As nursing is one of the most stressful occupations worldwide, its management warrants more attention to identify possible ways to cope with its pressures. This study aims to evaluate whether animal-assisted therapy (AAT) with the presence of a dog affects the stress level of nurses. As a stress biomarker, we used salivary cortisol level testing. Twenty female nurses (mean age: 30) in physical medicine (PMR) (n = 11) and the department of internal medicine and long-term care (IM < C) (n = 9). On each of the three observed days, saliva was collected at 10 a.m. and then again after 50 min. The first sampling was performed during a normal working process without a break (Condition A), the second was carried out during a normal working process with a break of choice (Condition B), and the third sampling was performed during a normal working process with a break with AAT (Condition C). All participants were enrolled in all three interventional conditions in a randomized order. The results demonstrated the effect of a reduction of cortisol levels in Condition C, where AAT was included (p = 0.02) only in nurses recruited from the IM < C department. By way of explanation, nurses from the PMR department already showed low cortisol levels at baseline. We propose including AAT with a dog in healthcare facilities where nurses are at a high risk of stress.

Department of Ethology and Companion Animal Science Faculty of Agrobiology Food and Natural Resources Czech University of Life Sciences 16500 Prague Czech Republic

Department of Rehabilitation Medicine Charles University 1st Faculty of Medicine 12108 Prague Czech Republic

Department of Statistics Faculty of Economics and Management Czech University of Life Sciences 16500 Prague Czech Republic

Institute of Medical Biochemistry and Laboratory Diagnostics Charles University 1st Faculty of Medicine 12808 Prague Czech Republic

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Salak-Johnson J.L., McGlone J.J. Making sense of apparently conflicting data: Stress and immunity in swine and cattle1. J. Anim. Sci. 2007;85:E81–E88. doi: 10.2527/jas.2006-538. PubMed DOI

Matheny J., Le Fevre M., Kolt G.S. Eustress, distress, and interpretation in occupational stress. J. Manag. Psychol. 2003;18:726–744.

Nelson D.L., Simmons B.L. Eustress: An Elusive Construct, an Engaging Pursuit. Emotional and Physiological Processes and Positive Intervention Strategies. Emerald Group Publishing Limited; Bingley, UK: 2003. pp. 265–322.

Kupriyanov R., Zhdanov R. The eustress concept: Problems and outlooks. World J. Med. Sci. 2014;11:179–185.

Kolt G., Matheny J., Le Fevre M. Eustress, distress and their interpretation in primary and secondary occupational stress management interventions: Which way first? J. Manag. Psychol. 2006;21:547–565.

Garkavi L.K.H., Kvakina Y.E.B., Kuz’menko T.S. Antistress Reactions and Activation Therapy. Imedis; Мoskva, Russia: 1998.

Gerhart J.I., Canetti D., Hobfoll S.E. Traumatic Stress and Long-Term Recovery. Springer Science and Business Media LLC; Berlin, Germany: 2015. Traumatic Stress in Overview: Definition, Context, Scope, and Long-Term Outcomes; pp. 3–24.

Andrews J., Ali N., Pruessner J.C. Reflections on the interaction of psychogenic stress systems in humans: The stress coherence/compensation model. Psychoneuroendocrinology. 2013;38:947–961. doi: 10.1016/j.psyneuen.2013.02.010. PubMed DOI

Dobnik M., Maletič M., Skela-Savič B. Work-Related Stress Factors in Nurses at Slovenian Hospitals—A Cross-sectional Study. Slov. J. Public Health. 2018;57:192–200. doi: 10.2478/sjph-2018-0024. PubMed DOI PMC

Maphangela T., Matenge S. PW 2280 Factors associated with occupational stress among nurses working in government clinics in gaborone, botswana. Injury Prev. 2018;24(Suppl. 2):A215.

Kiank C., Entleutner M., Fürll B., Westerholt A., Heidecke C.-D., Schütt C. Stress-induced immune conditioning affects the course of experimental peritonitis. Shock. 2007;27:305–311. doi: 10.1097/01.shk.0000239754.82711.c0. PubMed DOI

Glaser R., Kiecolt-Glaser J.K. Stress-induced immune dysfunction: Implications for health. Nat. Rev. Immunol. 2005;5:243–251. doi: 10.1038/nri1571. PubMed DOI

Machová K., Procházková R., Eretová P., Svobodová I., Kotík I. Effect of Animal-Assisted Therapy on Patients in the Department of Long-Term Care: A Pilot Study. Int. J. Environ. Res. Public Health. 2019;16:1362. doi: 10.3390/ijerph16081362. PubMed DOI PMC

Hoffmann A.O., Lee A.H., Wertenauer F., Ricken R., Jansen J.J., Gallinat J., Lang U.E. Dog-assisted intervention significantly reduces anxiety in hospitalized patients with major depression. Eur. J. Integr. Med. 2009;1:145–148. doi: 10.1016/j.eujim.2009.08.002. DOI

Lass-Hennemann J., Schäfer S.K., Römer S., Holz E., Streb M., Michael T. Therapy Dogs as a Crisis Intervention After Traumatic Events?—An Experimental Study. Front. Psychol. 2018;9:1627. doi: 10.3389/fpsyg.2018.01627. PubMed DOI PMC

Beetz A., Kotrschal K., Turner D.C., Hediger K., Uvnäs-Moberg K., Julius H. The Effect of a Real Dog, Toy Dog and Friendly Person on Insecurely Attached Children During a Stressful Task: An Exploratory Study. Anthrozoös. 2011;24:349–368. doi: 10.2752/175303711X13159027359746. DOI

Mills D., Hall S. Animal-assisted interventions: Making better use of the human-animal bond. Vet. Rec. 2014;174:269–273. doi: 10.1136/vr.g1929. PubMed DOI

Giuliani F., Jacquemettaz M. Animal-assisted therapy used for anxiety disorders in patients with learning disabilities: An observational study. Eur. J. Integr. Med. 2017;14:13–19. doi: 10.1016/j.eujim.2017.08.004. DOI

Zilcha-Mano S., Mikulincer M., Shaver P.R. Pet in the therapy room: An attachment perspective on Animal-Assisted Therapy. Attach. Hum. Dev. 2011;13:541–561. doi: 10.1080/14616734.2011.608987. PubMed DOI

Kaminski M., Pellino T., Wish J. Play and Pets: The Physical and Emotional Impact of Child-Life and Pet Therapy on Hospitalized Children. Child. Health Care. 2002;31:321–335. doi: 10.1207/S15326888CHC3104_5. DOI

Veiga G., Rodrigues A.D., Lamy E., Guiose M., Pereira C., Marmeleira J. The effects of a relaxation intervention on nurses’ psychological and physiological stress indicators: A pilot study. Complement. Ther. Clin. Pract. 2019;35:265–271. doi: 10.1016/j.ctcp.2019.03.008. PubMed DOI

Hellhammer D.H., Wüst S., Kudielka B.M. Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology. 2009;34:163–171. doi: 10.1016/j.psyneuen.2008.10.026. PubMed DOI

Vincent I., Michell A. Comparison of cortisol concentrations in saliva and plasma of dogs. Res. Vet. Sci. 1992;53:342–345. doi: 10.1016/0034-5288(92)90137-Q. PubMed DOI

Inder W.J., Dimeski G., Russell A. Measurement of salivary cortisol in 2012—Laboratory techniques and clinical indications. Clin. Endocrinol. 2012;77:645–651. doi: 10.1111/j.1365-2265.2012.04508.x. PubMed DOI

Owen L.J., Haslam S., E Adaway J., Wood P., Glenn C., Keevil B.G. A simplified liquid chromatography tandem mass spectrometry assay, using on-line solid-phase extraction, for the quantitation of cortisol in saliva and comparison with a routine DELFIA method. Ann. Clin. Biochem. Int. J. Lab. Med. 2010;47:131–136. doi: 10.1258/acb.2009.009053. PubMed DOI

Hannibal K.E., Bishop M.D. Chronic stress, cortisol dysfunction, and pain: A psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys. Ther. 2014;94:1816–1825. doi: 10.2522/ptj.20130597. PubMed DOI PMC

Rodriguez K.E., Bryce C.I., Granger D.A., O’Haire M.E. The effect of a service dog on salivary cortisol awakening response in a military population with posttraumatic stress disorder (PTSD) Psychoneuroendocrinology. 2018;98:202–210. doi: 10.1016/j.psyneuen.2018.04.026. PubMed DOI PMC

Eley D., Eley R., Bertello M., Rogers-Clark C. Why did I become a nurse? Personality traits and reasons for entering nursing. J. Adv. Nurs. 2012;68:1546–1555. doi: 10.1111/j.1365-2648.2012.05955.x. PubMed DOI

Hart P.D. The Nurse Shortage: Perspectives from Current Direct Care Nurses and Former Direct Care Nurses. Volume 20 The Federation of Nurses and Health Professionals; Washington, DC, USA: 2001. Peter D. Hart Research Associates.

Pereira S.M., Fonseca A.M., Carvalho A.S. Burnout in nurses working in Portuguese palliative care teams: A mixed methods study. Int. J. Palliat. Nurs. 2012;18:373–381. doi: 10.12968/ijpn.2012.18.8.373. PubMed DOI

Diehl E., Rieger S., Gutendorf M., Geißler B., Letzel S., Pinzon L.E. Belastungsfaktoren von Pflegekräften in der spezialisierten Palliativversorgung—Ergebnisse einer qualitativen Studie. Z. Palliativmedizin. 2018;19:306–311. doi: 10.1055/a-0666-3588. DOI

Vinothkumar M., Arathi A., Joseph M., Nayana P., Jishma E.J., Sahana U. Coping, perceived stress, and job satisfaction among medical interns: The mediating effect of mindfulness. Ind. Psychiatry J. 2016;25:195–201. doi: 10.4103/ipj.ipj_98_14. PubMed DOI PMC

Hämmig O. Explaining burnout and the intention to leave the profession among health professionals—A cross-sectional study in a hospital setting in Switzerland. BMC Health Serv. Res. 2018;18:785. doi: 10.1186/s12913-018-3556-1. PubMed DOI PMC

Crane P.J., Ward S.F. Self-Healing and Self-Care for Nurses. AORN J. 2016;104:386–400. doi: 10.1016/j.aorn.2016.09.007. PubMed DOI

Walsh F. Human-Animal Bonds II: The Role of Pets in Family Systems and Family Therapy. Fam. Process. 2009;48:481–499. doi: 10.1111/j.1545-5300.2009.01297.x. PubMed DOI

Hediger K., Hund-Georgiadis M. Animal-assisted therapy in the view of staff member before and after implementation in a rehabilitation clinic. Hum.-Anim. Interation Bul. 2017;5:61–73.

Bukhari G.M.J., Shaista H., Abbasi M.M.J. Frequency of depression in nurses working in various departments of a federal government hospital of Islamabad. Pak. J. Public Health. 2016;6:41–44.

Letvak S., Ruhm C.J., McCoy T. Depression in Hospital-Employed Nurses. Clin. Nurse Spéc. 2012;26:177–182. doi: 10.1097/NUR.0b013e3182503ef0. PubMed DOI

Welsh D. Predictors of Depressive Symptoms in Female Medical-Surgical Hospital Nurses. Issues Ment. Health Nurs. 2009;30:320–326. doi: 10.1080/01612840902754537. PubMed DOI

Souter M.A., Miller M.D., Megan A. Souter Department of Psychology Northern Arizona University USA, Michelle D. Miller Department of Psychology Northern Arizona University USACorrespondenceMichelle.Millernau.edu Do Animal-Assisted Activities Effectively Treat Depression? A Meta-Analysis. Anthrozoös. 2007;20:167–180. doi: 10.2752/175303707X207954. DOI

Li J., Bidlingmaier M., Petru R., Gil F.P., Loerbroks A., Angerer P. Impact of shift work on the diurnal cortisol rhythm: A one-year longitudinal study in junior physicians. J. Occup. Med. Toxicol. 2018;13:23. doi: 10.1186/s12995-018-0204-y. PubMed DOI PMC

Copertaro A., Bracci M., Gesuita R., Carle F., Amati M., Baldassari M., Mocchegiani E., Santarelli L. Influence of shift-work on selected immune variables in nurses. Ind. Health. 2011;49:597–604. doi: 10.2486/indhealth.MS1210. PubMed DOI

Liu W.W., Pan F.C., Wen P.C., Chen S.J., Lin S.H. Job Stressors and coping mechanisms among emergency department nurses in the Armed Force hospitals of Taiwan. Int. J. Hum. Soc. Scis. 2010;5:10.

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