title: Difficulties experienced by veterinarians when communicating about emerging zoonotic risks with animal owners: the case of Hendra virus.
abstract: BACKGROUND
  Communication skills are essential for veterinarians who need to discuss animal health related matters with their clients. When dealing with an emerging zoonosis, such as Hendra virus (HeV), veterinarians also have a legal responsibility to inform their clients about the associated risks to human health. Here we report on part of a mixed methods study that examined the preparedness of, and difficulties experienced by, veterinarians communicating about HeV-related risks with their clients.
  
  
  METHODS
  Phase 1 was an exploratory, qualitative study that consisted of a series of face-to-face, semi-structured interviews with veterinary personnel from Queensland, Australia (2009-10) to identify the barriers to HeV management in equine practices. Phase 2a was a quantitative study that surveyed veterinarians from the same region (2011) and explored the veterinarians' preparedness and willingness to communicate about HeV-related risks, and the reactions of their clients that they experienced. The second study included both multiple choice and open-ended questions.
  
  
  RESULTS
  The majority of the participants from Phase 2a (83.1%) declared they had access to a HeV management plan and over half (58.6%) had ready-to-use HeV information available for clients within their practice. Most (87%) reported "always or sometimes" informing clients about HeV-related risks when a horse appeared sick. When HeV was suspected, 58.1% of participants reported their clients were receptive to their safety directives and 24.9% of clients were either initially unreceptive, overwhelmed by fear, or in denial of the associated risks. The thematic analysis of the qualitative data from Phases 1 and 2a uncovered similar themes in relation to HeV-related communication issues experienced by veterinarians: "clients' intent to adhere"; "adherence deemed redundant"; "misunderstanding or denial of risk"; "cost"; "rural culture"; "fear for reputation". The theme of "emotional state of clients" was only identified during Phase 1.
  
  
  CONCLUSIONS
  Warning horse owners about health and safety issues that may affect them when present in a veterinary work environment is a legal requirement for veterinarians. However, emerging zoonoses are unpredictable events that may require a different communication approach. Future training programs addressing veterinary communication skills should take into account the particular issues inherent to managing an emerging zoonosis and emphasise the importance of maintaining human safety. Veterinary communication skills and approaches required when dealing with emerging zoonoses should be further investigated.
authors.affiliation: College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia. Diana.Mendez@jcu.edu.au.
authors.forename: Diana H
authors.initials: DH
authors.lastname: Mendez
authors.affiliation: Centre for Chronic Disease Prevention, James Cook University, Cairns, QLD 4870, Australia.|Tropical Health Solutions Pty Ltd, Townsville, 4811, QLD, Australia.
authors.forename: Petra
authors.initials: P
authors.lastname: Büttner
authors.affiliation: College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia.|Centre for Nursing and Midwifery Research, James Cook University, Townsville, QLD 4811, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Kelly
authors.affiliation: College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Nowak
authors.forename: Rick
authors.initials: R
authors.lastname: Speare Posthumously
mesh_terms: D000328:Adult; D000818:Animals; D021821:Communicable Diseases, Emerging / Q000635:transmission*; D003142:Communication; D005260:Female; D045404:Hendra Virus / Q000502:physiology*; D045464:Henipavirus Infections / Q000453:epidemiology / Q000662:veterinary* / Q000821:virology; D006734:Horse Diseases / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D006736:Horses; D006801:Humans; D008297:Male; D008875:Middle Aged; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors; D018634:Veterinarians; D015047:Zoonoses
keywords: Emerging zoonoses; Health and safety; Hendra virus; Horse owners; Risk communication; Veterinarians