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Hospitalisation can be distressing for children, often linked to stress, pain, and anxiety. Complementary therapies show promise in alleviating these effects, especially during medical procedures. Among them, Animal-Assisted Activity (AAA) with dogs has gained increasing recognition in both research and clinical practice for its comforting impact. While integrating dogs into paediatric healthcare offers therapeutic benefits, it also presents challenges such as the risk of pathogen transmission and allergic reactions.

The overall aim of this thesis was to examine the beneficial effects and potential risks, particularly bacterial transmission, of dogs as a complementary therapy in paediatric care. It explores child-dog interactions and how the activity affects the child from the perspectives of children, parents, and healthcare professionals, as well as investigating the risk of bacterial transfer.

Paper I employed a mixed-methods design with a convergent approach, using questionnaires administered before and after the child-dog sessions to explore the experiences of 49 children participating in AAA.

Paper II utilised a cross-sectional design incorporating semi-structured observations to describe the interactions between child and dog across 49 child-dog sessions.

Paper III adopted a quantitative design, supplemented by qualitative data from questionnaires, to examine the attitudes of 61 healthcare professionals (HCPs) towards complementary therapy involving dogs in AAA.

Paper IV applied a mixed-methods design with a convergent approach to investigate 49 parents’ perspectives on how dogs in AAA can comfort their children when admitted to the hospital.

Paper V used a descriptive design to explore whether, and to what extent, aerobic bacteria were exchanged between children and dogs before and after AAA sessions.

The metaphor of “being in a bubble” aptly describes the immersive and focused interaction between the child and the dog during AAA sessions. As children engaged with the dog, guided and supported, external distractions faded, creating a transparent and protective space of connection. Within this space, children reported enhanced well-being and a more positive hospital experience. Parents and HCPs also recognised the potential of AAA to provide physical and emotional comfort. With appropriate hygiene protocols in place, AAA involving dogs can be safely implemented, minimising the risk of clinically significant bacterial transmission.