国际神经康复杂志

A Logic Model as the Sequence of Needs and Experience that Lead PTSD Patients to Seek a Service Dog and Concerns Related to It: A Stakeholders Perspective

Abstract

Claude Vincent, Geneviève Belleville, Dany H Gagnon, Édouard Auger, Vicky Lavoie, Markus Besemann, Noël Champagne and Frédéric Dumont

Health professionals are hesitant to recommend psychiatric service dogs (PSD) to veterans with post-traumatic stress disorder given that there is no scientific evidence to support their effectiveness. In recent years, new dog training schools for PSD have emerged in the community with different approaches. The objective of this study is to propose a logic model that examines how service dogs assist veterans with post-traumatic stress disorder and that shows concerns related to PSD. A participatory design through a consultation with stakeholders across Canada was realized (dog trainers=12, veterans having a PSD=2, veterans from advocate organizations=4, medical doctors=3, Canadian general standard board=1). They were interviewed in February 2015 via a phone qualitative interview. Questions were about tasks for which the dog should be trained to help the veteran, disadvantages, difficulties and concerns related to having a PSD, promotion and standardization of PSD, difficulties regarding the evaluation process, dog allocation and follow-up/abandonment of the dog. A qualitative thematic content analysis was achieved with the interview’s materiel. A logic model was created to classify the theory related to diagnosis and treatment for post-traumatic stress disorder as well as the results of the consultation (n=30 themes). These included 4 dog roles (detection and intervention when the veteran is anxious, contributing to a feeling of safety, promoting a sense of relaxation, socialisation), 2 potential major undesirable events with the PSD, 9 potential effects of the PSD, 3 potential organizational impacts of the service dog and 12 co-factors affecting the accessibility and efficacy of the intervention with PSD. Some themes contradict the legal acceptance in the literature. Testimonies about the reported efficacy of PSD are enthusiastic compared to what was found in the literature. Future research is needed to validate how and when PSD’s roles and task make the differences in everyday life of the veterans with PSTD.