Effects of Animal-assisted Activities on Biobehavioral Stress Responses in Hospitalized Children: A Randomized Controlled Study

Purpose: This study assessed the effectiveness of animal-assisted activities (AAA) on biobehavioral stress responses (anxiety, positive and negative affect, and salivary cortisol and C-reactive protein [CRP] levels) in hospitalized children. Design and Methods: This was a randomized, controlled study. Method: Forty-eight participants were randomly assigned to receive a 10-minute AAA (n = 24) or a control condition (n = 24). Anxiety, positive and negative affect, and levels of salivary biomarkers were assessed before and after the intervention. Results: Although increases in positive affect and decreases in negative affect were larger in the AAA condition, pre- and post-intervention differences between the AAA and control conditions were not significant. In addition, pre- and post-intervention differences between the conditions in salivary cortisol and CRP were not statistically significant. Baseline levels of anxiety, cortisol, and CRP had a significant and large correlation to the corresponding post-intervention measures. Scores on the Pet Attitude Scale were high but were not associated with changes in anxiety, positive affect, negative affect, or stress biomarkers. Conclusions: Although changes were in the expected direction, the magnitude of the effect was small. Future randomized controlled trials with larger recruitment are needed to determine the effectiveness of AAAs in reducing biobehavioral stress responses in hospitalized children. Practice Implications: Nurses are positioned to recommend AAA as a beneficial and safe experience for hospitalized children. (C) 2017 Elsevier Inc. All rights reserved.