Abstract
AIM: To synthesise stakeholders' experiences and perceptions of animal-assisted intervention (AAI) for people with dementia in community care settings. DESIGN: Qualitative evidence synthesis. METHODS: We systematically searched Medline, CINAHL, Embase, Scopus, Web of Science, PsycINFO and AgeLine for potentially eligible studies. Thematic synthesis was used to analyse the data from included studies. We assessed the methodological limitations of included studies using an adaptation of the Critical Appraisal Skills Programme checklist and used Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) tool to assess confidence in review findings. This review is reported using the ENTREQ checklist. RESULTS: We included 14 reports from 11 studies and developed three analytical themes incorporating a gardening analogy: planting-connecting with animals, growing-engaging in AAI and nurturing-making AAI work; and six subthemes: willingness to connect, building relationships, a rich experience, the benefits of AAI, individualised and holistic approach and training and support, with 15 key findings. CONCLUSION: This review describes people's experiences and perceptions of AAI for people with dementia, and provides recommendations on the development and implementation of AAI, with moderate to high confidence. Nurses need to consider the factors that influence the implementation of AAI identified in this review, to facilitate engagement and long-term impacts while adopting AAI in community care settings. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: This review may enhance healthcare professionals' understanding of AAI for people with dementia in community care settings. AAI is a complex intervention that can be delivered in varied manner. A multicomponent, flexible and individualised AAI is important. Additional training and education for staff are needed. PATIENT OR PUBLIC CONTRIBUTION: A man with dementia and his wife who share a love of dogs, advised at each step of the review, providing insights and perspectives and contributing as co-authors.