A randomized controlled trial comparing a companion dog walking intervention to an attention control education intervention on the psychological health of adult intensive care unit survivors: the POOCH study

Abstract

Intensive care unit (ICU) survivors are at risk for persistent anxiety and depression after hospital discharge that contribute to the psychological component of post intensive care syndrome (PICS). Quality evidence supporting innovative home and community-based interventions that improve psychological health in ICU survivors is needed. The use of companion dogs to improve the health and wellbeing of ICU survivors is a novel strategy not previously explored in the ICU survivor population. The purpose of this randomized controlled trial (RCT) was to evaluate the feasibility and acceptability of a companion dog walking intervention compared to an attention control education intervention for adult ICU survivors and to compare outcome trends related to depression, anxiety, serum cortisol, and quality of life (QOL). A prospective, single-masked (participant), two-arm RCT was conducted. Adult ICU survivors were recruited from two acute care hospitals using consecutive sampling and out-patient clinics via recruitment flyers. Potential participants were identified, contacted, consented, and screened for eligibility prior to being discharged home from the hospital. Those meeting inclusion criteria were enrolled, masked, and randomly assigned (1:1) to an eight-week companion dog walking intervention or an attention control education intervention. The dependent variables of depression, anxiety, serum cortisol, and QOL were assessed at baseline, at week 4, and at the end of the 8-week intervention. Study feasibility and acceptability was assessed at the end of the 8-week study. Of the 2,191 patients screened, 210 (9.6%) met initial inclusion criteria, of which 143 (68%) received recruitment flyers, 25 (17.5%) communicated interest, and 10 (7%) enrolled. Results suggest the current protocol supports successful masking of participants and collection of measurements and data points, while protocol revisions are necessary to improve recruitment, intervention fidelity by participants, and attrition. Study processes and interventions were acceptable for both those in the attention control education group and companion dog walking intervention group. Analysis and interpretation of exploratory outcomes were limited due to the small sample size. While definitive trends were lacking, results suggest companion dog walking may have the potential to influence aspects of health in adult ICU survivors and future research is warranted.