Companion Animals in Human Health

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Edited by: Cindy C. Wilson & Dennis C. Turner

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  • Chapters
  • Front Matter
  • Back Matter
  • Subject Index
  • Part I: Historical and Value Perspectives

    Part II: Beyond Health: Extending the Definition of Health to Quality of Life

    Part III: Quality of Life Outcomes: Psychosocial Aspects of Human-Animal Interactions

    Part IV: Quality of Life Outcomes: The Relevance of Animals to Health and Disease

    Part V: Human Growth and Development: Age-Specific Quality of Life Outcomes

    Part VI: The Animal Side of the Coin: Training and Welfare Standards

  • Copyright

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    Foreword

    One day a long time ago, I received a telephone call from “friends of mine” who decided to write and edit a book. They felt somebody (me) should write a preface, or a foreword. Suddenly I found myself staring at over 400 pages of text I was asked to address in just a few pages.

    What makes a good preface or foreword in a multi-discipline text? I found a thoughtful one in a book published in 1991 entitled Man and Beast Revisited, based in part on a Smithsonian symposium in which I participated. One of the participants in this symposium, Tom Sebeok, recalled that he had been involved in planning and participating in a symposium that was published as a book entitled Man and Beast: Comparative Social Behavior. The host for the earlier meeting was, at that time The Smith-sonian secretary, S. Dillon Ripley. Sebeok reminded us that Ripley had written a sensitive and richly suggestive preface for this earlier book, justly characterizing it as a “feast of reason.” The contributors and editors of this book have not only prepared a feast of reason but a feast of reason and promise.

    In 1984, the first meeting of the Delta Society was held at the University of Pennsylvania at the invitation of Aaron Katcher and Alan Beck. During the banquet, the Delta Society announced Boris Levinson and Elizabeth and Sam Corson, as the first recipients of the Delta Distinguished Service award. It was a very happy occasion; and I was privileged to be seated at the same table as the Corsons and Boris Levinson. After the announcement, several people came up to the podium to visit with the honored guests. At this informal get together, Boris Levinson suggested a book be written about the Delta Society and its work. He looked at me and said, “Leo, you should do it.”

    I was already overextended and there were many within earshot who were well qualified for the task. Many of us had written books in the 80s and 90s, but I knew that none of them filled the voids that Boris addressed. The book which you are now reading comes a long way toward the fulfillment of Boris Levinson's vision.

    The Wilson and Turner book challenges us to look beyond the traditional perspective and reevaluate the field of human-animal interactions. For 30 years, attention has been focused upon the human-animal interaction as an all-encompassing rubric for a field of study. What was a seemingly simple relationship with positive outcomes became more complex as researchers and program practitioners collected and analyzed data from various sources. To invoke one of my favorite laws at this juncture: There is no complex problem, which if looked at in the proper way, doesn't become more complex!

    Issues arose, including but not limited to: selection of a conceptual framework, accountability for project or program management, credibility with colleagues and institutions, methodology and design, implementation, evaluation, political implications and impact upon professional review, training, training standards, and funding. Other issues related to the multidisciplinary nature of the field and the sometimes, tension provoking relationship between a research and programs. These issues have been both strengths and limitations of the continued development of the field.

    As with other clinically related areas, human-animal interaction must use research as the base for program development. At the same time, practitioners must heed the call for documentation and program evaluation in order to focus research endeavors in the most appropriate direction. Research and applied programs co-exist in a mutually interactive state and thus have the unique ability to enhance quality of life assessments by working with each other.

    This book, and the works of others, advances the concept of quality of life (QL) as a new perspective for considering, planning, and evaluating new projects, as well as re-evaluating and applying data gathered from older studies and programs. From the overview of potential quality of life outcomes associated with human animal interactions, this book offers the most current research and program interventions in the field. The quality of life construct is developed through critical review of past and existing research outcomes and program interventions. While few quantitative studies have evaluated the impact of a companion animal of quality of life of humans, there is ample evidence to warrant further studies and evaluative projects.

    Prior to 1983, there was little scientific evidence to document a measurable association or effect between companion animals and human health. However, between 1990 and 1996, baseline data have outlined applicable information on the use of companion animals as therapeutic interventions. One area of quality of life in which these data are evident is that of social support. This book provides the reader's appreciation of the potential benefits of the various sources of support. Likewise these new studies continue to build the knowledge base while posing essential questions for future endeavors. For example, the nature and value of a strong bond is critical when discussing and comparing effects of interaction of people and animals.

    To date, studies have shown animal contact could be healthy, contribute to child development of nurturance and self-concept, promote dialogue among family members, children, people with disabilities, and lonely people, contribute to physiological well-being and improvement of select cardiovascular markers and reduce anxiety levels. However, the combination of these quality of life-enhancing entities was often ignored with the extensive publicity at regional, national, and international levels. Initially this publicity brought well deserved attention to the field of study and programs. However, it became an impediment to the extension of studies on animal assisted therapy. Trained and licensed therapists took exception to considering the use of animals and volunteers to provide therapy, as they are not qualified to do so. Thus, the development of standards is an approach which should help program and research professionals earn the respect of other professional groups.

    As a clear definition of variables and outcomes is to applied research studies, a comprehensive set of standards of practice is to animals assisted activities and therapy. Once again, this book offers the reader a feast of information not only on research to date but also the current state-of-the-art for programs. In its broadest sense, quality of life assessment involves clarification of the values held by an individual, group, or entire society. It may be usefully defined as the process of quantifying human values and incorporating them into important human decisions. If one assumes that quality of life is rooted in individual wants, then one defends the autonomy of individuals so they can define their own concepts of the good life as a form of moral expressions. The question that continues to plague us asks: can any formal assessment take into account individual uniqueness, but still measure quality of life? Perhaps, answers to that question may be found, in part, in the feast of reason that follows.

    Leo K.Bustad

    Introduction

    Developmentally, the evolution of a field of study can be likened to that of a human (i.e., initially one crawls, walks, and then runs). For the field of human-animal interactions (HAI), growth and development has slowly evolved. From anecdote to pilot study, the field developed increased interest and support from various other disciplines and arenas. From pilot study to experimental design and program evaluation, researchers began to challenge the knowledge base and to test more sophisticated hypotheses against specific conceptual frameworks and paradigms. Data from these studies supplanted anecdote and pilot studies and led to a National Institutes of Health Technology Assessment Workshop in 1987. From this workshop, multi- and interdisciplinary approaches to measuring the therapeutic potential of companion animals on the health of humans was the “step into adolescence.” Yet more data were needed to move the field into “adulthood.” Explanatory models were needed to serve as a unifying theory base for future work.

    Researchers began to publish conceptual models to elicit responses from colleagues and as a means of generating new data and new perspectives; studies became more sophisticated in their approach to assessment of health benefits for both normal and impaired populations. To this end, the Seventh International Conference on Human-Animal Interactions issued its call for papers that looked at HAI on the basis of a conceptual framework of quality of life (QL) for both animals and humans.

    The Seventh International Conference, titled “Animals, Health, and Quality of Life,” was distinguished by adhering strictly to professionally established criteria for the review of abstracts and subsequent manuscripts. The process, although tedious and time-consuming, resulted in the first blind, peer review conference in this field. Papers presented in Geneva and selected, invited manuscripts were once again submitted to outside review by individuals not involved in this conference or authoring a chapter in this text. These reviewers are well-known in their primary area of research or program evaluation. Once accepted, the manuscripts were also reviewed by the editors, and a great deal of effort went into collaborative and collegial revisions. Although a readily accepted process in most disciplines, this review has focused a great deal of attention on the continued need for strong multidisciplinary and interdisciplinary assessment of research and programs related to HAI.

    Interest in QL as a conceptual framework has been stimulated by ethical and financial considerations associated with an aging population and the concomitant increase in chronic illness. QL is applicable, however, to all ages, conditions, and abilities. Broadly defined, QL can be divided into five major constituent domains: (1) physical status and symptoms (includes rest/sleep, energy and vitality, functional abilities, and health perceptions); (2) general life satisfaction; (3) mental/emotional status (includes cognition); (4) social activities; and (5) financial/role activity). Improving QL is a key ingredient in therapeutic interventions as well as in rehabilitation programs; QL is as important to an individual with good health as it is to a person who is hearing impaired or an individual with low self-esteem.

    The ways in which QL may be applied in HAI are numerous. QL helps place in context and also delimit the role of HAI. It clarifies that although HAI may affect larger domains of QL, HAI is not solely responsible for doing so. Indeed, its focus of action should be on the determinants and moderators that are most likely to affect health (see chapters in this volume by Collis & McNicholas; Copeland Fitzgerald & Tebay; McNicholas & Collis; Triebenbacher).

    The framework can also be used as a checklist for key elements to be considered in developing any therapeutic intervention. It makes clear the macro and immediate environmental, physiologic, and sociopsychological factors that need to be considered along with key moderating factors such as control, opportunities, resources, support systems, and skills.

    No longer can the discipline afford small pilot studies as markers in the field. Programs must establish measurable objects, and evaluation criteria must be included, before the scientific community at large will accept the outcomes.

    This volume includes perspectives from a wide range of disciplines reflecting both the interest and widely different approaches researchers have taken since the first international conference in the 1970s. Still growing and developing as a discipline, HAI research has yet to define its own theory base and methodologies. Yet the growing maturity of the field is manifested by the obvious attention to the need for strong conceptual frameworks and meticulously applied methodologies. Thus, this volume attempts to link “lessons learned” about HAI and QL with developments of therapeutic interventions and programs to enhance health and well-being.

    Cindy C.Wilson

    Acknowledgments

    During the production of this book, I have had help from a variety of sources. The contributors have given freely of their time, meeting every request for help. Their help went far beyond professionalism. It spoke volumes of their belief in a field of inquiry that is finally coming into its own. Each has given his or her best effort to improve the field for those who follow and for those whose health is improved and quality of life is enhanced.

    It would have been impossible to produce this text without our computer experts. In this day of technology, they made it possible to work internationally without leaving home! They certainly improved my quality of life when they patiently helped me work through one crisis after another. To Stephen R. Brown, Marisa Stoolmiller, and Conan Matthews, who were always ready to answer a “quick question,” and to the others at the various institutions who helped me to read, convert, and “talk” between systems—we are indebted to you.

    Most of all, my thanks to Jean-Pierre, who made writing this book doable. For he became the companion for Cable and Zack—all three of whom have made my life fuller and richer because they are part of it.

    Cindy C.Wilson

    Dedication

    I would like to acknowledge the Swiss Academy of Humanities and Social Sciences in Berne and the Zurich Animal Protection for support of my travel to work with Cindy Wilson in developing the prospectus for the book.

    Dennis C.Turner
  • About the Editors

    Cindy C. Wilson, Ph.D., C.H.E.S., received her B.S. in microbiology, her M.S. in animal science and statistics, and her Ph.D. in public health from the University of Tennessee. She is currently Professor and Faculty Development Director for Family Medicine programs through the Uniformed Services University of the Health Sciences in Bethesda, Maryland. She has research and practice experience in gerontological programs as well as in pet placement and visitation programs. She presented her research in the area of physiological and psychologic responses of college students to a pet at the National Institutes of Health Technology Assessment Conference in 1987 and continues to publish data-based as well as conceptual projects on therapeutic uses of human-animal interventions. In addition to her work on quality of life and clinical trials, she has served on the editorial board of Anthrozoös for many years and serves as a reviewer for four other major health journals. She continues to conduct her own research in a wide range of topic areas and to support the work of faculty colleagues at the military Family Medicine sites worldwide. She serves as a consultant to a number of businesses and university programs in the area of research design and methodology.

    Dennis C. Turner, B.S., Sc.D., received his B.S. in biology from San Diego State University and his doctorate in animal behavior and ecology from Johns Hopkins University School of Hygiene and Public Health in Baltimore. He is currently a tenured lecturer at the University of Zurich, Director of the private scientific Institute for Applied Ethology and Animal Psychology, President of the Konrad Lorenz Trust-IEMT in Switzerland, and President of the International Association of Human-Animal Interaction Organizations, I.A.H.A.I.O. His research concerns cat and dog behavior and the ethology and psychology of human-cat relations. He is European editor of the journal Anthrozoös and companion animal section editor of the journal Animal Welfare. He has authored several books and is coeditor (with Patrick Bateson) of The Domestic Cat: The Biology of Its Behaviour.

    About the Contributors

    Warwick P. Anderson is with the Alfred and Baker Medical Unit, Baker Medical Research Institute, WHO Collaborating Center for Research and Training in Cardiovascular Disease, Prahran, Victoria, Australia.

    Ivan Barofsky, Ph.D., is Associate Professor of Medical Psychology with the Pain and Work Rehabilitation Clinic at Johns Hopkins Bayview Medical Center in Baltimore, Maryland.

    Kathryn Batson, M.S.N., is a former graduate student from the University of Nebraska Medical Center, College of Nursing, Omaha.

    Mara M. Baun, D.N.Sc., F.A.A.N., is a professor at the University of Nebraska Medical Center, College of Nursing, Omaha.

    Reinhold Bergler, Ph.D., is with the Institute der Stiftung für empirische Sozialforschung in Nuremberg, Germany.

    Nancy M. Bodmer, M.Sc., specialized in developmental psychology at the Institute of Psychology, University of Berne, Switzerland.

    Leo K. Bustad, Ph.D., DVM, is Dean Emeritus at the College of Veterinary Medicine, Washington State University, Pullman.

    Glyn M. Collis, B.Sc., Ph.D., is Director of Postgraduate Studies in Psychology in the Department of Psychology of the University of Warwick, Coventry, England.

    Jane Copeland Fitzpatrick, B.Sc., M.A., is Executive Director of Pegasus Therapeutic Riding and Physical Therapist in Darien, Connecticut.

    Irene Christy is with the Alfred and Baker Medical Unit, Baker Medical Research Institute, WHO Collaborating Center for Research and Training in Cardiovascular Disease, Prahran, Victoria, Australia.

    Anthony Dart is with the Alfred and Baker Medical Unit, Baker Medical Research Institute, WHO Collaborating Center for Research and Training in Cardiovascular Disease, Prahran, Victoria, Australia.

    Susan L. Duncan, R.N., is Health Care Education Specialist and Coordinator for the Delta Society National Service Dog Center in Renton, Washington.

    Maureen Fredrickson, MSW, is Program Director of the Delta Society in Renton, Washington.

    Erika Friedmann, Ph.D., is Professor and Chairperson, Department of Health and Nutrition Sciences, Brooklyn College of CUNY, New York.

    Thomas F. Garrity, Ph.D., is Chairman and Professor of the Department of Behavioral Science, College of Medicine, at the University of Kentucky in Lexington.

    Linda Hines is President/CEO of the Delta Society in Renton, Washington.

    Robert Hubrecht, Ph.D., is with the Universities Federation for Animal Welfare, Potters Bar, Herts, England.

    Garry L. R. Jennings, Ph.D. or M.D., is Professor at the Heart Centre at Alfred Hospital and Director of the Alfred and Baker Medical Unit, Baker Medical Research Institute, WHO Collaborating Center for Research and Training in Cardiovascular Disease, Prahran, Victoria, Australia.

    Janis Jennings is with the Alfred and Baker Medical Unit, Baker Medical Research Institute, WHO Collaborating Center for Research and Training in Cardiovascular Disease, Prahran, Victoria, Australia.

    Carolyn P. Keil, R.N., Ph.D., is on the faculty of the School of Nursing at the University of Alaska in Anchorage.

    Barbara McCabe, Ph.D., R.N., is an associate professor at the University of Nebraska Medical Center, College of Nursing, Omaha.

    June McNicholas, B.Sc., is with the Department of Psychology of the University of Warwick, Coventry, England.

    Gail F. Melson, Ph.D., is Professor of Child Development and Family Studies at Purdue Univrsity, West Lafayette, Indiana.

    Christopher M. Reid is with the Alfred and Baker Medical Unit, Baker Medical Research Institute, WHO Collaborating Center for Research and Training in Cardiovascular Disease, Prahran, Victoria, Australia.

    Andrew Rowan, Ph.D., was Editor-in-Chief of the journal Anthrozoös and is on the faculty of the School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts, and Assistant Dean for new programs. He is now Vice President for the Humane Society of the U.S.

    Lorann Stallones, Ph.D., is Professor in the Department of Environmental Health, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins.

    Melanie C. Steffens is with the Institute of Psychology at the University Trier in Trier, Germany.

    Jean M. Tebay, B.A., M.S., is Director of Therapeutic Riding Services in Lutherville, Maryland.

    Sue A. Thomas, R.N., Ph.D., is Executive Director of New Life Directions in Ellicott City, Maryland.

    Sandra Lookabaugh Triebenbacher, Ph.D., is Assistant Professor in the Department of Child Development and Family Relations of East Carolina University, Greenville, North Carolina.

    Carol Wilson, R.N., M.S.N., is the retired Director of Nursing of the University Hospital and a clinical associate of the University of Nebraska Medical Center, College of Nursing, Omaha.


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