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1.
Canine Med Genet ; 10(1): 3, 2023 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-37029399
2.
Vet Rec ; 192(12): e2778, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36912155

RESUMO

BACKGROUND: Sources of population-based cat health information are scarce. The objective of this study was to determine disease frequency in cats using pet insurance data to inform health promotion efforts. METHODS: A descriptive analysis of cats insured with Agria Pet Insurance in Sweden (2011-2016) was performed. Incidence rates of broad disease categories were calculated based on veterinary care events and an exact denominator consisting of cat-years-at-risk. Rate ratios were calculated, comparing domestic crosses to all purebreds and specific purebreds to all other purebreds combined. RESULTS: The study included over 1.6 million cat-years-at-risk (78.5% were domestic crosses), 18 breeds and 24 disease categories. The most common disease categories causing morbidity in purebreds were digestive, whole body, injury, urinary lower, skin and female reproduction. Purebreds had the highest relative risk (compared to domestics crosses) in the female reproduction, heart, operation complication, respiratory lower and immunological disease categories. LIMITATIONS: There are typical limitations of secondary data, but they do not negate the overall value of such a large dataset. CONCLUSION: This study demonstrates how pet insurance data can be used to find breed-specific differences in the incidence of various disease categories in cats. This may be of importance for breeders, cat owners, veterinarians and researchers.


Assuntos
Doenças do Gato , Seguro , Gatos , Feminino , Animais , Suécia/epidemiologia , Morbidade , Incidência , Catalase , Doenças do Gato/epidemiologia , Doenças do Gato/genética
3.
J Am Vet Med Assoc ; 254(9): 1073-1085, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30986163

RESUMO

OBJECTIVE: To describe client and veterinarian perceptions of client-centeredness during euthanasia discussions and assess agreement between measures of these perceptions. DESIGN: Descriptive study. SAMPLE: Stratified random sample of 32 companion animal veterinarians in southern Ontario. PROCEDURES: 2 case scenarios (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to initiate euthanasia discussions were presented by 2 different undisclosed standardized clients (USCs) to study veterinarian communication during clinical visits. At the end of appointments, the USC's identity was disclosed, and questionnaires to measure veterinarian and client perceptions of client-centeredness were completed. Agreement was assessed by statistical methods. RESULTS: Data were analyzed from 60 appointments (30/scenario). Of 10 questions, significant agreement was found between veterinarians and USCs for only 1 (extent to which relevant personal and family issues were discussed; κ = 0.43) for the dog scenario and 3 (extent of discussion of respective roles [κ = 0.43], better preparedness of the USC to make a euthanasia decision [κ = 0.42], and discussion of relevant personal and family issues [κ = 0.25]) for the cat scenario. When the USC and veterinarian disagreed, the veterinarian perceived that the client-centeredness components were addressed more thoroughly than did the USC. CONCLUSIONS AND CLINICAL RELEVANCE: Lack of agreement was found between USC and veterinarian perceptions, with USCs perceiving less client-centeredness in euthanasia discussions. This communication gap suggested the need for training of veterinarians in eliciting client perspectives and assessing lifestyle-social information, including client social support systems.


Assuntos
Eutanásia , Médicos Veterinários , Animais , Gatos , Comunicação , Cães , Humanos , Relações Interpessoais , Ontário
6.
Artigo em Inglês | MEDLINE | ID: mdl-29234500

RESUMO

BACKGROUND: Breed-related health problems in dogs have received increased focus over the last decade. Responsibility for causing and/or solving these problems has been variously directed towards dog breeders and kennel clubs, the veterinary profession, welfare scientists, owners, regulators, insurance companies and the media. In reality, all these stakeholders are likely to share some responsibility and optimal progress on resolving these challenges requires all key stakeholders to work together. The International Partnership for Dogs (IPFD), together with an alternating host organization, holds biennial meetings called the International Dog Health Workshops (IDHW). The Société Centrale Canine (French Kennel Club) hosted the 3rd IDHW, in Paris, in April, 2017. These meetings bring together a wide range of stakeholders in dog health, science and welfare to improve international sharing of information and resources, to provide a forum for ongoing collaboration, and to identify specific needs and actions to improve health, well-being and welfare in dogs. RESULTS: The workshop included 140 participants from 23 countries and was structured around six important issues facing those who work to improve dog health. These included individualized breed-specific strategies for health and breeding, extreme conformations, education and communication in relation to antimicrobial resistance, behavior and welfare, genetic testing and population-based evidence. A number of exciting actions were agreed during the meeting. These included setting up working groups to create tools to help breed clubs accelerate the implementation of breed-health strategies, review aspects of extreme conformation and share useful information on behavior. The meeting also heralded the development of an online resource of relevant information describing quality measures for DNA testing. A demand for more and better data and evidence was a recurring message stressed across all themes. CONCLUSIONS: The meeting confirmed the benefits from inclusion of a diverse range of stakeholders who all play relevant and collaborative parts to improve future canine health. Firm actions were set for progress towards improving breed-related welfare. The next international workshop will be in the UK in 2019 and will be organized by the UK Kennel Club.

7.
J Am Vet Med Assoc ; 241(1): 81-8, 2012 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-22720991

RESUMO

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.


Assuntos
Comunicação , Relações Interpessoais , Médicos Veterinários/psicologia , Medicina Veterinária/métodos , Adulto , Idoso , Animais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ontário , Participação do Paciente , Relações Profissional-Paciente , Fatores Sexuais , Gravação de Videoteipe
8.
J Am Vet Med Assoc ; 240(7): 832-41, 2012 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-22443436

RESUMO

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.


Assuntos
Animais de Estimação , Médicos Veterinários , Adulto , Idoso , Animais , Comunicação , Estudos Transversais , Coleta de Dados , Feminino , Vínculo Humano-Animal , Humanos , Masculino , Pessoa de Meia-Idade , Personalidade , Gravação de Videoteipe
9.
J Am Vet Med Assoc ; 237(11): 1275-87, 2010 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-21118013

RESUMO

OBJECTIVE: To characterize veterinarian-client communication with undisclosed standardized clients (USCs) during discussions regarding euthanasia of a pet. DESIGN: Descriptive study. SAMPLE POPULATION: 32 companion animal veterinarians (16 males and 16 females) in southern Ontario. PROCEDURES: During 2 clinic visits, 2 cases (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to stimulate discussion regarding euthanasia of a pet were presented by different USCs (individuals trained to consistently present a particular case to veterinarians without disclosing their identity). Discussions were audio recorded and analyzed by use of the measure of patient-centered communication (MPCC [a tool to assess and score physician communication behaviors]). Veterinarian and client statements were classified by means of 3 patient-centered components: exploring both the disease and the illness experience, understanding the whole person, and finding common ground. RESULTS: 60 usable recorded discussions were obtained (31 veterinarians; 30 discussions/case). Overall, MPCC scores were significantly lower for the geriatric dog case. For both cases, veterinarians scored highest on finding common ground and lowest on exploring both the disease and the illness experience. Lack of exploration of client feelings, ideas, and expectations and the effect of the illness on the animal's function resulted in low scores among veterinarians. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the use of USCs and the MPCC are feasible methods for analysis of veterinarian-client communication during companion animal euthanasia discussions. Findings suggested that some veterinarians do not fully explore client concerns or facilitate client involvement in euthanasia decision making.


Assuntos
Comunicação , Eutanásia Animal , Adulto , Animais , Gatos , Cães , Feminino , Humanos , Relações Interpessoais , Masculino , Relações Profissional-Paciente , Médicos Veterinários
10.
J Feline Med Surg ; 12(12): 948-59, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21055987

RESUMO

The aim of the study was to describe patterns of morbidity, as reflected by reimbursed claims for veterinary care among cats covered by a Swedish insurance company during 1999-2006. The annual incidence rates of having at least one veterinary care event were calculated overall and stratified by sex, age, breed, diagnosis and urban/other location. The total rate was 875 (95% CI 858-892) cats with claims per 10,000 cat-years at risk. The Siamese, Burmese, and the Abyssinians had high rates of claims, compared to the Norwegian Forest cat, the Maine Coon, the European Shorthair and domestic cats. The most common causes for insurance claims were trauma, gastrointestinal and lower urinary tract problems and there was substantial breed, sex and age variation for certain problems. For example, among cats under 9 years of age, the rate for lower urinary tract problems was 2-3 times higher in males than females.


Assuntos
Doenças do Gato/epidemiologia , Seguro Saúde/estatística & dados numéricos , Distribuição por Idade , Animais , Gatos , Feminino , Masculino , Morbidade/tendências , Distribuição por Sexo , Especificidade da Espécie , Suécia/epidemiologia
11.
Prev Vet Med ; 93(2-3): 222-32, 2010 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-19819036

RESUMO

Our objective was to evaluate the association between grading of hip status as assessed by radiographic examination (hip screening) and subsequent incidence of veterinary care and mortality related to hip dysplasia (HD) in five breeds of insured dogs in Sweden. Screening results for hip status from the Swedish Kennel Club and data on veterinary care and mortality from the insurance company Agria were merged based on the registration number of the dog. Dogs of five breeds (Bernese Mountain Dogs, German Shepherds, Golden Retrievers, Labrador Retrievers, and Rottweilers) screened during 1995-2004 and covered by an insurance plan for veterinary care or life at the time of screening were included. The study populations included between 1667 and 10,663 dogs per breed. Breed-specific multivariable Cox proportional-hazards analyses were performed to evaluate the impact of radiographic hip status on time from hip screening to first HD-related veterinary and life claim, respectively. The effects of gender, birth season, and a time-varying covariate of year were also studied. Additional analyses, on the five breeds combined, were performed to investigate the effects of hip status, breed, and the interaction between hip status and breed. The effect of hip status was highly significant (P<0.001) for both life and veterinary claims related to HD in all five breeds with increased hazard ratio (HR) for deteriorating hip status. Dogs with moderate or severe hip status at screening had a markedly increased hazard of HD-related veterinary care and mortality compared with dogs assessed as free or mild. The time-varying covariate of year showed a significantly higher HR in the last time period for German Shepherds and Labrador Retrievers in the analyses of veterinary claims. In the analyses on all five breeds, German Shepherds had the highest HR for both veterinary care and mortality related to HD, followed by Bernese Mountain Dogs. Golden and Labrador Retrievers had the lowest HR. The effect of hip status on the hazard was the same irrespective of breed. However, as a consequence of differences between breeds in overall risk, the predictive ability of screening results for subsequent incidence of HD-related problems for individual dogs was breed-dependent. Based on the strong association between radiographic hip status and incidence of HD-related veterinary care and mortality, and the previously reported moderate heritability of hip status, we conclude that selection based on screening results for hip status can be expected to reduce the risk of HD-related clinical problems.


Assuntos
Cruzamento , Displasia Pélvica Canina/diagnóstico por imagem , Displasia Pélvica Canina/mortalidade , Seguro Saúde/estatística & dados numéricos , Medicina Veterinária/estatística & dados numéricos , Animais , Cães , Feminino , Predisposição Genética para Doença , Displasia Pélvica Canina/diagnóstico , Displasia Pélvica Canina/genética , Endogamia , Masculino , Programas de Rastreamento , Análise Multivariada , Modelos de Riscos Proporcionais , Radiografia , Fatores de Risco , Especificidade da Espécie , Suécia
12.
Acta Vet Scand ; 51: 50, 2009 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-20003256

RESUMO

BACKGROUND: Computerized diagnostic information offers potential for epidemiological research; however data accuracy must be addressed. The principal aim of this study was to evaluate the completeness and correctness of diagnostic information in a computerized equine clinical database compared to corresponding hand written veterinary clinical records, used as gold standard, and to assess factors related to correctness. Further, the aim was to investigate completeness (epidemiologic sensitivity), correctness (positive predictive value), specificity and prevalence for diagnoses for four body systems and correctness for affected limb information for four joint diseases. METHODS: A random sample of 450 visits over the year 2002 (nvisits=49,591) was taken from 18 nation wide clinics headed under one company. Computerized information for the visits selected and copies of the corresponding veterinary clinical records were retrieved. Completeness and correctness were determined using semi-subjective criteria. Logistic regression was used to examine factors associated with correctness for diagnosis. RESULTS: Three hundred and ninety six visits had veterinary clinical notes that were retrievable. The overall completeness and correctness were 91% and 92%, respectively; both values considered high. Descriptive analyses showed significantly higher degree of correctness for first visits compared to follow up visits and for cases with a diagnostic code recorded in the veterinary records compared to those with no code noted. The correctness was similar regardless of usage category (leisure/sport horse, racing trotter and racing thoroughbred) or gender.For the four body systems selected (joints, skin and hooves, respiratory, skeletal) the completeness varied between 71% (respiration) and 91% (joints) and the correctness ranged from 87% (skin and hooves) to 96% (respiration), whereas the specificity was >95% for all systems. Logistic regression showed that correctness was associated with type of visit, whether an explicit diagnostic code was present in the veterinary clinical record, and body system. Correctness for information on affected limb was 95% and varied with joint. CONCLUSION: Based on the overall high level of correctness and completeness the database was considered useful for research purposes. For the body systems investigated the highest level of completeness and correctness was seen for joints and respiration, respectively.


Assuntos
Diagnóstico por Computador/veterinária , Doenças dos Cavalos/diagnóstico , Animais , Bases de Dados Factuais/normas , Diagnóstico por Computador/normas , Feminino , Cavalos , Modelos Logísticos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Suécia
13.
Acta Vet Scand ; 51: 42, 2009 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-19874612

RESUMO

The primary aim of this article is to review the use of animal health insurance data in the scientific literature, especially in regard to morbidity or mortality in companion animals and horses. Methods and results were compared among studies on similar health conditions from different nations and years. A further objective was to critically evaluate benefits and limitations of such databases, to suggest ways to maximize their utility and to discuss the future use of animal insurance data for research purposes. Examples of studies on morbidity, mortality and survival estimates in dogs and horses, as well as neoplasia in dogs, are discussed.We conclude that insurance data can and should be used for research purposes in companion animals and horses. Insurance data have been successfully used, e.g. to quantify certain features that may have been hitherto assumed, but unmeasured. Validation of insurance databases is necessary if they are to be used in research. This must include the description of the insured population and an evaluation of the extent to which it represents the source population. Data content and accuracy must be determined over time, including the accuracy/consistency of diagnostic information. Readers must be cautioned as to limitations of the databases and, as always, critically appraise findings and synthesize information with other research. Similar findings from different study designs provide stronger evidence than a sole report. Insurance data can highlight common, expensive and severe conditions that may not be evident from teaching hospital case loads but may be significant burdens on the health of a population.


Assuntos
Seguro/estatística & dados numéricos , Seguro/normas , Medicina Veterinária/estatística & dados numéricos , Animais , Bases de Dados Factuais/normas , Benefícios do Seguro/normas , Benefícios do Seguro/estatística & dados numéricos , Prontuários Médicos/estatística & dados numéricos , Neoplasias/veterinária , Publicações Periódicas como Assunto/normas , Pesquisa/normas , Medicina Veterinária/economia
14.
J Am Vet Med Assoc ; 234(11): 1418-24, 2009 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-19480621

RESUMO

OBJECTIVE: To determine prevalence and nature of cost discussions between veterinarians and pet owners during clinical appointments in companion animal practice. DESIGN: Cross-sectional descriptive study. SAMPLE POPULATION: 20 veterinarians in companion animal practice in eastern Ontario and 350 clients and their pets. PROCEDURES: 200 veterinarian-client-patient interactions were randomly selected from all videotaped interactions and analyzed with the Roter interaction analysis system. Additional proficiency codes and blocking functions were developed to capture the prevalence, nature, and context of cost discussions. RESULTS: 58 of the 200 (29%) appointments that were analyzed included a discussion of cost. During 38 of these 58 (66%) appointments, the discussion involved costs associated with the veterinarian's time or with services provided by the veterinarian. Overall, reference to a written estimate was made during only 28 of the 200 (14%) appointments. Cost discussions were most common during appointments in which a decision related to diagnostic testing or dentistry was made. Appointments were significantly longer when a cost discussion was included than when it was not. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study suggested that discussions related to cost were relatively uncommon during clinical appointments in companion animal practice and that written estimates were infrequently used to aid these discussions. When discussions of cost did occur, veterinarians appeared to focus on explaining costs in terms of the veterinarian's time or services provided by the veterinarian, rather than on the medical information that could be obtained or the benefits to the future health or function of the pet.


Assuntos
Animais Domésticos , Comunicação , Custos de Cuidados de Saúde , Médicos Veterinários , Medicina Veterinária/economia , Animais , Gravação de Videoteipe
15.
Can Vet J ; 50(10): 1047-53, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20046603

RESUMO

The prevalence and patterns of antimicrobial susceptibility of fecal Escherichia coli, Salmonella spp., extended beta-lactamase producing E. coli (ESBL-E. coli), methicillin-resistant Staphylococcus aureus (MRSA), and methicillin-resistant Staphylococcus pseudintermedius (MRSP) were determined for healthy dogs (n = 188) and cats (n = 39) from veterinary hospitals in southern Ontario that had not had recent exposure to antimicrobials. The prevalence of antimicrobial resistance in E. coli was as follows: streptomycin (dogs - 17%, cats - 2%), ampicillin (dogs - 13%, cats - 4%), cephalothin (dogs - 13%, cats - < 1%), and tetracycline (dogs - 11%, cats - 2%). Eleven percent of dogs and 15% of cats had isolates that were resistant to at least 2 antimicrobials. Cephamycinase (CMY)-2 producing E. coli was cultured from 2 dogs. No Salmonella spp., ESBL-E. coli, MRSA, or MRSP isolates were recovered. The observed prevalence of resistance in commensal E. coli from this population was lower than that previously reported in companion animals, but a small percentage of dogs may be a reservoir for CMY-2 E. coli.


Assuntos
Antibacterianos/farmacologia , Gatos/microbiologia , Cães/microbiologia , Farmacorresistência Bacteriana , Escherichia coli/efeitos dos fármacos , Animais , Reservatórios de Doenças/microbiologia , Reservatórios de Doenças/veterinária , Farmacorresistência Bacteriana Múltipla , Escherichia coli/isolamento & purificação , Fezes/microbiologia , Feminino , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana/veterinária , Ontário/epidemiologia , Prevalência
16.
J Am Vet Med Assoc ; 233(10): 1576-86, 2008 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-19014290

RESUMO

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.


Assuntos
Comunicação , Relações Interpessoais , Educação de Pacientes como Assunto , Participação do Paciente , Médicos Veterinários/psicologia , Medicina Veterinária/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Estudos Transversais , Coleta de Dados , Feminino , Vínculo Humano-Animal , Humanos , Masculino , Pessoa de Meia-Idade , Ontário , Fatores de Tempo , Medicina Veterinária/normas , Gravação de Videoteipe , Adulto Jovem
17.
J Am Vet Med Assoc ; 233(7): 1072-80, 2008 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-18828715

RESUMO

OBJECTIVE: To compare veterinarians' and pet owners' perceptions of client expectations with respect to veterinarian-client communication and to identify related barriers and challenges to communication. DESIGN: Qualitative study based on focus group interviews. PARTICIPANTS: 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). PROCEDURES: Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on transcripts of the focus group discussions. RESULTS: Five themes related to veterinarian-client communication were identified: educating clients (ie, explaining important information, providing information up front, and providing information in various forms), providing choices (ie, providing pet owners with a range of options, being respectful of owners' decisions, and working in partnership with owners), using 2-way communication (ie, using language clients understand, listening to what clients have to say, and asking the right questions), breakdowns in communication that affected the client's experience (ie, owners feeling misinformed, that they had not been given all options, and that their concerns had not been heard), and challenges veterinarians encountered when communicating with clients (ie, monetary concerns, client misinformation, involvement of > 1 client, and time limitations). CONCLUSIONS: Results suggested that several factors are involved in providing effective veterinarian-client communication and that breakdowns in communication can have an adverse effect on the veterinarian-client relationship.


Assuntos
Comunicação , Relações Interpessoais , Relações Profissional-Paciente , Médicos Veterinários/psicologia , Medicina Veterinária/normas , Adulto , Idoso , Animais , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Propriedade , Percepção , Medicina Veterinária/economia
18.
J Am Vet Med Assoc ; 231(10): 1510-8, 2007 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-18020992

RESUMO

OBJECTIVE: To compare veterinarians' and pet owners' perceptions of client expectations with respect to the monetary aspects of veterinary care and identify challenges encountered by veterinarians in dealing with pet owners' expectations. DESIGN: Qualitative study based on focus group interviews. PARTICIPANTS: 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). PROCEDURES: Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on the focus group discussions. RESULTS: Pet owners expected the care of their animal to take precedence over monetary aspects. They also expected veterinarians to initiate discussions of costs upfront but indicated that such discussions were uncommon. Veterinarians and pet owners differed in the way they related to discussions of veterinary costs. Veterinarians focused on tangibles, such as time and services. Pet owners focused on outcome as it related to their pet's health and well-being. Veterinarians reported that they sometimes felt undervalued for their efforts. A suspicion regarding the motivation behind veterinarians' recommendations surfaced among some participating pet owners. CONCLUSIONS: Results suggested that the monetary aspects of veterinary care pose barriers and challenges for veterinarians and pet owners. By exploring clients' expectations, improving communication, educating clients, and making discussions of cost more common, veterinarians may be able to alleviate some of the monetary challenges involved in veterinarian-client-patient interactions.


Assuntos
Bem-Estar do Animal , Comunicação , Motivação , Propriedade , Médicos Veterinários/economia , Médicos Veterinários/psicologia , Medicina Veterinária/economia , Bem-Estar do Animal/economia , Animais , Análise Custo-Benefício , Custos e Análise de Custo , Grupos Focais , Humanos , Relações Interpessoais , Propriedade/economia , Percepção , Gravação em Vídeo
19.
Prev Vet Med ; 82(3-4): 236-51, 2007 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-17644201

RESUMO

The aim was to evaluate the agreement between computerized insurance data in a large Swedish horse insurance database and the information in the corresponding clinical records (CR). A random sample of 400 veterinary care and 140 life claims was included. Information on name of the horse, breed and gender, year of birth, specific diagnosis and system diagnosis (e.g. joints, digestive and skeletal) was compared between sources. The concordance for demographic variables was categorized as agreement, disagreement or data missing. For diagnostic information, the categories were agreement, minor disagreement and major disagreement and for system information agreement or disagreement. There were missing values for demographic information in the CR, varying from 2% for name to 16% for breed. The overall agreement for demographic information was >94% (disregarding missing data), 92% for system and 84% for specific diagnosis. For veterinary care and life claims, the observed agreement for diagnosis was 85 and 83%, minor disagreement 6 and 5%, and major disagreement 9 and 12%, respectively. Using the CR data as gold standard, for the systems evaluated (joints, digestive, skeletal, skin and hooves), sensitivity varied between 62% (skin) and 89% (digestive) whereas the specificity was >96% for all systems. The positive predictive values ranged from 86% (skin) to 97% (digestive). Logistic regression analysis was used to examine factors associated with agreement for diagnosis. Analyses were performed separately for veterinary care and life claims. Factors examined were type of visit (clinic/field), treating veterinarian/clinic (categorized as district veterinarians, private practitioners, small clinics, medium clinics and, for the clinics with > or =20 claims, the specific clinics), computerized or manual CR, processing clerk, whether the CR was included in the paper file, if the claim was rejected or reimbursed, system diagnosis and if a immediate settlement (in analysis for veterinary care claims) or death certificate (in analysis for life claims) was included in the paper file. For veterinary care claims, in the logistic regression model type of visit was significantly associated with agreement, with clinic visits generating better agreement than field visits.


Assuntos
Cavalos , Hospitais Veterinários , Seguro , Prontuários Médicos , Medicina Veterinária , Animais , Doenças dos Cavalos/diagnóstico , Reprodutibilidade dos Testes , Suécia
20.
J Vet Intern Med ; 20(4): 894-903, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16955814

RESUMO

BACKGROUND: Population-based information on disease occurrence is paramount in clinical decision making and in designing preventative measures, but such information is scarce. HYPOTHESIS: The risk of cardiac death is higher in certain breeds and mortality varies by age and sex. DOGS: Dogs that were life insured by an animal insurance company between 1995 and 2002. METHODS: The mortality pattern for heart disease in insured dogs up to 10 years of age was studied. The influences of sex, age, breed, month, and geographic location were investigated by means of incidence rates, proportions, and survival proportions. Cox proportional hazards regression was used to model time to heart disease. RESULTS: 405,376 dogs contributed to a denominator of 1,431,933 dog-years at risk (DYAR) and 3,049 dogs had been assigned a cardiac-related diagnosis as cause of death. The cardiac-related mortality for dogs <10 years of age, was 21.3 deaths per 10,000 DYAR. This mortality in males and females was 27.3 deaths and 15.4 deaths per 10,000 DYAR, respectively. Twelve of 54 breeds had a point estimate above the overall rate. The 3 breeds with the highest point estimates were: Irish Wolfhounds, Cavalier King Charles Spaniels, and Great Danes (rates of 356, 247, and 179 deaths per 10,000 DYAR, respectively). CONCLUSIONS AND CLINICAL IMPORTANCE: Breed, age, and sex affect cardiac mortality in certain breeds of dogs, but no effects of month and geographic location were identified. These findings can assist clinicians in establishing diagnoses, and can assist breeders in defining priorities for preventative measures.


Assuntos
Causas de Morte , Doenças do Cão/mortalidade , Cardiopatias/veterinária , Seguro , Fatores Etários , Envelhecimento , Animais , Cães , Feminino , Cardiopatias/mortalidade , Masculino , Suécia/epidemiologia
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