The aim of this study was to evaluate the effects of animal-assisted activity on self-esteem, control over activities of daily living, and other psycho-physiological aspects among Taiwanese inpatients with schizophrenia. Thirty participants were randomly assigned to either the treatment or control group. A weekly animal-assisted activity program was arranged for patients in the treatment group for 2 months. A questionnaire assessing self-esteem, self-determination, social support, and psychiatric symptoms was completed the week before and the week after the animal-assisted activity. Compared with the control group, the treatment group showed significant improvement on all measures except for social support and negative psychiatric symptoms. The results of this study showed that animal-assisted activity can promote significant improvements in many clinical aspects among inpatients with schizophrenia. Therefore, animal-assisted activity should be integrated into the treatment of institutionalized patients with schizophrenia.

BackgroundThere is a lack of research examining patient-perceived empathy and its effect on low-literacy patients’ understanding of health information. This study investigated the moderating effect of patient-perceived empathy on the relationship between health literacy and understanding of preoperative information.MethodsDuring a 2-month period, a total of 144 patients took a survey that included the Chinese-edition Rapid Estimate of Adult Literacy in Medicine, the Barrett-Lennard Relationship Inventory and the Preoperative Information Understanding Scale. Hierarchical multiple regression analysis provided a test of moderator effects.ResultsAll Cronbach’s alphas exceeded 0.6, with REALM at 0.91, BLRI at 0.67, and PIUS at 0.77.The finding that the interaction term was significant suggests perceived empathy is a relevant factor when considering the relationship between health literacy and the understanding of information by patients. The relationship between the health literacy and understanding of information was stronger and positive among patients who perceived greater empathy from their physicians.ConclusionOur study demonstrates that a focus on improving physician–patient empathy skills could be beneficial in helping to overcome the negative consequences associated with limited health-literacy capabilities. Healthcare providers who wish to improve the understanding of information by low health-literacy patients should first identify components of their empathic communication mechanisms, and then try to refine these skills to better serve their patients.

Objective: Both Alzheimer's disease (AD) and Parkinson's disease (PD) are associated with lower cancer risk. However, the cancer risk in Parkinson's disease dementia (PDD) has never been discussed. We aimed to test whether PDD is cancer protective, and to compare the types and risks of incident cancer between AD and PDD. Methods:We used Taiwan National Health Insurance Database. From 1997 to 2010, a total of 2,527 PD dementia and 25,557 AD patients were enrolled and followed up for cancer by record linkage. Age and sex standardized incidence ratios (SIRs) of overall and site-specific cancers were calculated. Cox proportional hazards model was used to compare the cancer risk of AD relative to PDD. Results:With an average 4.4 years of follow-up period, both AD and PDD were associated with lower overall cancer risk (SIR and 95% confidence interval (CI): 0.83 (0.77-0.89) and 0.70 (0.55-0.89), respectively). The adjusted overall cancer risk of AD was significantly higher than that of PDD (hazard ratio (HR) and 95% CI: 1.26 (1.04-2.53), p=0.02). As for the site-specific cancer risk, the colorectal cancer risk of AD was also significantly higher than that of PDD (SIR: 0.95 (0.80-1.12) and 0.53 (0.80-1.00); HR: 1.83 (1.07-3.14), p=0.029). Conclusions:Both AD and PDD are inversely associated with incident cancer. Compared to AD, PDD is associated with even lower cancer risk. The decreased cancer risk in PDD may be contributed by the combined effect from both AD and PD. The mechanism deserves further investigations.