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兽医皮肤病学中护理人员在病史报告方面的信息提供者差异。

Informant discrepancy between caretakers in history reporting in veterinary dermatology.

作者信息

Cordonier Joseph, Udenberg Tyler, Defalque Vincent, Korbelik Jay, Miljacic Ljubomir, Polissar Nayak

机构信息

North West Veterinary Dermatology Services, 1380 Kootenay Street, Vancouver, British Columbia V5K 4R1 (Cordonier, Udenberg, Korbelik); North West Veterinary Dermatology Services, 108-1497 Admirals Road, Victoria, British Columbia V9A 2P8 (Defalque); The Mountain-Whisper-Light Statistics and Data Sciences, 1827 23rd Avenue East, Seattle, Washington 98112-2913, USA (Miljacic, Polissar).

出版信息

Can Vet J. 2025 Jul 1;66(7):781-788. eCollection 2025 Jul.

Abstract

BACKGROUND

Collection of medical history is essential for making informed clinical decisions in veterinary medicine. In veterinary dermatology, historical patterns may alter a clinician's diagnostic and therapeutic recommendations. Veterinary patient reporting has similarities to reporting in human pediatric medicine, in which clinician history is collected from caretakers instead of patients themselves. Informant discrepancy between medical histories taken from co-parents has been observed in human pediatric medicine but has not been assessed in veterinary medicine.

OBJECTIVE

The objective of this questionnaire-based, prospective, descriptive study was to investigate informant agreement among caretakers of veterinary dermatology patients.

PARTICIPANTS AND PROCEDURE

A caretaker history questionnaire was designed to assess the primary concern of the caretaker, seasonality and duration of clinical signs, pruritus score, areas of the body affected, dietary history, and medication history. At initial dermatology consultations, caretakers completed the questionnaire in separate rooms, as anonymized pairs. Agreement proportion was analyzed by calculating the proportion of pairs, among all pairs, in which both caretakers agreed.

RESULTS

Fifty-three paired responses (106 caretakers) volunteered for the study. Agreement was highest for histories of gastrointestinal signs (94.1%), skin disease exacerbation by diet (84.3%), and duration of disease (80.4%). Caretakers reported pruritus visual analogue scores within 2 score units of one another for 61.5% of patients. "Individual affected body part" agreement and "individual protein consumed" agreement proportions were 53.5 and 55.7%, respectively. The lowest agreement was seen for seasonality of disease (38.5%) and individual medication use (38.7%).

CONCLUSION AND CLINICAL RELEVANCE

Our findings supported the concept that informant discrepancy exists between caretaker histories reported in veterinary dermatology, suggesting that all caretakers' histories should be taken into consideration.

摘要

背景

病史采集对于兽医做出明智的临床决策至关重要。在兽医皮肤病学中,病史模式可能会改变临床医生的诊断和治疗建议。兽医患者报告与人类儿科学中的报告有相似之处,在人类儿科学中,临床医生从看护人而非患者本人那里收集病史。在人类儿科学中已观察到来自共同看护人的病史之间存在信息提供者差异,但在兽医医学中尚未进行评估。

目的

这项基于问卷的前瞻性描述性研究的目的是调查兽医皮肤病学患者看护人之间的信息提供者一致性。

参与者与程序

设计了一份看护人病史问卷,以评估看护人的主要关注点、临床症状的季节性和持续时间、瘙痒评分、身体受影响部位、饮食史和用药史。在初次皮肤科会诊时,看护人作为匿名配对在单独的房间里完成问卷。通过计算所有配对中两位看护人意见一致的配对比例来分析一致比例。

结果

53对回答(106名看护人)自愿参与了该研究。胃肠道症状病史(94.1%)、饮食导致皮肤病加重(84.3%)和疾病持续时间(80.4%)的一致性最高。61.5%的患者看护人报告的瘙痒视觉模拟评分彼此相差在2分以内。“个体受影响身体部位”的一致性比例和“个体摄入蛋白质”的一致性比例分别为53.5%和55.7%。疾病季节性(38.5%)和个体用药情况(38.7%)的一致性最低。

结论与临床意义

我们的研究结果支持了兽医皮肤病学中报告的看护人病史之间存在信息提供者差异这一概念,表明应考虑所有看护人的病史。

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