Evaluating the Effects of Animal Therapy on Anxiety in Pediatric Dental Patients

评估动物疗法对小儿牙科患者焦虑的影响

• 批准号: 10649010
• 负责人: Laura Anne Jacox
• 金额: $ 15.41万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2025-07-14
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10649010
• 关键词: Adult; Adverse event; Affect; Age; Anesthesia procedures; Animals; Anxiety; Appointment; Arousal; Behavior; Behavioral; Biometry; Canis familiaris; Caregivers; Caring; Cessation of life; Child; Childhood; Clinical Trials; Code; Collaborations; Computer software; Data; Data Analyses; Dementia; Dental; Dental Anxiety; Dental Care; Dentistry; Dentists; Devices; Diagnostic; Discipline; Elderly; Emergent care; Emotional; Ensure; Evaluation; Exhibits; Facial Pain; Faculty; Fright; Funding; Future; Galvanic Skin Response; General Anesthesia; Health; Heart Diseases; Heart Rate; Hormones; Hospitalization; Hydrocortisone; Individual; Infection; Inpatients; Intervention; Intravenous; Lead; Learning; Licensing; Literature; Malignant Neoplasms; Measurement; Measures; Medical; Methodology; Minor; Movement; Nervous System Trauma; Oral; Oral health; Outcome; Outpatients; Pain; Parents; Pathological anxiety; Patient Self-Report; Patients; Pediatric Dentistry; Perception; Persons; Physiological; Population; Preventive treatment; Protocols documentation; Public Health; Qualifying; Quality of life; Questionnaires; Randomized; Risk; Salivary; Sampling; Sedation procedure; Stress; Surveys; Techniques; Testing; Therapeutic; Therapeutic Intervention; Toothache; Training; Visit; Work; active control; adverse event risk; age group; alpha-amylase; animal efficacy; animal-assisted therapy; anxiety management; anxiety reduction; cohort; comparison control; expectation; experience; health care settings; health related quality of life; improved; innovation; novel; pain perception; pediatric patients; pharmacologic; protocol development; randomized, clinical trials; response; restraint; saliva sample; sedative; self-reported anxiety

ABSTRACT. Dental anxiety (DA) affects a striking 50-80% of adults and 6-22% of children. Individuals affected by DA often exhibit disruptive behavior and avoidance of dental care, leading to major adverse health outcomes, including increased rates of decay, pain, extractions, infections, emergent care and even hospitalization. DA frequently develops in childhood due to traumatic experiences and can lead to lifelong DA. Behavioral management techniques aimed at improving dental experiences must be employed during childhood to avoid these sequelae. For patients with severe anxiety and decay, pharmacological interventions may be used. However, sedatives and general anesthesia are frequently met with caregiver objections, as they carry low risks for adverse events, including neurological injury and death. Animal-Assisted Therapy (AAT) with a trained therapy dog has been used widely as a non-pharmacologic behavior guidance approach in numerous medical settings. Though in its nascent stages in dentistry, the novel use of AAT in a pediatric population holds promise for behavior management, reducing anxiety, mitigating pain, and creating positive associations. Furthermore, our data from 800 patients and parents confirm a pervasive desire for canine AAT in dentistry. The objective of this study is to evaluate whether AAT alleviates stress and improves perceptions during pediatric dental care. We hypothesize that AAT significantly alleviates biometric and self-reported measures of anxiety and pain in pediatric dental patients (with relative measure improvements of >20%). We propose to evaluate effects of AAT on objective measures of stress and pain during preventative treatment using salivary stress hormones, heart rate, sweat response, and observational coding data (Aim 1) along with patients' perceptions of dental pain, anxiety, and future visits with validated questionnaires (Aim 2). As part of an ongoing randomized clinical trial, data are collected from patients (age 4-7 years) randomized to a short AAT protocol, a long AAT protocol and an active control with a dental exam and cleaning (N=180, 60 per group). Altogether, data generated from these aims will be used to measure the impact of AAT on pediatric dental patients to guide implementation. This secondary data analysis project will generate results on feasible, rapidly implementable protocols for AAT use in dentistry to mitigate DA and improve experiences, to reduce dental avoidance and its significant health sequelae. Our interdisciplinary team is uniquely qualified to conduct the proposed work as we have the innovative methodologies, RCT patient data and samples, BLS2 facilities, and expertise to achieve our aims. This application includes collaboration between experienced and junior faculty across multiple disciplines to ensure the rigor and translatability of our findings.

抽象的。 牙齿焦虑（DA）影响了50-80％的成年人和6-22％的儿童。经常受到DA影响的个人 表现出破坏性行为和避免牙科护理，导致重大不良健康结果，包括 衰减，疼痛，提取，感染，紧急护理甚至住院的发生率增加。经常 由于创伤经历而在童年时期发展，并可能导致终生DA。行为管理 旨在改善牙齿体验的技术必须在童年时期采用 后遗症。对于严重焦虑和衰减的患者，可以使用药理学干预措施。然而， 镇静剂和全身麻醉经常会遇到护理人员的反对意见，因为它们的风险较低 不良事件，包括神经损伤和死亡。动物辅助疗法（AAT）和训练有素的疗法 在许多医疗环境中，狗已被广泛用作非药物行为指导方法。 尽管在牙科的新生阶段，在儿科人口中使用AAT的新颖使用仍然有望 行为管理，减轻焦虑，减轻疼痛并建立积极的关联。此外，我们的 来自800名患者和父母的数据证实了对牙科犬AAT的普遍渴望。这个目的 研究是为了评估AAT是否减轻了小儿牙科护理期间的压力并改善了看法。我们 假设AAT显着减轻了生物特征识别和自我报告的焦虑和疼痛措施 小儿牙科患者（相对测量改善> 20％）。我们建议评估 使用唾液应激激素在预防治疗期间的应力和疼痛的客观测量中， 心率，汗水反应和观察性编码数据（AIM 1）以及患者对牙齿的看法 疼痛，焦虑和未来的访问，并通过经过验证的问卷调查（AIM 2）。作为正在进行的随机临床的一部分 试验，从患者（4-7岁）随机分配给短AAT方案的患者（年龄4-7岁）的数据，这是长期的AAT协议 以及具有牙科检查和清洁的主动控制（n = 180，60）。总共产生的数据 这些目标将用于衡量AAT对小儿牙科患者指导实施的影响。 该二级数据分析项目将对AAT可行，可快速实现的协议产生结果 用于减轻DA并改善经验，减少牙齿避免及其重要健康状况 后遗症。我们的跨学科团队具有独特的资格来进行拟议的工作，因为我们拥有 创新方法，RCT患者数据和样本，BLS2设施以及实现我们目标的专业知识。 该申请包括跨多个学科的经验和初级教师之间的合作 确保我们发现的严格性和可翻译性。