Rapid increases in population ageing and the associated rise in the prevalence of dementia have created many challenges for the care of older people with dementia. As the majority of people now living in residential aged care facilities (RACFs) now have dementia, the need to maximise the quality of life for this group is increasingly recognised. While such issues have attracted research and policy attention in recent years, the evidence base for practice in dementia care is still underdeveloped. The need for more effective therapeutic interventions to improve the quality of life for older people with dementia is recognised, particularly those living in RACFs. The use of pets is one example of recent attempts to help create a more home-like environment and dog therapy is available in many facilities. Well designed research to demonstrate whether it actually has a positive impact on residents’ quality of life is lacking. This study is the first reported randomised controlled trial investigating dog therapy for people with dementia. Fifty-five older people with mild to moderate dementia living in three residential aged care facilities in the Greater Brisbane area participated in this study. The goal was to identify whether dog therapy accrued any benefits to residents’ well being and compare the benefits, if any, with human-only therapy intervention. The main hypothesis was that dog contact delivered in a small group recreational therapy format would have a beneficial effect on the well being of participants. It was additionally hypothesised that prior and current positive relationships with dogs would be related to improved outcomes of dog therapy and support a human-animal bond explanation of relationship development with the therapy dog(s). Participants were randomly assigned into two groups within each facility: The dog therapy group and a human-only therapy group. Session plans were structured according to a recreational therapy format. Three therapy dogs were used (a miniature Poodle, a Staffordshire Terrier and a German Shepherd Dog) with one dog present at any dog therapy session A before-and-after design was used with concealment of participants at allocation. Mixed methods were used including a panel of seven validated psychometric instruments, an observational measure and a series of four novel questionnaires, dogs for older groups with Alzheimer’s (DOGA), developed de novo specifically to investigate the effects of dog therapy on participants within this study. Measures of mood, quality of life, health and psychosocial functioning, collectively referred to as well-being, detected benefits accruing to dog therapy participants compared with human-only therapy that approached significance (p = .056) with a large effect size (partial eta squared 16.6%). A different measure of mood and apathy showed similar improvement for participants of both therapy types trialed with analyses of a smaller dataset (n = 36) revealing an overall highly significant result (p=.008) and large effect size (partial eta squared = 25.6%) for all participants. To explore the perceptions of care staff to the dog therapy intervention, a self-complete semi-structured questionnaire was completed by a sample of 21 from two of the study facilities. Content analysis revealed that staff overwhelmingly supported dog therapy with a total of 84 comments about benefits and 22 about risks. Responses were categorised and then linked into emergent themes: a temporal dimension, sense of self and increased opportunities for self expression. The opportunity provided by the therapy dog for accessible caring physical contact for participants was identified as important. General recreational therapy goals such as improved mood, reminiscence and increased levels of conversation were reported by staff to continue beyond interventions. The observed risks were: confusion over dog ownership, subsequent worry about losing the dog after sessions, jealousy over the therapy dog and one participant did not enjoy the small group format. Participants described their experiences of contact with the therapy dog as “like” above “attached”. Personal preference explanations are therefore supported, rather than “attachment”, to explain outcomes for participants. This suggests the psychosocial approach has greater relevance here than human-animal bond explanations. Effects of previous dog attachment on outcomes were inconclusive but there was some evidence that participants’ relationship with the therapy dog(s) influenced outcomes, though the nature of that relationship has not been clarified. Recommendations from the study findings are that dog therapy be conducted for people with mild to moderate levels of dementia in groups of 3-11 for a duration of around 10 weeks with sessions for 30 minutes held once or twice weekly and according to a standard format. Opportunities for participants to touch, hug and interact directly with the therapy dog should be maximised without compromising dog welfare. The findings suggest that respect for the personhood of participants is important to the success of the therapy types trialled, which further supports psychosocial therapies involving contact with people or live animals for use with people with dementia over those that minimise or exclude it.

Rapid increases in population ageing and the associated rise in the prevalence of dementia have created many challenges for the care of older people with dementia. As the majority of people now living in residential aged care facilities (RACFs) now have dementia, the need to maximise the quality of life for this group is increasingly recognised. While such issues have attracted research and policy attention in recent years, the evidence base for practice in dementia care is still underdeveloped. The need for more effective therapeutic interventions to improve the quality of life for older people with dementia is recognised, particularly those living in RACFs. The use of pets is one example of recent attempts to help create a more home-like environment and dog therapy is available in many facilities. Well designed research to demonstrate whether it actually has a positive impact on residents’ quality of life is lacking. This study is the first reported randomised controlled trial investigating dog therapy for people with dementia. Fifty-five older people with mild to moderate dementia living in three residential aged care facilities in the Greater Brisbane area participated in this study. The goal was to identify whether dog therapy accrued any benefits to residents’ well being and compare the benefits, if any, with human-only therapy intervention. The main hypothesis was that dog contact delivered in a small group recreational therapy format would have a beneficial effect on the well being of participants. It was additionally hypothesised that prior and current positive relationships with dogs would be related to improved outcomes of dog therapy and support a human-animal bond explanation of relationship development with the therapy dog(s). Participants were randomly assigned into two groups within each facility: The dog therapy group and a human-only therapy group. Session plans were structured according to a recreational therapy format. Three therapy dogs were used (a miniature Poodle, a Staffordshire Terrier and a German Shepherd Dog) with one dog present at any dog therapy session A before-and-after design was used with concealment of participants at allocation. Mixed methods were used including a panel of seven validated psychometric instruments, an observational measure and a series of four novel questionnaires, dogs for older groups with Alzheimer’s (DOGA), developed de novo specifically to investigate the effects of dog therapy on participants within this study. Measures of mood, quality of life, health and psychosocial functioning, collectively referred to as well-being, detected benefits accruing to dog therapy participants compared with human-only therapy that approached significance (p = .056) with a large effect size (partial eta squared 16.6%). A different measure of mood and apathy showed similar improvement for participants of both therapy types trialed with analyses of a smaller dataset (n = 36) revealing an overall highly significant result (p=.008) and large effect size (partial eta squared = 25.6%) for all participants. To explore the perceptions of care staff to the dog therapy intervention, a self-complete semi-structured questionnaire was completed by a sample of 21 from two of the study facilities. Content analysis revealed that staff overwhelmingly supported dog therapy with a total of 84 comments about benefits and 22 about risks. Responses were categorised and then linked into emergent themes: a temporal dimension, sense of self and increased opportunities for self expression. The opportunity provided by the therapy dog for accessible caring physical contact for participants was identified as important. General recreational therapy goals such as improved mood, reminiscence and increased levels of conversation were reported by staff to continue beyond interventions. The observed risks were: confusion over dog ownership, subsequent worry about losing the dog after sessions, jealousy over the therapy dog and one participant did not enjoy the small group format. Participants described their experiences of contact with the therapy dog as “like” above “attached”. Personal preference explanations are therefore supported, rather than “attachment”, to explain outcomes for participants. This suggests the psychosocial approach has greater relevance here than human-animal bond explanations. Effects of previous dog attachment on outcomes were inconclusive but there was some evidence that participants’ relationship with the therapy dog(s) influenced outcomes, though the nature of that relationship has not been clarified. Recommendations from the study findings are that dog therapy be conducted for people with mild to moderate levels of dementia in groups of 3-11 for a duration of around 10 weeks with sessions for 30 minutes held once or twice weekly and according to a standard format. Opportunities for participants to touch, hug and interact directly with the therapy dog should be maximised without compromising dog welfare. The findings suggest that respect for the personhood of participants is important to the success of the therapy types trialled, which further supports psychosocial therapies involving contact with people or live animals for use with people with dementia over those that minimise or exclude it.

Rapid increases in population ageing and the associated rise in the prevalence of dementia have created many challenges for the care of older people with dementia. As the majority of people now living in residential aged care facilities (RACFs) now have dementia, the need to maximise the quality of life for this group is increasingly recognised. While such issues have attracted research and policy attention in recent years, the evidence base for practice in dementia care is still underdeveloped. The need for more effective therapeutic interventions to improve the quality of life for older people with dementia is recognised, particularly those living in RACFs. The use of pets is one example of recent attempts to help create a more home-like environment and dog therapy is available in many facilities. Well designed research to demonstrate whether it actually has a positive impact on residents’ quality of life is lacking. This study is the first reported randomised controlled trial investigating dog therapy for people with dementia. Fifty-five older people with mild to moderate dementia living in three residential aged care facilities in the Greater Brisbane area participated in this study. The goal was to identify whether dog therapy accrued any benefits to residents’ well being and compare the benefits, if any, with human-only therapy intervention. The main hypothesis was that dog contact delivered in a small group recreational therapy format would have a beneficial effect on the well being of participants. It was additionally hypothesised that prior and current positive relationships with dogs would be related to improved outcomes of dog therapy and support a human-animal bond explanation of relationship development with the therapy dog(s). Participants were randomly assigned into two groups within each facility: The dog therapy group and a human-only therapy group. Session plans were structured according to a recreational therapy format. Three therapy dogs were used (a miniature Poodle, a Staffordshire Terrier and a German Shepherd Dog) with one dog present at any dog therapy session A before-and-after design was used with concealment of participants at allocation. Mixed methods were used including a panel of seven validated psychometric instruments, an observational measure and a series of four novel questionnaires, dogs for older groups with Alzheimer’s (DOGA), developed de novo specifically to investigate the effects of dog therapy on participants within this study. Measures of mood, quality of life, health and psychosocial functioning, collectively referred to as well-being, detected benefits accruing to dog therapy participants compared with human-only therapy that approached significance (p = .056) with a large effect size (partial eta squared 16.6%). A different measure of mood and apathy showed similar improvement for participants of both therapy types trialed with analyses of a smaller dataset (n = 36) revealing an overall highly significant result (p=.008) and large effect size (partial eta squared = 25.6%) for all participants. To explore the perceptions of care staff to the dog therapy intervention, a self-complete semi-structured questionnaire was completed by a sample of 21 from two of the study facilities. Content analysis revealed that staff overwhelmingly supported dog therapy with a total of 84 comments about benefits and 22 about risks. Responses were categorised and then linked into emergent themes: a temporal dimension, sense of self and increased opportunities for self expression. The opportunity provided by the therapy dog for accessible caring physical contact for participants was identified as important. General recreational therapy goals such as improved mood, reminiscence and increased levels of conversation were reported by staff to continue beyond interventions. The observed risks were: confusion over dog ownership, subsequent worry about losing the dog after sessions, jealousy over the therapy dog and one participant did not enjoy the small group format. Participants described their experiences of contact with the therapy dog as “like” above “attached”. Personal preference explanations are therefore supported, rather than “attachment”, to explain outcomes for participants. This suggests the psychosocial approach has greater relevance here than human-animal bond explanations. Effects of previous dog attachment on outcomes were inconclusive but there was some evidence that participants’ relationship with the therapy dog(s) influenced outcomes, though the nature of that relationship has not been clarified. Recommendations from the study findings are that dog therapy be conducted for people with mild to moderate levels of dementia in groups of 3-11 for a duration of around 10 weeks with sessions for 30 minutes held once or twice weekly and according to a standard format. Opportunities for participants to touch, hug and interact directly with the therapy dog should be maximised without compromising dog welfare. The findings suggest that respect for the personhood of participants is important to the success of the therapy types trialled, which further supports psychosocial therapies involving contact with people or live animals for use with people with dementia over those that minimise or exclude it.

Rapid increases in population ageing and the associated rise in the prevalence of dementia have created many challenges for the care of older people with dementia. As the majority of people now living in residential aged care facilities (RACFs) now have dementia, the need to maximise the quality of life for this group is increasingly recognised. While such issues have attracted research and policy attention in recent years, the evidence base for practice in dementia care is still underdeveloped. The need for more effective therapeutic interventions to improve the quality of life for older people with dementia is recognised, particularly those living in RACFs. The use of pets is one example of recent attempts to help create a more home-like environment and dog therapy is available in many facilities. Well designed research to demonstrate whether it actually has a positive impact on residents’ quality of life is lacking. This study is the first reported randomised controlled trial investigating dog therapy for people with dementia. Fifty-five older people with mild to moderate dementia living in three residential aged care facilities in the Greater Brisbane area participated in this study. The goal was to identify whether dog therapy accrued any benefits to residents’ well being and compare the benefits, if any, with human-only therapy intervention. The main hypothesis was that dog contact delivered in a small group recreational therapy format would have a beneficial effect on the well being of participants. It was additionally hypothesised that prior and current positive relationships with dogs would be related to improved outcomes of dog therapy and support a human-animal bond explanation of relationship development with the therapy dog(s). Participants were randomly assigned into two groups within each facility: The dog therapy group and a human-only therapy group. Session plans were structured according to a recreational therapy format. Three therapy dogs were used (a miniature Poodle, a Staffordshire Terrier and a German Shepherd Dog) with one dog present at any dog therapy session A before-and-after design was used with concealment of participants at allocation. Mixed methods were used including a panel of seven validated psychometric instruments, an observational measure and a series of four novel questionnaires, dogs for older groups with Alzheimer’s (DOGA), developed de novo specifically to investigate the effects of dog therapy on participants within this study. Measures of mood, quality of life, health and psychosocial functioning, collectively referred to as well-being, detected benefits accruing to dog therapy participants compared with human-only therapy that approached significance (p = .056) with a large effect size (partial eta squared 16.6%). A different measure of mood and apathy showed similar improvement for participants of both therapy types trialed with analyses of a smaller dataset (n = 36) revealing an overall highly significant result (p=.008) and large effect size (partial eta squared = 25.6%) for all participants. To explore the perceptions of care staff to the dog therapy intervention, a self-complete semi-structured questionnaire was completed by a sample of 21 from two of the study facilities. Content analysis revealed that staff overwhelmingly supported dog therapy with a total of 84 comments about benefits and 22 about risks. Responses were categorised and then linked into emergent themes: a temporal dimension, sense of self and increased opportunities for self expression. The opportunity provided by the therapy dog for accessible caring physical contact for participants was identified as important. General recreational therapy goals such as improved mood, reminiscence and increased levels of conversation were reported by staff to continue beyond interventions. The observed risks were: confusion over dog ownership, subsequent worry about losing the dog after sessions, jealousy over the therapy dog and one participant did not enjoy the small group format. Participants described their experiences of contact with the therapy dog as “like” above “attached”. Personal preference explanations are therefore supported, rather than “attachment”, to explain outcomes for participants. This suggests the psychosocial approach has greater relevance here than human-animal bond explanations. Effects of previous dog attachment on outcomes were inconclusive but there was some evidence that participants’ relationship with the therapy dog(s) influenced outcomes, though the nature of that relationship has not been clarified. Recommendations from the study findings are that dog therapy be conducted for people with mild to moderate levels of dementia in groups of 3-11 for a duration of around 10 weeks with sessions for 30 minutes held once or twice weekly and according to a standard format. Opportunities for participants to touch, hug and interact directly with the therapy dog should be maximised without compromising dog welfare. The findings suggest that respect for the personhood of participants is important to the success of the therapy types trialled, which further supports psychosocial therapies involving contact with people or live animals for use with people with dementia over those that minimise or exclude it.

Text in English / The aim of the current study is to provide detailed information regarding individuals’ turning-point experiences, in order to understand the psychological and spiritual aspects involved in moving beyond a significant low point towards a significant high point in one’s life. It seems that inadequate information regarding formal studies about this phenomenon exists in literature, which this study endeavours to address. Thereby, a qualitative phenomenological study was conducted amongst nineteen South African citizens, who were purposefully and conveniently selected from the diverse population of South Africa. Individual participants confirmed that they had experienced significant low points from which they had been able to move to reach a significant high point. Through interviews, River-of-life (RoL) drawings and a short background information questionnaire (SBIQ), participants were able to provide information on their experiences. The participants’ stories, obtained during the interviews, were transcribed, and then triangulated with information obtained from the RoL drawings, completed SBIQ’s, researcher notes and other additional sources, during the analysis phase. Thematic analysis was performed on individuals’ stories to obtain the research participants’ themes, which provided the aspects involved in their turning-point experiences. In-depth analysis of all participants’ stories produced a theme-model consisting of main and unique themes. Unique themes identified by the study supported the main themes. Themes highlighted through the study included minding oneself, support from and to, doing something, religion/faith in God, positive attitude and meaning. The positive psychology theoretical framework was applied in interpreting the findings. This study suggests that a combination of themes is relevant in one’s ability to move beyond a low point experience towards a high point experience. The application of the theme-model could assist others in similar situations to create change or a turning-point experience in order to move away from or transcend a low point. The study was linked to the subjective measuring of Quality of Life (QOL). It is recommended that more subjective indicators of QOL, including spirituality indicators, be investigated. While this study focussed on the internal influences affecting change in a person’s life towards fulfilment, further studies may investigate the external influences. / Psychology / Ph. D. (Psychology)

This study was done to assess the quality of life (QOL) of people living with HIV and AIDS (PLWHA) in Swaziland who are on antiretroviral therapy (ART). No study has been done on QOL of PLWHA in Swaziland who are on ART since it started to be administered in Swaziland in 2001. A qualitative, exploratory, descriptive, and contextual design was used to assess QOL of PLWHA in Swaziland who are on ART. Twenty-four PLWHA were purposely selected to participate in the study. Methods of data collection used were semi-structured individual in-depth interviews, focus group discussions, and observations. The data (tape-recorded interviews and discussions, and field notes) were transcribed verbatim for data analysis. Data analysed was done using Tesch’s framework of data analysis as described in Creswell (2002:256-283). The research findings are reflected, with the six domains of QOL identified through a literature review and validated by nurses’ expertise. These domains are the physiological, psychological, spiritual, socio-economic, cognitive, and environmental domains.The study revealed that PLWHA in Swaziland are faced with many challenges concerning ART, namely: inability to meet their nutrition needs, non-adherence to ART, experience of disfiguring side effects of ARVs, inconsistent condom use, experience of stigma and discrimination, depression, difficulty in accepting and coping with ARVs, lowered self-esteem, a negative influence of some religions on ART, a lack of financial support, poor support systems, poor understanding of ARVs, negative thoughts about HIV and AIDS and ART, an unsatisfactory health care delivery system, a negative influence of culture on ART, and violation of the rights of PLWHA. These challenges negatively influence the QOL of PLWHA and hence the study concluded that PLWHA in Swaziland who are on ART have a poor QOL. Conclusions drawn from the data analysis reveal that PLWHA in Swaziland are powerless to deal with the above challenges and improve their QOL. The researcher, therefore, developed guidelines to empower PLWHA to deal with these challenges and adhere to ART, thus improving their QOL. Recommendations were made with regard to nursing practice, nursing education, and further nursing research. / Health Studies / D. Litt. et Phil. (Health Studies)