As a member of the medical community, it is important for nurses to read and understand current research articles pertaining to the medical field to keep up with the latest treatments, procedures, and other topics that relates to medicine. These articles should contain valid and reliable research, and they should be peer-reviewed. In this paper, I have read and will evaluate the article “The Effect of Animal-Assisted Activity on Inpatients with Schizophrenia” from the Journal of Psychosocial Nursing (Chu, Liu, Sun, Lin, 2009).
The problem presented is that there are few studies that focus on the effects that animal-assisted activities have on people who suffer from schizophrenia. The researchers of this study revert to the historical significance of human interaction with animals. Previously, people relied on animals for work, such as in transportation or labor. With advancements in technology taking over, people have been free to obtain animals strictly as companions and service pets that can assist in activities of daily living. This study relates to nursing in that it offers an adjunct treatment option for mental health patients. Drugs cannot always be the answer, and for many, drugs are not even an option. The purpose of this research study is to examine how activities involving animals and institutionalized patients with schizophrenia can influence the patients’ “self-esteem, control over activities of daily living, and other psycho-physiological aspects” (Chu et al., 2009).
One major concept developed in this study is that having an animal companion, whether permanent or visiting, can positively affect a patient’s body and mind. This can be accomplished through touching an animal, taking care of it, playing with it, and even talking to it. Since animals do not verbally communicate as humans do, the patient is free to express his or herself emotionally. Another concept mentions that the use of animals in health care has been shown to boost the outcomes of traditional therapies. Animals can also help patients lower their anxiety and make them feel more comfortable during those therapies. Chu et al. (2009) cites many references in this study. Most of them were published within the last thirty years, with a few dating back to the late 70s. These older citations may have been included to show that these concepts are not new, yet should continue to be studied in more depth. It may be acceptable to include older references because the idea of animals having an influence on humans does not particularly change. What changes is the implementation of animal-assisted activities or therapies on the patients.
In reviewing this article, five theoretical concepts of animal-assisted activity are presented. These concepts include physical, psychotherapeutic, social, spiritual, and life purpose benefits. Physical benefits of patients interacting with animals include increased movement and muscle strength from playing with the animals, as well as improvements in vital signs such as blood pressure, heart rate, and respiratory rate. Patients who care for animals tend to also take better care of themselves. The psychotherapeutic benefits help in reducing anxiety and feelings of depressed moods. Animals can help patients feel safe and confident, and improve their self-esteem. Social benefits come from positive interactions with other pet owners or pet lovers. In caring for the animals, patients develop feelings of empathy toward the animal and other people. Through the spiritual aspect, animals bring peace and comfort to the patients. Finally, a greater purpose in life is gained because it is the patients’ duty and desire to make sure the animals are loved and well taken care of. All of these elements relate mostly to nursing since an illness is being treated using alternative therapy. However, the disciplines of psychiatry and social work may be incorporated as well.
The independent variable in this study is the animal that is used for the activities. The dependent variable is the patient interacting with the animal through a variety of different activities. The variables are measured through a questionnaire that is given one week before and one week after the program is completed. The questionnaire assesses each patient’s self-esteem and self-determination, whether they have social support, and any fluctuations in positive and negative symptoms of schizophrenia. The research question asks whether interactions between animals and schizophrenic patients can have a positive impact on the patients’ physiology and psychologic well-being.
The design of this study is qualitative in nature. Since it involves a lived experience of actual patients, it is considered phenomenological research. Inductive reasoning was implemented by providing small instances of positive animal and human interactions, and using these examples to investigate other results of the interactions.
This study was performed in a psychiatric facility in Taiwan with 30 randomly selected patients under 60 years of age who had been diagnosed with schizophrenia for more than 10 years. None of these patients were cognitively impaired or receiving other experimental treatments at the time of the study. There was a treatment group and a control group, and 15 patients were randomly assigned to each group. The treatment group had weekly visits with two trained dogs, while the control group continued with their usual treatment. The study was done over eight weeks, with sessions occurring once a week for 50 minutes. Each week, a different activity was offered. For example, after getting to know the dogs in the first week, the patients could walk with them during the second week. Some of the sessions involved throwing different sized balls to the dogs. The patients were encouraged to fully interact with the dogs by playing with and petting them.
Since the participants were chosen at random, a probability sample was used. Each patient had an equal opportunity of being chosen. The type of reliability was the inter-rater reliability test. The nurses involved as raters were impartial to the research, but regularly assessed the patients on a daily basis. They were used as blind raters. For validity, formal validity was used to measure ways this program could be improved in the future. No ethical considerations were mentioned in the article.
The data analysis tool used to evaluate the information was the Mann-Whitney U test. This test is used to compare two groups of the same sample size when each observation is independent of the other (Mann-Whitney U test, n.d.). The results were presented using a table that showed the mean of each group before and after interaction with the dogs. The table showed that following the two-month program of animal-assisted activities, there was great improvement in the patients’ overall self-esteem and self-determination, as well as a reduction in positive symptoms of schizophrenia and improved emotional symptoms. The study also revealed some unexpected effects such as patients showing happiness when the dogs were present.
Although this study was valid and reliable, there were both strengths and weaknesses. Some strengths were that the program was consistent in its implementation and it was unbiased. A limitation of the study is the small sample size and the fact that three of the 15 participants of the treatment group did not participate because of displaying fear toward the dogs. This reduces the sample size even further. Also, the study did not consider any medications that were being administered per the patients’ usual treatments. For these reasons, it would be difficult to generalize the findings to other populations.
Overall, this study is a good stepping-stone to further evaluation of the impact that animals have on humans’ well-being. Nurses can use this information to offer patients and their families other options that do not include drugs. Patients can develop compassion for others, love for themselves, and maybe find a new best friend in the process.