The meaningfulness of Canine-Assisted Interventions (CAIs) on the health and social care of older people residing in long term care: a systematic review.
BACKGROUND
Preliminary evidence suggests that canine-assisted interventions (any therapeutic process that intentionally involves dogs as part of the process ) may produce some short term beneficial effects on the health and social care of older people residing in long term care facilities; however there has been no formal qualitative synthesis on how these activities are experienced by those involved. Determining peoples' opinions and feelings towards this activity is crucial to its success.


OBJECTIVE
The aim of this systematic review was to synthesise the best available evidence on the meaningfulness of canine-assisted intervention on older people who reside in long term care.


METHODS
A comprehensive search was undertaken of 32 electronic databases and two reputable websites from their inception to 2009. The search was restricted to English language and both published and unpublished studies were considered.


METHODS
Studies that examined the experience of older people residing in long term care that were involved in canine-assisted interventions were considered. Critical appraisal of study quality was undertaken using Joanna Briggs Institute critical appraisal instruments. Data extraction was via the Joanna Briggs Institute standard data extraction form for evidence of meaningfulness.


RESULTS
Two studies met inclusion criteria and methodological quality requirements. Studies had some differences: one explored residents' experiences while the other focused on staff experiences, one was conducted in a 'Westernised' country and one included residents who had been involved in this activity for two years prior to the study being conducted. There were 41 findings extracted from both studies that were organised into 12 categories. A meta-synthesis was undertaken and two synthesised findings were developed; the first suggesting that providing residents of long term care facilities the opportunity to participate in canine-assisted interventions (more specifically canine-assisted activities) can provide a range of mental, emotional, physiological and social benefits and the other suggesting that undertaking a program in such a facility has both practical and safety considerations for staff, residents and animals.


CONCLUSIONS
The current evidence base for the meaningfulness of canine-assisted activities in long term care facilities is limited and methodologically weak. A qualitative meta-synthesis using the Joanna Briggs Institute Qualitative Assessment and Review Instrument software suggests that the experience of a resident being involved in a canine-assisted activity can be positive on an emotional, mental, physiological and social level but there are some practical issues to consider such as the personal preference of the resident and staff training. Caution is advised when interpreting these results due to the small number of studies included and their methodological limitations.


CONCLUSIONS
Canine-assisted activities may provide a positive experience for residents however the following should be considered: IMPLICATIONS FOR RESEARCH: Due to the limited number of qualitative studies attempting to determine the experiences of older people involved in canine-assisted interventions within a long term care environment, further high quality studies should be undertaken. Studies should focus on the experiences of the different people involved (staff, family, animal handlers), and compare residents with different medical or psychological conditions to determine if involvement is experienced differently across populations.
1. The Joanna Briggs Institute, The University of Adelaide, Adelaide, Australia.
Cindy
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Stern