181 A detailed analysis of consultations between equine nutritionists and a client

Abstract

Equine nutritionist is a relatively new profession with no formal educational entry pathway in the UK. Equine nutritionists are typically employed by commercial feed companies and offer advice freely or operate independently and charge for advice. The objective of the study was to compare consultations with a standardised client conducted by 3 employed and 3 independent equine nutritionists measuring their ability to empathise with the client, structure consultations and set goals. Nutritionists were invited to participate in a study and to conduct a consultation as normal. The dialog of their consultations was recorded, anonymised, transcribed and evaluated in accordance with the University of Glasgow's ethics policies. The client immediately assessed the nutritionists using a CARE questionniare adapted from medical consultations where it is used to determine clinicians' ability to empathise with patients. All 6 consultations were transcribed and assessd using a Roter Interaction Analysis System (RIAS); a quantitative medical communication coding system used to evaluate primary medical weight management consultations. RIAS divides professional consultations into discrete communication variables that reflect the 4 tasks of the clinical appointment; data gathering, education and counselling, building relationships, activation and partnership. All consultations by independent nutritionists were longer durationthan those by employed nutritionists. The longer the duration, the more relationship building statements were made. There were no significant differences between employed and independent nutritionists for RIAS categories. All nutritionists raised the potential for obesity in ponies and gave advice relating to weight monitoring. The client scored all nutritionists very highly for ‘human’ empathy aspects. Weaker areas for all nutritionists were planning and clarity of actions. Language used by all nutritionists was colloquial and humorous. The results suggest nutritionists raise the issue of obesity with clients which contrasts with reports that vets can find this difficult or lack time to do. Informal, euphemistic language appeared to allow the nutritionists to demonstrate empathy and build a relationship with the client, which independent nutritionists spent more time doing, but risks downplaying the seriousness of the issue in the client's mind. The impact of this on adherance to advice is an area for further research. An opportunity exists for nutritionists to assist horse owners in managing their horses weight by providing a structured approach based on the principles of SMART objectives (Specific, Measurable, Achievable, Realistic, Timed).