{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:38:11Z","timestamp":1792787891958,"version":"4.5.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T00:00:00Z","timestamp":1629676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"KIAS-CIH Alberta Humanities Research Grant"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Companion animal death is a common source of grief, although the extent and context of that grief is poorly understood, especially in older adulthood. The aim of this multiple-methods study was to develop a greater understanding of the impact of companion animal death on older women living alone in the community, as older women are a distinct at-risk group, and the supports that should be available to help these individuals with their grief.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were recruited from across Alberta, a Canadian province, through seniors\u2019 organizations, pet rescue groups, and social media groups of interest to older women. After completing a pre-interview online questionnaire to gain demographic information and standardized pet attachment and grief measures data, participants were interviewed through the Zoom \u00ae computer program or over the telephone. An interpretive description methodology framed the interviews, with Braun and Clarke\u2019s 6-phase analytic method used for thematic analysis of interview data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2020, twelve participants completed the pre-interview questionnaires and nine went on to provide interview data for analysis. All were older adult (age 55+) women, living alone in the community, who had experienced the death of a companion animal in 2019. On the standardized measures, participants scored highly on attachment and loss, but low on guilt and anger. The interview data revealed three themes: catastrophic grief and multiple major losses over the death of their companion animal, immediate steps taken for recovery, and longer-term grief and loss recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings highlight the importance of acknowledging and addressing companion animal grief to ensure the ongoing well-being and thus the sustained successful aging-in-place of older adult women in the community.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12877-021-02410-8","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T10:05:14Z","timestamp":1629713114000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Older women\u2019s experiences of companion animal death: impacts on well-being and aging-in-place"],"prefix":"10.1186","volume":"21","author":[{"given":"Donna M","family":"Wilson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Underwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloise","family":"Carr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas P","family":"Gross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Kane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxi","family":"Miciak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean E","family":"Wallace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cary A","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,23]]},"reference":[{"issue":"1\u20132","key":"2410_CR1","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.jad.2011.02.021","volume":"132","author":"RS Newson","year":"2011","unstructured":"Newson RS, Boelen PA, Hek K, Hofman A, Tiemeier H. The prevalence and characteristics of complicated grief in older adults. J Affect Disord. 2011;132(1\u20132):231\u2013238. doi:https:\/\/doi.org\/10.1016\/j.jad.2011.02.021.","journal-title":"J Affect Disord"},{"issue":"2","key":"2410_CR2","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1080\/08927936.2019.1569907","volume":"3","author":"M Enders-Slegers","year":"2019","unstructured":"Enders-Slegers M, Hediger K. Pet ownership and human\u2013animal interaction in an aging population: rewards and challenges. Anthrozo\u00f6s. 2019;3(2):255\u2013265. doi:https:\/\/doi.org\/10.1080\/08927936.2019.1569907.","journal-title":"Anthrozo\u00f6s"},{"key":"2410_CR3","doi-asserted-by":"publisher","first-page":"218","DOI":"10.3389\/fmed.2019.00218","volume":"6","author":"S Carmel","year":"2019","unstructured":"Carmel S. Health and well-being in late life: gender differences worldwide. Front Med. 2019;6:218. doi:https:\/\/doi.org\/10.3389\/fmed.2019.00218.","journal-title":"Front Med"},{"issue":"5","key":"2410_CR4","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1080\/13694670500212208","volume":"9","author":"K Brown","year":"2006","unstructured":"Brown K. Pastoral concern in relation to the psychological stress caused by the death of an animal companion. Ment Health Relig Cult. 2006;9(5):411\u2013422. doi:https:\/\/doi.org\/10.1080\/13694670500212208.","journal-title":"Ment Health Relig Cult"},{"issue":"4","key":"2410_CR5","doi-asserted-by":"publisher","first-page":"283","DOI":"10.17744\/mehc.34.4.41q0248450t98072","volume":"34","author":"M Cordaro","year":"2012","unstructured":"Cordaro M. Pet loss and disenfranchised grief: implications for mental health counseling practice. J Ment Health Couns. 2012;34(4):283\u2013294. doi:https:\/\/doi.org\/10.17744\/mehc.34.4.41q0248450t98072.","journal-title":"J Ment Health Couns"},{"issue":"2","key":"2410_CR6","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1086\/491750","volume":"31","author":"J Donovan","year":"2006","unstructured":"Donovan J. Feminism and the treatment of animals: from care to dialogue. Signs: J Women Culture & Society. 2006;31(2):305\u2013329. doi:https:\/\/doi.org\/10.1086\/491750.","journal-title":"Signs: J Women Culture & Society"},{"issue":"1","key":"2410_CR7","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1080\/08927936.2017.1270598","volume":"30","author":"JAL Adrian","year":"2017","unstructured":"Adrian JAL, Stitt A. Pet loss, complicated grief, and post-traumatic stress disorder in Hawaii. Anthrozo\u00f6s. 2017;30(1):123\u2013133. doi:https:\/\/doi.org\/10.1080\/08927936.2017.1270598","journal-title":"Anthrozo\u00f6s"},{"key":"2410_CR8","first-page":"225","volume-title":"Death of a companion animal: understanding human responses to bereavement. The Psychology of the Human-Animal Bond","author":"HL Davis","year":"2011","unstructured":"Davis HL. Death of a companion animal: understanding human responses to bereavement. The Psychology of the Human-Animal Bond. New York: Springer; 2011. p. 225\u201342."},{"issue":"4","key":"2410_CR9","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1080\/08927936.2016.1228772","volume":"29","author":"HR Kemp","year":"2016","unstructured":"Kemp HR, Jacobs N, Stewart S. The lived experience of companion-animal loss: a systematic review of qualitative studies. Anthrozo\u00f6s. 2016;29(4):533\u2013557. doi:https:\/\/doi.org\/10.1080\/08927936.2016.1228772.","journal-title":"Anthrozo\u00f6s"},{"key":"2410_CR10","doi-asserted-by":"crossref","unstructured":"Kogan L, Erdman P. Pet loss, grief, and therapeutic Interventions: practitioners navigating the human-animal bond. New York: Routledge; 2020.","DOI":"10.4324\/9780429505201"},{"issue":"1","key":"2410_CR11","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1163\/15685306-12341586","volume":"27","author":"K McKinney","year":"2019","unstructured":"McKinney K. Emotion work of coping with the death of a companion animal. Soc Anim. 2019;27(1):109\u2013125. doi:https:\/\/doi.org\/10.1163\/15685306-12341586.","journal-title":"Soc Anim"},{"key":"2410_CR12","doi-asserted-by":"publisher","unstructured":"Cowling DM, Isenstein SGE, Schneider MS. When the bond breaks: variables associated with grief following companion animal loss. Anthrozo\u00f6s. 2020;33(6):693\u2013708. https:\/\/doi.org\/10.1080\/08927936.2020.1824651.","DOI":"10.1080\/08927936.2020.1824651"},{"issue":"4","key":"2410_CR13","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1080\/08927936.2019.1621545","volume":"32","author":"B Spain","year":"2019","unstructured":"Spain B, O\u2019Dwyer L, Moston S. Pet loss: understanding disenfranchised grief, memorial use, and posttraumatic growth. Anthrozo\u00f6s. 2019;32(4):555\u2013568. doi:https:\/\/doi.org\/10.1080\/08927936.2019.1621545.","journal-title":"Anthrozo\u00f6s"},{"key":"2410_CR14","doi-asserted-by":"publisher","DOI":"10.1177\/0030222819853924","author":"AR Matte","year":"2019","unstructured":"Matte AR, Khosa DK, Meehan MP, Coe JB, Niel L. An exploratory study of veterinary professionals\u2019 self-reported support of bereaved clients before, during, and after companion animal euthanasia in Southwestern Ontario\u00a0Canada. OMEGA. 2019. https:\/\/doi.org\/10.1177\/0030222819853924.","journal-title":"OMEGA"},{"issue":"3","key":"2410_CR15","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1177\/0891241611435099","volume":"41","author":"P Morris","year":"2012","unstructured":"Morris P. Managing pet owners\u2019 guilt and grief in veterinary euthanasia encounters. J Contemp Ethnogr. 2012;41(3):337\u2013365. doi:https:\/\/doi.org\/10.1177\/0891241611435099.","journal-title":"J Contemp Ethnogr"},{"key":"2410_CR16","doi-asserted-by":"publisher","unstructured":"Owens N. Protecting the self: veterinarians\u2019 perspectives on dealing with people. Soc Anim. 2015;23(2):105\u2013127. doi:https:\/\/doi.org\/10.1163\/15685306-12341362.","DOI":"10.1163\/15685306-12341362"},{"issue":"2","key":"2410_CR17","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1080\/08927936.2019.1569909","volume":"32","author":"NR Gee","year":"2019","unstructured":"Gee NR, Galik E. Future directions for research on human\u2013animal interaction in an aging population. Anthrozo\u00f6s. 2019;32(2):283\u2013291. doi:https:\/\/doi.org\/10.1080\/08927936.2019.1569909.","journal-title":"Anthrozo\u00f6s"},{"issue":"2","key":"2410_CR18","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1080\/08927936.2019.1569903","volume":"32","author":"NR Gee","year":"2019","unstructured":"Gee NR, Mueller MK. A systematic review of research on pet ownership and animal interactions among older adults. Anthrozo\u00f6s. 2019;32(2):183\u2013207. doi:https:\/\/doi.org\/10.1080\/08927936.2019.1569903.","journal-title":"Anthrozo\u00f6s"},{"issue":"2","key":"2410_CR19","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1080\/08927936.2019.1569906","volume":"32","author":"CA Krause-Parello","year":"2019","unstructured":"Krause-Parello CA, Gulick EE, Basin B. Loneliness, depression, and physical activity in older adults: the therapeutic role of human\u2013animal interactions. Anthrozo\u00f6s. 2019;32(2):239\u2013254. doi:https:\/\/doi.org\/10.1080\/08927936.2019.1569906.","journal-title":"Anthrozo\u00f6s"},{"key":"2410_CR20","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1186\/s12877-018-0867-3","volume":"18","author":"G Mein","year":"2018","unstructured":"Mein, G., Grant, R. A cross-sectional exploratory analysis between pet ownership, sleep, exercise, health and neighbourhood perceptions: the Whitehall II cohort study. BMC Geriatr 18, 176 (2018). https:\/\/doi.org\/10.1186\/s12877-018-0867-3","journal-title":"BMC Geriatr"},{"key":"2410_CR21","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/1471-2318-14-106","volume":"14","author":"J Pikhartova","year":"2014","unstructured":"Pikhartova, J., Bowling, A. & Victor, C. Does owning a pet protect older people against loneliness?. BMC Geriatr 14, 106 (2014). https:\/\/doi.org\/10.1186\/1471-2318-14-106","journal-title":"BMC Geriatr"},{"key":"2410_CR22","volume-title":"Interpretive description (Vol. 1st)","author":"S Thorne","year":"2008","unstructured":"Thorne S. Interpretive description (Vol. 1st). Walnut Creek: Left Coast Press Inc.; 2008."},{"issue":"2","key":"2410_CR23","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77\u2013101. doi:https:\/\/doi.org\/10.1191\/1478088706qp063oa.","journal-title":"Qual Res Psychol"},{"issue":"2","key":"2410_CR24","first-page":"34","volume":"1","author":"LD Cromer","year":"2013","unstructured":"Cromer LD, Barlow MR. Factors and convergent validity of the pet attachment and life impact scale (PALS). Hum Anim Interact Bull. 2013;1(2):34\u201356.","journal-title":"Hum Anim Interact Bull"},{"issue":"4","key":"2410_CR25","doi-asserted-by":"publisher","first-page":"308","DOI":"10.2752\/089279306785415493","volume":"19","author":"M Hunt","year":"2006","unstructured":"Hunt M, Padilla Y. Development of the pet bereavement questionnaire. Anthrozo\u00f6s. 2006;19(4):308\u2013324. doi:https:\/\/doi.org\/10.2752\/089279306785415493","journal-title":"Anthrozo\u00f6s"},{"issue":"4","key":"2410_CR26","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1080\/15401383.2017.1328291","volume":"12","author":"CL Hess-Holden","year":"2017","unstructured":"Hess-Holden CL, Monoghan CL, Justice CA. Pet bereavement support groups: a guide for mental health professionals. J Creat Ment Health. 2017;12(4):440\u2013450. doi:https:\/\/doi.org\/10.1080\/15401383.2017.1328291.","journal-title":"J Creat Ment Health"},{"issue":"1","key":"2410_CR27","doi-asserted-by":"publisher","first-page":"57","DOI":"10.2752\/089279303786992378","volume":"16","author":"H Davis","year":"2003","unstructured":"Davis H, Irwin P, Richardson M, O\u2019Brien-Malone A. When a pet dies: religious issues, euthanasia and strategies for coping with bereavement. Anthrozo\u00f6s. 2003;16(1):57\u201374. doi:https:\/\/doi.org\/10.2752\/089279303786992378.","journal-title":"Anthrozo\u00f6s"},{"issue":"4","key":"2410_CR28","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1080\/08927936.2019.1621541","volume":"32","author":"J Bibbo","year":"2019","unstructured":"Bibbo J, Curl AL, Johnson RA. Pets in the lives of older adults: a life course perspective. Anthrozo\u00f6s. 2019;32(4):541\u2013554. doi:https:\/\/doi.org\/10.1080\/08927936.2019.1621541.","journal-title":"Anthrozo\u00f6s"},{"issue":"9","key":"2410_CR29","doi-asserted-by":"publisher","first-page":"2061","DOI":"10.1017\/S0144686X19000382","volume":"40","author":"N Obradovi\u0107","year":"2020","unstructured":"Obradovi\u0107 N, Lagueux \u00c9, Michaud F, Provencher V. Pros and cons of pet ownership in sustaining independence in community-dwelling older adults: a scoping review. Ageing Soc. 2020;40(9):2061\u201376. https:\/\/doi.org\/10.1017\/S0144686X19000382.","journal-title":"Ageing Soc"},{"issue":"1","key":"2410_CR30","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1080\/08927936.2017.1270599","volume":"30","author":"I Testoni","year":"2017","unstructured":"Testoni I, De Cataldo L, Ronconi L, Zamperini A. Pet loss and representations of death, attachment, depression, and euthanasia. Anthrozo\u00f6s. 2017;30(1):135\u2013148. doi:https:\/\/doi.org\/10.1080\/08927936.2017.1270599.","journal-title":"Anthrozo\u00f6s"},{"issue":"106","key":"2410_CR31","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1159\/000097969","volume":"76","author":"S B\u00fcchi","year":"2007","unstructured":"B\u00fcchi S, M\u00f6rgeli H, Schnyder U, Jenewein J, Hepp U, Jina E, et al. Grief and post-traumatic growth in parents 2\u20136 years after the death of their extremely premature baby. Psychother Psychosom. 2007;76(106):106\u2013114. doi:https:\/\/doi.org\/10.1159\/000097969.","journal-title":"Psychother Psychosom"},{"issue":"6","key":"2410_CR32","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1080\/08927936.2019.1673045","volume":"32","author":"J Rennard","year":"2019","unstructured":"Rennard J, Greening L, Williams JM. In praise of dead pets: an investigation into the content and function of human-style pet eulogies. Anthrozo\u00f6s. 2019;32(6):769\u2013783. doi:https:\/\/doi.org\/10.1080\/08927936.2019.1673045.","journal-title":"Anthrozo\u00f6s"},{"key":"2410_CR33","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1163\/15685306-12341456","volume":"25","author":"GE Dickinson","year":"2017","unstructured":"Dickinson GE, Hoffman HC. Saying goodbye to family: caretakers\u2019 experiences with euthanasia and honoring the legacy of companion animals. Soc Anim. 2017;25:490\u2013507. https:\/\/doi.org\/10.1163\/15685306-12341456.","journal-title":"Soc Anim"},{"issue":"4","key":"2410_CR34","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1177\/0030222817690403","volume":"78","author":"C Bussolari","year":"2019","unstructured":"Bussolari C, Habarth J, Kimpara S, Katz R, Carlos F, Chow A, et al. Posttraumatic growth following the loss of a pet: a cross-cultural comparison. OMEGA J Death Dying. 2019;78(4):348\u201368. https:\/\/doi.org\/10.1177\/0030222817690403.","journal-title":"OMEGA J Death Dying"},{"issue":"1","key":"2410_CR35","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1080\/08927936.2018.1406199","volume":"31","author":"R Pruchno","year":"2018","unstructured":"Pruchno R, Heid AR, Wilson-Genderson M. Successful aging, social support, and ownership of a companion animal. Anthrozo\u00f6s. 2018;31(1):23\u201339. doi:https:\/\/doi.org\/10.1080\/08927936.2018.1406199.","journal-title":"Anthrozo\u00f6s"},{"key":"2410_CR36","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1186\/s12877-020-01822-2","volume":"20","author":"J Stein","year":"2020","unstructured":"Stein, J., L\u00f6bner, M., Pabst, A. et al. Unmet care needs in the oldest old with social loss experiences: results of a representative survey. BMC Geriatr 20, 416 (2020). https:\/\/doi.org\/10.1186\/s12877-020-01822-2","journal-title":"BMC Geriatr"},{"issue":"5","key":"2410_CR37","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1089\/jpm.2014.0366","volume":"18","author":"SM Bruinsma","year":"2015","unstructured":"Bruinsma SM, Tiemeier HW, Heemst JV, van der Heide A, Rietjens JAC. Risk factors for complicated grief in older adults. J Palliat Med. 2015;18(5):438\u2013446. doi:https:\/\/doi.org\/10.1089\/jpm.2014.0366","journal-title":"J Palliat Med"},{"issue":"8","key":"2410_CR38","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1080\/07481181003761666","volume":"34","author":"MD Pilgram","year":"2010","unstructured":"Pilgram MD. Communicating social support to grieving clients: the veterinarians\u2019 view. Death Stud. 2010;34(8):699\u2013714. doi:https:\/\/doi.org\/10.1080\/07481181003761666.","journal-title":"Death Stud"},{"issue":"1","key":"2410_CR39","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1080\/08927936.2017.1270600","volume":"30","author":"LW R\u00e9millard","year":"2017","unstructured":"R\u00e9millard LW, Meehan MP, Kelton DF, Coe JB. Exploring the grief experience among callers to a pet loss support hotline. Anthrozo\u00f6s. 2017;30(1):149\u2013161. doi:https:\/\/doi.org\/10.1080\/08927936.2017.1270600.","journal-title":"Anthrozo\u00f6s"}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-021-02410-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-021-02410-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-021-02410-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T10:06:52Z","timestamp":1629713212000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgeriatr.biomedcentral.com\/articles\/10.1186\/s12877-021-02410-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,23]]},"references-count":39,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2410"],"URL":"https:\/\/doi.org\/10.1186\/s12877-021-02410-8","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,23]]},"assertion":[{"value":"17 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Participants gave online informed consent before study participation and again verbally at the start of the interviews. Research ethics approval was obtained from the University of Alberta Health Research Ethics Board (Pro00101778) and the University of Calgary Conjoint Health Research Ethics Board (REB20-1094) on the basis that the study complied with the declaration of Helsinki and that the protocol followed existing good clinical practice guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"470"}}