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nt

Author:nt
2004年4月よりアメリカの小児病院腫瘍科血液科にてChild Life Specialistとして勤務。2010年より異なる仕事でCLに関わっています。実習ではSurgical Unitと腫瘍科外来を経験し、インターンシップは脳外科神経外科&ERで行う。

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アニマルアシスティッドセラピー

2006.04.13 10:11|*アメリカ医療事情*

アニマルアシスティッドセラピーは最近良く話題になります。
犬やイルカなど、種類も形式も様々です。
Hippotherapy(乗馬によるセラピー)はBC460年から確認されているようですし、
動物による癒しは一言で片付けられないですね。
(Hippos=ギリシャ語で馬のこと。Hippo=英語の"カバ"とお間違いなく。)
http://www.americanequestrian.com/hippotherapy.htm

追記に病院で活躍する犬達のことをとりあげた記事を
転載します。
Associated Pressによる英文記事です。
Dogs dispatched to comfort ill children

By MICHAEL HILL Associated Press

ALBANY, N.Y. -- Jane is scampering around the children's cancer center, nuzzling a toddler who had a brain tumor removed, when 14-year-old Alexia walks in.

Girl and dog both flop on the hospital floor. Alexia scratches Jane's belly two-handed and gives a big smile. Jane licks Alexia's face.

The two met when Alexia was horribly sick with non-Hodgkins lymphoma, when she was suffering through chemotherapy, when she was sad and wanted a friend. Alexia couldn't get out of her hospital bed then, so Jane would curl into bed with her.

"She saved the day," Alexia says, rubbing Jane's thick black coat near her "I AM A THERAPY DOG" tag until Jane's handler, Teri Conroy, finally walks her over to another child in for treatment.

Therapy dogs, so often associated with nursing homes, have expanded their range. The trained animals now comfort people everywhere from disaster sites to hospitals to schools. At Albany Medical Center, doctors and nurses, figuring a bit of affection is good medicine, rely on volunteers like Conroy and dogs like Jane.

Jane is 2 1/2 years old. Her coat is trimmed tight with a rounded bang over her button eyes that gives her a look of constant attentiveness. Aides and nurses are always saying "Awwww!" when she passes in the hall, and asking: "What kind of dog is that?"

Conroy always answers: "Portuguese water dog!"

Jane likes to lick faces and will hop on hospital beds to get to one if invited. When a boy on a pediatric ward greets her wearing a surgical mask, Jane licks the mask. The boy puts on purple gloves to scratch Jane's tummy because of germs, but it barely matters.

"Ohh! You don't want me to stop!" the boy says. "You're so cute!"

Jane is part of a pack of about 14 dogs working the halls of Albany Medical Center. Among the others are Honor, a snow-colored, 130-pound Great Pyrenees who wears sunglasses, Honee, Muddy, Darla, Rocky, Viva and Seamus, Conroy's other therapy dog.

They each have their own bedside manner. Jane is bubbly. Seamus is laid back. Honee, a 9-pound coton de tulear, can be picked up. Honor cannot, and sometimes naps during group therapy.

Dogs are dispatched around the hospital based on requests from medical workers. Sometimes, three dogs at one time are visiting the young, the old, the recovering and the terminal.

There is research suggesting that visits from dogs can provide physical benefits for patients, like lower stress levels. But Dr. Richard Sills, director of Albany's Center for Childhood Cancer and Blood Disorders, stresses the psychological boost dogs provide to young patients and their families. They cheer up children, he said, and make hospitals more welcoming.

"The demand is always more than the supply," said Kelly Morrone, manager of volunteer services. "Never enough dogs."

Conroy carries a list of patients to visit, but will also walk through wards repeating, "Does anyone want a dog visit?"

A boy comes out to pet Jane, rolling along his intravenous unit. A mother beckons Jane to her teenage son's bed, where he is dozing. Jane hops on. He drapes an arm around her and shuts his eyes.

Jane is popular at the pediatric cancer center, where she has seen many of the children through hard times. Alexia, in remission now, used to get visits in the examining room and in her bed when things were touch and go.

"She would be out of it and she would be so weak and she would be talking about the dog coming by," said Alexia's mother, Pam Eubanks. "This was like the only thing when she was sick _ and she was sick constantly when she got diagnosed _ this was the only thing that raised her spirit."

Therapy dogs like Jane work not only in hospitals, but in schools and libraries, where they sit while children practice reading aloud. Therapy dogs were dispatched to Ground Zero after the Sept. 11 attacks and to the Gulf Coast after Katrina.

"In the last few years it's taken off like hot cakes," said Ann Kaczkowski, administrator for Therapy Dogs International, one of the groups that offers testing and accreditation. The not-for-profit group registered more than 12,000 dogs and 9,500 handlers registered.

Therapy dogs can be any breed, but dogs certified by Therapy Dogs International must meet strict standards for disposition, obedience and appearance. As part of her test, Jane had to walk past a cookie left in the open and navigate calmly through a jostling crowd.

Conroy is content being Jane's anonymous partner _ or "the other end of the leash," as she calls it. She became a volunteer through a friend who worked with therapy dogs. But she was already an animal person, living with her husband and daughter on a farm.

Melting away pain, even for a moment, makes it worth it for Conroy. She recalls visiting a comatose 12-year-old girl in an intensive care unit. My daughter loves dogs, the mother told Conroy, so her dog Seamus nuzzled under the tubes to find a spot on the bed right by the girl. The mother was thrilled.

Conroy lights up when talking about patients in remission, like Alexia. Still, the work can be anguishing. Her faces clouds over talking about children who didn't get a happy ending and the obituaries she has read.

"There are days when I cry on the way home," she concedes.

Conroy is convinced that Jane is every bit as empathetic _ that she knows when to hold back and when to go big.

The emotional capacity of dogs has been debated forever, but Jane does seem attuned to patients' needs. She will jump up on and lick the face of one patient who revels in it. Then she is reserved after a nurse whispers to Conroy that there's a newly diagnosed girl sitting quietly with her mom. She could use a visit, the nurse says.

Jane pads up to the teenager. The girl gives Jane an absent pat on the head. Conroy chats with the mother and daughter about dogs. Jane leans in close to the girl.

The girl strokes Jane's back, gently working her fingers through her thick coat.

"For five minutes she was asking me about my dog and was talking about her dog," Conroy says, "and not thinking about all that chemotherapy."
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私の実習先の病院でもPet Therapyとして犬を連れたボランティアが来ています。
病棟の廊下、プレイルーム、子どものベッドの上に
当然のように犬がいます。
日本の病院ではまず見られない光景ですよね。
私も初めて見たときには
「え!?いいの??」っと戸惑いました。
日本の病院とアメリカの病院では衛生管理にどれくらいの違いがあるのだろう?という疑問にかられています。
動物が得意ではない私。
最初は恐々でしたが、みんなトレーニングされた犬なので今ではすっかり安心。
病院1階で飼い主さんたちが犬の足に消毒のジェルを塗りこんでいる姿を毎日見ていますが、その光景がなんともかわいらしいと思えるまでになりました。。
犬のリードを持って病棟をお散歩することで歩くリハビリをしている子もいます。
病院で働いているスタッフにも笑顔を運んでくれます。
Therapy dogたちは病院に新鮮な「風」を運んでくれている存在だと感じています。v-286

>えみさん
たくさんの犬が色んなところで活躍していますよね。ご高齢の方の施設などには欠かせないセラピーでもあるようです。
実際に病院の危機管理対策という点でアメリカと日本の違いはあるような気がします。アメリカはリスクをわかった上でそれに対して対策をだし、責任を明確にする(確認書などにサインしてもらうとか)、そしてその評価体制がある(JCAHOとか)。管理職にどのような人がいるかにもよります・・・。私の血液腫瘍科にくる子どもたちは抵抗力が落ちている(抗がん治療などで)のですが、医師達はみんな犬を大歓迎しています。医師の一人は「感染する可能性が高いのは自分の体のなかにある菌やバクテリアだから過剰に隔離したり消毒する必要はあまりない。消毒剤を使いすぎるほうが体に悪い!!」と言っています。笑。ぜんそくやアレルギーのある人には、やはり考慮するべきだし、そのような対策は絶対必要ですね。具合のとっても悪いこどものところに連れて行くときはかならず医師と保護者の確認を怠らないようにしています。そして手洗いの徹底。そうゆうことをシステム化していますね。
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