S.C.S. Azevedo; V.C.C. Maia; B.M.C. Guimarães; M.J. Teixeira; M.C. Daltro Rodrigues; J. Telhado
Hospital Veterinário de Pequenos Animais da Universidade Federal Rural do Rio de Janeiro, Seropédica, Brazil
Cancer is one of the most severe illnesses that exist amongst the human race due to a number of aspects. They include psychological issues; the use of synonyms; aggressive surgical procedures that may aesthetically compromise the affected subject; collateral effects resulting from the administration of chemotherapy drugs and family issues may be presented as the most prominent aspects that generate fear and prejudice relative to this sickness (Rowland & Holland 1990, Alves 1993, McDaniel et al. 1994). By the end of 19th century and the beginning of 20th century, cancer was considered to be contagious (Gimenes 1998). Today, despite the development of small animals' Veterinary Oncology, cancer is still responsible for one of the biggest mortality rates of pets (Dobson & Gorman 1993, Morrison 1998, Scott et al. 2001, Withrow & Vail 2007). A great number of people have had traumatic experiences with affected relatives and friends, and those are quite similar when their pets also get sick. According to the qualitative research method, 28 dog owners were interviewed with the diagnosis of malignant neoplastic disorders that represent the work routine of the Oncology Sector of the Small Animals Veterinary Hospital that belongs to the Veterinary Institute of Universidade Federal Rural do Rio de Janeiro. The selection criteria was that the animal had been already subjected to surgery. The qualitative studies consider the adaptation mechanisms, acceptance or refusal to the treatment, stigma, reactions and the roles of professional caretakers and relatives (Turato 2003); on the other hand, an interview allows access to data sometimes unavailable by simple observation of the patient, like feelings, thoughts and intentions (Patton 1990). In Veterinary Medicine it is rare to find qualitative studies that use interviews and questionnaires that bring the owners' perspective regarding their pets' treatments (Yazbek 2005, Martins et al. 2007).
Materials and Methods
This study was approved by the Research Ethics Committee of the Veterinary Institute in the terms of the ordinance no. 04/IV of March 20th, 2007, protocol no. 23083.000847/2008-82. 28 dog owners have been interviewed by phone; their pets have been diagnosed with malignant neoplastic disorders and they represent the work routine of the Oncology Sector of the Small Animals Veterinary Hospital that belongs to the Veterinary Institute of Universidade Federal Rural do Rio de Janeiro. The selection criteria was that the animal had been already subjected to surgery. To be included in this study, the owners were informed about each step of the process, received the Term of Free and Informed Consent according to the Brazilian Ministry of Health Resolution no. 196/96 (that regulates research involving human beings) and have agreed with them. A questionnaire was offered to the owners divided in three sections: social-economic profile, illness perception and surgical treatment. At the day and hour previously scheduled, the questionnaire was applied in a way similar to an interview. To those whose pets have been subjected to surgery, it was asked about their fears after the procedure: if the animals have showed signs of pain; their opinion about their pets' quality of life and if they got upset by their pets' appearance. The contact by telephone was chosen because some owners lived far from the hospital and because some animals were already discharged.
From 28 people interviewed, 18 were female and 10 male. 13 owners were above 51 years old, 11 were from 31 to 50 and 4 varying from 18 to 30 years old. In relation to years of education, seven had elementary grade, 14 had high school and seven were graduates. Regarding the families income, four owners earned about R$1200 a month; 11 earned from R$1600 to R$2500; 10 from R$2900 to 4200 and three earned more than R$ 4600. In this study, all owners affirmed to know that cancer was not contagious. Definitions like "bad disease", "repellent disease", "malignant tumor" and "growth and multiplication of malign cells" were used by 25 people and only three did not know how to define cancer. When asked about the surgical procedure, 12 owners weren't apprehensive, six were concerned about the anesthesia, two were afraid because their ageing animals, four were concerned about these two last issues, three owners were afraid of the possibility that their pets could die during the surgery and one was afraid about a bad result. Regarding the animal's quality of life, 27 owners said that it was improved and just one did not. According to their subjective observation, no animal showed signs of pain and all of them were not upset about their dogs' appearance after the surgery.
Discussion and Conclusions
In this study, a bigger number of women chose the surgical treatment, what may indicate more availability of their time to take their pets to the clinic, particularly oncological consultations, their updates, surgeries and chemotherapy sessions or due to a stronger emotional connection between them and their pets, making them leave their own tasks to follow the treatment. Still about the qualitative research method, data of sex, age, years of education and family income are important for a better evaluation of the people studied regarding their social class and are related to the main objectives of the research; in a similar way, the adhesion to the treatment is related to a trustful relation between owner and the medical professional (Turato 2003). All 28 owners affirmed to know that cancer was not contagious in opposite to the common thought by the end of 19th century (Gimenes, 1998); despite that, questions like "can one catch it?" are still common during oncology consultations specially regarding cases involving ulcerating, exudative and itchy tumours. The use of synonyms for the illness was compatible with the literature (Rowland & Holland 1990, Alves 1993, McDaniel et al. 1994). The fear concerning the anesthesia and the pet's age may be linked to the unsafe methods of anesthesiology largely applied some decades ago and to the lack of value that was given to the pre-operatory exams. The fear of a bad result that was mentioned by one of the owners was related to the explanation given by the surgical team about the possible complications after the surgery, which was a cystotomy for the extraction of a transitional cells carcinoma (TCC). Regarding the animal's quality of live evaluation after the surgery, the only person that noticed no change was the owner of an animal which had hepatoid gland adenocarcinoma. This diagnosis was early and the exeresis was done before any ulceration, serum hemorrhagic exudate and presence of worms shown by some other cases. All interviewed owners have informed that their animals, subjected to diverse surgical procedures, showed no signs of pain. All prescriptions for painkillers were written specific to each animal, type of surgery and under the analgesic ladder suggested by the World Health Organization. It is important to emphasize that all owners who have agreed with surgeries were instructed about how they could evaluate signs of pain in their pets, like observing their ability to move and feed, the diameter of the animals' pupils and the respiratory frequency among others that could be done by layman. All 28 people in the survey informed that they did not feel upset about their dogs' appearance after the surgery, even in some cases considered to be mutilating. The interviewer notion is that the owners' fulfillment regarding the treatments given to their pets is extremely important to veterinarians as a class. Although rare to find, qualitative studies in Veterinary Medicine (Yazbek, 2005; Martins et al., 2007) like interviews allow the interviewer and other interested people access to data sometimes unavailable by mere observation of the patient, like feelings, thoughts and intentions (Patton 1990).
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