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Development and Application of the Lincoln Adherence Instrument Record for Assessing Client Adherence to Advice in Dog Behavior Consultations and Success.

ABSTRACT: Adherence to the advice of medical practitioners is critical to successful treatment outcomes and has been much researched in human health, but is less well studied in the veterinary and clinical animal behavior fields. Given that the management of behavior problems often requires substantial change in established client behavior, it is likely that adherence is a substantive issue affecting success. However, little is known about the relationships between relevant factors, and there is no established way of assessing these. Therefore, the aim of this study was to develop an instrument for coding factors likely to impinge on pet owner adherence to behavior advice and validate its utility through the identification of the factors appearing to relate most closely to a successful treatment outcome in a sample population from our clinic. Potential factors affecting adherence were identified from human health and animal behavior studies, and a survey instrument developed with items matched to these factors. Forty-two dog owners who had attended the University of Lincoln Animal Behavior Clinic over a 2-year period provided data used in the analysis. The assessment of treatment outcome success by clients and clinicians was correlated, but clinicians tended to overestimate success by half a point on a 5-point scale. Eleven items relating to adherence were found to correlate with client ratings of treatment success in a univariate analysis, with three of these remaining in an ordinal logistic regression model. These three related to trust in the advice given by the clinician, concern over distress caused to the pet in the longer term and the perceived recommendation of treatment measures that had failed. By further examining the relationship between all of these factors in a hierarchical cluster analysis, we were able to postulate ways in which we might be able to improve client adherence and thus treatment success. This provides a model for the application of the instrument in any veterinary behavior practice wishing to use client feedback to rationalize areas of the consultation which might be improved.

SUBMITTER: Lamb L

PROVIDER: S-EPMC5845580 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Development and Application of the Lincoln Adherence Instrument Record for Assessing Client Adherence to Advice in Dog Behavior Consultations and Success.

Lamb Lisanna L Affenzeller Nadja N Hewison Lynn L McPeake Kevin James KJ Zulch Helen H Mills Daniel S DS

Frontiers in veterinary science 20180306

Adherence to the advice of medical practitioners is critical to successful treatment outcomes and has been much researched in human health, but is less well studied in the veterinary and clinical animal behavior fields. Given that the management of behavior problems often requires substantial change in established client behavior, it is likely that adherence is a substantive issue affecting success. However, little is known about the relationships between relevant factors, and there is no establ ...[more]

PMID: 29560356

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Project description:There has been little investment in exploring the impact of the child-dog relationship on the dog. Since child-dog interactions can pose potentially serious threats to a dog's physical and psychological health, as well as the wider satisfaction of the owner with their dog, we describe the development and validation of an owner-completed pet dog quality of life scale (Lincoln P-QOL), to enable professionals and families to monitor dog well-being and employ suitable interventions as required. Four-hundred and two dog-owners (194 lived with a neuro-typically developing child; 208 lived with a child with a neuro-developmental disorder) responded to an online survey. Respondents recorded whether they had observed their dog displaying any of the 22 behavioral responses which have been identified as being common in 11 child-dog interactions. These behavioral responses appeared to group into three categories of behaviors (i.e., behavioral constructs), representing Excitability, Calmness, and Fearfulness in the dog. To assess convergent validity of the quality of life scale respondents completed additional measures including, dog body condition score, health issues (incorporating psychological factors such as anxiety and physical proxies of well-being, such as skin irritations) and dog-owner relationship satisfaction. Excitability and Fearfulness constructs were associated with a negative impact on dog health and the owner-dog relationship. Calmness was associated with a positive impact on the dog-owner relationship. A range of interactions, including carefully expressed child-dog physical affection and spending quiet time together appear to had a beneficial impact on dog quality of life, whereas rough contact, child meltdowns, and grooming/bathing had a negative effect. We found little evidence to support a difference in the overall quality of life of dogs living with neuro-typically developing children compared to those with a neuro-developmental disorder. However, parents and practitioners need to be aware of the potential increased risk to dog well-being when meltdowns, grooming/bathing, and quiet time involve a child with a neuro-developmental disorder. This is the first validated scale for the assessment of dog well-being around children, additionally, the behavioral constructs identified may form the rational basis of a more general dog behavior/stress assessment tool in social situations.

Project description:BackgroundDespite several years of guidance on infant feeding, there has been only a slight change in consumer compliance. Therefore, this study aimed to analyse parents feeding practices, explore physicians' advice about infant feeding and subsequent parent's adherence to advice.MethodsA multicentric cross-sectional qualitative and descriptive self-report online study was conducted in volunteers to participate in the study.ResultsFifty-four physicians (paediatricians and general practitioners) and 600 parents of infants were recruited. Of the infants, 20.2% presented at inclusion with at least one type of functional gastrointestinal disorder. The breastfeeding prevalence was quite low (37.3%). The main initial deviance from guidelines said they observed in infant feeding was the early use of cow's milk. More than two-thirds of infants older than 8 months were drinking cow's milk. The introduction of solid foods was globally in line with recommendations. Most physicians gave advice about the different aspects of infant feeding but were seeking more information, as did the parents. A discrepancy between the physicians' statements and the parents' perceptions was observed. However the majority (95.4%) of parents reported that they followed totally or partially the advice received, especially by abandoning subsequently the use of cow's milk in favour of a formula. The main reason for not adhering to the advice was that they did not consider it suitable for their infant and they preferred to rely on their feelings or recommendations from familiars.ConclusionsThis survey provides good insights into parents' infant feeding practices together with the advice given by their doctor. The gap between practices and current guidelines is notable only for breast-feeding and use of formula. Despite several guidelines professionals and parents seek nutrition information. It highlights the need to deliver consistent, relevant, and less confusing messages about infant feeding.

Project description:To date, several medication adherence instruments have been developed and validated worldwide. However, most instruments have only assessed medication adherence from the patient's perspective. The aim was to develop and validate the PATIENT-Medication Adherence Instrument (P-MAI) and the HEALTHCARE PROFESSIONAL-Medication Adherence Instrument (H-MAI) to assess medication adherence from the patient's and healthcare professional (HCP)'s perspectives. The P-MAI-12 and H-MAI-12 were developed using the nominal group technique. The face and content validity was determined by an expert panel and piloted. The initial version of these instruments consisted of 12 items were validated from October-December 2018 at a primary care clinic in Malaysia. Included were patients aged ≥21 years, diagnosed with diabetes mellitus, taking at least one oral hypoglycaemic agent and who could understand English. The HCPs recruited were family medicine specialists or trainees. To assess validity, exploratory factor analysis (EFA) and concurrent validity were performed; internal consistency and test-retest were performed to assess its reliability. A total of 120/158 patients (response rate = 75.9%) and 30/33 HCPs (response rate = 90.9%) agreed to participate. EFA found three problematic items in both instruments, which was then removed. The final version of the P-MAI-9 and the HMAI-9 had 9 items each with two domains (adherence = 2 items and knowledge/belief = 7 items). For concurrent validity, the total score of the P-MAI-9 and the H-MAI-9 were not significantly different (p = 0.091), indicating that medication adherence assessed from both the patient's and HCP's perspectives were similar. Both instruments achieved acceptable internal consistency (Cronbach's α: P-MAI-9 = 0.722; H-MAI-9 = 0.895). For the P-MAI-9, 7/9 items showed no significant difference between test and retest whereas 8/9 items in the H-MAI-9 showed significant difference at test and retest (p>0.05). In conclusion, the P-MAI-9 and H-MAI-9 had low sensitivity and high specificity suggesting that both instruments can be used for identifying patients more likely to be non-adherent to their medications.

Dataset Information

Development and Application of the Lincoln Adherence Instrument Record for Assessing Client Adherence to Advice in Dog Behavior Consultations and Success.

Publications

Development and Application of the Lincoln Adherence Instrument Record for Assessing Client Adherence to Advice in Dog Behavior Consultations and Success.

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