本研究は，就学前児童の親における「次世代育成支援対策推進政策に対する認知的評価」と「社会福祉関連QOL」の関係を明らかにすることを目的とした．政策評価における課題を整理し，プログラム評価，特にロジックモデル評価に焦点を当てた．大中小3都市の1,583名分のデータを用い，アウトカム指標を開発し，政策のロジックモデルを評価した．地域・性別ごとの分析も実施し，就学前児童の親の視点によるアウトカム・インパクトを効果的・効率的に高める政策に関する知見を得た． / The purpose of this study was to clarify the relationship between "cognitive appraisal of the policy on Advancement of Measures to Support Raising Next-Generation Children" and "social welfare related quality of life" of preschool children's parents. I organized the issues in policy evaluation and focused on program evaluation, especially logic model evaluation. I used 1,583 data of preschool children's parents in three large, medium and small cities and evaluated the logic model of the policy using the developed outcome and impact indicators. I also analyzed by region and gender, and gained knowledge on measures to effectively/efficiently enhance the outcome and the impact from the viewpoint of the parents. / 博士(社会福祉学) / Doctor of Philosophy in Social Welfare / 同志社大学 / Doshisha University

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)

Cette recherche étudie la perception de la qualité de vie (QV) et de la qualité de l'environnement intérieur (QEI) du point de vue des occupants d’espaces de travail certifiés « durables » selon le système d'énergie et de conception environnementale (LEED) et des occupants des immeubles de bureaux conventionnels. Dans cette étude, la QV est définie en termes de santé perçue, confort, et productivité. La qualité des environnements intérieurs est importante, car les gens passent la majorité de leur vie à l'intérieur des immeubles et, dans notre société contemporaine, plus de ce temps est passé dans des espaces de travail, tels que les espaces de bureaux. Les préoccupations grandissantes pour la durabilité des espaces de vie et la prise de conscience des effets négatifs que des bâtiments peuvent avoir sur les occupants font émerger les constructions dites ‘vertes’ comme étant des alternatives plus durables. LEED est le système d’accréditation le plus populaire de nos jours en Amérique du Nord qui évalue les bâtiments verts en terme de leur performance environnementale. Toutefois, la revue de littérature indique que des occupants des édifices de bureaux certifiés LEED ne sont pas toujours satisfaits avec la QEI. Les bâtiments certifiés LEED sont en effet uniquement évalués selon des critères techniques de performance. Pourtant, il y peut avoir des écarts entre les performances mesurées et celles perçues par les occupants. Cela soulève la question suivante: à quel point les bâtiments construits selon les critères LEED prennent-ils en compte la qualité de vie (QoL) et les facteurs humains dans l’évaluation des espaces de travail ? Cette recherche a donc pour but de proposer un nouveau cadre qui prend en considération non seulement des facteurs durables, mais aussi humains pour évaluer les environnements de travail. Cette recherche utilise une approche mixte – quantitative et qualitative – en trois phases afin d’étudier de manière approfondie la perception de la qualité de vie des occupants de deux bâtiments certifiés LEED et d’un immeuble de bureaux conventionnel. La phase I est dédiée à l’observation des environnements de travail et la documentation des traces d’interaction entre l’utilisateur et l’espace. La phase II est dédiée aux entrevues permettant aux participants de décrire leur expérience de la QV et les facteurs de la QEI qui façonnent leur expérience. Ils nous aident aussi à identifier les éléments constitutifs d'un environnement humain de travail. Parallèlement, des questionnaires aident à comprendre la relation entre la qualité de vie perçue par les occupants et les facteurs de QEI dérivés de la littérature. À l’aide de groupes de discussion, menés lors de la phase III, nous cherchons à valider les résultats préliminaires. Les données sont ensuite analysées séparément en utilisant la ‘triangulation’ afin d’interpréter et corroborer les résultats. Cette étude compare les expériences des espaces de travail « verts » et « conventionnels » et révèle 32 facteurs (30 facteurs QEI et deux autres) qui peuvent affecter de manière significative l'expérience des édifices de bureaux. De plus, des éléments constitutifs d'un environnement de travail humain du point de vue des occupants ont été identifiés. Ceux-ci nous permettent donc de mettre au point un nouveau cadre global, intégrant des critères humains pour évaluer la QEI dans des environnements de travail durables. Ce cadre met en relation la QEI des environnements de travail et la QV des occupants en tant que système environnement-comportement. / This research studies perceived Quality of Life (QoL) and Indoor Environmental Quality (IEQ) of occupants’ in the work environments of sustainable office buildings certified under the Leadership in Energy and Environmental Design (LEED) system (green buildings) and in conventional office buildings. QoL is defined in this research in terms of perceived health, comfort, and productivity. The quality of indoor environments is important because people spend most of their time inside buildings, and in contemporary society, much of the time spent in work environments is in office buildings. In this era of growing concerns about sustainability and the increased awareness of buildings’ negative impacts on occupants, green buildings have been promoted as sustainable solutions to these issues. LEED is the most popular rating system for measuring the performance of green buildings in North America. However, the literature review indicates that there are user complaints about the IEQ of LEED-certified office buildings. LEED-certified buildings are assessed based on technical measures of building performance. This assessment way may create a gap between measured and perceived performance from the user perspective. This raises the question of whether buildings certified with the LEED criteria are humane from the QoL experience of occupants in office buildings. Hence, this research is therefore to propose a new framework that takes into account not only sustainable but also humane factors for evaluating work environments. The study uses a mixed-methods approach – using both quantitative and qualitative methods and proceeds in three phases to comprehensively study occupants’ perceived QoL experience in two LEED and one conventional office building. Phase I uses observations to document the physical work environment and users’ behavioral interactions with the environment. Phase II uses interviews to describe the occupants’ QoL experience, explore the possible IEQ factors shaping their QoL, and to define the constructs of a humane work environment. Questionnaires were distributed concurrently to measure the relationship between occupants’ perceived QoL and IEQ factors that are derived from the literature. Phase III uses focus groups to converge and focus the results of the study. The results are analyzed separately and triangulated using an integrative mixed-methods analysis to interpret, corroborate, conclude, and increase the validation of the findings. The study compared occupants’ perceived QoL in «green» and «conventional» office buildings and revealed 32 quality factors (30 IEQ factors and two others) that influence the QoL experience in office work environments. Also the constructs of what composes a humane work environment based on occupants’ viewpoints have been identified. A new comprehensive, sustainable, and humane framework for assessing IEQ in work environments is developed. This framework guides the relationship between IEQ in work environments and occupants’ QoL as an environment-behavior system.

科学研究費補助金 研究種目:基盤研究(C)(2) 課題番号:10672124 研究代表者:大澤 功 研究期間:1998-2001年度

AIMS: This study investigated the perception of generic and disease-specific Health-Related Quality of Life (HRQoL) for adults living with hearing impairment (HI) in Aotearoa/New Zealand (NZ). This study aimed to answer three questions: (1) What is the perception of HRQoL amongst adults with hearing impairment in NZ? (2) How do these perceptions compare to adults with HI living in other countries for which we have data? (3) What are the demographic and audiometric variables related to device ownership? METHOD: HRQoL, demographic, and audiometric information was collected from 126 adults in NZ. The following demographic information was collected: age, relationship length, hours worked per week, income, ancestry, sex, level of education, city size, and sexual orientation. The following audiologic information was also collected: ownership of hearing aids (HA), ownership of hearing assistance technology (HAT), better-ear pure-tone average (BEPTA), worse-ear pure-tone average (WEPTA), and signal-to-noise ratio loss (SNR loss). HRQoL information was collected using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36; Ware & Sherbourne, 1992), and the Hearing Handicap Inventory (HHI) for both elderly (HHIE) and adults (HHIA; Ventry & Weinstein, 1982; Newman, Weinstein, Jacobson, & Hug, 1991). Variables discriminating HA and HAT owners from non-owners were also analysed. RESULTS: The relationship between demographic variables and HRQoL scores revealed that only age and income were significant. Audiometric variables had significant relationships with disease-specific HRQoL scores, as well as HA and HAT ownership. Finally, disease-specific HRQoL scores and all audiometric variables differentiated HA owners from non- owners, but demographic variables did not. Generic HRQoL scores and all audiometric variables differentiated HAT owners from non-owners. CONCLUSIONS: These results suggest that the negative impacts of HI on HRQoL as reported overseas are also present in NZ, and that not only do audiometric variables including SNR loss are related to HRQoL, but HRQoL is a significant predictor for HA and HAT ownership. Further QoL research is warranted amongst the HI population in NZ to identify and understand any causal relationships present amongst these variables. Furthermore, HRQoL instruments and a test of speech understanding in noise have been shown to provide additional meaningful information, and therefore clinicians might consider including them during consultation.

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.

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.