Bakgrund: Studier visar att hundar har en positiv effekt på den fysiska hälsan. De kan också öka det sociala samspelet, minska depression, öka självförtroende och självbestämmande samt reducera ångest genom hundassisterad aktivitet eller hundassisterad intervention. Syfte: Syftet med denna studie är att undersöka om hundar inom ramen för omvårdnad på en rättspsykiatrisk avdelning kan påverka patienternas välbefinnande. Metod: För att undersöka patienternas upplevelser användes en kvalitativ studiedesign. För att besvara syfte och frågeställningar gjordes semistukturerade intervjuer som analyserades med en kvalitativ innehållsanalys.   Resultat: Hundar på avdelningen upplevdes både positivt och negativt. De inverkade på välbefinnandet genom att de genererade glädje och välmående men också irritation och ilska. De gav också en känsla av att bli sedd som människa, ökade den fysiska aktiviteten, förbättrade sömnen och påverkade självkänslan och självförtroendet. Vårdmiljön påverkades också genom ett förbättrat klimat på avdelningen. De gav en meningsfullhet i vardagen, en möjlighet till närhet, en känsla av mindre kontrollerande miljö samt att de hade en inverkan på hur patienterna rörde sig på avdelningen. Det identifierades en ståndpunkt för hundar på avdelningen, men också en emot att ha hundar på avdelningen. Slutsats: Resultaten tyder på att det positiva överväger det negativa då majoriteten av resultatet belyser aspekter som ökar välbefinnandet hos patienterna. Hundar inom vården anses därför vara en bra komplementär omvårdnadsform för att som sjuksköterska på en rättspsykiatrisk avdelning. Detta för att kunna utföra god omvårdnad, främja välbefinnande och upprätthålla ett samhällsskydd och samtidigt reducera känslan hos patienten av att vara underordnad och kontrollerad. Det är dock viktigt att beakta olika individers åsikter för att hitta en form som passar. / Background: Studies have shown that dogs have a positive effect on humans physical health. They may also increase social interactions, decrease depression, increase peoples selfconfidence and autonomy and reduce anxiety trough animal-assisted interventions. Aim: The aim of this studie is to investigate if dogs can effect well-being in patients within forensic psychiatric care. Method: To investigate the patients experiences a qalitative reserch method were used. Semi-structured interviews were used to answer to the aim of the studie, and analysed with a content analysis. Result: The patients had both positive and negative experiences regarding the presence of the dogs at the unit. The dogs had an impact on the patients well-being by generating joy as well as anger and irritation. They gave a sense of being perceived as an individual, they increased physical activity, improved quality of sleep and had an inpact on self-esteem and self-confidence. The dogs also had an impact on the health facility environment trough an inprovement of the atmosphere at the unit. The dogs gave sense of mening in the everday life, an opportunity for intimacy, a sense of a less controlling environment and they also had an impact on how the patients moved at the unit. Some where proponents and some opponents to the impementation of dogs at the unit. Conclusion: The results shows that the positive experiences tops the negative because the majority of the results shows aspects of improved well-being. Dogs within healthcare facilities are therefore concidered to be a good complementary form of care for nurses working in forensic psychiatric care. This to perform good nursing care, promote well-being and maintain the civil protection and at the same time reduce feelings of being inferior, subordinated and controlled. It is however important to pay regards to the different idividual opinions and find a resolution that suits best.

Bakgrund: Vid demens drabbas individer av olika beteendemässiga, psykologiska och fysiska symptom som påverkar dess möjlighet till delaktighet i aktivitet. Tillsammans med dessa symptom kan en minskad motivation påverka möjligheten till aktivitetsutförande. Tidigare studier påvisar en positiv inverkan av djur på välbefinnandet och aktivitetsutförande. Utifrån arbetsterapeutisk teori ses sambandet mellan upplevelsen och möjligheten till aktivitet som en grund till delaktighet i vardagliga aktiviteter. Syfte: Syftet var att beskriva interventioner med hund i relation till personer med demens. Metod: Scoping review design som begränsades till demens, alla åldrar och kön. Inklusionskriterier var: artiklar inte äldre än sex år, på engelska, norska, danska och svenska. Kvantitativa, kvalitativa och grå litteratur via AMED, CINAHL, MEDLINE, PsychINFO, Anthrozoös och fulltext via Google Scholar. Exklusionkriterier var andra typer av sjukdomar eller skador och studier äldre än sex år. Resultat: Vanligaste interventionstypen vid demens är hund-assisterad aktivitet under en längre behandlingsperiod. Interventionerna genomförs 30–60 minuter, 2 gånger i veckan under 6–12 månader via fysisk, sensorisk, social och kognitiv stimulering. Vid behandling av demens kan interaktion med hund främja aktivitetsutförandet via en positiv inverkan på depression och livskvalité. Interventionerna med hund kan motverka förekomsten och uppkomsten av depression och kan främja kognitiv förmåga. Interventionerna främjar i större utsträckning individer med svårare demens, kognitiv nedsättning och oro. De kan även främja delaktighet i dagliga aktiviteter via en minskad förekomst av depression. Slutsats: Vanligaste interventionen är hund-assisterad aktivitet under en längre behandlingsperiod.  Interventioner med hund kan främja social och fysisk interaktion genom kognitiv stimulering. Hundar kan ha positiv inverkan på depression och livskvalité. Hundar kan även ha en positiv inverkan på oro och aktiviteter i det dagliga livet och kan främja kognition vid svårare kognitiv nedsättning och i större utsträckning vid svårare depression och demens. / Background: In dementia people gets affected by different behavioural, psychological, and physical symptoms that affect their ability to participate in activities. Together with these symptoms a decreased motivation may interact on the possibility of occupational performance. Earlier studies indicate a positive effect of animals on wellbeing and occupation performance. Through occupational theory the connection between the experience and possibility to activity are seen as a foundation for everyday activities. Purpose: The aim was to describe interventions with dogs in relation to persons with dementia. Method: Scoping review design, limited to dementia, all ages, and both sex. Inclusion criteria was; not more than sex year old, English, Norwegian, Danish, and Swedish articles. Quantitative, qualitative and grey literature through AMED, CINAHL, MEDLINE, PsychINFO, Anthrozoös, and full text by Google Scholar. Exclusion criteria was other types of diseases or injuries, and studies older than sex years. Results: Most common intervention with dog, during treatment of dementia, are dog-assisted activity during a longer treatment period. The interventions are implemented during 30-60 minutes, 2 times a week for 6-12 months through physical, sensory, social and cognitive stimulation. In treatment of dementia interaction with dogs may promote occupational performance through a positive effect on depression and quality of life. Interventions with dogs may reduce the presence and appearance of depression and may promote cognitive ability. They may promote to higher degree individuals with severe dementia, cognitive disability and anxiety. Intervention with dogs may promote participation in daily activities through a decrease of presence of depression. Conclusion: Most common intervention with dogs are dog-assisted activity during a longer treatment period. Interventions with dogs may promote social and physical interaction through cognitive stimulation. Dogs may have a positive influence on depression, and quality of life. The dogs may also have a positive influence on anxiety and activities in daily living and may also promote cognition in severe cognitive limitation, and to a higher degree with severe depression, and dementia.

In this piece I have attempted to perform descriptive quantitative research in the field of Animal-Assisted Activities and Animal-Assisted Therapies in the Czech Republic. I have placed emphasis on the professional background and dog handling skills of the dog-handler. I tried not only to focus on the impact of dogs on humans, but also to emphasize the importance of the personality of the therapist. I also consider the impact of different personality theories on the personality of the handler/therapist, and the importance of theoretical background and preparation in the given area in which the handler/therapist engages with dogs. Based on the positive respondent reactions, I trust that this research will prove to be of use to people involved in human-animal positive interactions.

The aim of this study was to examine the use of animals in the therapy of neurotic disorders under the settings of mental hospitals. First part of this work desribes neurotic disorders and their therapy with a particular emphasis on AAT (Anima-Assisted-Therapy, pet therapy) and its subdivisions (hippotherapy, canistherapy, etc.) Principals of AAT are explained. Further, contraindications and possible risks are mentioned and the inherent possibility of animal misuse is discussed. The theses include basic guidelines and methods used in AAT and concludes with practical observations made by psychotherapists from the Czech mental hospitals.

Estudos publicados a partir da década de 60 evidenciam o potencial terapêutico da participação de animais de estimação em situações clínicas. Desde então, as pesquisas e as práticas das denominadas Terapia Assistida por Animais (TAA) e Atividade Assistida por Animais (AAA) estão em amplo crescimento. A presente pesquisa analisa 12 registros filmados dos encontros realizados a partir da parceria entre uma escola de educação especial e um canil. Os encontros aconteciam num sítio, a freqüência era semanal e os horários eram fixos. Participaram quatro adolescentes com síndrome de Down. A narrativa dos encontros entre esses adolescentes e cães numa situação estabelecida tem por objetivo a elaboração de uma reflexão teórica cujo propósito é considerar o uso de um enquadre diferenciado que inclui a presença do cão como recurso. A lente sob a qual tais fenômenos são analisados e compreendidos é a psicanálise de D. W. Winnicott. A investigação psicológica dos encontros evidencia a necessidade de levar em consideração o contexto humano oferecido pelos profissionais e as relações interpessoais estabelecidas. Pode-se observar que a maneira de se relacionar com o animal apresenta-se qualitativamente diferente das relações essencialmente humanas e das com objetos inanimados. Destacando a complexidade dos fenômenos observados entre as pessoas e os animais, percebeu-se que os cachorros interagiam com as pessoas não a partir das intenções ou sentimentos destas, ou ainda por meio de um discurso representativo: o cão reagia ao fato, ao comportamento humano, a comunicação ocorria de forma não-verbal. Outra possível função dos cachorros foi a de despertar diferentes aspectos do self, manifestados pelos adolescentes em suas atitudes, ações e verbalizações, facilitando a expressão de sentimentos. A análise também revela que a maneira de ser do cachorro – através de suas ações de atender ou não aos comandos, de se deixar manipular ou não, de ser uma presença constante e segura, de ter uma inteireza e continuidade de ser – sugere a emergência de maior espontaneidade por parte dos adolescentes. Por fim, são tecidas reflexões teóricas que sustentam a possibilidade de uma clínica winnicottiana com enquadre diferenciado que inclui o cachorro como recurso. / Studies that have been published since the 1960s suggest the therapeutical potential of the use of pets in clinical situations. The research on and the practice of the called Animal Assisted Therapy (AAT) and Animal Assisted Activity (AAA) have become more and more popular ever since. The present research analyses 12 filmed meetings that aim at promoting such interaction between dogs and four adolescents with Down Syndrome, carried out by a special education school and a kennel. These weekly meetings took place in a small farm and had been previously scheduled, always at the same time. The description of these meetings between the adolescents and the dogs in an arranged situation aims at elaborating a theoretical reflection which has the objective of taking into account the use of a differentiated setting that involves the presence of the dog as a resource. The lens under which such phenomena are analysed and understood is the W.D.Winnicott psychoanalysis. The psychological investigation of the meetings explicits the need to take the human context offered by the professionals and the interpersonal relationships that take place into account. It is clear to notice that the way the adolescents relate to the animals is qualitatively different from the way they do in exclusively human relationships or even in their relationships with inanimate objects. It’s important to highlight that, among other complex phenomena that we observe in the relationship between people and animals, the communication between them is non-verbal: the dogs react to the human behaviour and not to their intentions, feelings or discourse. Also, the dogs have an important role in awakening different aspects of the self, acted out by the adolescents in their attitudes and speech, which makes the expression of their feelings easier. The analysis also shows that the dog’s behaviour– – whether or not responding to the commands of the adolescents, permitting or not being handled by them, of being a constant and safe presence, as well as its wholeness and continuity of being - suggests the emergence of more room for the adolescents’ spontaneity. Finally, some reflections that support the possibility of a winnicottian clinic with a differentiated setting that have the dog as a resource are presented.

It has already been established that animals have various constitutional effects on humans and influence quality of life and well-being in various ways (see Nestmann 2005). For a lot of people in all stages of their life, pets are important sources of support. They are able to contribute to our health as well as to buffer stress and illness. Especially elderly and frail people take profit from the human animal bond. Pets may be seen as important agents in support and therapy of people with dementia. Besides offering emotional support in times of struggle and loneliness, pets can even have a healing influence in situations of physical or mental illness. Since the 1960s animals have been used in professional and therapeutic settings. Even retirement and nursing homes experience the psychosocial benefits of animal assisted activities and integrate animals successfully in the daily routine of the residents. The longitudinal field study “Animals at the Johanniter-Stift Nursing Home” is the first to investigate the effects of animal assisted activities on the quality of life and well-being of elderly nursing home patients with dementia. In order to systematically establish the extent to which various forms of regular contact with animals can benefit such patients, psychological and social changes in patients with and without contact to animals were examined at three intervals over a three-year period, using research instruments such as non-participant observation (MTU), questionnaires completed by nursing staff (FSAK; NPI) as well as interviews with the nursing staff to examine the human-animal-contacts between the residents and the animals in the daily routine. The study demonstrates that elderly dementia sufferers with regular contact to animals tend to show greater agility, independence, strength of social network and communication abilities compared to those without contact to animals. The study shows the psychosocial effects and the options of animal assisted activities with and care of elderly people suffering from dementia as an alternative to pharmacological treatment.

Bakgrund: Medellivslängden i Sverige har aldrig varit så hög som de senaste åren vilket kommer ställa höga krav på äldreomsorgen. Situationen är komplex och påverkar framförallt patienterna i den kliniska vården. Tidigare studier visar att patienter inom äldreomsorgen löper större risk för ensamhet, depression och understimulans av olika anledningar. För att kunna möta dessa behov som sjuksköterskor i den kliniska vården, vill vi undersöka om alternativa metoder kan fungera som ett komplement till den vård som bedrivs inom äldreomsorgen. Alternativa metoder har blivit ett alternativ de senaste åren där bland annat djur kan användas i ett terapeutiskt syfte. Vi vill därför belysa faktorer för välbefinnandet hos dessa patienter som får djurassisterad intervention som ett komplement i vården. Syfte: Syftet var att belysa faktorer för välbefinnandet hos patienter inom äldreomsorgen som får djurassisterad intervention som ett komplement i vården. Metod: I denna studie tillämpas en litteraturöversikt där elva vetenskapliga artiklar från 2008 till 2018 ligger till grund för resultatet. De vetenskapliga artiklarna som inkluderades var nationella eller internationella. Datainsamlingen har gjorts i tre olika databaser; CINAHL Complete, PsycINFO och PubMed. Resultat: Efter analys av resultatet framkom fyra faktorer för välbefinnandet; fysiska, psykiska, sociala och existentiella. Resultatet visade att djurassisterade interventioner kan ha positiva, negativa och/eller inga effekter överhuvudtaget på äldre personers välbefinnande. Denna typ av intervention kan fungera som ett komplement i vården främst vid behandling för främjande av psykiska symtom och social påverkan/interaktion. Diskussion: Patienter inom äldreomsorgen är en riskgrupp för nedsatt välbefinnande och där farmakologiska behandlingar är vanligt förekommande. Djurassisterad intervention kan ses som en icke farmakologisk behandlingsform, där välbefinnandet kan främjas ur ett holistiskt perspektiv för den äldre patienten i vården. Mer forskning krävs för hur djurassisterad intervention kan ersätta viss farmakologisk behandling. Callista Roys adaptionsmodell stödjer sjuksköterskans arbete för förståelse av patienters strategier för att anpassa sig efter miljön och påverka miljön på ett självhävdande sätt. / Background: Life expectancy in Sweden has never been as high as in recent years, which will have a big influence on the care of the elderly. The situation is complex and affects primarily the patients in the clinical care. Previous studies show that the elderly patients are at greater risk of loneliness, depression and lack of stimulation for various reasons. In order to meet these needs as nurses in clinical care, we want to investigate whether alternative methods can serve as a complement to the care provided. Alternative methods have become more common in recent years, an example is using animals for therapeutic purposes. We therefore want to illuminate the factors of well-being in patients affected by animal-assisted intervention as a complement to health care. Aim: The aim was to illuminate the factors of well-being in patients of the geriatric nursing who receive animal-assisted intervention as a complement to standard care.    Method: A literature review has been done, where eleven scientific articles from 2008 to 2018 form the results. The articles that were included were national or international. The data collection has been made in three different databases; CINAHL Complete, PsycINFO and PubMed. Results: After analysis of the result, four factors emerged for the well-being; physical, mental, social and existential. The result showed that animal-assisted interventions may have positive, negative and / or no effects at all for the well-being of older patients. This type of intervention can serve as a supplement in the care of primary care in the treatment of mental and social interaction. Discussion: Patients in elderly care are a risk group for impaired well-being and where pharmacological treatments are commonplace. Animal-assisted intervention can be seen as a non-pharmacological treatment, where well-being can be promoted from a holistic perspective to the elderly patient in standard care. More research is needed on how animal-assisted intervention can replace certain pharmacological treatment. Callista Roys adaptation model supports the nurse's work for understanding patients' ability to adapt to the environment and influence the environment in a self-assertive manner.

Les symptômes psychologiques et comportementaux de la démence (SPCD) sont fréquents et peuvent concerner jusqu’à 90 % des patients atteints de la maladie d’Alzheimer. Considérant l’efficacité limitée et l’ampleur des effets secondaires observés avec les traitements psychotropes en France, la majorité des directives existantes soulignent l’importance de la recherche clinique sur la maladie d’Alzheimer et une amélioration de l’évaluation des approches non pharmacologiques (ANP). En 2016, Le recours à la médiation animale, comme prise en soins, en établissements d’hébergement pour personnes âgées dépendantes (EHPAD) est de plus en plus fréquent. Nous avions montré les bienfaits de cette ANP sur l'apathie dans la maladie d'Alzheimer et avons souhaité en démontrer son efficacité. Notre étude évalue et mesure, principalement à l’aide de l’Inventaire Neuropsychiatrique version Equipe soignante (NPI-ES), comment la présence du chien dans la psychothérapie des malades Alzheimer est associée à des niveaux de SPCD chez des femmes et des hommes, âgés en moyenne de 85 ans qui vivent en institution. Nous nous sommes concentrés sur le bien-être et la construction d’émotions positives de la personne âgée démente, en particulier sur la revalorisation de l’estime de soi, la stimulation, la remobilisation et le maintien des capacités cognitives préservées, comme base thérapeutique possible dans l’association de la présence du chien avec la diminution significative des SPCD. / Today, the use of animal mediation as a form of treatment in nursing homes has become more and more common. Our study assesses and measures, largely through the use of the Neuropsychiatric Inventory for Nursing Home (NPI-NH), how the presence of a dog in Alzheimer’s patient psychotherapy affects psycho-behavioral disorder (BPSD) levels in French men and women with a mean age of 85 years living in an institution. Our study focuses on well-being and on building positive emotion in the elderly with dementia, particularly through regaining self-esteem, stimulation, remobilization and maintenance of preserved cognitive abilities. This therapeutic basis is made possible through exposure to a dog with the goal of decreasing BPSD.

Introduktion: Hästunderstödd terapi är en behandlingsform där man ägnar sig åt ridning och andra aktiviteter med hästen för att främja fysisk och psykisk hälsa. Hästen har en central roll och bidrar till en icke-dömande och trygg plats för patienterna. Vidare har stallet och naturen positiva effekter inom behandlingen. Syfte: Belysa synen på hästunderstödd terapi hos fysioterapeuter som arbetar eller har arbetat med hästunderstödd terapi som behandlingsmetod. Metod: Fyra semistrukturerade intervjuer med legitimerade fysioterapeuter/sjukgymnaster, med erfarenhet av hästunderstödd terapi, genomfördes via telefon. Intervjuerna analyserades sedan med kvalitativ innehållsanalys utifrån en induktiv ansats. Resultat: Analysen resulterade i temat “Hästen ger möjlighet till en unik och omfattande behandling”, som beskriver bredden av behandlingen, hur kroppen och psyket påverkas samt vilken roll hästen, stallet och naturen har inom behandlingen. De fem kategorierna som identifierades var Mångsidig behandling som möter olika behov, Stallet och naturen blir ett annorlunda behandlingsrum, Hästen som stöttande behandlare, Personlighet och kropp tar stora steg framåt samt Ökad dialog och delaktighet genom hästen. Kategorierna inkluderar delar av behandlingsmetoden, vilka patientgrupper man kan komma i kontakt med, vilken roll hästen har samt effekterna av behandlingen. Konklusion: Hästunderstödd terapi lyftes fram som en bred behandlingsform av fysioterapeuterna. De upplevde behandlingen som speciell i förhållande till annan behandling genom dess möjlighet att påverka flera delar samtidigt, både för kroppen och psyket. Fler studier bör genomföras med större undersökningsgrupper; både fler fysioterapeuter, men även patienters erfarenheter bör lyftas fram.

Equine Assisted Therapy is, from a social work perspective, a relatively unexplored arrangement of therapy in which the horse is part of the treatment. This study illustrates the equine therapist’ experiences of Equine Assisted Cognitive Behavioural Therapy (EA-CBT) and Equine Assisted Therapy (EAT) up against people suffering from mental health issues. The research questions are: How do we use horses as a part of the treatment up against people with mental health issues? What components can be identified as a central part of the treatment in Equine Assisted Therapy? The empirical material was collected by using hermeneutic approach and qualitative semi-structured interviews with three practicing equine therapists. The main result showed that horses are used as therapeutical co-workers, as well as a metaphor for the individuals’ emotions. The horses take a significant part of the patients’ sense of coherence (KASAM) as well as the patients’ mentalization, especially through emotional understanding and communication. Furthermore, the result indicate that the horse is as an important link in the encounter between therapist and patient. The analysis was based on an analytic method, in which the empirical material is the starting point of coding and creating themes. The central conclusions were that the horse play a significant role in the promotion of the humans’ ameliorative mental health. It does not only play role for the mental health issues, but also for the patients’ conduction after the treatment.