Our results may be a clue to the relative success of the inclusion of a dog in Animal Assisted Therapy for individuals with autistic disorder: a window of opportunities for learning was opened