Anna Chur-Hansen

Evaluating the outcome of communication skill teaching for entry‐level medical students: does knowledge of empathy increase?

While the literature shows the clinical value for medical practitioners of skill in communicating with patients in an empathetic manner, objective evaluations of methods to teach empathy are few.

Health effects of ownership of and attachment to companion animals in an older population

Background: Two reasons for the inconclusiveness of the literature on the health effects of pet ownership are (1) failure to control for other known influences on health, and (2) inadequate consideration of the nature of the emotional relationship between owners and their companion animals.Purpose: The main aims were to develop a measure of pet attachment that reflects psychologists’ use of the attachment concept, and to see if pet ownership or attachment added to the health variance explained by known predictors.Method: Community-living older adults (n = 314) gave information by interview using structured questions and standardized scales. Multiple regressions were then conducted to examine the possible predictive role of health habits, human social supports, pet ownership, and owners’ attachment to the pet, on health and well-being.Results: The pet attachment measure showed good internal reliability. After controlling for other variables, neither pet ownership nor pet attachment added significantly to explained variance in health and well-being.Conclusions: The health of elderly people is related to their health habits and social supports but not to their ownership of, or attachment to, a companion animal.

Gaps in the evidence about companion animals and human health: some suggestions for progress.

A number of researchers have explored the relationship between companion animal ownership and human physical and psychological health. Results have been inconclusive, with positive, neutral and negative effects variously reported in the literature. Furthermore, the possible mechanisms of any influence are frustratingly unclear. A number of conceptual and methodological weaknesses have hampered progress in our understanding of how companion animals may impact upon human health. The two evidence gaps discussed in this paper, with suggestions for needed next steps, are: (i) a preponderance of anecdotal reports and cross-sectional research designs; and (ii) failure to control for a host of other known influences on human health including health habits, level of attachment to the companion animal and human social supports. Finally, an example of these gaps is provided in relation to the literature on the effects of animals on elderly nursing home residents.

Mental Health Implications of Human Attachment to Companion Animals

OBJECTIVES Because of the contradictory nature of findings and methodological weaknesses identified within current human-companion animal bond research, there is a need to further explore the connection between human-animal bonds and mental health. DESIGN The purpose of this survey questionnaire study was to explore the relationship of attachment to companion animal and human psychological distress after controlling for demographic variables, and to investigate whether the relationship between social supports and psychological distress would be moderated by attachment to a companion animal. RESULTS Results highlight the psychological vulnerability of individuals reporting a strong bond with their companion animal. CONCLUSIONS These findings are discussed in terms of their implications for mental health services designed to anticipate and address client-related companion animal needs.

Grief and bereavement issues and the loss of a companion animal: People living with a companion animal, owners of livestock, and animal support workers

Companion animals play various roles in peoples lives and these roles can impact on loss, grief, bereavement and mourning when the animal has been lost, whether that is through death, when missing, or when relinquished. This paper considers not only companion animal owners, but also those who own farm animals and those who work in animal service occupations. The focus is on adult clients, not children. Practical strategies are offered for the counsellor who is working with a bereaved pet owner, farmer, and service provider.

Initial responses of first‐year medical students to problem‐based learning in a behavioural science course: role of language background and course content

A trial of problem‐based learning (PBL) was conducted with first‐year undergraduate medical students who had no background knowledge of behavioural science and who included a substantial proportion with a first language other than English. Responses to standardized and open‐ended evaluation questions showed greater variability and there was no clear preference for PBL over traditional methods. Students found the PBL exercise time‐consuming and felt they needed more guidance. Feedback from clinicians and working in groups were seen as positive aspects of the exercise. Students with a first language other than English reported that language, but not cultural background, was an impediment to effective participation. It is recommended that this group of students be offered extra support for PBL in a subject‐based setting, and that all students would benefit from a formal induction session.

Should nursing-related work experience be a prerequisite for acceptance into a nursing programme? A study of students' reasons for withdrawing from undergraduate nursing at an Australian university.

AIM This paper reports on two studies that examined why students withdrew from a Bachelor of Nursing degree. BACKGROUND With the aim of recruiting undergraduate candidates who are the most likely to complete the degree and pursue a nursing career, the University of Adelaide requires high matriculation scores and satisfactory performance in a structured oral assessment as part of the process of selection. METHOD In the first study, two questionnaires were used to collect data from all applicants before and after an oral assessment. The degree of personal desire and motivation to become a Registered Nurse, including knowledge about nursing and the profession were among qualities rated. For the second study, semi-structured telephone interviews were conducted with students who had withdrawn. RESULTS Statistical comparison showed there were significant differences between continuing and withdrawing applicants in whether or not they had previous nursing-related experience and in knowing someone who was a nurse. The qualitative data reinforced the importance of these factors for attrition. Participants identified emotional issues surrounding an aversion to illness, sickness, pain, suffering and blood. CONCLUSION The results of both studies suggest that a primary factor in attrition is a lack of realistic expectation regarding nursing as a profession.

Methodological Considerations in Designing and Evaluating Animal-Assisted Interventions

Simple Summary There is a growing literature on the benefits of companion animals to human mental and physical health. Despite the literature base, these benefits are not well understood, because of flawed methodologies. This paper draws upon four systematic reviews, focusing exclusively on the use of canine-assisted interventions for older people residing in long-term care. Two guides are offered for researchers, one for qualitative research, one for quantitative studies, in order to improve the empirical basis of knowledge. Research in the area of the human-animal bond and the potential benefits that derive from it can be better promoted with the use of uniform and rigorous methodological approaches. Abstract This paper presents a discussion of the literature on animal-assisted interventions and describes limitations surrounding current methodological quality. Benefits to human physical, psychological and social health cannot be empirically confirmed due to the methodological limitations of the existing body of research, and comparisons cannot validly be made across different studies. Without a solid research base animal-assisted interventions will not receive recognition and acceptance as a credible alternative health care treatment. The paper draws on the work of four systematic reviews conducted over April–May 2009, with no date restrictions, focusing exclusively on the use of canine-assisted interventions for older people residing in long-term care. The reviews revealed a lack of good quality studies. Although the literature base has grown in volume since its inception, it predominantly consists of anecdotal accounts and reports. Experimental studies undertaken are often flawed in aspects of design, conduct and reporting. There are few qualitative studies available leading to the inability to draw definitive conclusions. It is clear that due to the complexities associated with these interventions not all weaknesses can be eliminated. However, there are basic methodological weaknesses that can be addressed in future studies in the area. Checklists for quantitative and qualitative research designs to guide future research are offered to help address methodological rigour.

Animal-Assisted Interventions in Children's Hospitals: A Critical Review of the Literature

ABSTRACT There is a perception in the scientific and general communities that hospitalized children benefit from visits by animals. Animal-assisted interventions (AAI), including animal-assisted therapy and animal-assisted activities, usually involving dogs, are thus employed in pediatric hospitals. However, the actual prevalence of AAI in childrens hospitals has been poorly documented in the literature. Furthermore, the evidence base for claims that children in hospital benefit from AAI is limited. There are nine existing research studies in the area, all with methodological challenges that make conclusive statements in either direction about the efficacy of AAI difficult. In this critical review we consider methodological considerations pertinent to evaluations of AAI interventions for hospitalized children. These include: definitions and terminology; cultural attitudes; childrens receptivity to animals, including phobia, type of illness and health status of the child, familiar as opposed to unknown animals, and age of the child; animal welfare; zoonoses and allergies; and hospital staff attitudes toward AAI. We highlight the many difficulties involved in conducting research on AAI in pediatric settings. Given the limited information around AAI for hospitalized children, including the risks and benefits and the limitations of existing studies, future research is required. This should take into account the methodological considerations discussed in this review, so that our knowledge base can be enhanced and if and where appropriate, such interventions be implemented and rigorously evaluated.

Medical students’ essay‐writing skills: criteria‐based self‐ and tutor‐evaluation and the role of language background

An exercise is described which aimed to make clear to first‐year undergraduate medical students the expected writing skills required for an essay examination in one discipline.