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Abstract

Objective—To identify specific components of veterinarian- client-patient communication during clinical appointments in companion animal practice.

Design—Cross-sectional descriptive study.

Sample Population—A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets.

Procedure—For each practitioner, 6 clinical appointments (3 wellness appointments and 3 appointments related to a health problem) were videotaped, and the Roter interaction analysis system (RIAS) was used to analyze the resulting 300 videotapes. Statements made during each appointment were classified by means of a communication framework reflecting the 4 essential tasks of the appointment (ie, data gathering, education and counseling, relationship building, and activation and partnership).

Results—57% of the veterinarians contacted (50/87) and 99% of the clients contacted agreed to participate in the study. Mean duration of the appointments was 13 minutes. Typically, veterinarians contributed 62% of the total conversation and clients contributed 38%. Fifty-four percent of the veterinarian interaction was with the client, and 8% was with the pet. Data gathering constituted 9% of the veterinarian-to-client communication and was primarily accomplished through closed-ended questioning; 48% of veterinarian-to-client communication involved client education and counseling, 30% involved relationship building, and 7% involved activation and partnership (the remaining 6% constituted orientation).

Conclusions and Clinical Relevance—Results suggest that the RIAS was a reliable method of assessing the structure, process, and content of veterinarianclient-patient communication and that some veterinarians do not use all the tools needed for effective communication. (J Am Vet Med Assoc 2004;225:222–229)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To compare the clinical interview process, content of the medical dialog, and emotional tone of the veterinarian-client-patient interaction during wellness appointments and appointments related to a health problem in companion animal practice.

Design—Cross-sectional descriptive study.

Sample Population—A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets.

Procedure—For each practitioner, 6 clinical appointments (3 wellness appointments and 3 problem appointments) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes.

Results—Wellness appointments were characterized by a broad discussion of topics, with 50% of data-gathering statements and 27% of client education statements related to the pet's lifestyle activities and social interactions. Wellness appointments included twice as much verbal interaction with the pet as did problem appointments, and the emotional atmosphere of wellness appointments was generally relaxed. There were more social talk, laughter, statements of reassurance, and compliments directed toward the client and pet. In contrast, during problem appointments, 90% of the data gathering and client education focused on biomedical topics. Coders rated veterinarians as hurried during 30 of the 150 (20%) problem appointments; they rated clients as anxious during 39 (26%) problem appointments and as emotionally distressed during 21 (14%).

Conclusions and Clinical Relevance—Results suggested that veterinarian-client-patient communication differed between wellness and problem appointments. Owing to the emphasis on biomedical content during problem appointments, veterinarians may neglect lifestyle and social concerns that could impact patient management and outcomes, such as client satisfaction and adherence to veterinarian recommendations.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To measure veterinarian satisfaction with companion animal visits through an adaptation of a previously validated physician visit satisfaction scale and to identify demographic, personality, appointment, and communication factors that contribute to veterinarian visit satisfaction.

Design—Cross-sectional descriptive study.

Sample—Random sample of 50 companion animal practitioners in southern Ontario, Canada, and convenience sample of 300 clients and their pets.

Procedures—For each practitioner, 6 clinical appointments were videotaped, and the resulting 300 videotapes were analyzed by use of the Roter interaction analysis system. The physician satisfaction scale, Rosenberg self-esteem scale, and interpersonal reactivity index were used to measure veterinarian visit satisfaction, self-esteem, and empathy, respectively. Linear regression analysis was conducted to study the relationship between factors and veterinarian visit satisfaction.

Results—Veterinarian visit satisfaction ranged from 1 to 5 (mean ± SD, 3.97 ± 0.99) and differed significantly between wellness appointments (mean scale score, 4.13) and problem appointments (mean scale score, 3.81). Various elements of client and veterinarian communication as well as personality measures of veterinarian self-esteem and empathy were associated with veterinarian satisfaction. The specific factors differed depending on the nature of the appointment.

Conclusions and Clinical Relevance—Results suggested that veterinarian visit–specific satisfaction is enhanced through the use of communication that builds relationships with clients and is associated with degrees of veterinarian empathetic concern and veterinarian self-esteem. The implications extend to overall job satisfaction and its potential link to the health and well-being of individual veterinarians.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To describe the relationship between veterinarian and client genders and veterinarian-client-patient communication.

Design—Cross-sectional descriptive study.

Sample—Random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets.

Procedures—For each practitioner, 6 clinical appointments were videotaped, and the resulting 300 videotapes were analyzed with the Roter interaction analysis system (RIAS). Linear regression was conducted to study the relationship between demographic factors, measures of veterinarian-client-patient communication, and gender of the veterinarian and client.

Results—Female veterinarians conducted more relationship-centered appointments, provided more positive and rapport-building statements, talked more to the patient, and were perceived as less hurried or rushed, compared with male veterinarians. Clients were more likely to provide lifestyle-social information to female veterinarians. Same-gender veterinarian-client interactions were relationship centered and included client provision of more lifestyle-social information.

Conclusions and Clinical Relevance—Gender influenced veterinarian-client-patient communication, and previously described physician gender differences in medical communication were largely replicated in the veterinary context.

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in Journal of the American Veterinary Medical Association

Abstract

Case Description—A 40.3-kg (88.7-lb) 6-year-old spayed female Labrador Retriever was evaluated because of acute unilateral epistaxis.

Clinical Findings—During the initial evaluation of the dog, systemic hypertension and a left adrenal gland mass were detected. The left adrenal gland mass was surgically removed; results of histologic examination of the mass indicated it was a pheochromocytoma. Ten months later, the dog was evaluated because of persistent systemic hypertension and development of polyuria, polydipsia, and excessive panting. Abdominal ultrasonography revealed a mass in the cranial aspect of the right adrenal gland; results of MRI suggested the mass was a malignant tumor.

Treatment and Outcome—Epistaxis resolved after treatment and resolution of severe systemic hypertension. A partial right adrenalectomy was performed to remove the right adrenal gland mass. Results of histologic examination of the mass indicated it was a well-differentiated carcinoma of the cortex of the adrenal gland. Results of ACTH stimulation tests after surgery indicated the dog had adequate adrenal gland function.

Clinical Relevance—Partial adrenalectomy may be a safe and feasible treatment option to preserve adrenal gland function in dogs with small eccentrically located adrenal gland masses, particularly for dogs that have undergone removal of the contralateral adrenal gland.

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in Journal of the American Veterinary Medical Association