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- Author or Editor: Clare MacMartin x
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Abstract
Objective—To establish the types of initial questions used by veterinarians in companion animal practice to solicit nutritional history information from owners of dogs and cats, the dietary information elicited, and the relationship between initial question-answer sequences and later nutrition-related questions.
Design—Cross-sectional qualitative conversation analytic study.
Sample—98 appointments featuring 15 veterinarians drawn from an observational study of 284 videotaped veterinarian-client-patient visits involving 17 veterinarians in companion animal practices in eastern Ontario, Canada.
Procedures—Veterinarian and client talk related to patient nutrition was identified and transcribed; conversation analysis was then used to examine the orderly design and details of talk within and across turns. Nutrition-related discussions occurred in 172 visits, 98 of which contained veterinarian-initiated question-answer sequences about patient nutritional history (99 sequences in total, with 2 sequences in 1 visit).
Results—The predominant question format used by veterinarians was a what-prefaced question asking about the current content of the patient's diet (75/99). Overall, 63 appointments involved a single what-prefaced question in the first turn of nutrition talk by the veterinarian (64 sequences in total). Dietary information in client responses was typically restricted to the brand name, the subtype (eg, kitten), or the brand name and subtype of a single food item. When additional diet questions were subsequently posed, they typically sought only clarification about the food item previously mentioned by the client.
Conclusions and Clinical Relevance—Results suggested that question design can influence the accuracy and completeness of a nutritional history. These findings can potentially provide important evidence-based guidance for communication training in nutritional assessment techniques.
Abstract
Objective—To elucidate factors influencing practitioner decisions to refer dogs with cancer to veterinary oncology specialists.
Design—Cross-sectional study.
Sample—2,724 Ontario primary care companion animal veterinarians.
Procedures—Practitioners were invited to participate in a survey involving clinical scenarios of canine cancer patients, offered online and in paper format from October 2010 through January 2011. Analyses identified factors associated with the decision to refer patients to veterinary oncology specialists.
Results—1,071 (39.3%) veterinarians responded, of which 603 (56.3%) recommended referral for dogs with multicentric lymphoma and appendicular osteosarcoma. Most (893/1,059 [84.3%]) practiced within < 2 hours’ drive of a specialty referral center, and most (981/1,047 [93.7%]) were completely confident in the oncology service. Few (230/1,056 [21.8%] to 349/1,056 [33.0%]) were experienced with use of chemotherapeutics, whereas more (627/1,051 [59.7%]) were experienced with amputation. Referral was associated with practitioner perception of patient health status (OR, 1.54; 95% confidence interval [CI], 1.15 to 2.07), the interaction between the client's bond with the dog and the client's financial status, practitioner experience with treating cancer (OR, 2.79; 95% CI, 1.63 to 4.77), how worthwhile practitioners considered treatment to be (OR, 1.66 to 3.09; 95% CI, 1.08 to 4.72), and confidence in the referral center (OR, 2.20; 95% CI, 1. 11 to 4.34).
Conclusions and Clinical Relevance—Several factors influenced practitioner decisions to refer dogs with lymphoma or osteosarcoma for specialty care. Understanding factors that influence these decisions may enable practitioners to appraise their referral decisions and ensure they act in the best interests of patients, clients, and the veterinary profession.
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.
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.
Abstract
OBJECTIVE
To examine the effect of 3 diet history questions on the amount and type of diet-related information gathered from pet owners and to assess whether diet-related information obtained with each question in person differed from information obtained with a diet history survey.
SAMPLE
99 pet owners.
PROCEDURES
Participants' responses to 1 of 3 randomly selected diet history questions (“Tell me everything he [or she] eats throughout a day, starting first thing in the morning right through to the end of the day”; “What kind of food does she [or he] eat?”; or “What kind of foods does he [or she] eat?”) were recorded and coded for analysis. Participants completed a postinteraction diet history survey. Amount and type of diet-related information obtained were compared among responses to the 3 diet history questions and between the response to each question and the diet history survey.
RESULTS
The “Tell me…” question elicited a significantly higher total number of diet-related items (combined number of main diet, treat, human food, medication, and dietary supplement items) than did the “What kind of food…” or “What kind of foods…” questions. The diet history survey captured significantly more information than did the “What kind of food…” or “What kind of foods…” questions; there was little difference between results of the diet history survey and the “Tell me…” question, except that treats were more frequently disclosed on the survey.
CONCLUSIONS AND CLINICAL RELEVANCE
Findings reinforced the value of using broad, open questions or requests that invite expansion from clients for gathering diet-related information.
