Stoewen Debbie L, Coe Jason B, MacMartin Clare, Stone Elizabeth A, Dewey Catherine E
Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
Department of Family Relations and Applied Nutrition, College of Social & Applied Human Sciences, University of Guelph, Guelph, ON, Canada.
Front Vet Sci. 2019 Jun 5;6:147. doi: 10.3389/fvets.2019.00147. eCollection 2019.
Uncertainty has been identified as the central psychological feature of illness experiences, necessitating a variety of coping strategies to effectively manage it and successfully adapt. The purpose of this qualitative study was to determine the expectations of veterinary clients accessing oncology care services at a tertiary referral center for dogs with life-limiting cancer. The study consisted of 43 dog owners participating in 30 independent in-person single and dyadic interviews conducted with standardized open- and closed-ended questions from April to October 2009. Thematic analysis (supplemented with content analysis) was performed on transcripts of the interview discussions. Uncertainty was inadvertently identified as a central theme of the clients' experience. The diagnosis of a serious, life-limiting cancer and its treatment appeared to move clients into a world of uncertainty, which affected their feelings, thoughts, behaviors, attitudes, and personal expectations in relation to their dog, and their expectations of the oncology service. With uncertainty appraised mostly as a danger, clients appeared to employ multiple coping strategies to reduce uncertainty in the effort to adapt to the new reality of living with and caring for a dog with cancer. The need to manage uncertainty influenced their expectations of the service, specifically for information, ongoing relationships, 24-h access, and timely care. Our findings have implications for the delivery of specialty oncology services and for client welfare. When working with owners of dogs with life-limiting cancer, results suggest health care providers can facilitate the management of uncertainty to enhance clients' psychological well-being, thereby supporting clients' successful adaptation to the cancer experience.
不确定性已被确认为患病经历的核心心理特征，这就需要采取各种应对策略来有效管理它并成功适应。这项定性研究的目的是确定在一家三级转诊中心为患有危及生命癌症的犬只提供肿瘤护理服务的兽医客户的期望。该研究由43位犬主参与，于2009年4月至10月进行了30次独立的面对面单人及双人访谈，采用标准化的开放式和封闭式问题。对访谈讨论的文字记录进行了主题分析（辅以内容分析）。不确定性被意外地确定为客户经历的一个核心主题。严重的、危及生命的癌症诊断及其治疗似乎使客户进入了一个充满不确定性的世界，这影响了他们对犬只的感受、想法、行为、态度和个人期望，以及他们对肿瘤服务的期望。由于不确定性大多被视为一种危险，客户似乎采用了多种应对策略来减少不确定性，以努力适应与患癌犬只共同生活和照料它的新现实。管理不确定性的需求影响了他们对服务的期望，特别是对信息、持续关系、24小时接入和及时护理的期望。我们的研究结果对专科肿瘤服务的提供和客户福利具有启示意义。当与患有危及生命癌症的犬只的主人合作时，结果表明医疗保健提供者可以促进不确定性的管理，以提高客户的心理健康，从而支持客户成功适应癌症经历。
