Communication

Question 1

What is the HCAB?

Answer 1

The human animal/human companion animal bond
Involves complex emotional responses throughout culture and economies
Independent of utility

Question 2

What is attachment theory?

Answer 2

The dynamics of long term relationships (psychological connectedness) between people
Based on early childhood experience with primary caregiver impacting adult life

Question 3

What are the main characteristics of attachment theory?

Answer 3

Seeking proximity
Distress at separation
Pleasure at reunion
Orientation to the caregiver

Question 4

What are the different attachment styles?

Answer 4

Secure
Anxious
Avoidant

Question 5

What is biophilia?

Answer 5

Love of life or living systems - the innate emotional affiliation of humans with organisms

Question 6

What are the function of pets (relational value)?

Answer 6

Caring and responsibility roles - attachment
Social lubricant - more sociable when have animal around
Companion/friend
Generate feeling of security
Opportunities for play and fun

Question 7

What is loss?

Answer 7

An ending
Or point of change
Or transition

Question 8

What is bereavement?

Answer 8

Loss of a significant other

Question 9

What is grief?

Answer 9

Reaction to loss

Question 10

What are the types of loss?

Answer 10

Primary - loss of animal itself
Secondary - disruptions and stresses associated with loss eg. no more walks, going to vet etc.
Ambiguous - loss that leaves a question in the owners mind
Symbolic - the loss has a specific link to other losses

Question 11

What are the models of grief for?

Answer 11

Are models rather than obligatory process - an attempt to understand it rather than what actually happens

Question 12

What are some symptoms of grief?

Answer 12

Shock (denial)
Protest (anger, bargaining)
Disorganisation (depression)
Reorganisation (acceptance)

Question 13

What determines what behaviours and emotions are felt surrounding loss?

Answer 13

Features of the relationship
Features of death
Personal circumstances

Question 14

What features of a relationship can be determinants of grief?

Answer 14

Strong attachment or perceived social support/ relational value/ need
Ambivalence towards dead individual - not bothered, or guilty about not loving it enough

Question 15

What features of death can be determinants of grief?

Answer 15

Sudden, unexpected
Traumatic or violent
Uncertainty whether death has occured
Potentially unavoidable - anger, guilt
Euthanasia
Accompanies other significant losses

Question 16

What personal circumstances can be determinants of grief?

Answer 16

Age, sex, life stage, health
Financial issues
Other stresses/losses/parallels
Personality
Religious beliefs
Options for future

Question 17

Why is euthanasia important?

Answer 17

It can relieve suffering - is an important part of caring for and loving an animal companion
Shorter lifespans means inevitably going to experience their end of life/loss

Question 18

What grief is shown at first sign of deterioration/diagnosis which is specifically associated with the human animal bond?

Answer 18

Anticipatory grief

Question 19

What type of grief is associated with euthanasia which is specifically associated with the human animal bond as its one of the only times euthanasia occurs?

Answer 19

Responsibility grief

Question 20

What type of grief can occur in veterinary staff?

Answer 20

Responsibility grief - anticipating having to euthanase an animal
Some avoid the topic, some feel apathy, some feel embarrassment for feeling sad

Question 21

What skills do you need when dealing with clients experiencing loss and grieving?

Answer 21

Compassionate communication skills - empathy

Question 22

When is empathy thought to be developed?

Answer 22

At 7-12 years old

Question 23

What is empathy?

Answer 23

Experiencing anothers point of view and conveying that sense of being understood back to the individual

Question 24

What are two parts of empathy developed in childhood?

Answer 24

Emotional contagion - matching emotions
Emotional perspective taking - seeing things from another peoples point of view

Question 25

What are the positives and negatives of being empathetic?

Answer 25

Positive - clinician wellbeing, meaningful work, job satisfaction Negative - decline in empathy over time (burnout)

Question 26

When do experience the greatest strain on emotions?

Answer 26

When negotiating challenging euthanasia decision making consultations The desire to achieve a good death for the animal and their owner

Question 27

What should you consider when communicating about euthanasia?

Answer 27

Preparation and planning Informed consent The euthanasia itself Following the euthanasia

Question 28

What is bad news?

Answer 28

Any information that changes a persons view of the future in a negative way

Question 29

What does SPIKES stand for?

Answer 29

Setting up Perception Invitation Knowledge Emotions with empathy Strategy/summary

Question 30

What is the difference between an estimate and a quotation?

Answer 30

Estimate - estimation of the likely costs of a procedure/product Quotation - represents a fixed price

Question 31

What proportion of dogs are insured in the UK?

Answer 31

70%

Question 32

What proportion of cats are insured in the UK?

Answer 32

40%

Question 33

What is usually not covered by insurance policies?

Answer 33

Pre-existing conditions

Question 34

What insurance policy gives the highest level of cover?

Answer 34

Life time policy

Question 35

What model is useful when dealing with anger? What are they?

Answer 35

The 5 As Acknowledge Allow Affirm Agree Assure

Question 36

What are the two main types of reasoning?

Answer 36

Type 1 - non-analytical, pattern recognition Type 2 - analytical, inductive, deductive, hypothetical reasoning

Question 37

What are the pros and cons of type 1 (non analytical) reasoning?

Answer 37

Fast, requires little effort, frequently gets right answer, prevents cognitive overload But subject to error and bias, high emotional attachment to ability to pattern recognise

Question 38

What are the pros and cons of type two (analytical) reasoning?

Answer 38

Systematic, reliable, rarely wrong, less likely to miss something, resists bias Relies on working memory, slow, high effort

Question 39

What can you use when there is still no diagnosis despite using type 1 and 2 reasoning?

Answer 39

Test of treatment - response to treatment to confirm Test of time - can be used where case not urgent (no red flags)

Question 40

How many cases end in diagnosis?

Answer 40

Less than 50%

Question 41

What decisions about cases are made other than evidence related clinical reasoning?

Answer 41

Resources available Client resources - time, finance Value of patient Ethics Social

Question 42

What two terms relate to the medicine taking behaviour of the patient?

Answer 42

Compliance and concordance

Question 43

What is concordance?

Answer 43

The establishment of a therapeutic alliance between the clinician and the patient

Question 44

What is compliance?

Answer 44

Whether the client is doing what the clinician advises

Question 45

What are some causes of patient non adherence to medication?

Answer 45

Social Ethical Financial Health related Relationship with medical professionals Animal factors COnfusion

Question 46

What is motivational interviewing?

Answer 46

Trying to persuade people by having themselves discover the reasoning rather than be told by others

Question 47

What model is used in motivational interviewing?

Answer 47

Stages of change model The readiness ruler

Question 48

What are the 6 things of the stages of change model?

Answer 48

Pre-contemplation Contemplation Preparation Action Maintenance Relapse (In a circle)