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Animal-Assisted Activity in Critically Ill Older Adults: A Randomized Pilot and Feasibility Trial

机译:危重老年人的动物辅助活动:随机试点和可行性试验

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Background: Limited evidence suggests the efficacy of animal-assisted activities (AAA) in improving biobehavioral stress responses in older patients in intensive care units (ICUs). Objectives: To assess the feasibility of an AAA (dog) intervention for improving biobehavioral stress response, measured by self-reported stress and anxiety and salivary cortisol, C-reactive protein, and interleukin-1 beta in older ICU patients, we examined enrollment, attrition, completion, data collection, and biobehavioral stress responses. Methods: ICU patients >= 60 years old were randomly assigned to a 10-min AAA intervention or control/usual ICU care. Attitudes toward pets were assessed before the intervention. Self-reported stress and anxiety and salivary stress biomarkers were collected before and after the intervention and the usual care condition. Results: The majority of patients were ineligible due to lack of decisional capacity, younger age, inability to provide saliva specimens, or critical illness. Though 15 participants were randomly allocated (AAA = 9; control = 6), only 10 completed the study. All participants completed the questionnaires; however, saliva specimens were significantly limited by volume. AAA was associated with decreases in stress and anxiety. Biomarker results were variable and revealed no specific trends associated with stress responses. Conclusions: Barriers to recruitment included an insufficient number of patients eligible for AAA based on hospital policy, difficulty finding patients who met study eligibility criteria, and illness-related factors. Recommendations for future studies include larger samples, a stronger control intervention such as a visitor without a dog, greater control over the AAA intervention, and use of blood from indwelling catheters for biomarkers.
机译:背景:有限的证据表明动物辅助活动 (AAA) 在改善重症监护病房 (ICU) 老年患者的生物行为应激反应方面具有疗效。目的: 为了评估 AAA(狗)干预改善生物行为应激反应的可行性,通过自我报告的压力和焦虑以及老年 ICU 患者的唾液皮质醇、C 反应蛋白和白细胞介素-1 β 来衡量,我们检查了入组、损耗、完成、数据收集和生物行为应激反应。方法:将 >= 60 岁的 ICU 患者随机分配到 10 分钟的 AAA 干预或对照/常规 ICU 护理组。在干预前评估对宠物的态度。在干预和常规护理条件之前和之后收集自我报告的压力和焦虑以及唾液压力生物标志物。结果:大多数患者因缺乏决策能力、年龄较小、无法提供唾液标本或危重疾病而不符合条件。虽然15名受试者被随机分配(AAA=9;对照=6),但只有10人完成了研究。所有参与者都完成了问卷调查;然而,唾液标本受到体积的显着限制。AAA与压力和焦虑的减少有关。生物标志物结果是可变的,没有显示与应激反应相关的特定趋势。结论:招募的障碍包括根据医院政策符合 AAA 条件的患者数量不足、难以找到符合研究资格标准的患者以及疾病相关因素。对未来研究的建议包括更大的样本、更强的控制干预(例如没有狗的访客)、对 AAA 干预的更大控制以及使用留置导管的血液作为生物标志物。

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