Clients' Service Expectations and Practitioners' Treatment Recommendations in Veterinary Oncology

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Clients' Service Expectations and Practitioners' Treatment Recommendations in Veterinary Oncology

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dc.contributor.advisor Coe, Jason
dc.contributor.advisor Dewey, Cate
dc.contributor.author Stoewen, Debbie Lynn
dc.date 2012-04-11
dc.date.accessioned 2012-05-18T19:06:00Z
dc.date.available 2012-05-18T19:06:00Z
dc.date.issued 2012-05-18
dc.identifier.uri http://hdl.handle.net/10214/3671
dc.description.abstract Service provision in veterinary oncology in Ontario was examined using a mixed methods approach. First, an interview-based qualitative study explored the service expectations of oncology clients at a tertiary referral centre. Next, a survey-based quantitative study established an understanding of oncology service in primary care practice and investigated the treatment recommendations of practitioners for dogs diagnosed with cancer. The first study, which involved 30 individual and dyadic interviews, identified “uncertainty” (attributable to the unpredictable nature of cancer and its treatment) as an overarching psychological feature of clients’ experience. Consequently, “the communication of information” (both content and process) was the foremost service expectation. For clients, it enabled confidence in the service, the ability to make informed patient care decisions, and preparedness for the potential outcomes of those decisions; it also contributed to creating a humanistic environment, which enhanced client resiliency. Findings suggest that services can support client efforts to manage uncertainty through strategic design and delivery of service, and incorporate intentional communication strategies to support clients’ psychological fortitude in managing the cancer journey. The second study, a vignette-based survey of primary care practitioners across Ontario (N=1071) which investigated veterinarian decision-making in relation to oncology care, determined that 56% of practitioners recommended referral as their first choice of intervention, while 28% recommended palliative care, 13% in-clinic treatment, and 3% euthanasia. Recommendations were associated with patient, client and veterinarian factors. Specifically, referral and treatment were recommended for younger dogs, healthier dogs, and dogs with lymphoma versus osteosarcoma; for strongly bonded clients, and financially secure clients; and by veterinarians who graduated from a North American college, had experience with treating cancer, felt confident in the referral centre, and believed treatment was worthwhile, with variation in relation to practitioner gender and the type of medicine practiced. The human-animal bond appeared to be the primary factor associated with practitioners’ advocacy for quality of medical care for patients. Through a blend of qualitative and quantitative methodologies, this thesis contributes to the evidence upon which best practices may be built so as to enhance the quality of patient and client care in veterinary oncology. en_US
dc.description.sponsorship Ontario Veterinary College Pet Trust Fund 049406 and 049854 en_US
dc.language.iso en en_US
dc.subject client expectations en_US
dc.subject treatment recommendations en_US
dc.subject veterinary oncology en_US
dc.subject practitioner en_US
dc.subject service expectations en_US
dc.subject qualitative research en_US
dc.subject quantitative research en_US
dc.subject thematic analysis en_US
dc.subject vignette-based en_US
dc.subject vignette-based inquiry en_US
dc.subject full factorial experiment en_US
dc.subject vignette-based research en_US
dc.subject specialty oncology service en_US
dc.subject primary care practice en_US
dc.subject veterinary client en_US
dc.subject logistic regression analysis en_US
dc.subject uncertainty en_US
dc.subject client uncertainty en_US
dc.subject interview en_US
dc.subject cancer en_US
dc.subject cancer care en_US
dc.subject canine cancer en_US
dc.subject lymphoma en_US
dc.subject osteosarcoma en_US
dc.subject veterinary communication en_US
dc.subject communication en_US
dc.subject communication skills en_US
dc.subject information en_US
dc.subject content and process en_US
dc.subject veterinary cancer care en_US
dc.subject Ontario en_US
dc.subject survey en_US
dc.subject questionnaire en_US
dc.subject referral en_US
dc.subject euthanasia en_US
dc.subject in-clinic treatment en_US
dc.subject palliative care en_US
dc.subject quality of care en_US
dc.subject quality of medical care en_US
dc.subject illness uncertainty en_US
dc.subject service provision en_US
dc.subject oncology en_US
dc.subject epidemiology en_US
dc.subject tertiary referral centre en_US
dc.subject social epidemilogy en_US
dc.subject veterinary epidemiology en_US
dc.subject client well-being en_US
dc.subject human-animal bond en_US
dc.subject practitioner attitude en_US
dc.subject best practice en_US
dc.subject information preferences en_US
dc.subject preparatory information en_US
dc.subject cancer journey en_US
dc.subject communication process en_US
dc.subject continuity of care en_US
dc.subject clinical decision making en_US
dc.subject decision making en_US
dc.subject practice variation en_US
dc.subject adaptation en_US
dc.title Clients' Service Expectations and Practitioners' Treatment Recommendations in Veterinary Oncology en_US
dc.type Thesis en_US
dc.degree.programme Population Medicine en_US
dc.degree.name Doctor of Philosophy en_US
dc.degree.department Population Medicine en_US


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