Kanji Noureen, Coe Jason B, Adams Cindy L, Shaw Jane R
Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
J Am Vet Med Assoc. 2012 Feb 15;240(4):427-36. doi: 10.2460/javma.240.4.427.
To explore the relationship between veterinarian-client-patient interactions and client adherence to dental and surgery recommendations and to test the a priori hypotheses that appointment-specific client satisfaction and relationship-centered care are positively associated with client adherence.
Cross-sectional study.
A subsample of 19 companion-animal veterinarians and 83 clients from a larger observational study consisting of 20 randomly recruited veterinarians and a convenience sample of 350 clients from eastern Ontario.
Videotaped veterinarian-client-patient interactions containing a dentistry recommendation, surgery recommendation, or both were selected for inclusion from the larger sample of interactions coded with the Roter interaction analysis system. Client adherence was measured by evaluating each patient's medical record approximately 6 months after the videotaped interaction. The clarity of the recommendation, appointment-specific client-satisfaction score, and relationship-centered care score were compared between adhering and nonadhering clients.
Among the 83 veterinarian-client-patient interactions, 25 (30%) clients adhered to a dentistry recommendation, surgery recommendation, or both. The odds for adherence were 7 times as great for clients who received a clear recommendation, compared with clients who received an ambiguous recommendation from their veterinarian. Moreover, adhering clients were significantly more satisfied as measured after the interview. Interactions resulting in client adherence also had higher scores for relationship-centered care than did interactions leading to nonadherence.
Veterinarian use of a relationship-centered care approach, characterized as a collaborative partnership between a veterinarian and a client with provision of clear recommendations and effective communication of the rationale for the recommendations, has positive implications for client adherence.
探讨兽医-客户-患者互动与客户对牙科和手术建议的依从性之间的关系，并检验先验假设，即特定预约的客户满意度和以关系为中心的护理与客户依从性呈正相关。
横断面研究。
从一项更大的观察性研究中抽取的19名伴侣动物兽医和83名客户的子样本，该研究包括20名随机招募的兽医和来自安大略省东部的350名客户的便利样本。
从使用罗特尔互动分析系统编码的更大互动样本中，选择包含牙科建议、手术建议或两者的兽医-客户-患者互动录像进行纳入。通过在录像互动后约6个月评估每位患者的病历，来衡量客户的依从性。比较了依从和不依从客户之间建议的清晰度、特定预约的客户满意度得分和以关系为中心的护理得分。
在83次兽医-客户-患者互动中，25名（30%）客户依从了牙科建议、手术建议或两者。与从兽医那里收到含糊建议的客户相比，收到明确建议的客户依从的几率高出7倍。此外，访谈后测量发现，依从的客户满意度明显更高。导致客户依从的互动在以关系为中心的护理方面的得分也高于导致不依从的互动。
兽医采用以关系为中心的护理方法，其特点是兽医与客户之间建立合作关系，提供明确的建议并有效传达建议的理由，这对客户的依从性具有积极影响。
