狗輔助療法於失智症精神行為症狀改善成效－－系統性文獻回顧暨統合分析

Effectiveness of Dog-Assisted Therapy in Improving the Behavioral and Psychological Symptoms of Dementia: A Systematic Review and Meta-Analysis

背景：失智症個案普遍有憂鬱、退縮、躁動等失智症精神行為症狀（behavioral and psychological symptoms of dementia，BPSD），影響個案生、心理健康、增加照顧者負擔，以及增加住院率與死亡率。
目的：以系統性文獻回顧暨統合分析，探討狗輔助療法（dog-assisted therapy，DAT）於BPSD改善成效。
方法：本研究依循Joanna Briggs Institute有效性系統性文獻回顧報告指引，搜尋AgeLine、CINAHL、Cochrane Library、Embase、ProQuest、PubMed、華藝線上圖書館共7個資料庫，在2025年4月前之中英文文獻，鍵入「失智症」、「狗輔助療法」等MeSH與同義詞關鍵字，限制隨機控制試驗（randomized controlled trial，RCT）文獻，排除不符合後共得10篇RCT，以Joanna Briggs Institute 2023 RCT評核表評讀，GRADE建議強度評估、發展與評值系統（The Grading of Recommendations Assessment，Development and Evaluation）做證據品質評等，RevMan 5.4軟體進行統合分析。
結果：DAT比常規照護顯著改善失智症BPSD（SMD = -0.46，p < .0001）、提升活動功能（SMD = 0.31，p = .03），然認知功能未達顯著差異。BPSD次群組分析顯示DAT顯著改善躁動與憂鬱症狀。
結論／實務應用：DAT顯著改善失智症BPSD，現有證據多為小樣本研究、整體為高偏差風險，證據力偏薄弱。建議DAT納入長照機構之非藥物照護介入選項之一，並藉由長期追蹤驗證其臨床應用效益。

Background: Patients with dementia commonly exhibit behavioral and psychological symptoms of dementia (BPSD)
such as depression, withdrawal, and agitation. These symptoms are known to significantly impact both mental and
physical health, increase caregiving burdens, and lead to higher rates of hospitalization and mortality.
Purpose: This study was designed to evaluate using a systematic review and meta-analysis the effectiveness of dogassisted
therapy (DAT) in improving BPSD.
Methods: In line with the Joanna Briggs Institute guidelines for systematic reviews of effectiveness, a literature
search was conducted in seven databases, including AgeLine, CINAHL, Cochrane Library, Embase, ProQuest,
PubMed, and Airiti Library for relevant articles in Chinese or English published before April 2025. The keywords
“dementia”,“dog-assisted therapy”, and their related MeSH terms and synonyms were used. The scope of the search
was limited to randomized controlled trials (RCTs), with studies not meeting the criteria were excluded. A total of 10
RCTs were included. The literature was assessed using the Joanna Briggs Institute 2023 RCT appraisal checklist, the
Grading of Recommendations Assessment, Development and Evaluation system was used to rate the quality of the
evidence, and the meta-analysis was performed using RevMan version 5.4.
Results: The results of the meta-analysis revealed that DAT improved BPSD significantly compared to routine care
(SMD = -0.46, p < .0001) and enhanced functional activity (SMD = 0.31, p = .03). However, no statistically significant
difference was found in terms of cognitive function. The subgroup analysis results for BPSD indicate DAT significantly
alleviates agitation and depressive symptoms.
Conclusions/ Implications for Practice: The findings indicate DAT has the potential to significantly improve
BPSD in patients with dementia. However, the existing evidence relies primarily on small sample studies with an
overall high risk of bias, making the evidence relatively weak. Based on current evidence, DAT should be used as a
non-pharmacological care intervention in long-term care facilities, with long-term follow-up necessary to verify its
clinical application benefits.