The Effect of Animal-Assisted Activity Programme Based on Human Caring Theory on Perceived Stress, Social Adaptation and Communication Skills of Children With Speech and Language Disorders

Animal-assisted practice is an intervention method explained with different mechanisms and theories that provides protection and development of health through human-animal interaction. Animal-assisted practices can be applied to children, adults, elderly, healthy or sick individuals of all ages. Children are among the most commonly used groups. Studies conducted with children have indicated that animal-assisted practices facilitate the expression of emotions, improve health perception, increase communication skills, desire to continue school, increase adaptation to treatment, and reduce pain, anxiety and stress levels. Animal-assisted practices are included in the classification of nursing interventions (NIC) and there are sources in the literature that they are used directly as nursing interventions.

The use of models in nursing allows the focus to be on the essence and applications of nursing. One of the important theories used in the field of nursing is the Human Caring Theory (HCT) because it reflects the nursing discipline very well. HCT is a theory that reflects the essence of nursing and includes the concepts of love, compassion, self-compassion, respect, trust, human dignity, morality and ethics and can be applied by integrating with various interventions. The theory values the care given to the individual as well as the existence of the caregiving nurse and has been used in different samples in nursing practice and research for many years.

As psychiatric nurses, protecting and developing the mental health of children with speech and language disorders, who are among the vulnerable groups, is among our primary goals. In studies conducted with children with speech and language disorders, it has been stated that animal-assisted practices increase social interaction, have a better positive mood, reduce anxiety, have positive changes in the number of smiles, observation skills, and blood flow rate, increase self-confidence and creativity, develop communication skills, improve collective work skills, enrich vocabulary, and produce more complex sentences in the speech structure. It is anticipated that animal-assisted practices will reduce the perceived stress level of children with poor communication skills, weak/underdeveloped socialization, and may exhibit avoidance behavior from social events, and will increase social adaptation and communication skills.

In this context, this study was planned to determine the effects of the Animal-Assisted Activity Program Based on Human Caring Theory on the perceived stress, social adaptation and communication skills of children with speech and language disorders.

It is a randomized controlled study and a pretest, posttest control group research design will be used. Research data will be obtained through the Individual Identification Form (IDF), Perceived Stress Scale for Children Aged 7-11, Social Adaptation and Skills Scale for Turkish Children Aged 6-12 Mother Form (SUBÖ-A), Communication Skills Scale and Turkish School Age Language Development Test (TODİL). In addition, vital signs (pulse, blood pressure, respiration) and salivary serotonin level (Elisa Test) will be checked to evaluate the stress level of each child before and after each application.

In the study, it was planned to apply animal-assisted practices as an independent variable to the intervention group, two days a week, in 6 sessions of 40-60 minutes each, while no intervention was applied to the control group. Pre-test, post-test and follow-up data will be obtained simultaneously from the intervention group and the control group. Following the post-test applications, follow-up evaluations will be made to the intervention group and the control group at the end of the first month. The control group will be seen a total of three times, and the intervention group a total of eight times.

The universe of the study will consist of 30 children who applied to the Department of Language and Speech Therapy at Istanbul Atlas University for treatment, and the sample will consist of 30 children who meet the inclusion and exclusion criteria.

The analysis of the data obtained as a result of the research is planned to be done using SPSS 24.0 (Statistical Package for Social Science) package program. In the evaluation of the data, descriptive statistics such as frequency distribution, mean, standard deviation will be used to define the sample. In the analysis of continuous distributions of two groups, Student-t test or Mann-Whitney U test will be used according to the test assumptions, in the comparison of groups within themselves, two-pair test or Wilcoxon pair test will be used according to the parametric test assumptions, in the analysis of categorical data according to groups and in the evaluation of pictures, Chi-square test will be used. In the analyzes, 95% significance level (or α=0.05 margin of error) will be used to determine the differences. The answers given to the open-ended questions will be categorized by the researchers and evaluated as numbers and percentages.

It is thought that the research will contribute to the scientific literature on this subject, create a data source for the disciplines working with children with speech and language disorders, and provide scientific information that will guide nursing practices, especially within the scope of child-adolescent psychiatric nursing practices. As a result of the research, it will be evaluated whether the animal-assisted activity program is effective on this group. It is predicted that there will be a decrease in the stress level of children with speech and language disorders and an increase in their language, social adaptation and communication skills.