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Researchers investigate power of human-animal interactions among children with cancer
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Researchers at Vanderbilt University School of Nursing have received a grant from the nonprofit Human Animal Bond Research Institute to study the health benefits of human-animal interactions among children receiving treatment for cancer.
“In this carefully designed research, we are evaluating the effects of human-animal interactions on reducing anxiety, depression, worry and pain, and increasing quality of life in children with advanced cancer as well as their parents,” Mary Jo Gilmer, PhD, MBA, RN-BC, FAAN, professor of nursing at Vanderbilt University School of Nursing, said in a press release. “The goal is to obtain strong data to support the positive health benefits of human-animal interactions in decreasing suffering of children, particularly those diagnosed with advanced cancer.”
HemOnc Today spoke with Gilmer about the research and how she hopes the results will help clinicians and researchers care for these patients.
Question: What prompted this research?
Answer : Two experiences prompted this research. As clinical director of a pediatric palliative care team, I was called to meet an adolescent girl who was actively dying. She had two transplants and her body rejected them both. She decided she was not willing to go through another surgery, nor did she want extensive debilitating treatments at the end of life. I found it very difficult to talk with her about her impending death, but asked if there was anything that might make the transition easier. Her response was, ‘I really miss my dog.’ I asked what kind of dog she had. ‘A black pug,’ she said. Black pugs are a bit unusual, but our youngest son had a black pug puppy. I rather impulsively decided to go to our son’s condo and pick up the puppy. When we arrived at the hospital, I slipped the puppy under my coat and went up to my patient’s room. I did not know what that puppy might do, but the puppy just seemed to intuit what was going on. She curled up under the patient’s arm and stayed there quietly until she died about an hour later. Although we broke the rules, I really did not care. That experience energized me to ensure registered dogs were welcome in the hospital and could support other children going through stressful encounters.
Secondly, we completed an NIH study examining adjustment of parents and siblings to the death of a child due to cancer. We asked children between ages 8 and 17 years who provided the most support to them after the death of their sibling. I was expecting the majority to say their best friend or a teacher, pastor or their parents. The data showed that as many youth said their pets as said their best friends. This finding led me to want to document the support that pets can provide. Some hospitals still do not allow dogs to visit their patients, and my hope is to collect and share data that show the benefits of animal-assisted interactions along with the evidence of minimal risks for infection or injuries to patients.
Q: How will you conduct the study?
A: The purpose of this study is to evaluate the feasibility and preliminary efficacy of a randomized clinical trial using animal-assisted interactions with children diagnosed with advanced cancer. Preliminary data with dog therapy show strong promise to improve psychosocial outcomes for children newly diagnosed with cancer. During the 2-year study, we will recruit children (n = 36) between the ages of 3 and 17 years and their primary caregiver (n = 36). Through an experimental design, we will assess anxiety, stress and quality of life before and after human-animal interaction sessions. We will measure this through physiological, survey, interview and observational data.
Animal-assisted interventions in the treatment group will involve use of a registered dog during each child’s potentially anxiety-producing visits to the hematology/oncology clinic. Children in the usual care group will be exposed to the same conditions without a dog. Children and parents will complete measures of anxiety, stress and quality of life at baseline and at every clinic visit for 12 weeks. Physiologic measures will include heart rate, blood pressure and child’s salivary cortisol. Data from surveys and videos collected during the study, as well as patient/parent interviews at the study’s conclusion, will be included. Unlike much of the existing research in the human-animal interaction field, this rigorously designed study will benefit from expertise of a multidisciplinary team, a randomized control cohort, reliable measures used previously in human-animal interactions research, and outcomes among children and their parents. Results will provide a strong foundation for full-scale testing of human-animal interactions with children and young adults with advanced cancer and potentially other life-threatening conditions, such as neurodegenerative conditions, cystic fibrosis and heart disease.
Q: What is the anticipated timeline for results?
A: Data collection will continue through December 2020. We anticipate study results will be available soon after.
Q: What do you hypothesize that you will find?
A: We hypothesize that children with advanced cancer who receive the intervention will experience less anxiety and stress and have improved health-related quality of life throughout the study period compared with patients who do not receive the intervention. We also hypothesize that primary caregivers of children with advanced cancer who receive the intervention will experience less anxiety and stress than parents of children who do not receive intervention.
Q: What makes this study unique ?
A: This study will identify potential emotional resources for children with advanced cancer and their caregivers, and show the effects of human-animal interactions on emotional well-being and physiologic responses through reliable, quantitative data.
Q: Do you plan to conduct additional research on this topic?
A: Yes. I would very much like to conduct research on the benefits of animal-assisted therapy in other populations, such as children on the autism spectrum and children with other life-threatening conditions, such as congenital heart defects or neurological degenerative conditions.
Q: Is there anything else that you would like to mention?
A: I want to thank the nonprofit Human Animal Bond Research Initiative for funding this important work, and acknowledge the support of Vanderbilt University School of Nursing and the Monroe Carell Jr. Children’s Hospital at Vanderbilt along with the work of our dedicated interdisciplinary team. Finally, I want to thank the impressive and precious families who participate in this research. – by Jennifer Southall
Reference:
Akard TF, et al. Cancer Nurs. 2019;doi:10.1097/NCC.0000000000000573.
For more information:
Mary Jo Gilmer, PhD, MBA, RN-BC, FAAN, can be reached at Vanderbilt University School of Nursing, 417 Godchaux Hall, 461 21st Ave. South, Nashville, TN 37240; email: maryjo.gilmer@vanderbilt.edu.
Disclosure : Gilmer reports no relevant financial disclosures.