- Long waits and common environmental stressors in the E.R. can increase the experience of pain in patients.
- A short visit with a therapy dog can reduce feelings of anxiety and depression and improve feelings of well-being in E.R. patients.
- More than half of all E.R. patients who received a brief visit from a therapy dog reported a reduction in their pain.
There are a lot of published data that confirm that interacting with a dog can reduce stress levels and lower a person's feelings of anxiety. It is for these reasons that therapy dogs exist. However, Ben Carey of the University of Saskatchewan in Saskatoon, Canada, along with a team of 21 other researchers, wondered if the effects of touching and communicating with a friendly and cooperative dog might have more profound effects, even to the point of reducing the perception of pain in individuals.
There have been anecdotal reports that this is the case. For example, Bernadette Johnson, of Surrey, British Columbia, found herself in the hospital after a traffic accident that broke several of her ribs. She told me the following:
I was laying there all taped up with my leg in a cast, and every breath that I took hurt. All I could think about was the pain that I was feeling. Then they brought in a therapy dog—a lovely golden retriever. She licked my hand, and I stroked her and spoke with her for a little while, and then she had to leave. I thought to myself that my little session with her was the first time in the three days after the accident when I didn't hurt so badly that it swamped my thinking. My surprise was that that pain relief lasted for the next hour or so after the dog left.
Pain in the Emergency Room
The Canadian investigative team knew that pain is both an emotional and a sensory experience that is extremely unpleasant and often specific to an individual. Pain turns out to be the primary reason why patients visit a hospital emergency room (E.R.), and studies show that around 80 percent of all E.R. visits are by individuals seeking relief from painful symptoms. The truth of the matter is that patient pain is not adequately managed in emergency departments, in part because of long wait times. It has also been acknowledged that experiencing anxiety during those prolonged waits in the E.R. can increase the patient's perception of pain.
In actuality, the E.R. setting has been implicated as a contributor to patient pain. There are a number of common stressors in the emergency ward, which include constant bright lighting and high noise levels. Some studies even suggest that these stressors can slow down the recovery process and prolong a patient's symptoms of pain.
A Study of Whether Therapy Dogs Can Reduce Pain in E.R. Patients
This team of researchers chose the Royal University Hospital Emergency Department as the site of their study. It has a long-standing visiting therapy dog program in association with St. John Ambulance. Its E.R. was the first to be visited by a therapy dog team in Canada (in 2016). It is also the busiest E.R. in the province of Saskatchewan, averaging 150 to 200 adult visits per 24 hours.
Compared to other research involving therapy dogs, this was a fairly large study, with 97 participants recruited into a group that would receive an intervention involving a therapy dog visit and a total of 101 participants in a control group that would be tested the same way but would not get to see a therapy dog.
All of the patients in the study were waiting to be seen by a doctor, were in treatment, or were waiting for a bed following admission. In addition to the more typical measures of anxiety, depression, and well-being that have been used in other studies of the effects of therapy dogs, these patients were also asked questions about their pain and required to rank their experience of ongoing pain from 0 (the lowest) to 10 (the highest). After the original assessment, the patients in the intervention group received a visit from a therapy dog and its handler that lasted about 10 minutes (which is the usual length of a session in many health care settings). At the end of the session, the patients were offered a trading card with the therapy dog's picture on it. Twenty minutes later, the measures of anxiety, depression, well-being, and pain were repeated. Those patients in the control group were also measured twice, using exactly the same time separations as the intervention group, only they did not get to interact with a therapy dog.
A Short Visit With a Therapy Dog Makes a Difference
The results of this study are quite straightforward. Compared to the control group, the group of patients who interacted with the therapy dog showed statistically significant (although modest) reductions in their anxiety and depression and a significant (albeit small) increase in their overall sense of well-being. This confirms previous research on the effects that therapy dogs have on hospital patients.
The interesting and novel finding is that, in addition, the scientists found a significant decrease in the perception of pain being experienced by the patients who interacted with the therapy dogs. Of these patients, 43 percent reported a strong reduction in pain (meaning a decrease in their pain rating by 50 percent or more), and an additional 17 percent showed a low to moderate reduction in their pain ratings. This means that the 10-minute session with a therapy dog can reduce the amount of pain that the patients experience in more than half of the patients who receive this kind of intervention.
The exact mechanism by which the therapy dogs reduce feelings of pain is still being investigated. It certainly is not due to repairing any physical injury. However, it is known that petting a friendly and sociable dog can reduce the levels of the hormone cortisol in the blood (a hormone associated with stress). In addition, it increases the concentration of oxytocin (a hormone associated with positive emotions). Both of these chemical alterations in the blood may help to reduce feelings of pain.
There is another simpler possibility that probably contributes to the overall outcome—namely, distraction. Many psychologists believe that thinking about the pain that you are experiencing and focusing your attention on it tends to actually increase your feelings of distress. In other words, the more you think about how much you hurt, the more you hurt. It is possible that the social interaction that you have with a therapy dog simply pulls your attention away from concentration on the parts of your body that are aching, and, at least for a while, it makes the pain more tolerable and lowers its overall magnitude.
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Carey B, Dell CA, Stempien J, Tupper S, Rohr B, Carr E, et al. (2022). Outcomes of a controlled trial with visiting therapy dog teams on pain in adults in an emergency department. PLoS ONE 17(3): e0262599. https://doi.org/10.1371/journal.pone.0262599
Handlin L, Hydbring-Sandberg E, Nilsson A, Ejdebäck M, Jansson A, Uvnäs-Moberg K. (2011). Short-term interaction between dogs and their owners: effects on oxytocin, cortisol, insulin and heart rate—an exploratory study. Anthrozoos, 24(3):301–315. https://doi.org/10.2752/175303711X13045914865385