Research study investigates impact of therapy dogs for dialysis patients
Buddy, Gus, Nike, Prince, Shadow, Dolly and Sunshine.
These are the names of a very important health care team that works diligently to improve patient outcomes – through cues and hugs.
The Dialysis Doggos, as they are affectionately known, are part of a research study led by Meredith L. Stensland, PhD, LMSW, assistant research professor in the Department of Psychiatry and Behavioral Sciences.
The study examines the effect of an animal-assisted intervention for patients on dialysis, and whether this intervention improves symptoms of pain and depression and reduces the number of missed dialysis treatment sessions.
“This is the first time that a procedure like this has been performed for dialysis patients,” Dr. Stensland said. “It’s a safe, non-addictive, non-pharmacological approach to treating chronic pain and depression, both of which are prevalent in dialysis patients.”
Dr. Stensland’s interest in pain research and animal-assisted interventions was sparked after her experience working as a hospice social worker providing end-of-life care.
“During this time, I observed the comfort that therapy dogs provided to terminally ill patients with pain,” Dr. Stensland said. “I know this is beneficial for patients. But I want to help generate empirical evidence and add to the knowledge base for animal interventions. It can benefit patients in ways that other interventions simply cannot.
Dr. Stensland explained that unmanaged chronic pain and depression are known predictors for patients missing dialysis treatment sessions, which can quickly lead to hospitalization and very poor patient outcomes. Given the nature of dialysis treatment, which requires patients to attend four-hour sessions three times a week, finding ways to make the experience more comfortable and enjoyable can have big benefits.
She also explained that previous pet therapy research has shown that interacting with a dog can have a significant impact on specific biomarkers related to pain and stress. Petting a dog releases oxytocin and lowers cortisol levels, which play a role in both pain processing and mood.
Additionally, dogs can act as an extensive social support network for patients, which is known to be linked to improved health outcomes for patients of all kinds.
“Patients form a bond with the dog and look forward to seeing it. They even ask for more visits, which is difficult for us because if the patient was randomized to one visit per week, we have to stick with that even when they ask for more visits. We got a lot of positive feedback,” Dr. Stensland said.
Patients participating in the study enroll for 12 weeks. During the first two weeks, the patient receives no therapy dog visits to train the baseline. In the remaining weeks, a pre-test/post-test design is used to evaluate the therapy dog intervention. Patients take a pre-test assessing their pain level and mood in the waiting room. Then they can interact with therapy dogs. After lots of play, pets, and cuddles, the dog is removed from the room and the patient does another pain and mood assessment. All of these steps take place before the patient returns to the treatment floor for dialysis.
“The hope is that they get a little oxytocin boost, lower their cortisol, and maybe the dialysis experience is less stressful and less uncomfortable.” Therapy dogs represent a unique approach to treatment adherence through improved symptom management.
Therapy dogs and their handlers are provided by volunteers from several organizations, including the local chapter of Pet Partners, Therapy Animals of San Antonio and Pets Are a Wonderful Support (PAWS). Partners in the University Health System’s Paws Up pet therapy program were key in establishing contacts for the study, Dr. Stensland said.
Although the results of the data collection are not yet available, Dr. Stensland can see many possibilities for the benefits of animal-assisted interventions. She is currently conducting therapy dog sessions for UT Health San Antonio affiliated outpatient clinics New Opportunities for Wellness and the Transitional Care Clinic.
“Going to the doctor or receiving treatment can be a nerve-wracking process,” she said. “Sitting in the waiting room and having someone look at you with unconditional acceptance can do a lot for patients.”