Abstract

During the pandemic, there were a lot of lockdowns that brought changes to the population’s daily routine, reducing social interactions, changing work and study methods, isolating the family at their home, which brought changes to family dynamics. These changes sparked the interest of nursing students in carrying out a research study. Starting from the question: What is the role of the dog in the family dynamics in times of pandemic? and the objective: identify the guardians’ perceptions about the role of the dog in the family dynamics in a period of confinement, a qualitative, exploratory, and descriptive study was carried out, collecting data through a focus group with six guardians from different families. Bardin’s protocol was used to analyze and process the data. Three categories emerged in this study, highlighting the benefits in terms of mental health, physical and psychological well-being of the family with the presence of the dog, its importance in strengthening family ties and the lessons learned from adopting the dogs. We conclude that, in nursing, it is necessary to highlight the presence of the dog in the family since it brings benefits to its dynamics.

Key words:
Companion animals; Nursing; Family Health

Introduction

With the onset, in 2020, of a new strain of coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), responsible for the disease COVID-19, several extraordinary measures were taken with implications in terms of restrictions, confinements, social isolation and distancing, aimed at containing the spread of the disease¹1 Sinclair RR, Allen T, Barber L, Bergma M, Britt T, Butler A, Ford M, Hammer L, Kath, Probst T. Occupational Health Science in the Time of COVID-19: Now more than Ever. Occup Health Sci 2020; 4:1-22.. Suddenly, in most countries, including Portugal, these measures changed the population’s way of life. This situation led to changes in the population’s daily routine, reducing social interactions, changing work and study methods, confining the family to their home²2 Fine AH. The Year That Has Passed Us By: Animals in Our Life of COVID-19. Animals 2021; 1(2):395.. The home, which, in many cases, was a place where the family got together for different family dynamics, became a place of work or a classroom, blurring the boundaries between personal and family life and professional life.

Family companion animals (especially dogs) played a vital role as an individual’s strategy to reduce restrictions to going out, given the possibility of having to walk them³3 Applebaum JW, Zsembik BA. Pet attachment in the context of family conflict. Anthrozoös 2020; 33(3):361-370.. We know that humankind’s relationship with animals started in prehistory and humanity has always depended on interactions with other species for their survival. This interaction was established, first, by resorting to hunting and protection for their own survival. Later, with the close relationship that was developed, the animal was included in their own homes and humankind and the animals started to form bonds that remain to this day³3 Applebaum JW, Zsembik BA. Pet attachment in the context of family conflict. Anthrozoös 2020; 33(3):361-370.. This bond between humanity and companion animals is considered beneficial and dynamic, as it has a direct influence on the well-being and health of both, as well as the community in which they live. Having a companion animal conveys security and encourages physical contact and communication throughout the human life cycle. During its entire life cycle - whether in the family or community context - humanity seeks to create strategies for their benefit, through knowledge of available information, using social, economic and cultural resources⁴4 Murdaugh CP. Health Promotion in Nursing Pratice. 8ª ed. Boston: Pearson; 2019..

The concept of family has varied over time and place. Currently, the family is not only based on consanguinity, it also considers adoption, which includes the companion animal itself⁵5 Mossoi AC, Vieira TR. Direito à saúde, animais domésticos e o bem-estar da família multiespécie. Rev Biodireito Direito Animais 2020; 6(2):56-78.. It is up to the family to take care of their companion animals’ health, contributing to the prevention of diseases, through compliance with the vaccination schedule and providing it with a beneficial and healthy environment⁵5 Mossoi AC, Vieira TR. Direito à saúde, animais domésticos e o bem-estar da família multiespécie. Rev Biodireito Direito Animais 2020; 6(2):56-78. because, when this does not happen, the possibility of pathologies arising from the animal-humanity interaction can increase. It is humanity’s duty to provide the food, hygiene, affection and health care needs of their companion animals⁵5 Mossoi AC, Vieira TR. Direito à saúde, animais domésticos e o bem-estar da família multiespécie. Rev Biodireito Direito Animais 2020; 6(2):56-78..

In this context, Nursing performs educational and health promotion actions, as it takes into account all the risks and benefits that humanity may have in the environment where they live. Understanding these dynamic intra-family relationships - both in their structure and their operation, both from the perspective of health promotion and disease management⁶6 Brás M, Neves C. 1º Congresso Internacional de Enfermagem de Saúde Familiar - livro de resumos. In: Sociedade Portuguesa de Enfermagem de Saúde Familiar. 1º Congresso Internacional de Enfermagem de Saúde Familiar [Internet]. 2019 [acessado 2023 jun 10]. Disponível em: www.spesf.pt.
www.spesf.pt.... ^,77 Figueiredo MH. Modelo Dinâmico de Avaliação e Intervenção Familiar: Uma abordagem colaborativa em Enfermagem de Família. Lisboa: Lusociência - Edições Técnicas e Científicas; 2012. - is part of the areas of intervention of the nursing profession.

As teachers at a Higher Education School of Health in the area of Nursing, we consider that research is a key area in the training process of nursing students, with an impact on both their learning and the improvement of the provided care⁸8 Einarsen KA, Giske T. Nursing students' longitudinal learning outcomes after participation in a research project in a hospital. IPDJ 2019; 9(1):1-4..

Based on this premise, students attending the Nursing Degree Course (in the Research Curricular Unit) were asked to develop research work, with the following objective: Identify the guardians’ perceptions about the role of the dog in family dynamics during the times of pandemic. This topic generated interest among the students, on the one hand, because it reflects their own experiences in such a troubled time. On the other hand, because it includes the introduction of learning in research focused on qualitative methodology, as recommended in the academic curriculum of this course. For students, as beginners in research, the use of Qualitative Research is an excellent opportunity, because it provides an adequate experience with the implementation of all phases during the research work, allowing them to learn how to investigate and acquire practical skills in this area⁹9 Amado J. Ensinar e aprender a investigar - reflexões a pretexto de um programa de iniciação à pesquisa qualitativa. Rev Portuguesa Pedago 2010; 44(1):119-142..

Methods

The present investigation was a qualitative, exploratory and descriptive study. Qualitative methodologies in the health sector have as their main objective the description with argumentative force and the inclusion of the individuals’ perspective. The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used, maintaining the credibility and transparency criteria¹⁰10 Raskind IG, Shelton RC, Comeau DL, Cooper HL, Griffith DM, Kegler MC. A review of qualitative data analysis practices in health education and health behavior research. Health Educ Behav 2019; 46(1):32-39.. Evidence based on qualitative methodology allows the humanization of decision-making processes by ensuring a subjective perspective of the different social actors involved¹¹11 Baixinho CL, Ferreira Ó, Marques FM, Oliveira ES, Presado MH, Cardoso M, Sousa AD, Nascimento T. Síntese, transferência e implementação de evidência qualitativa para a melhoria das práticas e da decisão clínica. New Trends Qualitative Res 2022; 13:568..

The Focus Group (FG) was selected as the data collection technique because its main advantage is to provide data from a certain group of participants, more quickly and at a lower cost, allowing topics to be addressed in depth¹²12 Walston JT, Lissitz RW. Computer-mediated focus groups. Evaluation Rev 2000; 24(5):457-483.. It consists in a qualitative research technique based on questions, carried out in groups, aimed at capturing the participants’ understanding of the specific topic being investigated¹³13 Krueger RA, Casey MA. Focus groups: A pratical guide for applied research. 4ª ed. California: Sage; 2009.^,1414 Stewart DW, Shamdasani PN, Rook DW. Focus groups: Theory and practice. 2ª ed. California: Sage; 2007.. In this study, data collection was done through e-Focus Group (electronic focus groups), carried out online and synchronously, since cyberspace increasingly occupies a place in social life and this type of interaction reaches new meanings and standards¹⁵15 Kim JY. Social interaction in computer-mediated communication. Bull Am Soc Inform Sci 2020; 26(3):15-17.. In a practical and comfortable way, participants express their opinions, with greater participation and in a more equitable way, as they tend to be more spontaneous, which also leads to more reliable results and the production of recommendations, with abundance and depth through the participants’ views¹⁶16 Schröeder CDS, Klerin LR. On-line focus group: uma possibilidade para a pesquisa qualitativa em administração. Cad EBAPE BR 2009; 7:332-348.. A FG script protocol was created, aiming to reorient the discussion if necessary¹³13 Krueger RA, Casey MA. Focus groups: A pratical guide for applied research. 4ª ed. California: Sage; 2009.. In this study there was no such need. The teacher was also present online in the group discussion as a facilitator of this process, in addition to the student participants and researchers.

It was decided to give the participants, in person and by hand delivery, the free and informed consent form. With regard to the confidentiality of the provided data, the researchers sent the email address individually to each of the participants, thus avoiding access and identification by others. At the beginning of the session, the importance of confidentiality of the discussion that would start was reinforced and it was also requested that the information provided not be reported to third parties¹⁷17 Kralik D, Price K, Warren J, Koch T. Issues in Data Generation using Email Group Conversations for Nursing Research. J Adv Nurs 2006; 53(2):213-220.. As a general rule, a FG takes place with a group of six to eight participants, purposefully selected based on characteristics they share, who participate in a discussion on the chosen topic for between 60 and 120 minutes¹³13 Krueger RA, Casey MA. Focus groups: A pratical guide for applied research. 4ª ed. California: Sage; 2009..

The participants of this study were six adult guardians of companion animals, selected intentionally, according to the inclusion criteria: adults with at least one child and one dog; have stayed at home for at least one month at the time of confinement; residents of Portugal at the time of the pandemic; and with access to a computer and skills to use digital platforms.

The data collection period took place in December 2022, lasting around 80 minutes. The session was fully recorded and only the researchers have access to it. The study was approved by the School Ethics Committee, and all procedures contained in the Declaration of Helsinki and the Oviedo Convention were followed.

The FG data analysis was carried out using the content analysis technique, understood as a set of techniques aimed at analyzing different contents, in a structured and systematized way¹⁸18 Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2011.. This was followed by the stages of pre-analysis¹⁸18 Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2011. (corpus selection, floating reading and definition of coding structure), examination of the material¹⁸18 Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2011. (definition of analysis categories privileging meanings, thoughts and assumptions in light of the study objectives) and data treatment, inference and interpretation¹⁸18 Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2011. (operation of decontextualizing the units of analysis, according with the established rules, in relation to the initial discourse, followed by an operation of contextualizing them within the topics, in a recursive process of interpellation and comparability, which finally resulted in the definitive analysis matrix). It is important to highlight that the analysis of these data followed the principles of exhaustiveness, representativeness, homogeneity and relevance to the topic being studied¹⁸18 Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2011..

After completing the e-FG, a literal and full transcription of the recording was performed, with several listening moments, aiming to guarantee the quality of the information provided by each participant. To guarantee the total confidentiality of the participants, a coding system was carried out, using the letter F (as they represent the family) followed by a number assigned according to the order of entry into the videoconference, culminating in the following ordering: F1 (43 year-old-woman), F2 (55-year-old woman), F3 (30-year-old woman), F4 (50-year-old man); F5 (32-year-old woman) and F6 (46-year-old woman). To guarantee the stringency of the study, all methodological procedures were monitored by teachers from the Research Unit¹⁹19 Marques FM, Pinheiro MJ, Alves PV. Estudante de enfermagem em ensino clínico: estudo qualitativo da tipologia de decisão. New Trends Qualitative Res 2021; 8:121-129.^,2020 Óscar RF, Baixinho CL, Medeiros M, Oliveira ESF. Aprender a usar evidência no curso de licenciatura em enfermagem: Resultados de um Focus Group. New Trends Qualitative Res 2021; 8:35-43..

Results/discussion

Six adult guardians of companion animals participated in the study, four female and two male individuals, aged between 30 and 55 years. It was verified that all of them had the knowledge and skills to easily work on digital platforms, due to their daily needs during confinement. Two of them were Elementary and High School teachers; the remaining four worked in the human resources area. Based on the content analysis of the FG, 54 Record Units (RU) emerged, with eight subcategories organized into three Categories: Influence of the dog on family dynamics; Presence of the dog in the family in a pandemic context and Affective bonds between the dog and the family (Chart 1).

The obtained results allow us to infer that the most cited subcategory was Mental health and psychological well-being (with 15 RU) and the least one was Disadvantages (with 2 RU).

In the category Influence of the dog on family dynamics, one can observe that in the subcategory of mental health and psychological well-being of the family, participants F1 and F3 share positive opinions: “Going for a walk with my dog always relieved the pressure a little, of always being locked up at home” (F1); “In terms of mental health, it improved a lot and the fact of having the dog’s company was very important” (F3). There are several studies that describe the existence of an increase in oxytocin, endorphin and dopamine levels and a decrease in cortisol levels, when there is interaction between a companion animal and its guardian, reducing peaks of stress and loneliness²¹21 Bowen J, Bulbena A, Fatjó J. The Value of Companion Dogs as a Source of Social Support for Their Owners: Findings From a Pre-pandemic Representative Sample and a Convenience Sample Obtained During the COVID-19 Lockdown in Spain. Frontiers Psychiatry 2021; 12:622060.. Regarding physical health, other participants showed this relationship with greater significance for one of their children, when they stated, “It was beneficial for my youngest son, because he was always withdrawn, when someone said to him ‘let’s go walk the dog!’ for him it was a joy, because he could go running” (F4); but also for their own experiences: “I ended up doing bigger circuits […] my body ended up missing walking to work a little […]. With the dog, it helped to solve it” (F5). This relationship between the animal and the improvement in the family’s physical health is in line with what is described in several studies, namely the increase in physical activity²¹21 Bowen J, Bulbena A, Fatjó J. The Value of Companion Dogs as a Source of Social Support for Their Owners: Findings From a Pre-pandemic Representative Sample and a Convenience Sample Obtained During the COVID-19 Lockdown in Spain. Frontiers Psychiatry 2021; 12:622060.^,2222 Bussolari C, Currin-McCulloch J, Packman W, Kogan L, Erdman P. I Couldn't Have Asked for a Better Quarantine Partner!: Experiences with Companion Dogs during Covid-19. Animals 2021; 11:330.. On the other hand, there was one participant who did not observe any changes in their physical health during the confinement period: “We didn’t notice much of a difference, we have a large roof top” (F2). This experience is in line with another study that tells us that, despite confinement, there were no changes in family dynamics due to several aspects, one of them being the physical space that existed before the pandemic²³23 Jezierski T, Camerlink I, Peden RS, Chou JY, Marchewka J. Changes in the health and behaviour of pet dogs during the COVID-19 pandemic as reported by the owners. Applied Animal Behav Sci 2021; 241:105395..

In the category Presence of the dog in a pandemic context, the participants’ opinions about the advantages of the dog are varied: “[...] going with her [dog] outside helped to break out of that routine that we all had to follow [isolation]” (F3). It was possible to understand that the dog changed some family behaviors: “[...] it was not the same person who went out with her all the time, we shared the time” (F2); “[...] we all ended up going together [walking the dog], something that didn’t happen before; normally, I went alone for a quicker walk, to do other things at home, and we ended up doing this routine in the morning, at lunch time and after dinner [...]” (F6). Based on these reflections it is understood that there were more moments when they played with the dogs, including, in some cases, an increase in the number of walks outside, something that is described in several articles on the topic of companion animals in times of pandemic²¹21 Bowen J, Bulbena A, Fatjó J. The Value of Companion Dogs as a Source of Social Support for Their Owners: Findings From a Pre-pandemic Representative Sample and a Convenience Sample Obtained During the COVID-19 Lockdown in Spain. Frontiers Psychiatry 2021; 12:622060.^,2222 Bussolari C, Currin-McCulloch J, Packman W, Kogan L, Erdman P. I Couldn't Have Asked for a Better Quarantine Partner!: Experiences with Companion Dogs during Covid-19. Animals 2021; 11:330.^,2424 Evans-Wilday AS, Hall SS, Hogue TE, Mills DS. Self-disclosure with dogs: dog owners' and non- dog owners' willingness to disclose emotional topics. Anthrozoos 2018; 31:353-366.. Observing the subcategory aimed at the disadvantages of the dog in the family in a pandemic context: “Everything remained the same” (F2); and there were reports from a participant about their dog’s restlessness as being a negative element in activities carried out at home, when they expressed: “She [dog] can’t see anyone being quiet, she goes straight to the person and if they don’t play with her, she doesn’t stop, doesn’t calm down” (F1). In the consulted bibliography, one can identify stress factors in animals when their daily routines are changed, either due to the dog’s need for greater attention due to having its guardian at home for longer periods of time, or due to the greater deal of noise that results from this new routine²¹21 Bowen J, Bulbena A, Fatjó J. The Value of Companion Dogs as a Source of Social Support for Their Owners: Findings From a Pre-pandemic Representative Sample and a Convenience Sample Obtained During the COVID-19 Lockdown in Spain. Frontiers Psychiatry 2021; 12:622060.^,2222 Bussolari C, Currin-McCulloch J, Packman W, Kogan L, Erdman P. I Couldn't Have Asked for a Better Quarantine Partner!: Experiences with Companion Dogs during Covid-19. Animals 2021; 11:330..

In the last Category that emerged in this study, Affective bond between the dog and the family, we can find the subcategory that was least cited by the participants, the one that concerns knowledge of Portuguese laws related to companion animals: “I didn’t know about the laws” (F2); “I was not aware of the existing regulations for adoption and consequences of abandoning companion animals” (F2). One of the participants had vast knowledge of the laws applied in Portugal and the forms of animal control and protection that exist in municipal shelters and the respective Chambers: “The shelter is very strict, it has home visits so they can see the space in which the person wants to keep the animal and if everything is in compliance, they go forward with the adoption [...]” (F3). When animal rights are mentioned, the subject is debated on the use of dogs to go out during confinement and the perception of abandonment of the dogs after restrictions were eased: “They only had dogs to have an excuse to go out into the street. [...] Now we see many more abandoned dogs” (F2); “I think people took advantage of the animal a little for their own benefit” (F4). Another point of view was: “I don’t have that perception, here where I live, because the Chamber is very aware of it” (F3). Currently, standards on non-human animal welfare, particularly companion animals, are being debated in the public sphere. Portugal recognizes the legal status, through the civil and criminal code (with fines), if there is no compliance with the law regarding the practice of abandonment, of acts that inflict pain or even death. Decree-Law Number 82/2019, of June 27²⁵25 Portugal. Decreto-Lei n.º 82/2019, de 27 de junho da Agricultura, Florestas e Desenvolvimento Rural. Diário da República; 2019. [Série I], also establishes the regulations for compliance with responsible adoption, the need for registration in the Companion Animals Information System (SIAC, Sistema de Informação de Animais de Companhia) and the guardian’s identification. Regarding the subcategory related to the guardian’s responsibility: “Just as we took off our shoes, we also took care of the dog’s paws” (F3); “The dog, it’s not just about coming and staying there, you have to take care of it, give it something to eat, drink, vaccinate it, give it affection and treat it well” (F6).

The concept of family has varied over time and place. Currently, the family is not only based on consanguinity, but also considers adoption, which includes companion animals²⁴24 Evans-Wilday AS, Hall SS, Hogue TE, Mills DS. Self-disclosure with dogs: dog owners' and non- dog owners' willingness to disclose emotional topics. Anthrozoos 2018; 31:353-366.^,2626 Kumar A, Nayar KR. COVID 19 and its mental health consequences. J Mental Health 2021; 30(1):1-2.. It is the family’s responsibility to take care of their companion animal’s health, contributing to the prevention of diseases, and providing food, hygiene, affection and health care needs⁵5 Mossoi AC, Vieira TR. Direito à saúde, animais domésticos e o bem-estar da família multiespécie. Rev Biodireito Direito Animais 2020; 6(2):56-78.. Another subject of debate was about the importance of the dog in the family configuration. All participants mentioned that they are part of the family, that they are treated like family members and, in some cases, they are even treated like one’s children: “I often say ‘I’m walking my daughter’” (F3); “I am in favor of justified work absences so that I can take the dog to the vet, as I do with my children” (F4); “Today I’m going to work and I think about him a lot more and I even bring him some sweets” (F1).

The way we see the relationship between humanity and companion animals today has changed. In fact, it ended up being widely experienced in a very specific context: in the middle of the pandemic crisis (and with the corresponding periods of confinement) the relationship maintained with their companion animals helped people compensate for moments of loneliness²⁶26 Kumar A, Nayar KR. COVID 19 and its mental health consequences. J Mental Health 2021; 30(1):1-2. and to decrease stress levels, was a source of comfort and contributed to an increase in the quality of life of the guardians and their animals²⁷27 Martins SM, Jesus ML, Santos AA, Amorim LD, Vieira ACA, Araujo KN, Santos BQR, Schräder JR, Silva E, Jesus CS. The productions of animal-assisted activities as an alternative therapy in cancer patients. Res Soc Develop 2022; 11(13):7.. Studies have identified a relationship of improved well-being between companion animals and their guardians, in this health/illness continuum, helping them in their recovery²⁶26 Kumar A, Nayar KR. COVID 19 and its mental health consequences. J Mental Health 2021; 30(1):1-2.^,2727 Martins SM, Jesus ML, Santos AA, Amorim LD, Vieira ACA, Araujo KN, Santos BQR, Schräder JR, Silva E, Jesus CS. The productions of animal-assisted activities as an alternative therapy in cancer patients. Res Soc Develop 2022; 11(13):7.. It is part of the Nursing profession to understand these intra-family dynamic relationships (both in their structure and their operation), as well as their involvement in the community and society, but also in the promotion of health and disease management⁴4 Murdaugh CP. Health Promotion in Nursing Pratice. 8ª ed. Boston: Pearson; 2019.^,77 Figueiredo MH. Modelo Dinâmico de Avaliação e Intervenção Familiar: Uma abordagem colaborativa em Enfermagem de Família. Lisboa: Lusociência - Edições Técnicas e Científicas; 2012..

Conclusions

Based on the research that was carried out, we were able to identify the benefits of the presence of a companion animal, in this case the dog, in the family during confinement. This bond between humanity and companion animals is considered beneficial and dynamic, as it has a direct influence on the well-being and health of both, as well as of the community in which they live. Having a companion animal conveys security and encourages physical contact and communication throughout the human life cycle. We are in the midst of a paradigm shift regarding the granting of rights to all animals. Given that nurses are usually the health professionals who are closest to the population, as they focus on community-based primary health care (both in terms of infectious and environmental risks and changes in behavior and lifestyles), this care with evidence-based decision-making makes perfect sense, sharing knowledge and information in an interdisciplinary way with the family as the source of control. It should also be noted that taking into account the nature of the study object, which refers to conceptions, beliefs and values, the qualitative approach emerged as the most adequate for clarifying “experiences from the point of view of those who live it”, in this case, the benefits of the dog in the family during a pandemic.

References

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History