tag:blogger.com,1999:blog-56168754832907958052024-03-21T06:46:10.255-07:00Nursing EssentiallyNursing Essentially focuses on the provision of evidence based practice in healthcare and is highly skilled in research methodologies and methods. All services are based on the latest evidence available and aim to personify a culture of care.Nursing Essentiallyhttp://www.blogger.com/profile/05858542671381889673noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-5616875483290795805.post-78571018959027021532018-05-05T02:14:00.001-07:002018-05-05T02:14:26.654-07:00Breaking News! Animal-Assisted Intervention in the ICU<br />
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A new journal article has just been published by <span style="mso-no-proof: yes;">(Hosey et al. 2018)</span> “Animal-assisted
intervention in the ICU: a tool for humanization” (as referenced below). As
described in their abstract:<br />
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;">Abstract</b></div>
<div class="MsoNormal">
“The combination of an aging population and advances in
critical care medicine is resulting in a growing number of survivors of
critical illness.[1] Survivors' descriptions of their stay in an intensive care
unit (ICU) are frequently filled with traumatic events, and include experiences
of confusion, anxiety, sleeplessness, pain, and loneliness.[2,3] Sedative and
anxiolytic medications administered to manage patient symptoms are associated
with delirium and worse physical and mental health outcomes.[4] Therefore, there
is growing interest in the use of non-pharmacologic interventions and in
creating a more humanized environment in the ICU for patients and their
families.[5] Such efforts have included a focus on understanding the critically
ill patient as an individual and providing comprehensive medical,
psychological, and rehabilitation care.[6–8] This publication aims to: 1)
suggest a conceptual model for the use of non-pharmacologic interventions to
reduce suffering and promote recovery in a more humanized ICU environment; 2)
describe animal-assisted intervention (AAI) as an exemplar of a
non-pharmacologic intervention and provide a conceptual model for the utility
of this intervention; and 3) discuss the basic principles for introducing a
non-pharmacologic intervention program in the ICU.” <span style="mso-no-proof: yes;">(Hosey et al. 2018, p. 1)</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<u>Highlights of this study include:</u></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
“Some healthcare facilities have integrated AAI, in
populations ranging from pediatrics to geriatrics, in order to reduce suffering
and promote recovery behaviour”.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
“Anecdotal evidence suggests that a dog sitting in a
patient's lap eases suffering and builds motivation in ways that medical
interventions may not”.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Directly quoted below, <span style="mso-no-proof: yes;">Hosey
et al. (2018, p. 5) have identified six critical success factors to build an
AAI Program in an ICU:</span></div>
<ol>
<li><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"><span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;">designating a champion who is consistently
present in the ICU with established credibility to create systematic change;</i></li>
<li><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"><span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;">having clear program goals with milestones
and measurable outcomes, such as</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;">improving patient mood,</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;">improving engagement in medical care and
rehabilitation therapies, and</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;">reducing perceived pain;</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> </span></span></i></li>
<li><i style="mso-bidi-font-style: normal;">including stakeholders who can help identify
and surmount barriers to implementation, such as risk management and hospital
epidemiology and infection control staff;</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> </span></span></i></li>
<li><i style="mso-bidi-font-style: normal;">identifying animal teams and partnering them
with an organization that has credibility in training teams for the hospital
environment, such as Pet Partners, Inc. (https://petpartners.org/) and
Assistance Dogs International (https://assistancedogsinternational.org);</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> </span></span></i></li>
<li><i style="mso-bidi-font-style: normal;">creating a policy that</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> a.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;">establishes goals of the program,</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> b.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;">outlines roles/responsibilities for all
involved in the program,</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> c.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;"><span style="mso-spacerun: yes;"> </span>outlines logistics of animal visits,</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> d.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;">specifies what do in the event of an
accident, and</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> e.<span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;">establishes a plan for program evaluation;
and</i><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"> </span></span></i></li>
<li><i style="mso-bidi-font-style: normal;"><span style="mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;"><span style="font: 7.0pt "Times New Roman";"> </span></span></span></i><i style="mso-bidi-font-style: normal;">launching the program with patients who have
a high likelihood of success, such as patients without delirium, communicable
disease, or the need for contact precautions due to colonization with a drug-resistant
microorganism, to build confidence and create momentum for the program.</i></li>
</ol>
<div class="MsoNormal">
Finally they conclude that in terms of non-pharmacological
interventions, Animal Assisted Interventions has the potential to reduce
patient suffering and enables people to be able to take and “active role in
their recovery”.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;">Reference</b></div>
<div class="EndNoteBibliography" style="margin-left: 36.0pt; text-indent: -36.0pt;">
<span lang="EN-US">Hosey, MM, Jaskulski, J, Wegener, ST, Chlan, LL & Needham, DM
2018, “Animal-assisted intervention in the ICU: a tool for humanization”, <i style="mso-bidi-font-style: normal;">Critical Care</i>, vol. 22, no. 22, pp. 1-5.</span></div>
Nursing Essentiallyhttp://www.blogger.com/profile/05858542671381889673noreply@blogger.comtag:blogger.com,1999:blog-5616875483290795805.post-92057353715482036282018-05-04T23:37:00.003-07:002018-05-04T23:37:37.335-07:00Focusing on Positivity, Hope and Acceptance NOT the “Illness”<!--[if gte mso 9]><xml>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhC-qNRfIYwx5eQL1AbF1op45os9qSMC26YBBA0ls3hvN2KpbZx8YaIpONCd8kdoRhyphenhyphencaMsNLgkqkmW1O6mVIXdfuX1gk3uplEx10xABR8B-xFTBSZo20QFkfffkAK5PnHHT1tIa09XyCkm/s1600/Hope.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="340" data-original-width="598" height="181" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhC-qNRfIYwx5eQL1AbF1op45os9qSMC26YBBA0ls3hvN2KpbZx8YaIpONCd8kdoRhyphenhyphencaMsNLgkqkmW1O6mVIXdfuX1gk3uplEx10xABR8B-xFTBSZo20QFkfffkAK5PnHHT1tIa09XyCkm/s320/Hope.jpg" width="320" /></a></div>
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Its
difficult topic to discuss, but one that needs a serious discussion, both in
the area of mental health, acute care and chronic illnesses. I stumbled across
an article yesterday that gave me pause to reflect upon the “Recovery Framework”
that is bandied around by mental health professionals, and indeed by myself at
times. One striking quote is as follows:</div>
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“The word “recovery” suggests that
people need to return to a “normal” state, rather than embrace their
differences. What does a person with bipolar disorder or autism need to
“recover” from? When people realize they are not their diagnoses, they can
start to find things that actually work to help them live successful and
productive lives. That’s hope, not recovery.” (Liza Long, 2015: <a href="https://www.huffingtonpost.com/liza-long/5-reasons-i-wish-we-would_b_6502318.html">https://www.huffingtonpost.com/liza-long/5-reasons-i-wish-we-would_b_6502318.html</a>)
</div>
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She then discusses the differences
between chronic illnesses and mental illness – both in terms of stigma and then
subsequent “recovery”:</div>
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“… if people recover, why aren’t you
recovering? It must be a choice you are making, or something you’re doing
wrong. Some people tell you the medications you take are preventing you from
recovery. Others tell you that your choice to stop medication is preventing you
from recovery. Who is right? Hope is a universal concept that embraces a wide
range of possibilities. Recovery seems dependent on a prescribed set of
treatments that may not work for everyone… We would never apply the blanket
expectation of recovery to any other chronic illness or disability. With cancer
and autoimmune disorders, we use the term “remission” to describe a
life-threatening systemic illness that with luck and treatment has been stopped
in its tracks. With other chronic illnesses like diabetes, we talk about
managing the illness. But with mental illness, we expect people to “choose”
recovery, even when they are experiencing psychosis, or when their disease
steals their ability to make rational choices.” (Long, 2015)</div>
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Ms. Long talks then about the
concept of hope… What I have noticed is that when people focus on their
diagnosis and their limitations, this would seem to hold true – it psychologically
takes away the concept of hope. Moving further, how can one maintain a positive
outlook on life should one lose hope?</div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 0cm; margin-right: 0cm; margin-top: 12.0pt;">
Ms. Mims (2016, <a href="https://themighty.com/2016/12/focusing-on-positives-of-life-with-chronic-illness/">https://themighty.com/2016/12/focusing-on-positives-of-life-with-chronic-illness/</a>
) discusses her journey of being diagnosed with Celiac disease and discusses
the initial feeling experienced such as “anger, grief, sadness, frustration and
fear. There may be tears, and there may be mourning… The thoughts flash quickly
through your mind: “But I can’t…”, “But I won’t ever be able to…”, “But now
I’ll never have a ‘normal’ life.” Interestingly however, her outlook is that
she perceives that these negative thought patterns have the potential make her
captive of her own mind, in this way she highlights the fact that she has noted
that some let the disease define them and it is there identity. She chooses the
opposite of that. In that way, while she struggles at time, she fights for joy
in her life so <u>she doesn’t become a captive of her own mind</u> and her
identity remains separate to her di-ease.</div>
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So what are we left with? First, how
to regulate your behaviours and emotions and then how to move forward onto a
path of positivity and hope. </div>
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So in this way you need to be able
to think that these thought patterns that your behaviours and thoughts are
actually causing you harm, and test whether you can resist in these thought
patterns or behaviours. “Self-destructive or dysregulated behaviours provide
relief or even pleasure in the short-term – but ultimately get in the way of
living a life that feels satisfying and fulfilling.” (Wupperman, 2016
Psychology Today). One helpful avenue is to actually process your emotions at
the time Wupperman suggests so they do not continue to build into a virtual
pressure cooker waiting to explode. If not, it may become a repetitive cycle.</div>
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A useful way to think about moving
forward has been discussed by Ms. Mulder, a Psychologist who is living with a
chronic illness (2017: <a href="https://thehealthsessions.com/lessons-learned-about-recovery-from-illness/">https://thehealthsessions.com/lessons-learned-about-recovery-from-illness/</a>
). Albeit, this is at odds with previous assertions about the divergent
terminology about “recovery”. Nevertheless, I believe it is up to the
individual to choose their own terminology to “fit” with their own journey in
order to move forward along their own pathway in life in order to promote hope
and positivity. Mulder’s seven steps are exceptional, simple and I believe can
be applied to most situations. It moves one from a situation of feeling
powerless to feeling empowered. That is a critical switch in thinking that must
be taken in many situations whether one is chronically ill, acutely ill or
diagnosed with a mental illness. Yet again however terminology is important and
thus I will simply say <i style="mso-bidi-font-style: normal;">a disabling
condition</i> with ascribing or labelling further.</div>
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She suggests that one should decide
what recovering from this means for yourself: “The conventional definition of
‘recovery’ is too limiting for these people: it implies a fixed final
destination at the end of the road – one that many of us may never reach. So
what if we stop thinking of recovery as an all-or-nothing deal, but rather as a
continuum with many more stages, variations and dimensions than simply “being
better”? ‘Recovery’ can mean anything you want it to be: (small) physical or
mental improvements, a better quality of life or being able to do something you
couldn’t do before. Meaningful examples of this new version of recovery could
be being able to walk to the shops again, becoming more independent, picking up
your favorite hobby again or getting back to work parttime.” (Mulder, 2017).</div>
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Next, one must remember that it is a
long and at time a winding arduous journey: “Healing is not a linear process. …
There are many ups and downs along the way. Depending on your illness – whether
it’s curable or chronic, relatively stable or progressive – this process of
setbacks and personal victories can repeat itself multiple times. That’s
because ‘being healthy’ isn’t as black-and-white as it’s usually portrayed.
Most of us find ourselves in the huge grey area between optimally fit and
terminally ill. Even a healthy person’s immune system can be working overtime
to (successfully) fight off a nasty virus, and even a chronically ill person
can have a relatively good week. Your health fluctuates every day for as long
as you will live, constantly trying to find that illusive equilibrium... So
don’t give up too soon if you don’t notice any improvements straight away.
Recovery is a marathon, not a sprint.” (Mulder, 2017).</div>
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While I am unsure of the next one
(more of a terminology than anything) she discusses the fact that you can fight
for your recovery, whilst at the time accepting you illness. Arguably, fighting
means a battle and a battle means expending energy that one may not have.
Accepting your illness as well may make one resigned to the fact and then you
could lose hope. However she most poignantly says here: “Contrary to what you
might think, it is possible to accept your current limitations and keep
fighting for your recovery at the same time. Because facing today’s reality
doesn’t mean you give up hope for tomorrow. It just means you make the best of
the given situation in this moment, instead of forcefully trying to change
something that cannot be changed right now. It’s saying: “<i style="mso-bidi-font-style: normal;">Apparently, this is all my body and mind are capable of doing right
now, and I will live life the best way I know how despite of my illness</i>.” At
the same time, you can still take smalls steps every day towards a better
health, just without the constant struggle and disappointment of not being able
to live up (your) expectations. Focus on what you can control or improve, however
little that might be today, and find ways to accept the things you cannot
change.” (Mulder, 2017).</div>
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Finally Mulder suggests that one
needs to arrive at the conclusion that sometimes there is no end goal: “But
sometimes, no matter how hard you try, your body and mind just can’t (fully)
heal themselves. <b style="mso-bidi-font-weight: normal;">If there’s no victory,
is it even worth the struggle? </b>Only you can decide that. But to me, it’s
not just the destination that matters, it’s the journey – basically, your life
– as well. What will you have done along the way? How much joy did you
experience? Were you able to achieve some of your dreams by striving? Did you
have less pain and symptoms – and therefore a better quality of life – thanks
to your recovery efforts? If you’re anything like me, knowing you’ve done all you
could have to get better, feel better, live life the way you wanted to can help
you learn to accept remaining limitations and disappointments.” (Mulder, 2017).</div>
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If we look at this in its entirety (terminology
aside) there demonstrates a lot of hope, a lot of positivity and very little
focus on the dis-ease itself. Rather the mind, body, spirit continuum and the
ability to self-regulate destructive behaviours and the cycles that can occur
that will eventually end up making one bitter, twisted and sick of their life
as evidence would suggest that leads to chronic depression and a multitude of
other co-morbidities ((Singer 2001: <a href="https://www.ncbi.nlm.nih.gov/books/NBK43790/">https://www.ncbi.nlm.nih.gov/books/NBK43790/</a>
). Changing habits takes a long time to occur (Evans, 2012: <a href="https://www.huffingtonpost.co.uk/jules-evans/mental-health-recovery-top-ten-tips-for-recoveri_b_2165212.html">https://www.huffingtonpost.co.uk/jules-evans/mental-health-recovery-top-ten-tips-for-recoveri_b_2165212.html</a>
). Termed “Neuroplacicity”, work on developing your brain to develop those
hopes, dreams and goals into a serious of goals and then into habits and then
keep a journal to the document your progress (Evans, 2012). You may be
surprised at the results on what you have achieved!</div>
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In sum the take home message is to
change your habits, change your thought patterns and definitively choose to
think that the dis-ease does not define you as a person. Rather you are a
useful, contributing member of society that can go out and achieve what you
want to – you may just have to do it in a variety of creative ways that other
people may not. A final note is that becoming self-absorbed in your dis-ease
bodes no one any good. If you become the observer self, you will begin to
understand that <i style="mso-bidi-font-style: normal;">everybody has problems,
issues and daily struggles and each person considers them just as important as
yours</i>; this means you do need to think of others as well during this
journey (Evans, 2012). Optimism and social support is vital and also has been
proven to prevent a relapse in chronic depression, so I urge you to give this
serious consideration (Singer 2001). Without this, there may indeed spark a
pathway of self-destructive behaviours that will ultimately affect your health
(Wupperman, 2016). By focusing on positivity and hope and considering that this
is your journey, allows one to also develop empathy for others, consideration
for others and who knows, you may just move that bit closer to the goals you
have set yourself without even knowing it! </div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwZLYVDJMA_i5qCPISTH4YRbtQ6bJiChwTrbEeqgxCExdbmtMjqJJvvHevZ5m-lJnGWLb7AZNd-BIhLwg9C8zqUbFVE4jvSc5tvVPfFWYPrGFEKcZZ3eZtD_XozU5z_x5gkGlCy8nszeqb/s1600/Stumble.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="340" data-original-width="510" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwZLYVDJMA_i5qCPISTH4YRbtQ6bJiChwTrbEeqgxCExdbmtMjqJJvvHevZ5m-lJnGWLb7AZNd-BIhLwg9C8zqUbFVE4jvSc5tvVPfFWYPrGFEKcZZ3eZtD_XozU5z_x5gkGlCy8nszeqb/s320/Stumble.jpg" width="320" /></a></div>
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Nursing Essentiallyhttp://www.blogger.com/profile/05858542671381889673noreply@blogger.comtag:blogger.com,1999:blog-5616875483290795805.post-54916476972153219542018-05-01T04:53:00.001-07:002018-05-01T04:53:27.108-07:00Animal Assisted Therapy & its Affects on the Dog<em><strong>Quoted from Pet Industry News:</strong></em><br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgt_BaQhzkYAK5YFCAZvkUaIwvUnSyF1KXS2CqeiMTxHkrSs58u-7OZKaDLoXRG1ttDRaksiBTbr6Eg8RmxRoVAZq5wNQtMkfgvd_YzHZxjN77dq-Aq8JiVhWkPjw6TJDii24UM2FPAsaof/s1600/Animal+Assisted+Therapy.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="500" data-original-width="808" height="198" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgt_BaQhzkYAK5YFCAZvkUaIwvUnSyF1KXS2CqeiMTxHkrSs58u-7OZKaDLoXRG1ttDRaksiBTbr6Eg8RmxRoVAZq5wNQtMkfgvd_YzHZxjN77dq-Aq8JiVhWkPjw6TJDii24UM2FPAsaof/s320/Animal+Assisted+Therapy.jpeg" width="320" /></a></div>
<em><strong> </strong> </em><br />
Animal-assisted interventions (AAIs) are becoming increasingly popular in clinical settings. AAIs are defined as the ‘purposeful incorporation of specially trained animals in services to improve human health’, and dogs are commonly used for these interventions.<br />
These therapy dogs interact with a variety of patients in a clinical setting, and it is possible that the dogs find these interactions stressful. There is currently a lack of agreement regarding if and how AAIs affect animal welfare, and further research is needed to ensure the welfare needs of therapy dogs are being met. This study measured the physiological and behavioural effects of regular AAI sessions on therapy dogs.<br />
The AAIs monitored in this study occurred between therapy dogs and children between the ages of 3-17 years who had recently been diagnosed with cancer in the USA. The children were enrolled in the study for a four-month period, during which they received weekly visits from the same therapy dog and handler. A total of 26 therapy dogs were used to visit 60 children, and each visit lasted for approximately 20 minutes. The dog handlers completed a questionnaire relating to how their dog typically responds to common events and stimuli in the environment, and collected saliva samples at home and immediately after an AAI to determine changes in stress physiology (cortisol). The behaviour of the dogs was video recorded during each AAI and the total frequency of stress-related behaviours and affiliative behaviours were recorded for each session.<br />
The results of this study indicate that therapy dogs show minimal signs of distress during AAI sessions. The therapy dogs did not have a significantly increased physiological stress response following the session, nor did they exhibit significantly more stress-related behaviours than affiliative-related behaviours. There were significant relationships found between salivary cortisol and behaviour, with a higher cortisol concentration associated with more stress behaviours, and lower cortisol concentration associated with more affiliative behaviours. This study provides valuable and rigorous evidence that AAI participation in paediatric hospitals does not appear to place therapy dogs at significant risk of stress.<br />
<em>McCullough A, Jenkins MA, Ruehrdanz A (2018)<br /> Physiological and behavioural effects of animal-assisted interventions on therapy dogs in pediatric oncology settings.<br /> Applied Animal Behaviour Science 200:86-95.<br /> Source: RSPCA Animal Welfare Science</em>Nursing Essentiallyhttp://www.blogger.com/profile/05858542671381889673noreply@blogger.comtag:blogger.com,1999:blog-5616875483290795805.post-12414724118698235732018-03-03T22:39:00.000-08:002018-03-03T22:39:17.454-08:00Dealing with Anxiety<!--[if gte mso 9]><xml>
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<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<b><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkXrfmDongNvpM4lxbURs4y4PWcBMjNqovODtNxeamRTXpjJfjecTjFM4DI4EqLBgJdiwclHCdBmO9ALgGZ9TKrUOxp4hBJ6NqrT3Y9MhdefWF3m3RVj1E15VRS-a6wjqDCvrXaKlXCZkf/s1600/Anxious.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="341" data-original-width="414" height="262" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkXrfmDongNvpM4lxbURs4y4PWcBMjNqovODtNxeamRTXpjJfjecTjFM4DI4EqLBgJdiwclHCdBmO9ALgGZ9TKrUOxp4hBJ6NqrT3Y9MhdefWF3m3RVj1E15VRS-a6wjqDCvrXaKlXCZkf/s320/Anxious.jpg" width="320" /></a></b></div>
<br />
<div class="MsoNormal">
<b><span lang="EN-AU">What is Anxiety</span></b></div>
<div class="MsoNormal">
<span lang="EN-AU"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-AU">Anxiety is an emotion that is characterised
with feelings like worrying thoughts, feeling tension and physical symptoms
such as increased heart rate and blood pressure. There are two kinds of anxiety
– normal anxiety (such as being anxious before sitting an exam) or an anxiety
disorder (requiring medical intervention – and this means the anxiety
experienced is out of proportion to the trigger or the severity of the anxiety
is disabling to the point of being able to function in your day to day life).</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-AU">Anxiety is your body’s reaction designed to
keep you safe – but when it is hard to control, then it becomes problematic!
Yet sometimes, no matter how much we tell ourselves not to be anxious, we
cant’s stop those emotions or physical symptoms.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span lang="EN-AU">Changing
your mindset</span></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-AU">Changing your mindset doesn’t happen
overnight, However, small repeated steps, will assist in transforming –
remember don’t hurry the process! Also, don’t try and do all of these suggested
strategies at once, it will only make you more anxious! Just be you and rejoice
in one accomplishment at a time!</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<u><span lang="EN-AU">BE PRESENT: </span></u></div>
<div class="MsoNormal">
<span lang="EN-AU">Don’t worry about the past or future. Don’t
follow your anxious thoughts. Anxiety is all about “maybes” and “what if’s”
then takes you to a potentially threatening and uncertain future. Try
experimenting with being fully present in the future and focus fully on what’s
happening around you – the noises, the sound of your breath, the outside noises
– just even for 2 minutes – set yourself a time limit. Congratulate yourself
after! What you’ve just done is developed an ability to pull yourselve back
from your anxious thoughts to the present. Try to practice this everyday
regularly.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<u><span lang="EN-AU">BE PATIENT:</span></u></div>
<div class="MsoNormal">
<span lang="EN-AU">Always know that feelings and thoughts
come, stay and then go. There’s a saying “this too shall pass”. So be patient,
ride the feeling/s and thought/s. Develop the wisdom to know that you can stay
with these feelings long enough to know that eventually that they will leave
and that you do not need them today. You could try developing an internal
dialogue and saying to yourself “thank you for these thoughts and feelings,
you’ll leave when you’re ready”. Then breathe deeply.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<u><span lang="EN-AU">DON’T ENGAGE:</span></u></div>
<div class="MsoNormal">
<span lang="EN-AU">Observe your thoughts and feelings without
engaging with them. Anxiety is exhausting. If you engage with the thoughts and
feelings it’s downright exhausting! So just observe them, don’t try to change
them, let them be, don’t try to understand them or talk yourself out of them – let
them float around you without becoming part of you.</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<u><span lang="EN-AU">TRUST YOURSELF:</span></u></div>
<div class="MsoNormal">
<span lang="EN-AU">Finally trust yourself! Know that you are
strong and resourceful! You have gotten this far in life and so no matter what
happens in life, you can deal with what ever comes your way! Remember,
underlying anxiety is anxiety worry, rejection and stress of failure <span style="mso-spacerun: yes;"> </span>and that you may not be able to cope with what
comes your way… Move towards trusting in yourself – act as if until it becomes
that. You can do it!</span></div>
Nursing Essentiallyhttp://www.blogger.com/profile/05858542671381889673noreply@blogger.comtag:blogger.com,1999:blog-5616875483290795805.post-61688692737661515062018-02-19T21:53:00.000-08:002018-02-20T01:09:55.305-08:00You Get 25,000 Mornings as an Adult: Here are 8 Ways to Not Waste Them by James Clear<!--[if gte mso 9]><xml>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieXXyjR3YCRIxmYdw_pifAhjiXVUyblu4nV70MX-qzfdjsaMKGJDVSeaD34cpMVyskXctSVrlZzgLEYIZv-zWhR79E37pnka1jf7J_1Jsjv3KNl3VAA6yGhFiMLGavFYOh_6qRbfoFAV9d/s1600/Good+morning+Blog.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="340" data-original-width="509" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieXXyjR3YCRIxmYdw_pifAhjiXVUyblu4nV70MX-qzfdjsaMKGJDVSeaD34cpMVyskXctSVrlZzgLEYIZv-zWhR79E37pnka1jf7J_1Jsjv3KNl3VAA6yGhFiMLGavFYOh_6qRbfoFAV9d/s320/Good+morning+Blog.jpg" width="320" /></a></div>
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<h2>
<b>An excerpt from an article From James Clear to read in its
entirety, please visit: <a href="https://jamesclear.com/25000-mornings">https://jamesclear.com/25000-mornings</a></b></h2>
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"<b>1. Manage your energy, not your time.</b> If you take a moment
to think about it, you'll probably realize that you are better at doing certain
tasks at certain times. For example, my creative energy is highest in the
morning, so that's when I do my writing each day.<br />
By comparison, I block out my afternoons for interviews, phone calls, and
emails. I don't need my creative energy to be high for those tasks, so that's
the best time for me to get them done. And I tend to have my best workouts in
the late afternoon or early evening, so that's when I head to the gym. What type of energy do you have in the morning? What task is that energy
best suited for?"<br />
<br />
"<b>2. Prepare the night before.</b> I don't do this nearly as
often as I should, but if you only do one thing each day then spend a few
minutes each night organizing your to–do list for tomorrow. When I do it right,
I’ll outline the article I’m going to write the next day and develop a short
list of the most important items for me to accomplish. It takes 10 minutes that
night and saves 3 hours the next day."<br />
<br />
"<b>3. Don’t open email until noon.</b> Sounds simple. Nobody does
it. It took me awhile to get over the urge to open my inbox, but eventually I
realized that everything can wait a few hours. Nobody is going to email you
about a true emergency (a death in the family, etc.), so leave your email alone
for the first few hours of each day. Use the morning to do what's important
rather than responding to what is “urgent.” "<br />
<br />
"<b>4. Turn your phone off and leave it in another room.</b> Or on
your colleagues desk. Or at the very least, put it somewhere that is out of
sight. This eliminates the urge to check text messages, Facebook, Twitter, and
so on. This simple strategy eliminates the likelihood of <a href="https://jamesclear.com/time-management-tips" title="time management tips">slipping
into half–work</a> where you waste time dividing your attention among
meaningless tasks."<br />
<br />
"<b>5. Work in a cool place.</b> Have you ever noticed how you feel
groggy and sluggish in a hot room? Turning the temperature down or moving to a
cooler place is an easy way to focus your mind and body. (Hat tip to Michael
Hyatt for this one.)"<br />
<br />
"<b>6. Sit up or stand up.</b> Your mind needs oxygen to work
properly. Your lungs need to be able to expand and contract to fill your body
with oxygen. That sounds simple enough, but here's the problem: most people sit
hunched over while staring at a screen and typing.<br />
When you sit hunched over, your chest is in a collapsed position and your
diaphragm is pressing against the bottom of your lungs, which hinders your
ability to breathe easily and deeply. Sit up straight or stand up and you'll
find that you can breathe easier and more fully. As a result, your brain will
get more oxygen and you'll be able to concentrate better. (Small tip: When sitting, I usually place a pillow in the small of my back.
This prevents my lower back from rounding, which keeps me more upright.)"<br />
<br />
"<b>7. Eat as a reward for working hard.</b> I practice
intermittent fasting, which means that I eat my first meal around noon each
day. I've been doing this for almost two years. There are plenty of health
benefits, which I explained in great detail <a href="https://jamesclear.com/the-beginners-guide-to-intermittent-fasting" title="intermittent fasting">here</a>, <a href="https://jamesclear.com/intermittent-fasting-lessons-learned" title="intermittent fasting">here</a>, and <a href="https://jamesclear.com/reader-mailbag-intermittent-fasting" title="intermittent fasting">here</a>.<br />
But health is just one piece of the puzzle. I also fast because it allows me
to get more out of my day. Take a moment to think about how much time people
spend each day thinking, planning, and consuming food. By adopting intermittent
fasting, I don’t waste an hour each morning figuring out what to eat for
breakfast, cooking it, and cleaning up. Instead, I use my morning to work on
things that are important to me. Then, I eat good food and big meals as a
reward for working hard."<br />
<br />
"<b>8. Develop a “pre–game routine” to start your day.</b> My
morning routine starts by pouring a cold glass of water. Some people kick off
their day with ten minutes of meditation. Similarly, you should have a sequence
that starts your morning ritual. This tiny routine signals to your brain that
it's time to get into work mode or exercise mode or whatever mode you need to
be in to accomplish your task. Additionally, a pre–game routine helps you
overcome a lack of motivation and get things done even when you don’t feel like
it."<br />
<br />
"For more details about why this works, read this: <a href="https://jamesclear.com/how-to-get-motivated" title="how to get motivated">How
to Get Motivated</a>."Nursing Essentiallyhttp://www.blogger.com/profile/05858542671381889673noreply@blogger.comtag:blogger.com,1999:blog-5616875483290795805.post-38699194168206459162018-02-15T21:27:00.000-08:002018-02-19T21:51:02.286-08:0025 Ways to be a happier healthier you!<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiWESenQjWP_HJ3pj48M_FsRQpFOKbgm0cBmEKWljlLG5cER5yFS-i4HgeITSqf_jUA2VXkmkl9N8aZaS_m2yw18-nxcd6GdF2DtHcLY0KY9lGOhGDLiyEfwJj0Pp01nRapqUVGNFkcEy37/s1600/Happy+student+Blog.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="340" data-original-width="519" height="209" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiWESenQjWP_HJ3pj48M_FsRQpFOKbgm0cBmEKWljlLG5cER5yFS-i4HgeITSqf_jUA2VXkmkl9N8aZaS_m2yw18-nxcd6GdF2DtHcLY0KY9lGOhGDLiyEfwJj0Pp01nRapqUVGNFkcEy37/s320/Happy+student+Blog.jpg" width="320" /></a></div>
<br />
Starting uni a happier and more healthy self:-) An interesting concept isn't it? How can one be a happier and healthier self? Yet when you are starting uni, in the middle, or about to graduate, it pays to make some small changes to ensure longevity.<br />
<br />
<br />
When we think about nursing in particular, these small changes can be transferred as you educate your clients as they too embark upon their life's journey. This <a href="https://www.youtube.com/watch?v=MXT5dDF3iDg&index=5&list=PLrBsx3LXzDhKnO2FqQ-2_H5u7msOoqeML" target="_blank">YouTube clip</a> gives a slightly humorous look at 25 ways we can all make some small changes to be a happier healthier version of ourselves.<br />
<br />Nursing Essentiallyhttp://www.blogger.com/profile/05858542671381889673noreply@blogger.com