An Exploratory, Qualitative Study of Perceptions of a Hospital-Based Animal-Assisted Intervention Program

Monday, 30 October 2017: 9:30 AM

Elizabeth A. Richards, PhD1
Kathleen Abrahamson, PhD1
Yun Cai, MSN1
Marguerite O'Haire, PhD2
Krista Cline, PhD3
(1)School of Nursing, Purdue University, West Lafayette, IN, USA
(2)College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
(3)Sociology and Criminology, Butler University, Indianapolis, IN, USA

Increasing research has been conducted on the effects of interactions with animals. Research has shown that there can be multiple outcomes, including physiological, psychological, and social benefits of animal-assisted interventions in a wide range of settings (Nimer & Lundhal, 2007). Studies have shown that having a companion animal can help to reduce the cardiovascular effects of stress during laboratory experiments (Allen, Blascovich, & Mendes, 2002). Animal-assisted therapy has been shown to benefit individuals in other ways as well. Children and adults have shown reduced anxiety, reduced depression, and reduced social isolation when interacting with a therapy animal in single time point studies in schools, clinics, and laboratory settings (Friedmann & Tsai, 2006). However, we tend to see that health fields, especially in the acute care setting, have been slow to assess and recognize these benefits and the importance of bonds with animals (Walsh, 2009).

Given the positive outcomes of animal-assisted intervention in other areas, we extended this work to focus on the effects for hospital staff and volunteers, particularly in acute care settings. One of the reasons we may see limited use of animal assisted intervention in the acute care field is the perception of infection control issues as well as staff burden issues. With respect to infection control, when appropriate protocols and guidelines for animals visits are in place, hygiene issues are easily eliminated (Murthy et al., 2015). However, the effect of animal-assisted intervention on staff burden and stress has received little empirical attention thus was the focus of this study.

Statement of purpose

The purpose of this exploratory pilot study was to contribute to the body of knowledge surrounding the experiences and perceptions of hospital staff and volunteers in acute settings who have participated in a hospital animal assisted intervention program.


Nine face-to-face semi-structured interviews were conducted by an Adult Nurse Practitioner from the research team between August 2015 and November 2015. Interviews were conducted at the hospital site that was implementing the pet therapy program, and were recorded for transcription. Interview respondents included 4 staff nurses that worked on units were the animals were present; 3 hospital staff members who interacted with the animals in the course of their workday (welcome desk receptionist, unit clerk, program manager), and 2 hospital volunteers. Respondents were identified through a list of names of persons who had frequent workplace interactions with the animals provided by the hospital volunteer director. This pilot study was approved by the IRB of author institutions.

Transcripts were thematically analyzed using NVIVO 11 software. Analyses were guided by an inductive content analysis approach. Themes were not developed prior to analysis but instead were allowed to emerge from the data. It should be noted, however, that the 22-item interview guide asked directly about contact with the animals and perceptions of those contacts, and as such influenced the themes that emerged from interview responses. Although probes were utilized to follow-up upon responses, the interviews did not substantially deviate from the interview guide. The interview guide centered upon the domains of frequency of contact, nature of contact, perception of contact’s influence on their daily experience, and perception of contact’s influence on the overall hospital environment. Respondents were also asked to describe examples of experiences with the animals that they perceived as particularly noteworthy. Findings

Five themes emerged from the respondent interviews: (1) descriptions of the therapy dogs; (2) contacts with the dogs at work; (3) connection with the dogs outside of work; (4) benefits; (5) drawbacks. The sub-set of the theme “benefits” consisted of: (1) decreasing staff stress; (2) promoting social interactions and interaction with patients; and (3) providing comfort and company to patients.

Descriptions of the dogs

The therapy animals in this program were all dogs, and each of the respondents described themselves as someone who likes dogs during the course of the interview. When asked to describe their contact with the animals they frequently spoke in descriptive terms, such as: “a big, white fluffy dog…so adorable”; “…like a teddy bear”; gentle and so sweet”; “gentle eyes”; warm and fuzzy”.

Contact with the dogs at work

Most respondents noted they had contact with the dogs once or twice a week and that individual time spent with the animals was generally under 15 minutes per visit. All respondents stated that they would have physical contacts with the therapy dogs every time the animals came to their working area. Most described feeling excited about the animal visits and made efforts to see and have physical contacts with the dogs.

Connection with the dogs outside of work

Respondents relayed instances where they had talked or thought about the animals outside of work hours, often with their family, friends or neighbors:

“…we talk with [our neighbor] all the time about Teddy”

“I talk about [the dogs] with my kids”

“I will tell stories to people… ‘Hey, I was at work and Teddy came to visit or this big Great Dane came to visit’. I will tell people how good the program is and I will wonder what those dogs are up to today and if they are getting into trouble or working hard.”


All respondents provided examples of areas where they perceived that the animal-assisted intervention program was beneficial. Program benefits fell within 3 sub-themes: perception of decreasing staff stress; promoting social interactions and interaction with patients; and providing comfort and company to patients.

Decreasing staff stress

A frequently noted benefit of the program was a perception that hospital staff felt more relaxed and happy when interacting with or thinking about the therapy dogs:

“[The dog]…brightens everyone’s day.”

“Several of us make the comment these dogs coming in are more therapy for the staff because if they are having a really stressful day and they just happen to be in the hall, our “Teddy break” is something that makes it go away for a second and is needed.”

Providing comfort and company to patients

Respondents perceived that the dogs were beneficial to the patient experience and health, and even provided a “healing magic”:

“There was one time that Teddy had jumped into the bed with a patient and that patient was going downhill really fast and he just laid with her for a good hour. By the end of the day, her health turned around and she was better.”

 “I think it made [the patient] feel like she was at home again. In this strange, cold medical environment, she had a friend there.”

 “… to have something as simple as [the dog] and to see [patient’s] look of relief and joy”

“This is the best medicine”

Promoting Social Interaction

The therapy dogs also acted as an “ice breaker” for the interaction between staff members, visitors and patients. Respondents noted that the animals created a bond or a “pet connection” between nurses and patients:

“It definitely is like a social lubricant. It allows you to say, ‘look at the dog, he is beautiful and he is so warm and fuzzy’. It kind of helps you find common ground with patients sometimes if you are having trouble with that.”


Respondents were specifically asked if they perceived there to be any negatives or drawbacks to having the dogs in an acute care setting. Three respondents noted that the dogs’ presence may sadden patients who missed their own dogs, but gave no specific examples of this occurring. No respondents mentioned allergies or distraction during caregiving as concerns. One nurse respondent felt it important that the dogs be limited to certain areas of the hospital due to infection control concerns. Interview respondents relayed that the dogs and the handlers were trained to work in the hospital setting, decreasing the risk of a harmful event. Two nurses raised the concern that their patients did not benefit as much as they could from the animals because of the short duration of their hospital stay.


The benefits of the program for hospital staff included reductions in stress, promotion of social interactions, and a perception of comfort and company provided to patients. These outcomes reflect findings in non-hospital populations from interactions with animals, primarily the themes of reduced stress and increased social isolation. The presence of animals has been linked to short-term reductions in physiological indicators in stress such as cortisol and blood pressure (Beetz, Unvas-Moberg, Julius, & Kotrschal, 2012) as well as the social facilitation of connection between humans in community and classroom settings (O’Haire, McKenzie, Beck, & Slaughter, 2013; Wood, Giles-Corti, & Bulsara, 2005). The capacity of animals to assist hospital staff in these ways represents a novel application of animal-assisted intervention that extends beyond its originally intended purpose to assist patients alone. The flow on effects for staff and other personnel who encounter animals has been understudied, and these findings indicate that further attention and acknowledgement is warranted to comprehend the full range of outcomes from these programs, particularly in acute hospital settings.