Play therapy and animal-assisted therapy are two specialized modalities within the field of counseling. Child-centered play therapy (CCPT) is a specific theoretical approach to play therapy that regards the therapeutic relationship as the primary healing factor. With much empirical support, CCPT is considered an effective mental health treatment option for working with children. Animal-assisted therapy in counseling (AAT-C) is acknowledged in the literature as a supplemental treatment modality to an existing counseling practice. Although past researchers have shown support for AAT-C as well as CCPT, there is a current dearth of literature examining the integration of these approaches. The present study sought to understand the approach of incorporating a therapy dog into child-centered play therapy while maintaining theoretical consistency. Using a constructivist grounded theory approach, I facilitated child-centered canine-assisted play therapy (C3APT) services for four children and reviewed the sessions with expert supervisors in AAT-C and CCPT. Three major themes emerged from the data: (a) principles of C3APT, (b) procedures of C3APT, and (c) relational dynamics. Implications for clinical practice and training of both therapy dogs and C3APT practitioners are also discussed.

Bakgrund: För många barn är mötet med sjukvården en ny miljö som kan skapa ångest eller rädsla vilket kan bidra till en ökad smärta eller obehaglig upplevelse för barnen. Att enbart behandla smärta med analgetika är sällan tillräckligt varför olika distraktionsmetoder kan användas för att minimera dessa känslor. Tidigare forskning har visat att vårdhunden kan ge positiva effekter på barn där läkemedelsanvändning har kunnat begränsas, dock krävs mer sammanställd forskning. Att inkludera en vårdhund i behandlingar skulle kunna minska barnets lidande.  Syfte: Att beskriva vilken effekt en vårdhund kan ha på ett barn i barnsjukvården. Metod: Allmän litteraturstudie med en deskriptiv design valdes som metod. Artikelsökning gjordes i databaserna PubMed, CINAHL samt Scopus och resulterade i 11 vetenskapliga originalartiklar med kvantitativ ansats.  Resultat: Resultatet skiljer sig vad gäller vilken effekt en vårdhund kan ha på barns ångest/oro och smärta inom barnsjukvården. Ungefär hälften av studierna påvisar en effekt där vårdhunden har lindrat både ångest/oro och smärta hos barn. Resterande del av resultatet kan inte påvisa en effekt om att en vårdhund kan lindra barns ångest/oro eller smärta i barnsjukvården.  Slutsats: Litteraturstudien visar effekter på barns ångest/oro och smärta av att använda en vårdhund inom sjukvården. Dock visar studien ingen vetenskaplig evidens om att vårdhundens användning är en metod som fungerar för alla barn. Individuella behov bör tas i beaktande där sjuksköterskan ansvarar för att se det enskilda barnet och identifiera i vilka situationer vårdhunden kan vara behjälplig. / Background: For many children, healthcare visits can create feelings of anxiety or fear, which can contribute to increased pain or unpleasant experiences. Treating pain only with analgesics is seldom sufficient, various distraction methods can be used to minimize these feelings. Previous research shows that animal assisted therapy can have positive effects and reduce the need to use drugs as treatment, however, more compiled research is required. Including animal assisted therapy in treatments could reduce the child's suffering.  Purpose: To describe what effect animal assisted therapy can have on a child in pediatric care. Method: Literature review with a descriptive design was chosen as method. Article searches were done in databases PubMed, CINAHL and Scopus and resulted in 11 quantitative original articles. Results: The results differ in terms of what effect animal assisted therapy can have on children's anxiety and pain in pediatric care. About half of the studies show an effect where animal assisted therapy has relieved both anxiety and pain. The remaining part of the result can not show an effect that animal assisted therapy can relieve children's anxiety or pain. Conclusion: Animal assisted therapy in healthcare shows some positive effects on children's anxiety and pain. However, the review sees no scientific evidence that the use of animal assisted therapy works for all children. Individual needs should be considered and the nurse is responsible for seeing the individual child and identifying in which situations animal assisted therapy can be helpful.

Animal Assisted Therapy (AAT) has become a popular intervention for the health and behavioral community as evidenced by media attention. The research that has been done on AAT has been mostly qualitative and anecdotal. The current study adds to the literature on AAT by collecting quantitative data on AAT. A multiple baseline design across three participants was used to evaluate the independent reading duration under a baseline condition (no dog present) and a non-contingent access to dog condition (which simulated how dog therapy is typically conducted). If reading did not increase during the non-contingent dog condition, a contingent access to the dog condition was implemented to determine if the participants would engage in increased reading duration to earn access to the dog. In this study, noncontingent access to the therapy dog resulted in increased reading duration for two of the participants. One participant showed variable results in the noncontingent phase and required the introduction of the contingent dog phase, which resulted in increases in reading duration.

Bakgrund: I Sverige började organiserade djurassisterade aktiviteter användas på 1950-talet. Det används idag inom flertalet områden och fler behandlingsmetoder som involverar djur är under utveckling. I dagsläget saknas det nationella riktlinjer och rekommendationer kring applikationsområden. Detta gör att djurassisterade aktiviteter förmodligen har potential till fler och bredare användningsområden inom omvårdnad. Syfte: Syftet med denna systematiska litteraturstudie var att undersöka inom vilka omvårdnadsområden djurassisterade aktiviteter har psykologiska samt fysiologiska effekter. Metod: Detta arbete är utformat som en systematisk litteraturstudie. De 13 studier som inkluderats har haft en kvantitativ ansats och har publicerats mellan 2009–2019. Samtliga studier har identifierats via PubMeds databas. Studierna har sedan analyserats utifrån en steg för steg metod i fem steg. Resultat: Effekter har setts inom ett flertal olika områden och med olika resultat. De mest omfattande effekterna har funnits inom vård av demenssjuka och inom äldreomsorg. Effekter som generellt förekommer är minskade depressionssymtom, förbättrad kognition, sänkta kortisolnivåer, upplevd förbättrad livskvalitet och minskad oro. Slutsats: Djurassisterade aktiviteter bör ses som ett komplement till sedvanlig vård och generell behandling. Inom vården av demenssjuka skulle många patienter gynnas av utökade djurassisterade aktiviteter. I områden som psykiatri, pediatrik och smärttillstånd kan patienter gynnas av djurassisterade aktiviteter, men fler studier med större, mer heterogena undersökningsgrupper behövs för att fastställa evidensunderlag. / Background: Animals have in Sweden been used in caregiving since the 1950´s. Today it is used in several areas and more treatments including animals are under development. Guidelines and recommendations about applications and usage have not been developed in Sweden. There are good possibilities that animal-assisted activity has the potential for more and wider usage in nursing. Aim: The aim of this literature review was to examine in which nursing areas animal assisted activities had physiological and psychological effects. Method: This bachelor thesis was designed as a systematic literature review based on 13 studies published from 2009 to 2019. All studies were acquired from the PubMed database and had a quantitative approach. The studies were later analysed thru a step by step method. Results: Effects have been showed in several areas. The most significant results have been found in care of patients diagnosed with dementia and in geriatric care. Effects that generally occur are decreased symptoms of depression, improved cognition, lower cortisol levels, perceived improved quality of life and decreased anxiety. Conclusion: Animal assisted activities could be used as a promoting addition to ordinary care but should not be used as a detached treatment. The most studied area within healthcare is different kinds of cognitive impairment, mostly patients diagnosed with dementia. Other areas of healthcare where animal assisted activities appear to have good effects both on physiological and psychological factors are different kind of psychiatric diagnoses, pain-management and paediatrics, but in these areas more research with a larger, more heterogenic population needs to be done to fully evaluate the effects.

No description available.

Bakgrund: Den åldrande befolkningen leder till utmaningar för hälso- och sjukvården. Incidensen av demens ökar med åldern och är en av de vanligaste neurodegenerativa sjukdomarna, det finns inget botemedel. Den medicinska behandlingen som används mot symptom har flertalet biverkningar. Forskning har visat på hälsofördelar för patienter vid kontakt med vårddjur men på grund av allergi- och infektionsrisk har i stället robotdjur börjat användas som ersättning för levande djur. Syfte: Syftet med studien var att beskriva inverkan av djurassisterad terapi i form av robotdjur hos personer med demenssjukdom. Metod: Allmän litteraturstudie, vilken följde Polit och Becks niostegsmodell, baserat på 18 artiklar av kvalitativ, kvantitativ samt mixad metod. Tematisk analys användes som dataanalys. Resultat: Tre huvudteman identifierades, psykisk inverkan, fysisk inverkan och social inverkan. Primära fynd var övervägande positiva effekter gällande sinnesstämning, livskvalitet, agitation och social interaktion. Slutsats: Användning av robotdjur kan vara ett användbart verktyg för sjuksköterskan vid omvårdnad av personer med demenssjukdom då det visat på goda effekter. Mer forskning krävs för att konstatera inverkan, nytta, design och implementering. / Background: The aging population in the world is challenging to the society and healthcare. Dementia is one of the most common neurodegenerative diseases and there is no cure. Medical treatment is symptomatic and includes many side effects. Research on care animals has shown health benefits for the patients. However, due to allergies and risk of infection, robotic animals could be an interesting substitute to live animals in the care of elderly. Aim: To describe the impact of animal-assisted therapy, i.e. robotic animals, in people with dementia. Method: A literature study based on 18 original articles with qualitative, quantitative, and mixed methods. Thematic analysis was used as data analysis. Results: Three main themes were identified; psychological impact, physical impact, and social impact. The results showed opportunities for development regarding the design of the robot and predominantly positive effects regarding aspects such as well-being, quality of life, agitation, and social interaction. Conclusion: Robotic animals can be a useful tool for nurses when caring for people with dementia, as it has shown beneficial effects. More research is needed to establish impact, benefits, and implementation.

Objective: To assess the reliability and usefulness of an EEG-based brain-computer interface (BCI) for patients with advanced amyotrophic lateral sclerosis (ALS) who used it independently at home for up to 18 months. Methods: Of 42 patients consented, 39 (93%) met the study criteria, and 37 (88%) were assessed for use of the Wadsworth BCI. Nine (21%) could not use the BCI. Of the other 28, 27 (men, age 28-79 years) (64%) had the BCI placed in their homes, and they and their caregivers were trained to use it. Use data were collected by Internet. Periodic visits evaluated BCI benefit and burden and quality of life. Results: Over subsequent months, 12 (29% of the original 42) left the study because of death or rapid disease progression and 6 (14%) left because of decreased interest. Fourteen (33%) completed training and used the BCI independently, mainly for communication. Technical problems were rare. Patient and caregiver ratings indicated that BCI benefit exceeded burden. Quality of life remained stable. Of those not lost to the disease, half completed the study; all but 1 patient kept the BCI for further use. Conclusion: The Wadsworth BCI home system can function reliably and usefully when operated by patients in their homes. BCIs that support communication are at present most suitable for people who are severely disabled but are otherwise in stable health. Improvements in BCI convenience and performance, including some now underway, should increase the number of people who find them useful and the extent to which they are used.

Objectives Many addicted pregnant patients receiving buprenorphine medication-assisted therapy (MAT) wish to discontinue this medication while pregnant. This study was undertaken to determine whether outpatient detoxification from buprenorphine during pregnancy is safe and effective when confirmed with postdetoxification urine drug screens (UDSs). Methods This case series reports the maternal and neonatal outcomes for 21 patients who ended MAT with buprenorphine while pregnant. A retrospective chart review of both maternal and newborn electronic medical records was performed to obtain results. Newborn neonatal abstinence syndrome (NAS) diagnosis, need for morphine, maternal safety and fetal/newborn complications were assessed. Maternal sobriety was documented with UDSs at the time of admission for delivery. Umbilical cord blood also was assessed for substances of abuse. An additional 182 pregnant women who lowered their buprenorphine doses but did not decide to end MAT were assessed via routine quality assurance methods. Results None of the women who stopped buprenorphine during their pregnancy as confirmed by UDSs and umbilical cord sampling delivered neonates who had NAS. Eleven patients ended MAT with medical assistance and 10 ended MAT without medical assistance. No overdoses were reported for the 182 additional pregnant patients who indicated an intention to taper buprenorphine dosage while pregnant but who did not decide to end MAT; the neonatal benefits were obtained without any identified maternal harm. Conclusions The neonates of pregnant women enrolled in an outpatient buprenorphine MAT tapering program who are able to completely stop taking buprenorphine (as documented by negative urinary drug screen) are very unlikely to have NAS. Further research will be important.

Bakgrund Djur tjänar som lojala och betydelsefulla följeslagare, som förser oss med villkorslös kärlek, tillgivenhet, och kamratskap. Varje människa är unik och ska bemötas efter sina förutsättningar. Det humanistiska perspektivet på hälsa, som kopplar ihop själ, kropp, och ande samt ser människan ur ett helhetsperspektiv, överskuggas ofta av den biomedicinska modellen där sjukdom beskrivs som något som drabbar personen utifrån, där denne inte aktivt behöver delta i behandlingen. Då den psykiska ohälsan ökar markant världen över skulle patienter kunna gynnas av fler komplementära behandlingsmetoder som väver in det humanistiska perspektivet på hälsa. Syfte Syftet med denna litteraturöversikt var att beskriva hur personer med psykisk ohälsa upplever djurassisterad terapi. Metod Denna litteraturöversikt är icke-systematisk och har baserats på 16 vetenskapliga artiklar med kvalitativ design samt tre med mixad metod där den kvalitativa delen inkluderades. Artiklarna inhämtades från de två databaserna PubMed och CINAHL. De granskades därefter utifrån bedömningsunderlaget för vetenskaplig klassificering och kvalitet som används av Sophiahemmets Högskola. En integrerad dataanalys gjordes sedan för att analysera och sammanställa resultatet. Resultat Resultatet är baserat på 16 vetenskapliga artiklar med kvalitativ inriktning varav tre artiklar med mixad metod användes som utgångspunkt. Två kategorier identifierades från den integrerade analysen: Förbättrad livskvalitet och Utvecklade relationer. Vidare sammanställdes även fyra underkategorier vilka var: Ökat självförtroende och självkänsla, Ökat välbefinnande, Ömsesidig vänskap samt Ökad samhörighet. Artiklarna beskriver hur personer med psykisk ohälsa upplever djurassisterad terapi. Återkommande i de analyserade resultaten var att djurterapi i dess många olika former verkar ha en direkt samt indirekt positiv inverkan på personer med psykisk ohälsa, där den pådrivande faktorn verkar vara den utvecklade relationen människa och djur. Denna relation blir i sin tur en katalysator till en rad olika faktorer såsom tillit till andra och sig själv, ett ökat självförtroende, samt en förbättrad känsla av sammanhang. Slutsats Att integrera djurassisterad terapi inom omvårdnad för personer med psykisk ohälsa kan vara ett värdefullt verktyg för att stärka människors känsla av sammanhang. Resultaten verkar tyda på att djurassisterad terapi ger en positiv inverkan på den psykiska ohälsan, vilket kan ge underlag till att vidareutveckla denna terapiform som en komplementär behandlingsmetod för att utveckla den psykiatriska vården. / Background Animals serve as loyal and meaningful allies, providing us with unconditional love, affection, and companionship. Each person is unique and should be treated according to their own personal circumstances. The humanistic perspective on health, which connects the soul, body and spirit and views the person from a holistic perspective, is often overshadowed by the biomedical model where illness is described as something that affects the person from the outside, where he does not need to actively participate in the treatment. As mental illness is increasing significantly worldwide, people could benefit from more complementary treatment methods that weave in the humanistic perspective on health. Aim The aim for this literature review was to describe how people with mental illness experience animal-assisted therapy. Method This literature review is non-systematic and has been based on 16 scientific articles with a qualitative design which also includes three mixed method ones where the qualitative part was included. The articles were obtained from the two databases PubMed and CINAHL. They were then reviewed based on the assessment basis for scientific classification and quality used by Sophiahemmet University. An integrated data analysis was then done to analyze and compile the results. Results The result is based on 16 scientific articles with a qualitative focus, in which three of those had a mixed method as a starting point. Two categories were identified from the integrated analysis: Improved quality of life and Enhanced relationships. Furthermore, four subcategories were compiled which were: Increased self-confidence, Increased well-being, Mutual friendship, and Increased affinity. The articles describe how people with mental illness experience animal-assisted therapy. Recurring in the analyzed results was that animal therapy in its many different forms seems to have a direct and indirect positive impact on the persons experiencing mental illness, where the driving factor seems to be the developed relationship between human and animal. This relationship in turn becomes a catalyst to a number of different factors such as trust in others and oneself, increased self-confidence, and an improved sense of coherence. Conclusions Integrating animal assisted therapy in nursing care for people with mental illness can be a valuable tool to strengthen people's sense of coherence. The results seem to indicate that animal-assisted therapy has a positive impact on mental illness, which can provide a basis for further developing this form of therapy as a complementary treatment method to develop the field of psychiatric care.

Bakgrund: Djur har under väldigt många år varit en del av människans vardag från början i form av vakt och jaktdjur. Idag används djuren mer som sällskap och familjemedlemmar. Hundar och människor har genom århundradena tillsammans utvecklat ett samspel som gör att de kan kommunicera. Många äldre personer har idag husdjur som enda sällskap när barnen flyttat ut och make/maka gått bort. När personen måste flytta till ett vårdboende kan de bli tvungna att göra sig av med sitt djur för att många vårdboende idag inte tillåter djur där. Syftet med denna studie är att undersöka djurs betydelse för människor inom äldrevård och demensvård. Metoden är en litteraturstudie där 10 både kvalitativa och kvantitativa vetenskapliga artiklar är granskade och bearbetade. Resultaten visar att ha djur bland äldre har många fördelar, där ibland att djur väckte positiva känslor hos deltagarna och minnen från när de äldre var barn, minnen som aldrig tidigare talats om på vårdboendet. Även en del negativa aspekter framkom så som att den demenssjuka skulle falla eller snubbla på grund av djuret.Slutsats: Examensarbetet visade att många studier visade resultat som var förväntade att till exempel hundar och även andra djur förbättrar äldre personer och dementas livskvalitet så som ensamheten och sociala förhållande. Det var dock förvånande hur många positiva effekter som djur faktiskt ger en människa som tycker om djur. / Background: Animals have for many years been a part of human's life from the beginning as guard and hunting animals. Today the animals are more companion and family members. Dogs and humans have through the centuries in cooperation developed an interface that allows them to communicate. Many old people currently have pets for company when the children moved out and the spouse's passed away. When the person must move to a nursing home they can be forced to dispose their animals because many nursing homes do not allow animals. The purpose of this study is to investigate animal impact on people in elderly care and dementia care. The method of this study is a literature study in which 10 both qualitative and quantitative research articles are reviewed and processed. The results show that animal among the elderly has many advantages, where sometimes the animals aroused positive feelings among the participants and memories from when they were children, memories that have never before been mentioned in medical accommodation. Despite this, some negative aspects emerged as to the person with dementia would fall or stumble because of the animal. Conclusion: This study showed that dogs and other animals, improve the elderly and senile quality of life such as loneliness and social relationship witch in some extent was expected. However, it was surprising how many positive effects animals actually can give a person who is fond of animals.