Pico assesmment 2- evidence based practice PDF

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Pico assesmment 2- evidence based practice - year 1...

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PICO question: “Does animal-assisted therapy reduce the anxiety of elder patients compare to other mental health issues?” P (Problem or Patient or Population): Elder patient; I (intervention/indicator): Animalassisted therapy; C (comparison): Other mental health issues; O (outcome of interest): Reduction in anxiety. Evidence Selection: Evidence for this study has been selected based on different types of journal articles. In this report, high quality and strong recommendations are undertaken that are relevant to the topic. References cited in this report were also reviewed and the articles are in English language and are appropriate for the title were considered in inclusion criteria. All the selected journals were recent, published between 2017-2018. This report was conducted by help of the articles present in MEDLINE, CINAHL, Cochrane database of systematic review. The selected articles provide crisp clear information about the evidence that animal-assisted therapy or intervention can help to reduce anxiety in older patients. So, they are completely relevant to use in this report. The highlighted features of these articles are the effectiveness and importance of animal-assisted therapy to reduce anxiety among elder patients. It is important to use these therapies for old patients, because mostly of them suffer from mental illness, which comes up with several comorbidities like anxiety, stress, or depression. Three best suitable evidences are selected for this report, which commonly includes study on animal-assisted therapies for old patients. According to one of the articles presented, long term animal-assisted therapies reduce the neuropsychiatric symptoms and works as an effective alternative for pharmacological interventions. Neuropsychiatric symptoms include depression, anxiety, apathy, and agitation, which are very common among elder people having dementia and Alzheimer’s disease (Tournier et al., 2017). Compare to this, Peluso et al., (2018) comment that when dementia patients interact with animals then it seems to affect the patient positively and minimize their anxiety and aggressiveness. Moreover, it improves the quality life of the patient by increasing their self-esteem and motivation and reduce their behavioral issues. Another research suggests about the effectiveness of dog-assisted therapy on depressive and anxious institutionalized elderly. Elder people show positive emotional responses and more social interaction by help of this therapy (Ambrosi et al., 2018).

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Evidence Summary: This report outlines the efficacy of animal-assisted therapy to reduce the anxiety symptoms among older patients. Animal-assisted therapy is basically a kind of interaction between the animal (trained or untrained) and the therapist. Usually these animals are dogs, but sometimes other animals like birds, horses, and cats are also used for the therapy. Many researchers suggest that animals are the effective object of attachment for old people, they can also improve the physical and sensory stimulations, social interactions, and reminiscences among patients (Tournier et al., 2017). One of major advantage of using animals in this therapy is that they are of non-judgmental in nature. Along with ageing, many people start showing symptoms of dementia and Alzheimer’s disease. These people have high risk of getting affected by other neuropsychiatric symptoms, such as depression, anxiety, apathy, and agitation. Animal-assisted therapy shows positive impact on to treat these neuropsychiatric diseases in elder patients having dementia (Peluso et al., 2018). According to a pilot study that is conducted to check the efficacy of Animal-assisted therapy implementation in nursing home and reduce the neuropsychiatric symptoms among older patients that has dementia. Towards this end, the researchers investigate the behavior of patient during the sessions of the therapy and both before and after 5 months of weekly therapy sessions. They concluded that along with the increase in number of sessions, positive behavioral frequency of patient will increase, and their interaction with the animal and participation is also improved (Tournier et al., 2017). Furthermore, researchers hypothesized the fact that severity and intensity of reported symptoms and the anxiety and stress is reduced after Animal-assisted therapy. In compare to this, another research suggest that Animalassisted therapy consists of non-pharmacological interventions that improve the health of human-being through use of both untrained and trained animals. They concluded that interaction of the patient that face mental illness issues such as dementia with animals would have positive impact on their mental as well as physical health. This would eventually lead to reduce anxiety and other behavioral problems among elder patients, and also improve the self-esteem, motivation, prosocial conduct in the patients (Peluso et al., 2018). In contrast with this research, another research conducted specifically on dogs, and named as dog’s assisted therapy. This therapy is also aimed to effectively control the anxiety and depression in institutionalized elderly patients (Ambrosi et al., 2018). This study is conducted with a randomized sample of institutionalized patients of 65 years age and more, and all the treatment groups were administered an examination of mini-mental state. People are divided

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based on their examination results, like depression scale, anxiety disorders, numeric pain, illness perceptions, and positive or negative affect. After this treatment analysis was performed on both inter and intra group data analysis. This analysis was performed both before and after the treatment. By 10 weeks, patients will participate individually for session of half-hour, and being observed. Finally, it has been concluded that do’s assisted therapy is efficient to minimize the symptoms of depression among elder patients. Moreover, by increasing the verbal interactions, the dogs were act as facilitator to improve the positive emotional responses of the patients and improved social interactions (Ambrosi et al., 2018). From this report, it has been concluded that animal-assisted therapy reduces the anxiety of elder patients compare to other mental health issues. Animal-assisted interventions are proved to be successful for people having dementia and other neuropsychiatric symptoms that includes anxiety. This report supports the fact that regular and long-term sessions of animalassisted therapy are an effective alternative to pharmacological interventions for the reduction of neuropsychiatric symptoms. Moreover, in patients with dementia, interaction with animals seems to have a positive influence on aggressiveness and anxiety and to improve quality-life and skills. Specifically, dog-assisted therapy is also proved to be effective to minimize the symptoms of anxiety, depression, and stress among patients, while improving their emotional responses and social interactions for a sense of treatment related empowerment (Peluso et al., 2018). However, further investigation is important to define the exactness of the therapy before assisted to the elder patients.

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References: Ambrosi, C., Zaiontz, C., Peragine, G., Sarchi, S., & Bona, F. (2018). Randomized controlled study on the effectiveness of animal-assisted therapy on depression, anxiety, and illness perception in institutionalized elderly. Psychogeriatrics, 19(1), 55-64. doi:10.1111/psyg.12367 Peluso, S., Rosa, A. D., Lucia, N. D., Antenora, A., Illario, M., Esposito, M., & Michele, G. D. (2018). Animal-Assisted Therapy in Elderly Patients: Evidence and Controversies in Dementia and Psychiatric Disorders and Future Perspectives in Other Neurological Diseases. Journal of Geriatric Psychiatry and Neurology, 31(3), 149-157. doi:10.1177/0891988718774634 Tournier, I., Vives, M., & Postal, V. (2017). Animal-Assisted Intervention in Dementia. Swiss Journal of Psychology, 76(2), 51-58. doi:10.1024/1421-0185/a000191...