Examining the Effect of an Animal-Assisted Intervention on Patient Distress in Outpatient Cystoscopy

Sandra B. Barker 1, Sarah C. Krzastek 1, Rebecca A. Vokes 1, Christine M. Schubert 2, Lauren Folgosa Cooley1 , & Lance J. Hampton1

1Virginia Commonwealth University
2Air Force Institute of Technology

Animal assisted interventions (AAI) have been shown to improve patient outcomes in some healthcare settings. Flexible cystoscopy, while minimally invasive, is associated with patient-reported pain, fear, and anxiety. Few techniques have been found to improve these adverse effects associated with cystoscopy. The purpose of this study was to extend existing research on AAI in outpatient settings to investigate the effectiveness of AAI in reducing patient distress associated with outpatient cystoscopy. Ninety-five patients (average age 55.5) were prospectively enrolled and randomized to receive one 15-minute AAI prior to cystoscopy (n=46), or cystoscopy performed per standard protocol (n=49). Distress was measured by Visual analogue scales (VAS) for fear, anxiety, and stress, systolic blood pressure, and heart rate at 3 time points: prior to intervention/prior to cystoscopy, following intervention/prior to cystoscopy, and following intervention/following cystoscopy. Pain was assessed by VAS post-cystoscopy. There were no significant differences between the AAI and control groups in changes in systolic blood pressure, heart rate, fear and pain between any time points. There were significant between-group differences in changes in anxiety and stress prior to cystoscopy with greater reductions found in anxiety and stress following AAI. The greater reductions in stress associated with AAI were maintained after cystoscopy. This is the first study to investigate the effectiveness of AAI in reducing distress associated with cystoscopy. More research is needed to determine if AAI is a viable method for improving patient outcomes associated with this and other outpatient procedures.

Keywords: Animal-assisted interventions, cystoscopy, therapy dogs