Communication during veterinarian-client-patient interactions in companion animal practice
This thesis is comprised of 3 studies that explore communication in veterinary-client-patient interactions. An initial qualitative study involving 6 pet owner (n=32) and 4 veterinarian (n=24) focus groups explored the needs and expectations of veterinary clients. Eight general themes emerged including the veterinarian-client relationship, veterinarian-pet relationship, client-pet relationship, veterinarian-client communication, veterinarian's confidence and competence, the monetary aspects of veterinary care, the role of the support staff and the physical aspects of the clinic. Findings specific to the monetary aspects of veterinary care and veterinarian-client communication are discussed. The second study built on the findings from the focus groups to develop a measure of appointment-specific client satisfaction. The final Client Satisfaction Questionnaire (CSQ) was psychometrically tested with 20 veterinarians and 345 clients in companion animal practice. Reliability (internal consistency G-coefficient=0.96) and face, content and construct validity of the CSQ were established. The CSQ provides a validated outcome measure for use in veterinary communication research. Finally, an observational study including video-recorded interactions between 20 veterinarians and 350 clients and their pets was conducted. A dataset of 200 randomly selected interactions, stratified by appointment type (wellness and problem), was analyzed using the Roter Interaction Analysis System (RIAS). To extend findings from the previous studies, the prevalence and nature of cost discussions and determinants of appointment-specific client satisfaction were investigated. Discussions of cost occurred in 58 (29%) of the analyzed visits, written estimates were used as an aid 28% of the time, and the majority of cost discussions were presented in terms of the time and/or service being provided. Client satisfaction was greater for client-centered patterns of communication and positively associated with interactions involving the client's regular veterinarian, increased social conversation with the client, and the combination of both medical information and social talk directed to the pet by the veterinarian. Through a blend of qualitative and quantitative research techniques, this thesis contributes to the understanding of communication during veterinarian-client-patient interactions in companion animal practice. Findings provide veterinarians with a basis to reflect and build upon their own interactions in order to provide clients and patients with the best possible veterinary care.