Animal-assisted therapy program helps radiation therapy outpatients decrease anxiety

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The radiation oncology department at Duke University Medical Center, Durham, North Carolina, has instituted an animal-assisted therapy (AAT) program to help outpatients reduce stress, improve mood, and decrease anxiety during their radiation therapy visit, according to a presentation during the Oncology Nursing Society 36th Annual Congress.

Mary Ann Plambeck, RN, MSN, OCN®, noted that pets play an important role in many people's lives by offering companionship, sensory stimulation, and an unbiased audience. In addition, numerous studies have demonstrated the physiologic and emotional benefits of AAT.

The program helps address the holistic aspect of patient care, identified as important by the Joint Commission, she said, and reflects the trend in health care moving from the inpatient to the outpatient setting.

In addition to decreasing symptoms of stress, depression, and anxiety by using AAT as an effective psychotherapy, objectives included providing patients with a means of coping and relaxation by giving them the opportunity to interact with dogs while coming for daily treatment; enhancing short- and long-term memory through discussion of the animals and past/present household pets; and reducing feelings of isolation by providing patients with the opportunity to interact with dogs.

The first step was to partner with oncology recreation therapy, which coordinates inpatient AAT at Duke for the oncology inpatient units; inpatient policies were reviewed and then revised to accommodate the outpatient setting. The proposal and policy was sent to infection control, hospital administration, and the radiation therapy staff for review, and a literature review was conducted to mitigate infection control concerns; ie, regarding spread of methicillin-resistant Staphylococcus aureus (MRSA) and other communicable diseases. Other obstacles/barriers addressed including fear of and/or allergic reaction to animals.

After the plan was approved, a visit procedure was established that included a low traffic entrance and exit route, an examination of the animal prior to patient contact, escort of the animal to the designated visitation area, visitor handwashing prior to and following contact with the animal, and a photo opportunity. Staff volunteers were sought and trained on how to assess the animal and trainer during the visit to the radiation therapy department and how to approach patients and visitors regarding the animal visit.

Since the program's initiation in October 2010, 207 patients have visited with 15 animals, and it has been successful. Both patients and staff have provided positive feedback, and Plambeck noted “several poignant and emotional patient/dog interactions.” Several future research projects will assess if the animals can play a greater role in further reducing anxiety, such as during treatment planning. Other opportunities include expanding the program to clinics in the new Duke Cancer Institute and other nononcology outpatient departments and working with infection control and the Duke School of Nursing to establish evidence-based research regarding infection control concerns.
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