Use of the measure of patient-centered communication to analyze euthanasia discussions in companion animal practice

摘要

Objective-To characterize veterinarian-client communication with undisclosed standardized clients (USCs) during discussions regarding euthanasia of a petDesign-Descriptive studyProcedures-During 2 clinic visits 2 cases (a geriatric dog with worsening arthritis and a cat with inappropriate urination) designed to stimulate discussion regarding euthanasia of a pet were presented by different USCs (individuals trained to consistently present a particular case to veterinarians without disclosing their identity) Discussions were audio recorded and analyzed by use of the measure of patient-centered communication (MPCC [a tool to assess and score physician communication behaviors]) Veterinarian and client statements were classified by means of 3 patient-centered components exploring both the disease and the illness experience understanding the whole person and finding common groundResults-60 usable recorded discussions were obtained (31 veterinarians 30 discussions/case) Overall MPCC scores were significantly lower for the geriatric dog case For both cases veterinarians scored highest on finding common ground and lowest on exploring both the disease and the illness experience Lack of exploration of client feelings ideas and expectations and the effect of the illness on the animal s function resulted in low scores among veterinariansConclusions and Clinical Relevance-Results indicated that the use of USCs and the MPCC are feasible methods for analysis of veterinarian-client communication during companion animal euthanasia discussions Findings suggested that some veterinarians do not fully explore client concerns or facilitate client involvement in euthanasia decision making (J Am Vet Med Assoc 2010 237 1275-1287)