Abstract
Simple SummaryIn Italy, there are approximately 60.5 million companion animals, and 92% of Italian owners consider them as family members. Despite the growing interest in pet bereavement and in end-of-life (EOL) issues in veterinary medicine across the world, there are still very few Italian studies on the psychological impact of losing a pet, and there are no instruments in the Italian language to assess grief, following the death of a companion animal and the impact of effective veterinary communication skills on pet bereavement. The aim of this study is the Italian adaptation of instruments (Pet Bereavement Questionnaire (PBQ); Regret of Bereaved Family Members (RBFM); Shared Decision-Making Questionnaire (SDM-Q-9); Consultation and Relational Empathy Measure (CARE)), which can be useful in assessing bereavement in companion animal owners and communication skills in veterinary medicine. All the instruments obtained good internal reliability. The results showed that the use of the Italian versions of all the instruments is useful, and that the CARE, the SDM-Q-9, and the Regret of Bereaved Family Members (RBFM) developed for the human healthcare context, may also be used in veterinary medicine, and in further Italian pet bereavement and EOL veterinary studies.In Italy, there are still very few studies on the psychological impact of losing a pet. The need to fill this gap springs from the fact that pet loss counseling services are increasingly being activated. The aim of this study is the Italian adaptation of instruments for veterinary counseling services. The survey instruments adapted were: Pet Bereavement Questionnaire (PBQ) to describe the individual experience of pet-grief; Regret of Bereaved Family Members (RBFM) to assess the family regret; Shared Decision-Making Questionnaire (SDM-Q-9) for decision making in end of life; Consultation and Relational Empathy Measure (CARE) to assess the veterinarian relational empathy during clinical encounters. All the instruments obtained good internal reliability, and the results of the confirmative factor analysis of all the Italian versions were in accordance with the original ones. The correlational analysis among the variables evidenced the following aspects: the more the owner feels involved by the veterinarian in the decision making process the more the veterinarian is perceived by the owner as empathetic; when the veterinarian is perceived as empathic and the decision making is shared the owners’ pet bereavement distress and regrets are reduced; negative dimensions of bereavement (grief, guilt, anger, intrusive thoughts and decisional regrets) are strictly linked to each other, therefore if one dimension increases or decreases the others do too. The path analysis suggests that developing a veterinary relationship-centered care practice may be beneficial for pet owners facing end-of-life issues and the death of their companion animals since it showed that shared-decision making strategies and empathic communication may reduce negative dimensions of bereavement that may complicate grief. Interestingly, adopting shared decision-making strategies may contribute to be perceived as more empathic. These aspects may be taken into consideration in end-of -life communication training in veterinary medicine.
Highlights
Grief and mourning counseling is a form of psychological support that aims to help people cope with loss
Confirmatory factor analysis: Most of the items showed a left-skewed distribution, and some item showed a right-skewed distribution
0.61 and 2.35 for eight items of Pet Bereavement Questionnaire (PBQ); between 0.73 and 2.07 for four items of Regret of Bereaved Family Members (RBFM)), further supporting the appropriateness of an analytical approach that takes the ordinal nature of the data into account [43].Confirmatory factor analysis results indicated a good fit of the hypothesized factor structure for Consultation and Relational Empathy Measure (CARE), RBFM, SDM and a lower fit, but always adequate for PBQ (Table 1)
Summary
Grief and mourning counseling is a form of psychological support that aims to help people cope with loss. Pet bereavement is a field in which grief counseling may be very useful This kind of mourning attracts the support of others, but the cultural disenfranchising of this form of suffering may generate negative consequences due to the lack of social support. When this happens, people withdraw from their networks, feeling helpless and experiencing strong regrets or guilt, and grief can remain unresolved, thereby leading to depression [7,8,9]. In these situations, counseling may provide an avenue for healthy resolution, and research in this area has been slowly growing [10,11]
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