Structured Abstract
Multiple Sclerosis Structured Abstract - MS #1
Service dogs to provide functional and psychological benefits
CITATION: Allen, K., & Blascovich, J. (1996). The value of service dogs for people with severe ambulatory disabilities. JAMA, 275, 1001-1006.
LEVEL OF EVIDENCE: IA1a
RESEARCH OBJECTIVE/QUESTION
To assess the value of service dogs for providing instrumental and emotional support for people with ambulatory disabilities.
DESIGN
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x |
RCT |
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Single Case |
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Case Control |
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Cohort |
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Before-After |
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Cross Sectional |
This was described as a split plot factorial design. The participants were matched for age, sex, race, marital status, and nature and severity of disease. One member of each pair was randomly assigned into either a treatment or a control group. The treatment group received their dogs 1 month after the study started, the control 13 months after the study started. Data collection occurred every 6 months for 2 years, resulting in a total of five collection points for each subject (0, 6, 12, 18, and 24 months).
SAMPLING PROCEDURE
Individuals who had expressed an interest in service dogs and who required substantial assistance were contacted by local advocacy groups to participate in the study.
SAMPLE
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N = 48 |
Mean age = 25 |
Male = 24 |
Female = 24 |
OUTCOMES
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x |
Life roles |
x |
Tasks |
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Activities |
|
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Abilities/habits |
x |
Capacities |
OUTCOME AREAS
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Outcome area |
Measure |
Reliability |
Validity |
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Psychological variables |
Sphere of Control Scale (internal locus of control), Rosenberg Self-Esteem Scale, Affect Balance Scale (psychological well-being), Community Integration Scale |
Standardized but not listed |
Not reported |
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Demographic variables |
Demographic Questionnaire asking about marital status, educational achievements, work status, and living arrangements |
Not reported |
|
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Assistance variables |
Number of hours of paid and unpaid assistance |
Self-report |
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INTERVENTION
Description
Participants provided with service dog (at 1 month for treatment and 13 months for controls). Dog interacted with participant for remainder of study.
Who delivered
Service dog
Setting
Participant's home
Frequency
Continuous
Duration
24 months
RESULTS
ANOVA for continuous (psychological, assistance) and chi square for frequency data (demographic).
- Comparison of first three data points - compared treatment and control group for data collection points 0, 6, and 12 on all variables. Significant main effects for group and month (p < .001) for all psychosocial variables, assistance variables, and school attendance and part-time employment. All treatment participants showed a steady improvement in these areas.
- Comparison of relative data points - Compared treatment data points 0, 6, and 12 to control data points for 12, 18, and 24 for all variables. No significant difference.
CONCLUSIONS
Biases - masking
- Participants with service dogs reported substantial improvements in self-esteem, internal locus of control, and psychological well-being. They also reported increased community integration, school attendance, and part-time employment.
- Participants reported a decrease of an average of 68% in paid assistance hours with the presence of a service dog.
Limitations:
- All participants had severe disabilities. This study may not generalize to groups with less severe disabilities.
- Participants were selected by advocacy groups anxious to implement policies about service dogs.
- Participants were aware of the purpose of the study
COMMENTARY
Occupational therapists may wish to consider recommending service dogs for clients with severe disabilities as adjuncts to assisted living situations. This study suggests that service dogs provide both psychological and functional benefits to those who have severe disabilities. This intervention is also very cost-effective.
A further possiblity is for OT to participate in service dog programs by providing adaptive equipment, dog referrals, and possibly training to dogs and owners.
Terminology used in this document is based on two systems of classification current at the time the evidence-based literature reviews were completed: Uniform Terminology for Occupational Therapy Practice-Third Edition (AOTA, 1994) and International Classification of Functioning, Disability and Health (ICIDH-2) (World Health Organization [WHO], 1999). More recently, the Uniform Terminology document was replaced by Occupational Therapy Practice Framework: Domain and Process (AOTA, 2002), and modifications to ICIDH-2 were finalized in the International Classification of Functioning, Disability and Health (WHO, 2001).
This work is based on the evidence-based literature review completed by Nancy Baker, ScD, OTR, and Linda Tickle-Degnen, PhD, OTR/L, FAOTA.
For more information about the Evidence-Based Literature Review Project, contact the Practice Department at the American Occupational Therapy Association, 301-652-6611, x 2040.
Copyright 2003 American Occupational Therapy Association, Inc. All rights reserved. This material may be reproduced and distributed without prior written consent.
