Impact of Animal-Assisted Interactions on Children with Advanced Cancer

Abstract

Background:

Children with advanced cancer and their caregivers experience significant stress, which can diminish quality of life (QoL). Animal-assisted interaction (AAI) is beneficial in pediatric populations but less well studied in children with advanced cancer.

Objectives:

To (i) evaluate the effect of AAI on QoL and depressive symptoms in children with advanced cancer and on stress in their caregivers, and to (ii) evaluate the feasibility of measuring stress hormones in AAI.

Design:

Longitudinal cohort study.

Setting/Subjects:

Children (n = 29) and caregivers (n = 29) participated in up to eight weeks of AAI during routine oncology clinic visits or admissions at an academic children’s hospital in Southeast United States.

Measures:

Child participants completed surveys to evaluate QoL and depressive symptoms at baseline and weeks 4 and 8 post-AAI. Caregivers completed surveys to evaluate parental stress, as well as proxy forms for child QoL and depressive symptoms at the same time points. Salivary cortisol and serum epinephrine and norepinephrine were obtained from child participants at baseline and pre- and post-AAI sessions at weeks 4 and 8.

Results:

Child overall and physical QoL scores improved, while caregiver-proxy scores for children’s QoL improved overall and within physical, psychosocial, school, and emotional domains. There was a statistically significant decrease in caregiver stress over time. Salivary cortisol and serum epinephrine levels were feasible to collect and demonstrated statistically significant decreases both over time and before and after AAI sessions.

Conclusion:

The results indicated that AAI improved child QoL over an 8-week period and reduced caregiver stress. Collecting salivary cortisol and serum epinephrine and norepinephrine was feasible during visits. While decreases in cortisol, epinephrine, and norepinephrine were demonstrated following sessions, the implication of these findings on child physiological stress requires further study.