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Abstract

OBJECTIVE

Pet weight may be difficult for veterinary professionals to address with clients, particularly when pets are overweight or obese. The objective of this study was to characterize the communication processes and content of weight-related conversations occurring between veterinary professionals and clients.

SAMPLE

Audio-video recordings of 917 veterinarian-client-patient interactions involving a random sample of 60 veterinarians and a convenience sample of clients.

PROCEDURES

Companion animal veterinarians in southern Ontario, Canada, were randomly recruited, and interactions with their clients were audio-video recorded. Interactions were reviewed for mentions of weight, then further analyzed by means of a researcher-generated coding framework to provide a comprehensive assessment of communication specific to weight-related interactions.

RESULTS

463 of 917 (50.5%) veterinary-client-patient interactions contained an exchange involving the mention of a single patient’s (dog or cat) weight and were included in final analysis. Of the 463 interactions, 150 (32.4%) involved a discussion of obesity for a single patient. Of these, 43.3% (65/150) included a weight management recommendation from the veterinary team, and 28% (42/150) provided clients with a reason for pursuing weight management.

CLINICAL RELEVANCE

Findings illustrate opportunities to optimize obesity communication to improve the health and wellbeing of veterinary patients.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To investigate the association of demographic, career, and lifestyle factors with resilience and the association of resilience with mental health outcomes in Canadian veterinarians.

SAMPLE

1,130 veterinarians in clinical practice across Canada.

PROCEDURES

An online questionnaire was used to collect participant data and included 5 validated psychometric scales to evaluate resilience (through the Connor-Davidson Resilience Scale [CD-RISC]), perceived stress (through the Perceived Stress Scale), emotional distress (through the Hospital Anxiety and Depression Scale), burnout (through the Maslach Burnout Inventory), and secondary traumatic stress (through the Professional Quality of Life Scale). A multivariable linear regression model was used to investigate associations between CD-RISC scores and demographic, career, and lifestyle characteristics. Univariable linear regression models were used to assess the relationship between resilience scores and other mental health outcomes.

RESULTS

The strongest positive association was between CD-RISC score and overall health. The level of satisfaction with support from friends and workplace resources had positive associations with the CD-RISC score. The presence of mental illness had the strongest negative association with the CD-RISC score. Being married, working in a small animal practice, or having an associate role were negatively associated with the CD-RISC score. The CD-RISC score had negative associations with scores for perceived stress, anxiety, depression, burnout, and secondary traumatic stress.

CONCLUSIONS AND CLINICAL RELEVANCE

Models provided evidence for the role of resilience in protecting against negative mental health outcomes in veterinarians. Both personal and workplace factors were associated with resilience, presenting opportunities for intervention at each of these levels.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To examine companion animal owners’ perceptions of appropriate veterinarian attire and investigate potential associations between a veterinarian's attire and clients’ ratings of trust in, confidence in, and comfort with a veterinarian.

SAMPLE

449 pet owners.

PROCEDURES

Participants were randomly assigned to complete a questionnaire containing photos of a male or female model veterinarian photographed in 8 attire types (formal attire, white dress shirt with black pants, white casual shirt with khaki pants, surgical scrubs, white casual shirt with jeans, surgical scrub top with jeans, surgical scrub top with khaki pants, and white laboratory coat with khaki pants). Participants were asked to rate their trust in, confidence in, and comfort with the pictured individual on a response scale of 1 (low) to 7 (high), rank photos according to their preferences for attire, and provide input on the importance of attire and other appearance-related subjects. Attire and gender of photographed individual and participant demographics were investigated for associations with trust, confidence, and comfort scores.

RESULTS

Most (317/445 [71%]) respondents indicated veterinarians’ attire was important. Attire type was significantly associated with respondents’ trust, confidence, and comfort scores. Model veterinarian gender and participant education level were also associated with trust and comfort scores.

CONCLUSIONS AND CLINICAL RELEVANCE

Veterinarians’ attire is a form of nonverbal communication that is likely to inform clients’ first impressions and may influence clients’ trust in, confidence in, and comfort with a veterinarian. Veterinary personnel and veterinary management should consider how attire and general appearance represent staff members or their practice.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To investigate effects of an intensive 2-day practice-level communication skills training program (CSTP) with a 3-month follow-up communication in practice program (CIPP) on veterinary health-care team members' communication confidence, client satisfaction, and practice financial metrics.

SAMPLE

5 US companion animal veterinary practices.

PROCEDURES

Following pilot testing at 1 veterinary practice, communication skills training was performed on-site at 4 practices. The 2-day CSTP focused on veterinary communication–specific content. The CIPP included in-practice training sessions every other week to reinforce and build upon communication skills. Team members' communication skills confidence (before and after the CSTP and after the CIPP) and client satisfaction with veterinary visits (2 months before and 3 months after the CSTP) were assessed with surveys. Practice-level financial metrics were collected for 18 months. Variables of interest were compared among time points.

RESULTS

Measures of team member communication skills confidence and initiation of client conversations regarding the value of goods and services were significantly greater after the CIPP than before the CSTP. Composite communication skills confidence scores 3 months after the CSTP were positively correlated with the mean practice transaction charge and percentage change in the number of heartworm tests performed in the 3 months after the CSTP, compared with results for the same 3 months in the previous year. Measurements of client satisfaction were high before and after the CSTP. There was no significant change in financial metrics in the 3 months after CSTP, compared with the same 3 months in the previous year.

CONCLUSIONS AND CLINICAL RELEVANCE

This study highlighted opportunities to increase veterinary health-care team members' communication confidence and identified future considerations for communication training in veterinary workplaces.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine the prevalence and nature of cost conversations occurring during veterinarian-client-patient interactions within companion animal practice.

SAMPLES

60 randomly selected, practicing veterinarians working in 55 practices across southern Ontario, Canada, and 909 of their clients, sampled by convenience.

PROCEDURES

A cross-sectional descriptive study including 917 video-recorded appointments. Associations between veterinarian, client, or appointment-level factors and occurrence of a cost conversation were evaluated using multi-level logistic regression.

RESULTS

215 of 917 (23.4%) videos included a discussion of cost between the veterinarian and client. Cost conversations involving veterinarians primarily focused on conveying the price in relation to the time or service being offered (74.0% [159/215]), whereas the benefit to the future health and wellness of the patient was conveyed in 14.4% (31/215) of veterinarians’ cost conversations. Costs were most frequently discussed by veterinarians in relation to diagnostic testing (44.2% [96/215]). The odds of a cost discussion occurring were greater during problem appointments versus wellness (P = .011) or recheck (P = .029) appointments, for feline versus canine patients (P = .037), as appointment duration increased (P < .001), and as a client’s number of visits in the past year decreased (P = .049).

CLINICAL RELEVANCE

Discussing cost of care in veterinary practice continues to be relatively uncommon. Opportunities exist for veterinary professionals to frame their communication of the cost of veterinary care in relation to the benefits offered to the future health and wellbeing of the veterinary patient.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To compare pet owners’ and veterinarians’ perceptions of veterinarian-client conversations concerning pet weight and identify challenges related to communication about weight.

SAMPLE POPULATION

Veterinarians (n = 24) and pet owners (27) in southern Ontario, Canada.

PROCEDURES

3 veterinarian and 5 pet owner focus groups were conducted with a semistructured interview format. Thematic analysis of verbatim transcripts was conducted.

RESULTS

Pet owners valued weight as an important health indicator for pets yet did not expect to discuss weight extensively at every appointment. Owners expected veterinarians to provide options and tailor recommendations when discussing weight management. Owners appeared more concerned with underweight animals, whereas veterinarians focused on obese animals. Veterinarians identified communication challenges, including the perception that owners are uninterested in discussing weight and conversations can become adversarial. Veterinarians reported various benefits and challenges of using humor to address pet weight and emphasized that weight-related conversations often depend on the existing veterinarian-client relationship.

CLINICAL RELEVANCE

Some perceptions of pet owner expectations expressed by veterinarians in this study align with owner preferences, yet several opportunities exist for changes to veterinarians’ approaches to weight-related communication with clients.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To describe veterinarians’ communication of the companion animal physical exam (CAPE) to veterinary clients and to identify factors associated with the number of physical exam components communicated by veterinarians to clients.

SAMPLE

376 video-recorded veterinarian-client-patient interactions, involving 60 veterinarians.

PROCEDURES

18 CAPE components were studied in relation to veterinarians’ use of 7 communication-related parameters. A mixed linear regression model was used to assess veterinarian, patient, and appointment factors associated with the number of components conveyed by a veterinarian.

RESULTS

Veterinarians conveyed 1,566 of 2,794 (56.1%) of the components that they examined to clients, as having been examined. Of those components that were examined and conveyed by veterinarians, the impact of the finding was communicated for 496 of 1,566 (31.7%) of the components. Visual aids and take-home literature were each used in relation to an examined component during 15 of the 376 interactions (4%). A significant association was found between number of CAPE components conveyed and gender of the veterinarian (females conveyed 1.31 more), as well as the type of appointment (2.57 more were conveyed in wellness appointments and 1.37 more in problem appointments, compared to rechecks).

CLINICAL RELEVANCE

Findings identify an opportunity for veterinarians to further emphasize components of the CAPE, which may in turn increase clients’ perceived value of the CAPE due to understanding the benefits for their pet. This may be accomplished with the Talking Physical Exam, in which veterinarians discuss CAPE components findings with clients in real time, and the relevance of the findings to the patient’s health.

Open access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the role of veterinary team effectiveness regarding job satisfaction and burnout in companion animal veterinary practice.

Design—Cross-sectional observational study.

Sample—48 companion animal veterinary health-care teams.

Procedures—274 team members participated in an online survey. Overall job satisfaction was evaluated with a 1-item measure, and the 3 dimensions of burnout (exhaustion, cynicism, and professional efficacy) were measured with the Maslach Burnout Inventory-General Survey. Team effectiveness was assessed with a survey developed for this study. Demographic and team effectiveness factors (coordinated team environment, toxic team environment, team engagement, and individual engagement) associated with job satisfaction and burnout were evaluated.

Results—Overall mean job satisfaction score was 5.46 of 7 (median, 6.00); veterinary technicians and kennel attendants had the lowest scores. According to the Maslach survey results, 22.4% of participants were in the high-risk category for exhaustion, 23.2% were in the high-risk category for cynicism, and 9.3% were in the high-risk category for professional efficacy. A coordinated team environment was associated with increased professional efficacy and decreased cynicism. A toxic team environment was negatively associated with job satisfaction and positively associated with exhaustion and cynicism. Individual engagement was positively associated with job satisfaction and professional efficacy and negatively associated with exhaustion and cynicism.

Conclusions and Clinical Relevance—Results suggested the effectiveness of a veterinary team can significantly influence individual team members’ job satisfaction and burnout. Practices should pay specific attention to the effectiveness with which their veterinary team operates.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the content aspects of the information expectations of clients accessing oncology care services at a tertiary referral center for dogs with life-limiting cancer.

Design—Qualitative analysis of data acquired during in-person single and dyadic interviews.

Sample—43 dog owners participating in 30 interviews.

Procedures—Independent in-person interviews were conducted with standardized open- and closed-ended questions from April to October 2009. Thematic analysis was performed on transcripts of the interview discussions.

Results—For the clients, the central qualification was that the information given had to be the truth. Information was expected about all aspects of their dog's cancer and its treatment, varying in relation to clients’ basic understanding of cancer, their previous experience with cancer, and their information preferences. Provision of information generated the trust and confidence necessary to engage in treatment, the ability to make informed decisions, and the ability to be prepared for the future. Provision of information also engendered a sense of control and capability and fostered hope.

Conclusions and Clinical Relevance—When dealing with owners of dogs with life-limiting cancer, results indicated that in addition to abiding by the principle of truth-telling, it is important for health-care service providers to ascertain clients’ understanding of and experiences with cancer as well as their information preferences and thereby adopt a tailored approach to information giving. Provision of information enabled client action and patient intervention but also enhanced clients’ psychosocial well-being. Veterinary healthcare service providers can purposely provide information to build and sustain clients’ ability to successfully cope with their pet's condition.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To describe the process aspects (communication) of the information expectations of clients accessing oncology care services at a tertiary referral center for dogs with life-limiting cancer.

Design—Qualitative analysis of data acquired during in-person single and dyadic interviews.

Sample—43 dog owners participating in 30 interviews.

Procedures—Independent in-person interviews were conducted with standardized open- and closed-ended questions from April to October 2009. Thematic analysis was performed on transcripts of the interview discussions.

Results—The participants expected information to be communicated in a forthright manner; in multiple formats; with understandable language; in an unrushed environment wherein staff took the time to listen, answer all questions, and repeat information when necessary; on a continuous basis, with 24-hour access to address questions or concerns; in a timely manner; with positivity; with compassion and empathy; with a nonjudgmental attitude; and through staff with whom they had established relationships.

Conclusions and Clinical Relevance—Results indicated that the manner in which information is communicated is vitally important to clients of dogs with life-limiting cancer in that it not only facilitates comprehension but also creates a humanistic environment from which clients derive the psychosocial support needed to successfully cope with their pet's condition.

Full access
in Journal of the American Veterinary Medical Association