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友善是不够的——用结构方程模型探索以关系为中心的兽医护理。一项关于德国宠物主人认知的定量研究。

Being Nice Is Not Enough-Exploring Relationship-Centered Veterinary Care With Structural Equation Modeling. A Quantitative Study on German Pet Owners' Perception.

作者信息

Küper Alina M, Merle Roswitha

机构信息

Department of Veterinary Medicine, Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany.

出版信息

Front Vet Sci. 2019 Feb 28;6:56. doi: 10.3389/fvets.2019.00056. eCollection 2019.

Abstract

During the last years, the philosophy of relationship-centered care gained increasing attention in veterinary medicine. Relationship-centered care is based on a joint venture between pet owner and veterinarians and therefore offers the opportunity to satisfy the pet owners' need for participation in medical decision-making and to provide the best care for the patient. Although research on relationship-centered care in the veterinary consultation is still limited, the available findings suggest that the characteristics of relationship-centered care reflect the pet owners' expectations on satisfactory veterinary care. In this study a quantitative survey was conducted among German pet owners that collected information regarding their perception of the veterinarians' communication during the last appointments. Questionnaires were available online and paper-based. Data were analyzed using exploratory factor analysis and structural equation modeling using SAS. First aim of the study was to explore structural equation modeling (SEM) as an opportunity to evaluate quantitative data in the field of research on relationship-centered care. Further, SEM was used to evaluate associations between the implementation of different characteristics of relationship-centered care in the veterinary practice (empathic communication, partnership-building) and latent outcome variables regarding the pet owners (pet owners' need for further information, consultation of competing health care providers). = 1,270 valid questionnaires were completed. Participants owned small companion animals (55.6%), horses (7.6%), or both (36.9%) within the last 2 years. Results of SEM suggest that partnership-centered and empathic communication decreased the pet owners' needs for further information (e.g., from online sources) and their need to consult alternative health providers (e.g., homeopaths). Especially addressing the pet owners' worries and fears, discussing pros and cons of diagnostic and therapeutic options as well as providing the required amount of information were shown to be large influence factors within the model. Therefore, veterinarians are recommended to implement the concept of partnership-centered care in their daily practice, for it may increase pet owners' loyalty and satisfaction. Results may motivate future research in this field. Further development of the proposed model assumptions may enable valuable progress in the field of quantitative research on relationship-centered care.

摘要

在过去几年中,以关系为中心的护理理念在兽医学中受到越来越多的关注。以关系为中心的护理基于宠物主人和兽医之间的合作,因此提供了满足宠物主人参与医疗决策需求并为患者提供最佳护理的机会。尽管关于兽医咨询中以关系为中心的护理的研究仍然有限,但现有研究结果表明,以关系为中心的护理的特点反映了宠物主人对满意的兽医护理的期望。在本研究中,对德国宠物主人进行了一项定量调查,收集了他们对上一次就诊时兽医沟通的看法的信息。问卷有在线和纸质两种形式。使用SAS进行探索性因素分析和结构方程建模对数据进行分析。该研究的首要目的是探索结构方程建模(SEM),作为评估以关系为中心的护理研究领域定量数据的一种机会。此外,SEM用于评估兽医实践中以关系为中心的护理的不同特征(共情沟通、建立伙伴关系)的实施与宠物主人的潜在结果变量(宠物主人对更多信息的需求、咨询其他医疗服务提供者)之间的关联。共完成了1270份有效问卷。在过去两年中,参与者拥有小型伴侣动物(55.6%)、马匹(7.6%)或两者都有(36.9%)。SEM结果表明,以伙伴关系为中心的共情沟通减少了宠物主人对更多信息(如来自在线资源)的需求以及他们咨询替代医疗服务提供者(如顺势疗法医生)的需求。特别是解决宠物主人的担忧和恐惧、讨论诊断和治疗方案的利弊以及提供所需的信息量在模型中被证明是很大的影响因素。因此,建议兽医在日常实践中实施以伙伴关系为中心的护理理念,因为这可能会提高宠物主人的忠诚度和满意度。研究结果可能会推动该领域未来的研究。所提出的模型假设的进一步发展可能会在以关系为中心的护理的定量研究领域取得有价值的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/df2c/6403131/a75e9e9fb4ce/fvets-06-00056-g0001.jpg

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