Equine Assisted Activities and Therapy (EAA/T) is a non-invasive treatment modality recommended by the medical and educational community for a subset of challenged children and adults. As its popularity increases, so too are the concerns among stakeholders and the medical and educational professions about its legitimacy as a treatment modality. The main concern being that EAA/T practitioners have not acquired the professional skills required and that the EAA/T treatment programmes are not evidence-based. The central question of this research focused on identifying Equine Assisted Activities and or Therapy (EAA/T) and creating an optimal learning curricula and more practical experience for future practitioners. In order to explore these issues an extensive multi-method research study was conducted to identify gaps in EAA/T curricula, which included a review of empirical data and different curriculum models. The Delphi Method (DM), a robust, qualitative, naturalistic, systematic and interactive research method was used to support the research. Part of the DM required an analysis of data, adaptation of issues and amendments to questions culminating in a collective consensus among EAA/T experts. The key research findings suggested that current training programmes use curricula with significant gaps resulting in poor professional knowledge formation, a lack of experiential learning, insufficient knowledge of equestrianism and an inability to use pedagogic paradigms. Other findings showed that curricula being used were not being built as an application of sound theoretical principles but rather, transmitted in a manner that does not motivate active and meaningful learning or promote the best practical experience. As a consequence, national organisations and academies dedicated to EAA/T training sidestep high standards and core values for the sake of membership and financial gain. This rigorous research study has highlighted gaps in current training practices and has made it possible to make recommendations for a future curriculum. Recommendations that suggest the future curriculum is built on sound theoretical principles developing foundation knowledge to operate EAA/T in all fields of practice. This could set new quality and performance benchmarks and provides EAA/T practitioners with adequate tools to connect best practices to people with real-life challenges.

Background: In an ever-changing society with inadequate resources, the elderly are easily forgotten. Despite the risk of side-effect, pharmaceutical drugs are added to promote their quality of life. Instead of drugs as a first step, perhaps one can give man's best friend a chance. Aim: The aim of this study was to illuminate the therapy dog’s impact on the quality of life of the elderly person. Method: This study was a qualitative literature-based study with an inductive approach, using a qualitative content analysis of the results from eight qualitative scientific articles. Result: The study resulted in three themes and eight sub-themes. The therapy-dog had a positive impact on the quality of life of the elderly person, both subjective and objective. The experience of well-being was created by the therapy-dog's influence to develop old memories, the feeling of harmony, and a break from everyday life. New opportunities were created when the care dog motivated the elderly to dare to open up, activate, and seek new relationships. Conclusion: The result shows that the meetings with the therapy-dog had positive impacts on several fronts of the elderly. What counts as beneficial impacts is subjective as well as relative. Contrary to everything positive, negative impacts may also occur. Conclusions that can be deduced from this study’s result are that the therapy-dog as an implementation contributes positively to the elderly's quality of life. It should be noted, however, that this intervention is not for everyone as there are allergies, fears, negative impacts and general dislike towards dogs and that this has to be respected. Keywords: Elderly, animal assisted therapy, health, quality of life.

Bakgrund: Varje år insjuknar uppskattningsvis 25 000 personer i Sverige i någon form av demenssjukdom. Behovet av anpassad vård för denna specifika grupp kräver nya och även utvecklade omvårdnadsmetoder. I nuläget finns ingen botande behandling för de olika demenssjukdomarna, utan fokus ligger vid att mildra besvären av sjukdomsbundna symtom. Animal-assisted therapy (AAT) och Animal-assisted activity (AAA) har blivit allt mer populärt inom olika områden av omvårdnadsarbete. Djur kan inverka positivt på både fysiologiska och psykologiska symtom, och därmed användas av sjuksköterskor som ett ytterligare verktyg inom den personcentrerade omvårdnaden. Syfte: Att undersöka hur personer med demenssjukdom påverkas av omvårdnadsåtgärder som innefattar djur. Metod: Systematisk litteraturstudie med deskriptiv design. Arbetet behandlade 18 artiklar som på något sätt använde sig av Animal-Assisted Therapy eller Animal-Assisted Activities eller som på annat sätt hade djur inom demenssjukvården. Studien innefattade djur som hund, katt, akvariefisk, fågel och både gosedjur och mer avancerad djurrobot. Resultat: Studiens resultat visar hur djurs deltagande i omvårdnadsarbetet med demenssjuka personer, eller att bara finnas i deras vårdmiljö, hjälpte att minska nivåerna av ångest och stress, sänkte blodtrycket, och även om de inte minskade den degenerativa utvecklingen av demenssjukdomar, så visade resultat att de inte blev sämre. Slutsats: Enligt denna litteraturstudie framgår det att djur av olika slag bör ses som en värdefull tillgång inom omvårdnadsarbetet av demenssjuka, då det ökar livskvalité och bromsar sjukdomens fortskridande. / Background: Every year, approximately 25 000 people in Sweden are diagnosed with a form of dementia. The need for adapted care for this demographic is current and thus new forms of care and treatment need to be found and be up to date. There are currently no curing treatment for dementia, instead, focus is to decrease the suffering of the symptoms connected to a dementia diagnosis. Animal-assisted therapy (AAT) and Animal-assisted activity (AAA) has increased its popularity within different areas of care. Animals can have a positive effect of both physical as psychological symptoms. Thus there are reasons to believe that animals can and should be used by nurses, as a further step of developing patient-centred methods of care. Aim: This review looked into the different forms animals can help in the treatment of people with dementia, especially focusing on how animals affect the different but typical symptoms of dementia. Method: A review of 18 original articles that has been studying Animal-Assisted Therapy (AAT) and Animal-Assisted Activity (AAA) or any other form of animals presenting itself in the dementia care. This included several different types of animals, like dogs, cats, aquatic fish and even stuffed animals and a robot seal. Result: The result of this review was that animals’ participation in the treatment of people with dementia, or just occurring in these people’s every day life, helped reducing the levels of anxiety and stress, lowered their blood pressure, and if not reduced at least halted the degenerative process of the illness. Conclusion: According to the results to this review, animals should be considered to be a valuable asset in the treatment and care of people suffering of dementia, since they increase the quality of life of those with dementia, and in best case scenario reduces the progression of the disease.

Constructs of human-animal relational theory (HART) were investigated to determine how those constructs manifested in animal-assisted therapy in counseling (AAT-C) from the perspectives of 6 participants (2 counselors, females, ages 28 and 32, both non-Hispanic and White; 2 clients, male and female, ages 55 and 23, respectively, both non-Hispanic and White; and, 2 therapy animals, canines, Labrador retriever and spaniel mix, ages 4 and 5, respectively). Using constructivist-grounded theory, a research team analyzed qualitative data from observations, interviews, and field notes. From the iterative process of multiphasic coding and constant comparison, these findings emerged: (a) consistency between Chandler's (in press) constructs and participants' experiences of AAT-C, (b) more meaningful therapeutic impacts for clients from client-initiated human-animal relational processes (HARPs) than counselor-initiated HARPs, (c) development of rich definitions and descriptions of Chandler's constructs, and (d) descriptions of interactive experiences of AAT-C and client resistance in the context of HART. Clinicians and educators in the field of AAT can apply the processes, practices, and principles from this study in their work to enhance positive therapeutic impacts for clients. As Chandler's constructs were supported in this study, AAT authors and researchers can solve a glaring problem of inconsistent terminology in the AAT literature by using those constructs in future studies and publications as operationalized nomenclature for standardized AAT interventions.

Syftet med studien är att få ökad kunskap om hur professionella upplever att hästunderstödda insatser (HUI) bidrar till utveckling hos individer. Den metodologiska utgångspunkten för undersökningen är en kvalitativ ansats med hermeneutiskt perspektiv, datainsamlingen utgick från semistrukturerade intervjuer. Studiens resultat visar att intervjupersonerna använder hästen som ett pedagogiskt verktyg i arbetet med individerna de möter och att HUI kan bidra till individens lärande och utveckling. Resultatet visar att HUI fokuserar på det friska hos individen och att de professionella arbetar ur ett holistiskt perspektiv, vilket överensstämmer med KASAM som är den teori som studien har utgått ifrån. Slutsatsen av studien är att HUI kan hjälpa individer i lärande och utveckling både när det kommer till psykisk och fysisk hälsa.

Bakgrund: Sveriges befolkning blir allt äldre. Det är en stor heterogen grupp i behov av vårdinsatser och ett antal äldre bor idag på särskilda boenden. Det är vanligt förekommande med fysisk och psykisk ohälsa, ensamhet samt bristande social interaktion på särskilda boenden för äldre. Det har tidigare visats att införandet av hundar inom vården kan minska fysisk och psykisk ohälsa samt öka motivation till deltagande i fysioterapi. Syfte: Undersöka och sammanställa vad vetenskaplig littereratur visar angående fysiska, psykiska och sociala hälsoeffekter hos äldre på särskilda boenden vid regelbunden interaktion med vårdhund. Metod: Litteratursökningen genomfördes via databasen PubMed och åtta vetenskapliga artiklar inkluderades. Artiklarna granskades via PEDro-skalan i syfte att skatta studiekvaliteten. Evidensstyrkan betygsattes sedan via SBU:s metod GRADE. Resultat: Begränsad evidens har visat sig för effektmåtten depression, apati, ångest, aggression, livskvalité, emotioner och ensamhet. Det har visat sig att djurassisterad terapi med hund har otillräckligt vetenskapligt underlag för effektmåtten energiåtgång, fysisk aktivitet, ADL, vikt, BMI, kognition och social interaktion. Konklusion: Resultatet från denna litteraturstudie visar varierande evidens för djurassisterad terapi med hund. Studien påvisar att djurassisterad terapi med hund kan ha positiv effekt på vissa effektmått hos äldre personer på särskilda boenden. Evidensen är som starkast för psykiska effektmått. Vidare forskning med större väl genomförda studier är relevant för att fortsatt kunna utvärdera effekterna av djurassisterad terapi med hund. / Background: The population of Sweden is getting older. It is a big and heterogeneous group in need of health care and a number of older people are living in a nursing home. It is common with physical and mental disorders, loneliness and lack of social interaction in nursing homes. It is shown that animal assisted therapy with dogs can reduce physical and mental illness and motivate older people to participate in physiotherapy. Objective: Examine and compile evidence of animal assisted therapy with dogs on physical, mental och social function in elderly living in a nursing home. Methods: The search was done in the PubMed database and eight articles became included. The articles were assessed for study quality confirmed by the PEDro scale. The evidence from the articles were assessed confirmed by the SBU GRADE. Results: Limited evidence was shown for that animal asssisted therapy with dogs can improve symptoms of depression, apathy, anxiety, agitation, quality of life, emotions and loneliness. Insufficent evidence was found for energy expenditure, physical activity, ADL, weight, BMI, cognition and social interaction. Conclusions: Results show varying evidence for animal assisted therapy with dogs. This study shows that animal assisted therapy with dogs can improve some limited effects in the population of older people at nursing homes, especially for mental health effects. More well made research with larger groups is indicated to ensure and value these effects.

The benefits of horse therapy for special needs children have been documented for centuries, but direct experience and perspective from special needs children and their families involved in horse therapy are missing from the literature. The purpose of this study was to enhance understanding on the health, well-being, and ecological impacts of horse therapy for special needs children, and to demonstrate how horse therapy aligns with public health, by interviewing 8 special needs families who utilize the therapy, 8 adults who underwent horse therapy as children, and 12 ecological experts in local communities. Data were hand-coded and organized based on the phenomenology of the horse, the ethnography of horse and horse therapy culture and environment, and grounded theory to explain how and why horse therapy works. All 16 horse therapy participants with diverse challenges and limitations reported a successful experience with concrete changes in health and/or well-being as a result of horse therapy; all 12 ecological experts endorsed horse therapy centers as beneficial fixtures within the communities, despite obvious challenges, such as funding, in running them. Horse therapy can be used to help and support a wide-range of special needs families; horse therapy centers are beneficial assets to local communities and their public health programs. With respect to the social change implications of this study, the information can be used by community members (e.g., doctors, health professionals, occupational therapists, families) to better understand horse therapy and its benefits for special needs children. In an attempt to improve access and promote horse therapy as a viable public health initiative, a basic blueprint for horse therapy center start-up operations has been provided for local communities.

I Sociologiskt perspektiv på Hästunderstödd terapi studeras hur deltagares upplevelser och effekter av Hästunderstödd terapi med någon form av psykosocial inriktning kan förstås ur ett sociologiskt perspektiv. Fyra artiklar som behandlar Hästundersstödd terapi analyseras med ett konstruktivistiskt förhållningssätt och en induktiv ansats har antagits. Resultatet av analysen ställs i relation till tidigare sociologisk forskning och sociologiska teorier som behandlar interaktion, kommunikation och relation mellan människa och djur. Resultatet mynnade i tre kategorier som står i relation till varandra. Kategorierna är: Sociala relationer, emotionell utveckling och identitetsskapande. Analysen visar att både det terapeutiska innehållet och målet med den Hästunderstödda terapin i de fyra analyserade artiklarna till största del innefattar sociala relationer. Utifrån detta dras slutsatsen att deltagares upplevelser och effekter av Hästunderstödd terapi låter sig förstås ur ett sociologiskt perspektiv, då sociala relationer är essentiellt inom sociologin.

Bakgrund   En växande äldre befolkning innebär utmaningar gällande ensamhet, fallolyckor, demenssjukdom och att kunna tillgodose en god hälsa bland äldre personer. För att möta de utmaningarna krävs en bredd av åtgärder. Ett område som fått allt större genomslag är djurassisterad terapi. Tidigare studier har bland annat visat hur djurens närvaro bland människor bidrar med upplevelser av lugn. I Sverige finns numera rekommendationer från Socialstyrelsen om att djurassisterad terapi kan användas hos äldre med demenssjukdom. En central del av sjuksköterskans profession är att främja hälsa och förebygga sjukdom. De omvårdnadsåtgärder som görs för att uppnå detta ska vara evidensgrundande. Ett ökat intresse finns därmed för djurassisterad terapi utifrån den kontexten.   Syfte Syftet var att beskriva vilken betydelse djurassisterad terapi kan ha för äldres hälsa.  Metod En icke-systematisk litteraturöversikt gjordes med sökningar i tre olika databaser. Dessa var PubMed, CIHNAL och PsycINFO. Tydliga avgränsningar med inklusions- och exklusionskriterier arbetades fram. Totalt inkluderades 15 artiklar med både kvantitativ och kvalitativ design. Nogsam kvalitetsgranskning av artiklarna gjordes utifrån Sophiahemmets bedömningsunderlag. Vidare gjordes en integrerad dataanalys beskriven av Kristensson för att sammanställa resultatet. Först gjordes detta individuellt för att sedan diskuteras gemensamt. Detta för att säkerställa ett så tillförlitligt tillvägagångssätt som möjligt.  Resultat Tre områden där hälsan kan påverkas av djurassisterad terapi framkom, dessa var fysisk, psykisk och social hälsa. Bland annat ökade rörelseförmågan och den sociala interaktionen. Smärta och känslor av ensamhet minskades samtidigt som puls och blodtryck sänktes och det allmänna stämningsläget förbättrades. Slutligen påverkades även den kognitiva förmågan. Slutsats Djurassisterad terapi kan ha betydelse för äldre personers hälsa även om det finns ett behov av fortsatt forskning på området. Vidare finns behovet av riktlinjer på nationell nivå för implementering av djurassisterad terapi. I dagsläget bygger det nämligen på enskilda kommuners arbete för att ta fram riktlinjer kring användningen på särskilda boenden. / Background An increasing amount of elderly people creates challenges regarding loneliness, fall injuries, dementia as well as challenges to work towards a good health. One method which has gotten more attention recently is animal assisted therapy because it contributes to people’s experience of calmness among other things. In Sweden there are recommendations from the National Board of Health and Welfare that animal assisted therapy can be used in nursing homes for people with dementia. An important part of the profession of nurses is to promote health and to prevent diseases. This work should be based on evidence. Therefore, there is a growing interest for animal assisted therapy. Aim The aim was to describe the importance of animal assisted therapy for the health of elderly people.  Method  A non-systematic literature review was conducted by using terms in three databases: PubMed, CINAHL and PsycINFO. Delimitations with clear inclusion and exclusion criteria are presented in the literature review. In total 15 articles were included with quantitative and qualitative data. Their quality was analyzed by using an assessment tool from Sophiahemmet University. The result was compiled by using an integrative data analysis described by Kristensson. First made individually and then together to make sure it was made in a reliable manner.  Results Three main categories were identified where animal assisted therapy can influence the physical, mental, and social health. Among other things it improved the patients’ mood, mobility and social interaction while it decreased blood pressure, heart rate as well as the feeling of loneliness and pain. The cognitive functioning also got affected. Conclusions Animal assisted therapy can be important for the health of older people, but it needs further research. National guidelines to implement animal assisted therapy are also needed because today the municipalities themselves must create the guidelines in their nursing homes.

The purpose of this integrative review of the literature is to examine the effectiveness of equine assisted therapy with individuals diagnosed with Autism Spectrum Disorder (ASD). An extensive review of the literature was conducted regarding children diagnosed with ASD who received equine therapy, equine psychotherapy, therapeutic horseback riding, or horse therapy. Inclusion criteria include articles written in the English language, articles that were peer-reviewed, and had a publication date from 2006 to present. Fourteen articles were analyzed regarding children with ASD who participated in different types of equine therapy. The majority of the studies found individuals with ASD who participated in equine therapy had improvements in behavior, social interactions, and communication with decreased stereotypical ASD behaviors. Only one article found no changes in behavior. Most of the articles had very small sample sizes that limited the generalizability of the findings. There were many different ways that the research was conducted and therefore the screening measures were completely different for all studies. Many studies did not take gender of participants into account, whether the participants were verbal or nonverbal, and other treatments the participants were receiving. Although the literature analyzed had different methodologies, the overall research suggests equine assisted therapy can be a beneficial therapy for individuals with ASD and therefore could be considered a viable treatment option. The outcomes of this integrative review supports the need for larger, randomized, controlled trials with larger samples to effectively evaluate the effects of equine therapy.