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Home / Equine Research Bank / Front Vet Sci / Being Nice Is Not Enough-Exploring Relationship-Centered Vet...
Frontiers in veterinary science2019; 6; 56; doi: 10.3389/fvets.2019.00056

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

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.
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Publication Date: 2019-02-28 PubMed ID: 30873422PubMed Central: PMC6403131DOI: 10.3389/fvets.2019.00056Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research study examines relationship-centered veterinary care in Germany to understand how aspects of this approach influence pet owners’ responses, specifically their need for further information and their inclination to seek alternative healthcare providers. The study revealed that partnership-building and empathic communication reduced pet owners’ need for additional information and consultation with alternative providers.

Research Context and Methodology

  • The research focuses on the philosophy of relationship-centered care in veterinary medicine, which suggests a partnership between pet owners and veterinarians. This approach aims to satisfy pet owners’ needs for participation in the decision-making process pertaining to their pets’ health.
  • The study collected data through a quantitative survey administered to German pet owners. It gathered information about their perception of their veterinarians’ communication during recent appointments. The survey was available online as well as in a paper-based format.
  • Using Structural Equation Modeling (SEM), a statistical technique, and Exploratory Factor Analysis via the software SAS, the responses were then analyzed. SEM was employed to evaluate associations between aspects of relationship-centered care and pet owners’ responses.

Study Sample and Results

  • The sample for the study consisted of 1,270 valid responses. Majority of the participants owned small companion animals, horses, or both.
  • The results showed a significant influence of partnership-centered and empathic communication over pet owners’ needs. These aspects of care reduced the pet owners’ need to seek further information from sources like the internet or alternative health providers.
  • Veterinary practices that addressed pet owners’ concerns, discussed the pros and cons of treatment options, and provided an adequate amount of information had a substantial effect on pet owners’ responses.

Conclusion and Recommendations

  • The research supports the implementation of relationship-centered care in veterinary practice, as it seems to increase pet owners’ satisfaction and loyalty. Especially, strategies focusing on partnership building and empathetic communication showed high efficacy.
  • The researchers recommend that future studies should focus on further refining the proposed model assumptions, which could lead to valuable advancements in the field of quantitative research on relationship-centered care.

Cite This Article

APA
Küper AM, Merle R. (2019). Being Nice Is Not Enough-Exploring Relationship-Centered Veterinary Care With Structural Equation Modeling. A Quantitative Study on German Pet Owners’ Perception. Front Vet Sci, 6, 56. https://doi.org/10.3389/fvets.2019.00056

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 6
Pages: 56
PII: 56

Researcher Affiliations

Küper, Alina M
  • Department of Veterinary Medicine, Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany.
Merle, Roswitha
  • Department of Veterinary Medicine, Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Berlin, Germany.

References

This article includes 89 references
  1. Adams C, Kurtz SM. Skills for Communicating in Veterinary Medicine. Oxford: Otmoor Publishing; (2017). xxi, 310.
  2. Donovan JL. Patient decision making. The missing ingredient in compliance research.. Int J Technol Assess Health Care 1995 Summer;11(3):443-55.
    doi: 10.1017/S0266462300008667pubmed: 7591546google scholar: lookup
  3. Donovan JL, Blake DR. Patient non-compliance: deviance or reasoned decision-making?. Soc Sci Med 1992 Mar;34(5):507-13.
    doi: 10.1016/0277-9536(92)90206-6pubmed: 1604357google scholar: lookup
  4. Kanji N, Coe JB, Adams CL, Shaw JR. Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practice.. J Am Vet Med Assoc 2012 Feb 15;240(4):427-36.
    doi: 10.2460/javma.240.4.427pubmed: 22309015google scholar: lookup
  5. Williams GC, Grow VM, Freedman ZR, Ryan RM, Deci EL. Motivational predictors of weight loss and weight-loss maintenance.. J Pers Soc Psychol 1996 Jan;70(1):115-26.
    doi: 10.1037/0022-3514.70.1.115pubmed: 8558405google scholar: lookup
  6. Abood SK. Increasing adherence in practice: making your clients partners in care.. Vet Clin North Am Small Anim Pract 2007 Jan;37(1):151-64; abstract ix-x.
    doi: 10.1016/j.cvsm.2006.09.011pubmed: 17162118google scholar: lookup
  7. Suchman AL. A new theoretical foundation for relationship-centered care. Complex responsive processes of relating.. J Gen Intern Med 2006 Jan;21 Suppl 1(Suppl 1):S40-4.
    doi: 10.1111/j.1525-1497.2006.00308.xpmc: PMC1484839pubmed: 16405709google scholar: lookup
  8. Borrell-Carrió F, Suchman AL, Epstein RM. The biopsychosocial model 25 years later: principles, practice, and scientific inquiry.. Ann Fam Med 2004 Nov-Dec;2(6):576-82.
    doi: 10.1370/afm.245pmc: PMC1466742pubmed: 15576544google scholar: lookup
  9. Böcken J. Gesundheitsmonitor 2016: Bürgerorientierung im Gesundheitswesen. Gütersloh: Verlag Bertelsmann Stiftung; (2016). 1340 p.
  10. Tresolini CP. The Pew-Fetzer Task Force. Health Professions Education and Relationship-centered Care. San Francisco, CA: Pew Health Professions Commission and the Fetzer Institute; (1994).
  11. Ryan RM, Deci EL. Intrinsic and Extrinsic Motivations: Classic Definitions and New Directions.. Contemp Educ Psychol 2000 Jan;25(1):54-67.
    doi: 10.1006/ceps.1999.1020pubmed: 10620381google scholar: lookup
  12. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being.. Am Psychol 2000 Jan;55(1):68-78.
    doi: 10.1037/0003-066X.55.1.68pubmed: 11392867google scholar: lookup
  13. Shaw JR. Four core communication skills of highly effective practitioners.. Vet Clin North Am Small Anim Pract 2006 Mar;36(2):385-96, vii.
    doi: 10.1016/j.cvsm.2005.10.009pubmed: 16442449google scholar: lookup
  14. Shaw JR, Barley GE, Broadfoot K, Hill AE, Roter DL. Outcomes assessment of on-site communication skills education in a companion animal practice.. J Am Vet Med Assoc 2016 Aug 15;249(4):419-32.
    doi: 10.2460/javma.249.4.419pubmed: 27479287google scholar: lookup
  15. Roter D. The enduring and evolving nature of the patient-physician relationship.. Patient Educ Couns 2000 Jan;39(1):5-15.
    doi: 10.1016/S0738-3991(99)00086-5pubmed: 11013543google scholar: lookup
  16. Roter DL, Hall JA, Kern DE, Barker LR, Cole KA, Roca RP. Improving physicians' interviewing skills and reducing patients' emotional distress. A randomized clinical trial.. Arch Intern Med 1995 Sep 25;155(17):1877-84.
    doi: 10.1001/archinte.1995.00430170071009pubmed: 7677554google scholar: lookup
  17. Kurtz S, Silverman J, Draper J. Teaching and Learning Communication Skills in Medicine. Oxford: Radcliffe; (2006). 369 p.
  18. Adams CL, Frankel RM. It may be a dog's life but the relationship with her owners is also key to her health and well being: communication in veterinary medicine.. Vet Clin North Am Small Anim Pract 2007 Jan;37(1):1-17; abstract vii.
    doi: 10.1016/j.cvsm.2006.10.003pubmed: 17162108google scholar: lookup
  19. Stoewen DL, Coe JB, MacMartin C, Stone EA, Dewey CE. Qualitative study of the information expectations of clients accessing oncology care at a tertiary referral center for dogs with life-limiting cancer.. J Am Vet Med Assoc 2014 Oct 1;245(7):773-83.
    doi: 10.2460/javma.245.7.773pubmed: 25229529google scholar: lookup
  20. Stoewen DL, Coe JB, MacMartin C, Stone EA, E Dewey C. Qualitative study of the communication expectations of clients accessing oncology care at a tertiary referral center for dogs with life-limiting cancer.. J Am Vet Med Assoc 2014 Oct 1;245(7):785-95.
    doi: 10.2460/javma.245.7.785pubmed: 25229530google scholar: lookup
  21. Coe JB, Adams CL, Bonnett BN. A focus group study of veterinarians' and pet owners' perceptions of the monetary aspects of veterinary care.. J Am Vet Med Assoc 2007 Nov 15;231(10):1510-8.
    doi: 10.2460/javma.231.10.1510pubmed: 18020992google scholar: lookup
  22. Coe JB, Adams CL, Bonnett BN. A focus group study of veterinarians' and pet owners' perceptions of veterinarian-client communication in companion animal practice.. J Am Vet Med Assoc 2008 Oct 1;233(7):1072-80.
    doi: 10.2460/javma.233.7.1072pubmed: 18828715google scholar: lookup
  23. Kedrowicz AA. Clients and Veterinarians as Partners in Problem Solving during Cancer Management: Implications for Veterinary Education.. J Vet Med Educ 2015 Winter;42(4):373-81.
    doi: 10.3138/jvme.0315-048Rpubmed: 26421515google scholar: lookup
  24. Roter D, Hall JA. Doctors Talking With Patients/Patients Talking With Doctors: Improving Communication in Medical Visits. Westport, CT: Auburn House; (1992). 203 p.
  25. Dysart LM, Coe JB, Adams CL. Analysis of solicitation of client concerns in companion animal practice.. J Am Vet Med Assoc 2011 Jun 15;238(12):1609-15.
    doi: 10.2460/javma.238.12.1609pubmed: 21671816google scholar: lookup
  26. Bard AM, Main DC, Haase AM, Whay HR, Roe EJ, Reyher KK. The future of veterinary communication: Partnership or persuasion? A qualitative investigation of veterinary communication in the pursuit of client behaviour change.. PLoS One 2017;12(3):e0171380.
    doi: 10.1371/journal.pone.0171380pmc: PMC5336212pubmed: 28257511google scholar: lookup
  27. Shaw JR, Bonnett BN, Adams CL, Roter DL. Veterinarian-client-patient communication patterns used during clinical appointments in companion animal practice.. J Am Vet Med Assoc 2006 Mar 1;228(5):714-21.
    doi: 10.2460/javma.228.5.714pubmed: 16506932google scholar: lookup
  28. Case DB. Survey of expectations among clients of three small animal clinics.. J Am Vet Med Assoc 1988 Feb 15;192(4):498-502.
    pubmed: 3372299
  29. Jagosh J, Donald Boudreau J, Steinert Y, Macdonald ME, Ingram L. The importance of physician listening from the patients' perspective: enhancing diagnosis, healing, and the doctor-patient relationship.. Patient Educ Couns 2011 Dec;85(3):369-74.
    doi: 10.1016/j.pec.2011.01.028pubmed: 21334160google scholar: lookup
  30. Beach MC, Inui T. Relationship-centered care. A constructive reframing.. J Gen Intern Med 2006 Jan;21 Suppl 1(Suppl 1):S3-8.
    doi: 10.1111/j.1525-1497.2006.00302.xpmc: PMC1484841pubmed: 16405707google scholar: lookup
  31. Moumjid N, Gafni A, Brémond A, Carrère MO. Shared decision making in the medical encounter: are we all talking about the same thing?. Med Decis Making 2007 Sep-Oct;27(5):539-46.
    doi: 10.1177/0272989X07306779pubmed: 17873252google scholar: lookup
  32. Street RL Jr, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician-patient communication to health outcomes.. Patient Educ Couns 2009 Mar;74(3):295-301.
    doi: 10.1016/j.pec.2008.11.015pubmed: 19150199google scholar: lookup
  33. Scheibler F, Janssen C, Pfaff H. [Shared decision making: an overview of international research literature].. Soz Praventivmed 2003;48(1):11-23.
    doi: 10.1007/s000380300002pubmed: 12756885google scholar: lookup
  34. Loh A, Simon D, Kriston L, Härter M. Patientenbeteiligung bei medizinischen Entscheidungen: effekte der partizipativen entscheidungsfindung aus systematischen reviews. Deutsches Ärzteblatt (2007) 104:1483–9.
    doi: 10.1055/s-2005-918235google scholar: lookup
  35. Scheibler F, Freise D, Pfaff H. Die einbeziehung von patienten in die behandlung. J Public Health (2004) 12:199–209.
    doi: 10.1007/s10389-004-0034-5google scholar: lookup
  36. Case DB. The Path to High-Quality Care: Practical Tips for Improving Compliance. Lakewood, CO: American Animal Hospital Association; (2003). ix, 84.
  37. Dillard JP, Shen L. On the nature of reactance and its role in persuasive health communication. Commun Monogr (2005) 72:144–68.
    doi: 10.1080/03637750500111815google scholar: lookup
  38. Hatcher L, O'Rourke N. A Step-by-Step Approach to Using SAS for Factor Analysis and Structural Equation Modeling. Cary, NC: SAS Institute; (2014). 420 p.
  39. Scholl I, Kriston L, Härter M. PEF-FB-9 – Fragebogen zur Partizipativen Entscheidungsfndung (revidierte 9-Item-Fassung). Klinische Diagnostik und Evaluation (2011) 4:46–9.
    doi: 10.1016/j.pec.2009.09.034google scholar: lookup
  40. Silverman J. Skills for Communicating with Patients, 3rd ed. Boca Raton, FL: CRC Press; (2016). 1317 p.
  41. Lenzner T, Neuert C, Otto W. Kognitives Pretesting. SDM-Survey Guidelines (GESIS Leibniz Institute for the Social Sciences: ).
  42. Porst R. Im Vorfeld der Befragung: Planung, Fragebogenentwicklung, Pretesting. Mannheim: ZUMA; (1998).
  43. Cattell RB. Extracting the Correct Number of Factors in Factor Analysis. (2016) Available online at: http://journals.sagepub.com/doi/10.1177/001316445801800412#articleCitationDownloadContainer (Accessed July 23, 2018).
    doi: 10.1177/001316445801800412#articleCitationDownloadContainergoogle scholar: lookup
  44. Nunnally JC. Psychometric Theory. New York, NY: McGraw-Hill; (1978). 701 p.
  45. Bentler PM. EQS 6 Structural Equations Program Manual. Encino, CA: Multivariate Software, Inc; (1989).
  46. Hox JJ, Bechger TM. An introduction to structural equation modeling. Fam Sci Rev (1998) 11:354–73.
  47. Bentler PM. Comparative fit indexes in structural models.. Psychol Bull 1990 Mar;107(2):238-46.
    doi: 10.1037/0033-2909.107.2.238pubmed: 2320703google scholar: lookup
  48. Fornell C, Larcker DF. Evaluating structural equation models with unobservable variables and measurement error. J Market Res (1981) 18:39–50.
    doi: 10.1177/002224378101800104google scholar: lookup
  49. Chaitchik S, Kreitler S, Shaked S, Schwartz I, Rosin R. Doctor-patient communication in a cancer ward.. J Cancer Educ 1992;7(1):41-54.
    doi: 10.1080/08858199209528141pubmed: 1571245google scholar: lookup
  50. Schaeffer D, Berens EM, Vogt D. Health Literacy in the German Population.. Dtsch Arztebl Int 2017 Jan 27;114(4):53-60.
    doi: 10.3238/arztebl.2017.0053pmc: PMC5319379pubmed: 28211318google scholar: lookup
  51. Murphy SA. Consumer health information for pet owners.. J Med Libr Assoc 2006 Apr;94(2):151-8.
    pmc: PMC1435850pubmed: 16636707
  52. Walsh F. Human-animal bonds II: the role of pets in family systems and family therapy.. Fam Process 2009 Dec;48(4):481-99.
    doi: 10.1111/j.1545-5300.2009.01297.xpubmed: 19930434google scholar: lookup
  53. Podberscek A, Paul ES, Serpell J. Companion Animals and us: Exploring the Relationships Between People and Pets. Cambridge: Cambridge University Press; (2001). 335 p.
  54. Dwyer F, Bennett PC, Coleman GJ. Development of the monash dog owner relationship scale (MDORS). Anthrozoös (2006) 19:243–56.
    doi: 10.2752/089279306785415592google scholar: lookup
  55. Adams CL, Kurtz SM. Building on existing models from human medical education to develop a communication curriculum in veterinary medicine.. J Vet Med Educ 2006 Spring;33(1):28-37.
    doi: 10.3138/jvme.33.1.28pubmed: 16767635google scholar: lookup
  56. Bartram DJ, Yadegarfar G, Baldwin DS. Psychosocial working conditions and work-related stressors among UK veterinary surgeons.. Occup Med (Lond) 2009 Aug;59(5):334-41.
    doi: 10.1093/occmed/kqp072pubmed: 19482885google scholar: lookup
  57. Kersebohm JC, Doherr MG, Becher AM. Lange Arbeitszeiten, geringes Einkummen und Unzufriedenheit: Gegenüberstellung der Situation praktizierender Tiermediziner mit vergleichbaren Berufsgruppen der deutschen Bevölkerung. Berliner und Münchener Tierärztliche Wochenschrift (2017).
    doi: 10.2376/0005-9366-16093google scholar: lookup
  58. Bartram DJ, Baldwin DS. Veterinary surgeons and suicide: a structured review of possible influences on increased risk.. Vet Rec 2010 Mar 27;166(13):388-97.
    doi: 10.1136/vr.b4794pubmed: 20348468google scholar: lookup
  59. Bartram DJ, Sinclair JM, Baldwin DS. Interventions with potential to improve the mental health and wellbeing of UK veterinary surgeons.. Vet Rec 2010 Apr 24;166(17):518-23.
    doi: 10.1136/vr.b4796pubmed: 20418512google scholar: lookup
  60. Dawson BF, Thompson NJ. The Effect of Personality on Occupational Stress in Veterinary Surgeons.. J Vet Med Educ 2017 Spring;44(1):72-83.
    doi: 10.3138/jvme.0116-020Rpubmed: 28206844google scholar: lookup
  61. Hansez I, Schins F, Rollin F. Occupational stress, work-home interference and burnout among Belgian veterinary practitioners.. Ir Vet J 2008 Apr 1;61(4):233-41.
    doi: 10.1186/2046-0481-61-4-233pmc: PMC3113869pubmed: 21851711google scholar: lookup
  62. Gittell JH, Logan C, Cronenwett J, Foster TC, Freeman R, Godfrey M, Vidal DC. Impact of relational coordination on staff and patient outcomes in outpatient surgical clinics.. Health Care Manage Rev 2020 Jan Mar;45(1):12-20.
    doi: 10.1097/HMR.0000000000000192pubmed: 29303904google scholar: lookup
  63. Shaw JR, Adams CL, Bonnett BN, Larson S, Roter DL. Veterinarian satisfaction with companion animal visits.. J Am Vet Med Assoc 2012 Apr 1;240(7):832-41.
    doi: 10.2460/javma.240.7.832pubmed: 22443436google scholar: lookup
  64. Böcken J, Braun B, Meierjürgen R. Gesundheitsmonitor 2014: Bürgerorientierung im Gesundheitswesen. Gütersloh: Verlag Bertelsmann Stiftung; (2014). 267 p.
  65. Sänger S. Evidenzbasierte patientenentscheidung - wirklichkeit oder wunsch?. Z Allg Med (2005) 81:528–36.
    doi: 10.1055/s-2005-918155google scholar: lookup
  66. SZASZ TS, KNOFF WF, HOLLENDER MH. The doctor-patient relationship and its historical context.. Am J Psychiatry 1958 Dec;115(6):522-8.
    doi: 10.1176/ajp.115.6.522pubmed: 13595126google scholar: lookup
  67. Boudreau JD, Jagosh J, Slee R, Macdonald ME, Steinert Y. Patients' perspectives on physicians' roles: implications for curricular reform.. Acad Med 2008 Aug;83(8):744-53.
    doi: 10.1097/ACM.0b013e31817eb4c0pubmed: 18667888google scholar: lookup
  68. Krasner MS, Epstein RM, Beckman H, Suchman AL, Chapman B, Mooney CJ, Quill TE. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians.. JAMA 2009 Sep 23;302(12):1284-93.
    doi: 10.1001/jama.2009.1384pubmed: 19773563google scholar: lookup
  69. Preisendörfer P. Vertrauen als soziologische Kategorie. Zeitschrift für Soziol (1995) 24:623.
    doi: 10.1515/zfsoz-1995-0402google scholar: lookup
  70. Jeffrey D. Empathy, sympathy and compassion in healthcare: Is there a problem? Is there a difference? Does it matter?. J R Soc Med 2016 Dec;109(12):446-452.
    doi: 10.1177/0141076816680120pmc: PMC5154411pubmed: 27923897google scholar: lookup
  71. Coplan A, Goldie P. EmpathyPhilosophical and Psychological Perspectives. Oxford: University Press; (2011).
  72. Schofield PE, Butow PN, Thompson JF, Tattersall MH, Beeney LJ, Dunn SM. Psychological responses of patients receiving a diagnosis of cancer.. Ann Oncol 2003 Jan;14(1):48-56.
    doi: 10.1093/annonc/mdg010pubmed: 12488292google scholar: lookup
  73. Stacey D, Légaré F, Lewis K, Barry MJ, Bennett CL, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L. Decision aids for people facing health treatment or screening decisions.. Cochrane Database Syst Rev 2017 Apr 12;4(4):CD001431.
    doi: 10.1002/14651858.CD001431.pub5pmc: PMC6478132pubmed: 28402085google scholar: lookup
  74. Kogan LR, Schoenfeld-Tacher R, Viera AR. The Internet and health information: differences in pet owners based on age, gender, and education.. J Med Libr Assoc 2012 Jul;100(3):197-204.
    doi: 10.3163/1536-5050.100.3.010pmc: PMC3411254pubmed: 22879809google scholar: lookup
  75. Jehn CT, Perzak DE, Cook JL, Johnston SA, Todhunter RJ, Budsberg SC. Usefulness, completeness, and accuracy of Web sites providing information on osteoarthritis in dogs.. J Am Vet Med Assoc 2003 Nov 1;223(9):1272-5.
    doi: 10.2460/javma.2003.223.1272pubmed: 14621213google scholar: lookup
  76. Bates BR, Romina S, Ahmed R, Hopson D. The effect of source credibility on consumers' perceptions of the quality of health information on the Internet.. Med Inform Internet Med 2006 Mar;31(1):45-52.
    doi: 10.1080/14639230600552601pubmed: 16754366google scholar: lookup
  77. Brown BR. The Dimensions of Pet-Owner Loyalty and the Relationship with Communication, Trust, Commitment and Perceived Value.. Vet Sci 2018 Nov 6;5(4).
    doi: 10.3390/vetsci5040095pmc: PMC6313907pubmed: 30404210google scholar: lookup
  78. Lekander M, Fürst CJ, Rotstein S, Blomgren H, Fredrikson M. Social support and immune status during and after chemotherapy for breast cancer.. Acta Oncol 1996;35(1):31-7.
    doi: 10.3109/02841869609098476pubmed: 8619937google scholar: lookup
  79. Kuhltau CC. A principle of uncertainty for information seeking. J Document (1993) 49:339–55.
    doi: 10.1108/eb026918google scholar: lookup
  80. Watson GF, Beck JT, Henderson CM, Palmatier RW. Building, measuring, and profiting from customer loyalty. J Acad Mark Sci (2015) 43:790–825.
    doi: 10.1007/s11747-015-0439-4google scholar: lookup
  81. Pine BJ, Gilmore JH. The Experience Economy. Boston, MA: Harvard Business Review Press; (2011). 359 p.
  82. Verband Deutscher Tierheilpraktiker. Statistics of Members, German National Association of Complementary Animal Practitioners. (2018) Available from: https://www.tierheilpraktiker.de/mitgliederbereich/mitglieder-map.html (Accessed July 8, 2018).
  83. Hall JA, Roter DL, Katz NR. Meta-analysis of correlates of provider behavior in medical encounters.. Med Care 1988 Jul;26(7):657-75.
    doi: 10.1097/00005650-198807000-00002pubmed: 3292851google scholar: lookup
  84. Beattie M, Murphy DJ, Atherton I, Lauder W. Instruments to measure patient experience of healthcare quality in hospitals: a systematic review.. Syst Rev 2015 Jul 23;4:97.
    doi: 10.1186/s13643-015-0089-0pmc: PMC4511995pubmed: 26202326google scholar: lookup
  85. Al-Abri R, Al-Balushi A. Patient satisfaction survey as a tool towards quality improvement.. Oman Med J 2014 Jan;29(1):3-7.
    doi: 10.5001/omj.2014.02pmc: PMC3910415pubmed: 24501659google scholar: lookup
  86. Hartzband P, Groopman J. The new language of medicine.. N Engl J Med 2011 Oct 13;365(15):1372-3.
    doi: 10.1056/NEJMp1107278pubmed: 21995384google scholar: lookup
  87. Krones T, Richter G. [Physicians' responsibility: doctor-patient relationship].. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2008 Aug;51(8):818-26.
    doi: 10.1007/s00103-008-0601-ypubmed: 18787858google scholar: lookup
  88. Dark Horse Innovation, Murmann Publishers GmbH. Digital Innovation Playbook: Das Unverzichtbare Arbeitsbuch für Gründer, Macher, Manager Taktiken Strategien Spielzüge. Hamburg: Murmann Publishers; (2017). 311 p.
  89. Gigerenzer G, Gray JA. Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020. Cambridge, MA: MIT Press; (2011). 391 p.
    doi: 10.7551/mitpress/9780262016032.001.0001google scholar: lookup

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    doi: 10.3390/ani12131728pubmed: 35804627google scholar: lookup
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    doi: 10.3389/fvets.2021.745345pubmed: 34957275google scholar: lookup
  3. Morris A, Wu H, Morales C. Barriers to Care in Veterinary Services: Lessons Learned From Low-Income Pet Guardians' Experiences at Private Clinics and Hospitals During COVID-19.. Front Vet Sci 2021;8:764753.
    doi: 10.3389/fvets.2021.764753pubmed: 34746292google scholar: lookup
  4. Merle R, Küper AM. Attitude of Veterinarians Toward Self-Informed Animal Owners Affects Shared Decision Making.. Front Vet Sci 2021;8:692452.
    doi: 10.3389/fvets.2021.692452pubmed: 34746272google scholar: lookup
  5. Kogan LR, Accornero VH, Gelb E, Slater MR. Community Veterinary Medicine Programs: Pet Owners' Perceptions and Experiences.. Front Vet Sci 2021;8:678595.
    doi: 10.3389/fvets.2021.678595pubmed: 34169110google scholar: lookup
  6. Küeper AM, Merle R. Partners in Sickness and in Health? Relationship-Centered Veterinary Care and Self-Educated Pet Owners in Germany: A Structural Equation Model.. Front Vet Sci 2020;7:605631.
    doi: 10.3389/fvets.2020.605631pubmed: 33585596google scholar: lookup
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