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Stress Responses to Therapy Dog Visits in the Emergency Department: A Nonrandomized Intervention Study

J Emerg Nurs. 2026 Aug 28:S0099-1767(26)00253-9. doi: 10.1016/j.jen.2026.07.015. Online ahead of print.

ABSTRACT

INTRODUCTION: Emergency departments are high-stress clinical environments where health care workers are exposed to unpredictable patient acuity, trauma, workplace violence, and rapid decision making. Animal-assisted interventions have demonstrated benefits for patients, with emerging evidence suggesting potential value for reducing health care worker stress and improving emotional well-being. However, objective physiological outcomes and emergency department-specific data remain limited.

METHODS: This descriptive, interventional study examined the association between therapy dog visits and perceived and physiological stress among emergency department health care workers. Patient- and nonpatient-facing staff completed measures of salivary cortisol, perceived stress, and blood pressure immediately before and after dog interactions. Participants also provided qualitative descriptions of their feelings pre- and postintervention.

RESULTS: A total of 76 staff members participated, accounting for 100 therapy dog interactions. Overall, pre- to postintervention changes in salivary cortisol were not statistically significant. Perceived stress decreased significantly for all participants (P < .001), and mean arterial pressure decreased at the α = 0.10 level. Qualitative findings revealed a shift from negative emotional states (stressed and overwhelmed) before dog visits to more positive emotions (calmer, happier, and reenergized) afterward.

DISCUSSION: Results of this study suggest that therapy dog visits were associated with lower perceived stress and were well received by staff. Pet therapy may be considered as 1 component of broader organizational strategies to support health care workers in high-stress clinical environments. Therapy dog programs may represent a feasible, low-cost approach for promoting a supportive healing environment.

PMID:42667276 | DOI:10.1016/j.jen.2026.07.015

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