Rajiv Gandhi University of Health Sciences s132

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

PROFORMA FOR REGISTRATION OF

SUBJECT FOR DISSERTATION

1. NAME OF THE CANDIDATE : Mr. DAYANANDA.B.O. AND ADDRESS I YEAR M.Sc.NURSING.

GOVERNMENT COLLEGE OF

NURSING, FORT, BANGALORE-02

2. NAME OF THE : GOVERNMENT COLLEGE OF INSTITUTION NURSING, FORT, BANGALORE- 02

3. COURSE OF STUDY& : I YEAR M.Sc.NURSING. SUBJECT PSYCHIATRIC NURSING.

4. DATE OF ADMISSION : 29-05-2008

5. TITLE OF THE STUDY : A STUDY TO ASSESS THE KNOWLEDGE REGARDING PET THERAPY FOR REDUCING SELECTED PSYCHOLOGICAL PROBLEMS AMONG GERIATRIC CLIENTS AT RESIDENTIAL AREAS BANGALORE SOUTH WITH A VIEW TO DEVELOP AN INFORMATION GUIDE SHEET.

6. BRIEF RESUME OF THE INTENDED WORK

6.1 Need for the study:

Pet therapy-healing, recovery and love.

Animals have been associated with human for at least fifty thousand years, initially perhaps as scavenger, then as working companions, as domesticated sources of food and finally as pets and sources of pleasure. We bloom and thrive when we have others to love and look after usually these are our family members and friends but animals are easily included in our group of intimates.1

Pet therapy is the utilization of animals/ birds as a therapeutic modality to facilitate healing and rehabilitation of patient. Pet therapy covers wide range of activities, from a simple visit to a patient to provide company, through providing stimulation and co-ordination, retraining to a stroke victim or independent living assistant to physically handicapped.2

Most therapy pets are small animals. Dogs of any breed however are probably the most popular type of domestic pet involved. The most important factor in deciding pet is friendly, obedient and will interact with those around it. Animals includes: rabbits, cats, birds, fish, dogs, pigs, dolphins & elephants.2

A vast amount of people can benefit from pet therapy. Common group of people includes: elderly, mentally ill, eating disorder treatment patients, abused children, and

2 cancer and alcohol treatment patients. The benefits of pet therapy include: reduced loneliness, relieves depression, improved mood, reduced stress and anxiety, lowered blood pressure, improved self esteem & reduction of small health complications. Pet therapy is also called as animal assisted therapy and Pet assisted therapy.2

It is projected that those 65 and older with potentially disabling serious mental illness will increase from 4 million in 1970 to 15 million in 2030.3 Psychological problem accounts for major chronic problem among geriatric. Depression is particularly prevalent ranging from 30-40% of cases, Anxiety disorder accounts for 10-20% cases, alcohol abuse 5% to 10% cases, and suicide 2 to 5% cases and others.4

A study was conducted to evaluate the effect of pet therapy on institutionalized elderly patients in long term care. They enrolled twenty-eight subjects with chronic age- related disabilities living in the nursing home and they were assigned to a pet-therapy intervention group, consisting of 3/week sessions of almost one-hour visit for 6 weeks with a little cat, of to a control group undergoing usual activity programs. The purpose of this study was to evaluate the effects of pet-therapy on nursing home inpatients. Results showed that patients with animal interaction had reduced depressive symptoms and a significant decrease in blood pressure values.5

During the investigator’s community experience as a student nurse, the investigator has observed many older clients suffering with psychological problems and also who have inadequate knowledge regarding management of these problems. Pet therapy is becoming popular in our country for treating selected psychological problems of geriatrics. Hence the investigator felt that there is a need to assess the knowledge

3 regarding pet therapy and planned to provide information guide sheet regarding pet therapy to reduce psychological problems among geriatric clients.

6.2 Review of literature:

Tribet J, Boucharlat M, Myslinski M.(2008) conducted a study on pet therapy for people suffering from depression. This study is a qualitative study. Subjects were 20 female and 35 male patients admitted in a nursing home. They were diagnosed with depression. Their mean age was 64 years. All of them agreed to attend the dog therapy activities and informed consent from their family was requested. The investigator met these patients 15 times over nine months. The meetings always took place in the same place for 30 min, once a week. The evaluation was based on the clinical observations of the psychologist. Result shows that the pet therapy had a calming effect on the patients. It could well be helpful as a communication link during therapy sessions. The dog, because of its unconditional acceptance, increases the self-esteem of the patient and contributes to a more secure environment.6

Prosser L, Townsend M, Staiger P. (2008) conducted a study to investigate knowledge regarding pet therapy in a cross sectional survey of community elderly population in London. Out of 70 elder samples who attended interview programme. 28% were involved in rearing pets. 49% were seldom asked about benefits of pet therapy. 23% elder’s response that, they did not have sufficient time to rearing the pets. The researcher

4 found that need for sufficient programme to improve the awareness on benefits of pet therapy.7

Cangelosi PR, Embrey CN. (2006) conducted research on healing power of dog among geriatric patients. The study design was a randomized, parallel-group control treatment trial with pretreatment and post treatment measures. Fifty-eight subjects with chronic age-related disabilities who were patients of the Wills Hospital Geriatric Unit were assigned to a pet therapy intervention group or an exercise control group for 1 hr a day for 5 consecutive days. Every subject was blindly evaluated with the

Multidimensional Observation Scale for Elderly Subjects (MOSES) before and after the intervention week. Result shown that subjects who received the pet intervention to have less irritable behavior after treatment.8

Marian RB, William AB. (2006) conducted a study on The Effects of Animal-

Assisted Therapy on Loneliness in an Elderly Population in Long-Term Care Facilities.

They selected 45 residents and administered the Demographic and Pet History

Questionnaire and Version 3 of the Loneliness Scale. They were then randomized into three groups (no AAT; AAT once/week; AAT three times/week; n = 15/group) and retested with loneliness scale near the end of the 6-week study. The data was analyzed by analysis of covariance followed by pair wise comparison. The study revealed that pet therapy significantly reduced loneliness scores in comparison with the no AAT group.9

Sandra B, Barker, Kathryn S, Dawson. (2005) conducted a research on the effects of pet therapy on anxiety rating of hospitalized psychiatric patients. Study subject

5 were 230 patients referred for therapeutic recreation sessions. A pre and post treatment crossover study design was used to compare the effects of a single pet therapy session with those of a single regularly scheduled therapeutic recreation session. A mixed models repeated measures analysis was used to test differences in scores from before and after the two types of sessions. Results revealed that there is statistically significant reduction in anxiety scores were found after the pet therapy for patients with psychotic disorder, mood disorder, and other disorders.10

Joseph PD. (2000) conducted study to identify the current uses of pet therapy in nursing facilities located in southern California and South Dakota. A mail questionnaire was sent to a random sample of 105 California and 45 South Dakota nursing facility administrators. Both California and South Dakota nursing facility administrators identified sensory stimulation, facilitation of resident social interaction, stress reduction, and companionship as the top four therapeutic purposes for using pets and animals in the nursing home. Administrator also identified patient therapist interaction, increasing muscle strength and ROM, pain management, reduction of blood pressure and heart rate, self esteem, and patient independence as therapeutic benefits of pet therapy.11

Raina P, Waltner TD, Bonnett B, Woodward C, Abernathy T.(1999) conducted a study to examine Influence of companion animals on the physical and psychological health of older people. A 1-year longitudinal study with standardized telephone interview data collected at baseline and repeated at 1-year. An age- and sex stratified random sample (baseline n = 1054; follow-up n = 995) of non institutionalized adults aged 65 and older (mean age = 73, SD +/- 6.3), Wellington County, Ontario,

6 Canada. Physical health was assessed as the ability to perform Activities of Daily Living.

Psychological health was measured as a summed score comprising the level of satisfaction regarding one's health, family and friend relationships, job, finances, life in general, overall happiness, and perceived mental health. Sociodemographic variables assessed include subject age, sex, marital status, living arrangements, education, household income, and major life events. Results shown that pet owners were younger, currently married or living with someone, and more physically active than non-pet owners and pet ownership significantly modified the relationship between social support and the change in psychological well-being (P = .001) over a 1-year period.12

Dembicki D, Anderson J. (1998) conducted study on Pet ownership may be a factor in improved health of the elderly. A new model was developed, based on pet ownership leads to better self care, to show possible associations between pet ownership with eating, exercise, nutritional status, and specific cardiovascular risk factors. Seniors aged sixty and above were solicited mainly at senior congregate meals program sites in north-central Colorado (n = 127) to participate in this cross-sectional, observational study. Statistical analyses of questionnaire, anthropometric, physiological, and biochemical data were performed. Dog owners walked significantly longer than non- owners (p < 0.05), and pet owners had significantly lower serum triglycerides than non- owners (p < 0.01). Results suggest that pets may be good for the health.13

Statement of the problem:

7 A study to assess the knowledge regarding pet therapy for reducing selected psychological problems among geriatric clients at residential areas Bangalore south with a view to develop an information guide sheet.

6.3 Objectives of the study:

1. To assess the knowledge regarding pet therapy for reducing selected

psychological problems among geriatric clients.

2. To find the association between knowledge regarding pet therapy for reducing

selected psychological problems & selected demographic variables.

3. To develop and provide an information guide sheet regarding pet therapy for

reducing selected psychological problems of geriatric clients.

6.3.1 Assumption:

a) Geriatric clients may have some knowledge regarding pet therapy for reducing

selected psychological problems.

b) There may be significant association between knowledge regarding pet

therapy for reducing selected psychological problems & selected demographic

variables.

6.3.2 Operational definition.

Knowledge: The correct response of geriatric clients regarding pet therapy for

reducing selected psychological problems as per the structured interview schedule.

Geriatric clients: Clients who are aged 60 years and above.

8 Pet: It refers to domestic animals and birds which are kept as a companion.

Pet therapy: It is the utilization of pet as a therapeutic modality to solve psychological problems.

Psychological problems: It refers to the mental changes that occurs in geriatric clients like feeling sad and stress due to physiological & social changes.

Information guide sheet: It refers to concise and comprehensive information material regarding benefits of pet therapy for reducing sadness and stress.

7. MATERIALS AND METHODS

7.1 Sources of Data : Data will be collected from geriatric clients

at residential area Bangalore south.

7.2 Method of Collection of Data

7.2.1. Definition of the Study Subject. : Clients who are aged 60 years and

above.

7.2.2 Inclusion and Exclusion criteria

(a) Inclusion Criteria : (I) Clients who are aged 60 years

and above.

(II) Geriatric clients who are residing at

Bangalore south.

(III) Geriatric clients who are willing to

participate in the study.

9 (IV) Geriatric clients who can understand

& Speak Kannada / English.

(b) Exclusion Criteria : (I) Geriatric clients who are suffering from

illness.

7.2.3 Research Design : Descriptive survey design.

7.2.4 Setting : The study will be conducted at a

residential area Bangalore south.

7.2.5 Sampling technique : Purposive sampling technique.

7.2.6 (a) Sample size : 50 geriatric clients .

(b) Duration of study : 30 days

7.2.7 Tools of research : Structured interview schedule

Will be constructed in 2 parts

Part I- The demographic variables

Part II- The investigator will develop

a structured interview schedule to

assess the knowledge regarding pet therapy

for reducing selected

psychological problems among geriatric

clients.

7.2.8 Collection of data : The investigator himself will collect the data

from geriatric clients by using the structured

interview schedule.

10 7.2.9 Method of data analysis : (i) The investigator will use and Presentation descriptive, inferential statistical techniques

and other statistical analyses such as mean,

median, mode, chi square.

(ii) The analyzed data will be presented in

the form of tables, diagrams and graphs.

7.3 Does the study require any investigation to be conducted on patients or other human or animals? If so please describe briefly.

Yes, the study will be conducted on geriatric clients regarding pet therapy for reducing psychological problems.

7.4 Has ethical clearance has been obtained from your institution in case of 7.3?

 Yes, informed. Consent will be obtained from concerned subjects and

authority.

 Privacy, confidentiality and anonymity will be guarded.

 Scientific objectivity of the study will be maintained with honesty and

impartiality

8. LIST OF REFERENCES

1) Vidyashree amaresh. Pet therapy becoming popular. The Hindu 2006 Jan 6;

sect.D:9 (17).

11 2) Morrison, Michele L. Health benefits of animal assisted interventions.

Complementary Health Practice Review[serial online] 2007 Jan [cited 2008

Oct29]; 12(1): 51-62. Available from: URL: www. [email protected].

3) Gail WS, Michele TL. Principles and Practice of psychiatric nursing. 8th ed.

New Delhi: Elsevier publication; 2005.p.778.

4) Barnara BB. Mental health nursing. Philadelphia: W.B.Saundars Company;

2005.p.205.

5) Stasi MF, Amati D, Costa C, Resta D, Senepa G, Scarafioiti C et al. Pet- therapy: a trial for institutionalized frail elderly patients. Arch Gerontol Geriatr

Suppl [serial online] 2004 [cited 2008 Nov 5] ;( 9):407-12. Available from: URL: http://www.pubmeb.com

6) Tribet J, Boucharlat M, Myslinski M. Pet therapy for people suffering from

depression. Encephale [Serial online] 2008 Apr [cited 2008 Nov 5]; 34(2):183-6.

Available from: URL: http://www.pubmeb.com

7) Prosser L, Townsend M, Staiger P. Older people’s knowledge on pet therapy.

Nurs Older People [Serial online] 2008 Apr [cited 2008 Nov 5]; 20(3):29-32.

8) Cangelosi PR, Embrey CN. The healing power of dogs. J Psychosoc Nurs Ment

Health Serv [serial online] 2006 Jan [cited 2008 Nov 7]; 44(1):17-20. Available

from: URL: http://www.pubmeb.com

9) Marian RB, William AB. The Effects of Animal-Assisted Therapy on

Loneliness in an Elderly Population in Long-Term Care Facilities. Image J Nurs

12 Sch [serial online] 2006 [cited 2008 Nov 7]; 29(3):249-54. Available from: URL: http://www.pubmeb.com

10) Sandra B, Barker, Kathryn S, Dawson. Effects of pet therapy on anxiety rating of hospitalized psychiatric patients. Am J Occup Ther [Serial online] 2005

Jan [cited 2008 Nov 7]; 50(1):47-51. Available from: URL: http://www.pubmeb.com

11) Joseph PD. Pet therapy in southern California and South Dakota nursing homes. J Nerv Ment Dis [serial online] 2000 [cited 2008 Nov 7]; 171(8):461-5.

12) Raina P, Waltner-Toews D, Bonnett B, Woodward C, Abernathy T. Influence of companion animals on the physical and psychological health of older people. J

Am Geriatr Soc [serial online] 1999 Mar [cited 2008 Nov 7]; 47(3):323-9.

13) Dembicki D, Anderson J. Pet ownership may be a factor in improved health of the elderly. J Nerv Ment Dis [serial online] 1998 [cited 2008 Nov 7]; 15(3):15-

31. Available from: URL: http://www.pubmeb.com

13 9. Signature of Candidate :

10. Remarks of the Guide : The research topic selected by the candidate is relevant. Assessing knowledge regarding pet therapy for reducing psychological problem among geriatric clients is an essential component of psychiatric nursing. 11. Name & Designation of 11.1Guide : Sri H.H. DASEGOWDA BA, LLB, MSc (N) Principal and Head of the Department of psychiatric nursing Government College of Nursing Fort, Bangalore-560 002

11.2 Signature :

11.3 Co-Guide (if any) : Sri. R.K. MUNISWAMY. MSc (N), DPN Lecturer & PG Guide Department of Pediatric Nursing Government College of Nursing Fort, Bangalore-560 002 Community Health Nursing 11.4 Signature : 11.5 Head of the : Sri H.H. DASEGOWDA Department BA,LLB,MSc(N) Principal and Head of the Department of psychiatric nursing Government College of Nursing

14 Fort, Bangalore-560 002

11.6 Signature : 12. 12.1 Remarks of the : Topic selected for the study is relevant & Principal forwarded for needful action.

12.2 Signature :

ETHICAL COMMITTEE CLEARANCE

1. TITLE OF THE DISSERTATION : A study to assess the knowledge regarding pet therapy for reducing selected psychological problems among geriatric clients at residential areas Bangalore south with a view to develop an information guide sheet.

2. NAME OF THE CANDIDATE : Mr.DAYANANDA.B.O. AND ADDRESS I Year M.Sc. Nursing Government College of Nursing Fort, Bangalore-560 002

3. SUBJECT : M.Sc. Nursing Psychiatric Nursing

4. NAME OF THE GUIDE : Sri H.H. DASEGOWDA Principal and Head of the Department of psychiatric nursing Government College of Nursing Fort, Bangalore-560 002

5. APPROVED/NOT APPROVED : (If not approved, suggestion)

Sri H.H. DASEGOWDA Dr. SUVARNA B. TALAWAR Principal and Head of the Head of the Department of Department of Psychiatric Nursing Obstetrics and Gynecological Nursing Government College of Nursing Government College of Nursing Fort, Bangalore-560 002 Fort, Bangalore-560 002

Smt. M. JHANCI Sri H.B. PRAKASH

15 Head of the Department of Head of the Department Medical Surgical Nursing Community Health Nursing Government College of Nursing Government College of Nursing Fort, Bangalore-560 002 Fort, Bangalore-560 002

Smt. N. RENUKA Head of the Department of Pediatric Nursing Government College of Nursing Sri H.H. DASEGOWDA Fort, Bangalore-560 002 Principal Government College of Nursing Fort, Bangalore-560 002 LAW EXPERT