OCT 1121 - Seminar OCT 1121 - Seminar PresentationPresentation

Monday, November 24, 2008Study Group #2

Olivia, Phuong, Audrey, Jacqui, Joanna, Devon, Lauren & Shu-Hyun

Mrs. Greenwald and Mrs. Greenwald and HoneyHoney

http://archives.umc.org/interior.asp?ptid=1&mid=10974

OutlineOutline Our question

◦ Definitions Initial model Delving into the literature

◦ Search terms◦ Databases◦ Our process of elimination

Critical appraisal of 3 articles The gaps

◦ Appraisal of current research◦ Gaps in literature◦ Final model◦ Future directions◦ Application to OT

◦ Discussion

Our QuestionOur QuestionHow does pet ownership among

older adults affect their occupational performance in the domains of self-care, productivity, and leisure?

Our QuestionOur QuestionDefinitions

◦Pet: a domesticated animal kept for pleasure rather than utility

◦Ownership: the state, relation, or fact of being an owner Owner: to have or hold as property; possess

◦Older adults: an individual over 65 years of age 

◦Occupational performance: The actual execution or carrying out of an occupation

(Canadian Association of Occupational Therapists, 1997)(Merriam-Webster Online, 2008)

Initial ModelInitial Model

Delving into the LiteratureDelving into the LiteratureSearch terms

Pet ownership Elderly Occupational performance

Occupations

Pet ownership Elderly Performance Occupations

Domestic pet Seniors Engagement Self-care

Animal Aged Participation Leisure

Dog Retirees Recreation Productivity

Veterans Play

Older adults

Involvement

Interaction

Quality of life

Activities of daily living

Delving into the LiteratureDelving into the LiteratureDatabases

◦CINAHL◦Medline◦Embase◦Scopus◦Pubmed◦Scholars Portal (Ageline)◦PsychInfo◦Web of Science

Delving into the LiteratureDelving into the LiteratureOur process of elimination

◦Initially 53 articles◦Eliminated articles pertaining to:

Pet therapy Physiological health benefits Irrelevant to our question

◦Resulted in 19 articles relevant to our question

Recap - Our QuestionRecap - Our QuestionHow does pet ownership among

older adults affect their occupational performance in the domains of self-care, productivity, and leisure?

Wood, Giles-Corti, Bulsara & Bosch, 2007

Raina, Waltner-Toews, Bonnet, Woodward & Abernathy, 1999

Dembicki & Anderson, 1996

Pets and LeisurePets and LeisureWood, L. J., Giles-Corti, B., Bulsara, M. K. & Bosch, D. A. (2007).

More than a furry companion: The ripple effect of companion animals on neighbourhood interactions and sense of community.

Society and Animals, 15(1), 43-56.

Key ThemesKey ThemesPet ownershipSocial interactionCommunity participation

PurposePurposeTo explore the community-level

impacts of pet ownership, focusing on social interaction and sense of community

Re-report of Wood et al. (2000; 2005)

Design & ParadigmDesign & ParadigmSample populationTwo-phase Qual/QUANT design

1. Qual: Focus groups 2. QUANT: Phone survey

Paradigm: Pragmatic positivism

Levels of DesignLevels of Design

1. Describe the factors

2.Explore relationships3. Experimental (cause-effect)

Level of EvidenceLevel of Evidence

I. At least one systematic review of RCTs

II. At least one RCTIII. Well-designed, non-randomized

trials

IV.Well-designed, non experimental

V. Opinions of respected authorities, clinical evidence, descriptive studies

ResultsResults

Pet ownership is associated with:Increased social interaction Increased community

participationIncreased sense of community

(dog owners)

CritiqueCritiqueStrengths

◦Triangulation of dataLimitations

◦Limited generalizability◦Level IV evidence◦Dogs vs. other types of pets?◦Differences between age groups

Relevance to QuestionRelevance to QuestionHow does pet ownership

among older adults affect their occupational performance in self-care, productivity and leisure?

Relevance to OSRelevance to OSOccupations and community health

◦Individual occupations affect community◦Shared occupations increase community

health E.g. Dog ownership and sense of community

Social aspects of occupational participation◦“Participation” usually occurs with others

(J. Davis, personal communication, November, 2008)

Pets and Self-CarePets and Self-CareDembicki, D. &

Anderson, J. (1996). Pet ownership may be a factor in improved health of the elderly. Journal of Nutrition for the Elderly, 15, 15-31.

Raina, P., Waltner-Toews, D., Bonnet, B., Woodward, C. H. & Abernathy, T. (1999). Influence of companion animals on the physical and psychological health of older people: An analysis of a one-year longitudinal study. American Geriatrics Society, 47, 323-329.

Key ThemesKey ThemesDembicki & Anderson

(1996)

Pet ownershipElderlyPhysical healthSelf-care defined

as:◦ Eating/nutrition ◦ Exercise◦ Cardiovascular risk

Raina et al. (1999)

Pet ownershipElderlyPhysical healthSelf-care defined

as:◦ ADLs◦ Exercise ◦ Risk of chronic

illness

Are pets Are pets goodgood for your health? for your health?May motivate the elderly to walk and/or exercise.May motivate the elderly to walk and/or exercise.

(Dembicki & Anderson, 1996; Raina et al., 1999)(Dembicki & Anderson, 1996; Raina et al., 1999)

www.msd.agovt.nz/.../2men-walking-dogs.jpg

www.guilfordortho.com

www.mindbodywellnesspc.com

Are pets good for your health?Are pets good for your health?May serve as a clock, adding routine to the lives of the May serve as a clock, adding routine to the lives of the

elderly.elderly.(Dembicki & Anderson, 1996)(Dembicki & Anderson, 1996)

www.cartoonstock.com

Are pets good for your Are pets good for your health?health?

May provide motivation to engage in daily May provide motivation to engage in daily activities.activities.

(Raina et al. 1999)(Raina et al. 1999)

www.macspride.com

PurposePurposeDembicki & Anderson

(1996)

To examine the associations between pet ownership and self-care

Raina et al. (1999)

To examine if companion animals were associated with changes in physical health

Scientific FoundationScientific FoundationDembicki & Anderson

(1996)

Previous experimental research by:◦ Friedmann et al.

(1980)◦ Lago et al. (1982)◦ Stallones et al.

(1988)

Raina et al. (1999)

Previous experimental research by:◦ Friedmann et al.

(1980)◦ Hendy (1984)◦ Serpel (1990)

Design & Paradigm Design & Paradigm *of both studies*of both studies

Pragmatic positivism

QUANT design◦ QUANT: cross-

sectional study (Dembicki & Anderson, 1996) Questionnaires Food diaries Medical data

◦ QUANT: longitudinal (Raina et al., 1999) Questionnaires Medical data

images.google.ca

Levels of DesignLevels of Design

1. Describe the factors

2.Explore Relationships *for both studies

3. Experimental (cause-effect)

Level of EvidenceLevel of Evidence

1. At least one systematic review of RCTs

2. At least one RCT3. Well-designed, non-randomized trials

4. Well-designed, non-experimental *for both studies

5. Opinions of respected authorities, clinical evidence, descriptive studies

MethodMethodDembicki & Anderson

(1996)

Quantitative study:◦ Convenience

sample of 127 seniors (60+)

◦ Cross-sectional design

◦ Statistical data analysis

Raina et al. (1999)

Quantitative study:◦ Stratified random

sample of 1054 adults (65+)

◦ Longitudinal design

◦ Statistical data analysis

ResultsResults

Dembicki & Anderson (1996)

Hypothesis that pet ownership leads to improved self-care was not supported

BUT:Pet owners were at

lower risk for cardiovascular problems

Raina et al. (1999)

ADL level of non-owners deteriorated more within one year

BUT:Pet-owners

younger than non-owners

Relevance to QuestionRelevance to QuestionHow does pet ownership

among older adults affect their occupational performance in self-care, productivity and leisure?

Relevance for OS Relevance for OS *of both studies*of both studies

More well-designed studies needed to examine the link between pet ownership and self-care◦Self-care should be uniformly defined ◦Adults in the age range 65+ and

adults in the age range 80+ should be studied separately

Appraisal of Current Appraisal of Current ResearchResearchOriginal question:

◦How does pet ownership among older adults affect their occupational performance in the domains of self-care, productivity, and leisure?

19 relevant articles reviewed◦Self-care◦Productivity◦Leisure◦Mediating factors

Pet Ownership & Self-CarePet Ownership & Self-CareFew articles addressed impact of

pet ownership on self-care

Older adults with pet found to have higher ADL scores than older adults without pets (Raina et al.,1999)

Pets may have role in helping structuring daily routines and responsibilities (Allen, Kellegrew, & Jaffe, 2000)

Pet Ownership & Pet Ownership & ProductivityProductivityProductivity in terms of pet

ownership

Structure of daily routines including pet maintenance occupations (Allen, Kellegrew, & Jaffe, 2000; Johnson & Meadows, 2002)

◦Feeding pet◦Grooming pet◦Veterinary appointments

Pet Ownership & LeisurePet Ownership & LeisureMost articles researched impact of

pet ownership on leisure occupations

Facilitating social interactions (Allen, Kellegrew, & Jaffe, 2000; Cutt et al., 2007; Knight & Edwards, 2008; Johnson & Meadows, 2002; Miller, Staats, & Partlo, 1992; Wood et al., 2007a; Wood et al., 2007b)

Association with increased exercise (Cutt et al., 2007; Brown & Rhodes, 2006; Knight & Edwards, 2008; Johnson & Meadows, 2002; Thorpe et al., 2006a/b; Wood et al., 2007a; Wood et al., 2007b)

Mediating Factors to Pet Mediating Factors to Pet OwnershipOwnershipSome mediating factors to owning

a pet and effects on occupational performance identified

Mediating factors (Brown & Rhodes, 2006; Johnson & Meadows, 2002; McNicholas et al., 2005; Pachana et al., 2005; Richeson & McMullough, 2004; Siegel, 1990)

◦Health factors◦Environmental factors◦Social factors

Gaps in LiteratureGaps in LiteratureGaps from original question

Gaps identified through research process

Gaps from Original Gaps from Original QuestionQuestion What We Looked For: Population

◦ Older adults (≥ 65 years)

Self-care◦ Motivation for morning

routine◦ Grooming◦ Hygiene◦ Eating◦ Dressing◦ Cooking◦ Shopping◦ Banking◦ Cleaning◦ Laundry

What We Found: Population

◦ 5 articles addressing pet ownership among older adults

Self-care

◦ Hygiene

◦ Dressing◦ Cooking

Gaps from Original Gaps from Original QuestionQuestionWhat We Looked For: Productivity

◦ Animal maintenance Feeding Grooming Shopping Veterinary

appointments

◦ Work (paid or unpaid) Leisure

◦ Social interaction◦ Exercise◦ Other interests

What We Found: Productivity

◦ Animal maintenance Feeding Grooming Shopping Veterinary

appointments

Leisure◦ Social interaction◦ Exercise

Gaps from Original Gaps from Original QuestionQuestionWhat We Looked For: Mediating factors

◦ Self esteem and motivation

◦ Health factors◦ Sense of purpose◦ Environmental factors◦ Social factors◦ Type of pet◦ Partners/widowhood◦ Income level◦ Cognitive capacity◦ Cultural norms

What We Found: Mediating factors

◦ Health factors

◦ Environmental factors◦ Social factors

Modified ModelModified Model

Gaps Identified Through Gaps Identified Through Research ProcessResearch ProcessLack of research addressing:

◦Understanding why or how pet ownership has the effects that it does

◦Unique experiences of pet ownership

Future DirectionsFuture DirectionsConstructivist paradigm

What are the experiences of pet ownership among older adults?

Possible ModelPossible Model

Future DirectionsFuture DirectionsPositivist paradigm

What are the differences in the frequency, duration, and type of weekly active recreational activities between dog, cat, and bird owners?

Application to OTApplication to OTIn the context of an aging

population…◦Pet ownership:

Physical and psychological benefits As therapeutic intervention to enable

Self-care Productivity Leisure

Promote sense of well-being, productivity, and quality of life in older adult population

*For more information on our presentation:http://individual.utoronto.ca/prax/petsite/

ReferencesReferences Allen, J. M. Kellegrew, D. H., & Jaffe, D. (2000). The experience of pet ownership as a meaningful

occupation. Canadian Journal of Occupational Therapy, 67, 271-278.

Brown, S. & Rhodes, R. (2006). Relationships among dog ownership and leisure-time walking in Western Canadian adults. American Journal of Preventive Medicine, 30, 131-136.

Canadian Association of Occupational Therapists. (1997). Enabling occupation: An occupational therapy perspective. Ottawa, ON: CAOT Publications ACE.

Cutt, H., Giles-Corti, B., Knuiman, M., & Burke, V. (2007). Dog ownership, health, and physical activity: A critical review of the literature. Health & Place, 13, 261-272.

Dembicki, D. & Anderson, J. (1996). Pet ownership may be a factor in improved health of the elderly. Journal of Nutrition for the Elderly, 15, 15-31.

Friedmann, E. & Thomas, S. A. (1995). Pet ownership, social support, and one-year survival after acute myocardial infarction in the cardiac arrhythmia suppression trial (CAST). American Journal of Cardiology,

76, 1213-1217.

Johnson, R. A., Meadows, R. L. (2002). Older Latinos, pets, and health. Western Journal of Nursing Research, 24, 609-620.

Knight, S. & Edwards, V. (2008). In the company of wolves: The physical, social, and psychological benefits of dog ownership. Journal of Aging Health, 20, 437-455.

Koivusilta,L. K.; Ojanlatva,A. (2006). To have or not to have a pet for better health?. PLoS ONE, 1, 1-9.

Kurrle, S. E., Day, R., Cameron, I. D. (2004). The perils of pet ownership: A new fall-injury risk factor. Medical Journal of Australia, 181, 682-683.

McNicholas, J., Gilbey, A., Rennie, A., Ahmedzai, S., Dono, J. A. (2005). Pet ownership and human health: a brief review of evidence and issues. British Medical Journal, 331, 1252-1254.

Merriam-Webster Online. (2008). Retrieved November 20, 2008, from http://www.merriam-webster.com/

Miller, D., Staats, S., Partlo, C. (1992). Discriminating positive and negative aspects of pet interaction: sex differences in the older population. Social Indicators Research, 27, 363-374.

ReferencesReferences Pachana, N. A., Ford, J. H., Brooke, A., & Dobson, A. J. (2005). Relations between

companion animals and self-reported health in older women: Cause, effect, or artifact?. International Journal of Behavioural Medicine, 12, 103-110.

Raina, P., Waltner-Toews, D., Bonnet, B., Woodward, C., & Abernathy, T. (1999). Influence of companion animals on the physical and psychological health of older people: An analysis of a one-year longitudinal study. American Geriatrics Society, 47, 323-329.

Richeson, N.E., & McCullouh, W.T. (2004). Animal-assisted activities: Sample programs. Activities Directors’ Quarterly for Alzheimer’s and Other Dementia Patients, 5, 42-48.

Siegel, J.M. (1990). Stressful life events and use of physician services among the elderly: The moderating role of pet ownership. Journal of Personality and Social Psychology, 58, 1081-1086.

Thorpe, R. J. Kreisle, R. A., Glickman, L. T., Simonsick, E. M., Newman, A. B., & Kritchevsky, S. (2006). Physical activity and pet ownership in year 3 of the Health ABC Study. Journal of Aging and Physical Activity, 14, 154-168.

Thorpe, R. J., Simonsick. E. M., Brach, J. S., Ayonayon, H., Satterfield, S., Harris, T. B. et al. (2006). Dog ownership, walking behaviour, and maintained mobility in late life. Journal of the American Geriatrics Society, 54, 1419-1424.

Wood, L. J., Giles-Corti, D., Bulsara, M. K., Bosch, D. A. (2007). More than a furry companion: The ripple effect of companion animals on neighbourhood interactions and sense of community. Society and Animals, 15, 43-56.

Wood, L., Giles-Corti, B. & Bulsara, M. (2005). The pet connection: Pets as a conduit for social capital?. Social Science & Medicine, 61(6), 1159-1173.

Discussion QuestionsDiscussion QuestionsMany studies that we looked at showed some relationship between pet ownership and positive occupational and health outcomes. However, there were confounds in the studies and the direction of the relationship was somewhat unclear. Traditionally, to increase internal validity and determine the directional causality of a relationship researchers would do a level three (or experimental) design. Do you think it’s possible to run a study to

determine the occupational benefits of pet ownership using a level 3 design and level 2 in evidence? What would be the ethical concerns of having pets in this study?

Would the ethical concerns be different in a naturalistic type study?

Discussion QuestionsDiscussion QuestionsOne gap we found in the literature was information about engagement in the occupation of pet ownership. Because in the study by Raina et al. (1999), positive occupational outcomes were not dependent on exercise or attachment to the pet, we thought engagement might have been the missing link.

How would you operationally define engagement in pet ownership and how would you measure it? Definition of Occupational Engagement

“To involve oneself or become occupied, to participate in occupation. Involvement for being, becoming, and belonging, as well as for performing or doing occupations.” (Townsend & Polatajko, 2007, pp. 370)

Can engagement, performance and participation be separated when looking at pet ownership?

Definition Christiansen & Townsend, 2004

Townsend & Polatajko, 2007

Occupational Participation

“The engagement of the individual’s mind, body, and soul in goal-directed pursuits.” (p. 278)

“Refers to the involvement in a life situation through occupation.” (p.371)

Occupational Performance

“The task-oriented, completion or doing aspect of occupations, often, but not exclusively, involving observable movement.” (p.278)

Is the "result of a dynamic, interwoven relationship between P-E-O over a person's lifespan; the ability to choose, organize, and satisfactorily perform meaningful occupations that are culturally defined and age appropriate in a person’s self-care, leisure and productivity domains.” (p.371)

Occupational Engagement

No definition “To involve oneself or become occupied, to participate in occupation. Involvement for being, becoming, and belonging, as well as for performing or doing occupations.” (p.370)

ReferencesReferences Christiansen, C. H. & Townsend, E. A. (2004). Introduction to

occupation: The art and science of living. Upper Saddle River, NJ: Pearson Education.

Townsend, E. A. & Polatajko, H. J. (2007). Enabling Occupation II: Advancing an occupational therapy vision for health, well-being, & justice through occupation. Ottawa, ON: Canadian Association of Occupational Therapists.