O1006: Impact of Animal Assisted Therapy on Quality, Completeness, and Patient and Parental Satisfaction in Children Undergoing Clinical Echocardiography

Background: In Pediatric Cardiology, children often have difficulty cooperating with echocardiograms which limits image quality and exam completeness. While standard distraction techniques such as movies or iPads can be helpful, sedation with anesthesia may be necessary to obtain crucial diagnostic information. Therapy dogs have been shown to comfort children in other medical settings and may alleviate anxiety experienced by both parents and children during clinical procedures. This study investigates whether the presence of a therapy dog improves echocardiogram quality and completeness, as well as patient and family comfort.

Methods: Patients 0-17 years of age presenting for a clinical echocardiogram were included in the study. A pilot phase of n=20 subjects underwent echocardiograms with a therapy dog present to determine an optimal workflow. Subsequently subjects were randomly assigned to 1 of 3 groups for their echocardiogram: 1) canine assisted therapy only; 2) canine assisted therapy plus standard distraction techniques; or 3) standard distraction techniques only. After the echocardiogram, the family and care team were surveyed to measure patient, parent, and dog comfort and satisfaction. Length of echocardiogram was calculated from the time stamps of the first and last images. To analyze echocardiogram completeness and quality, each echocardiogram was scored by experts blinded to the study group using the Echo Lab’s existing protocol document.

Results: To date, n=100 out of 320 subjects have been enrolled and analyzed. The canine assisted therapy only group had the highest median echocardiogram completeness score (Figure 1). In the post-exam survey, parents reported that the distractions used during the exam increased their child’s comfort, as well as their own comfort, more frequently in the canine assisted therapy groups compared to the standard distractions group (Figure 2). Patient compliance was also highest in the canine assisted therapy only group, with patients rated as “Easy, highly compliant” or “Moderately compliant” in 93% of the studies compared to 88% in the standard distractions only group. Moreover, echocardiograms performed with canine assisted therapy were 10-25% shorter in duration than echocardiograms performed using only standard distraction techniques.

Conclusion: Analysis to date demonstrates that the presence of a therapy dog during a pediatric echocardiogram provides a clinical and emotional benefit over standard distraction techniques. Although the overall high completeness scores suggests that dedicated pediatric cardiac sonographers can achieve nearly complete scans in almost every patient, the improvement of a few additional points on the echo completeness scoresheet with a therapy dog present suggests better visualization of key cardiac structures. Child and parent comfort, patient compliance, and exam efficiency are all increased with the use of canine assisted therapy. With continued exploration of this novel strategy, canine assisted therapy may reduce the need for sedated studies in children, and improve child comfort and family satisfaction.