A cross-sectional study of mental health and well-being and their associations in the UK veterinary profession

Alcohol-related stigma within the UK veterinary profession

BACKGROUND

Veterinarians have poorer mental health and have higher levels of alcohol consumption compared to the general population. This study aimed to explore perceptions and experiences of problem drinking within the veterinary profession in the UK.

METHODS

Online semi-structured interviews were completed with multidisciplined practising veterinarians in the UK. The data were analysed using reflexive thematic analysis.

RESULTS

Seventeen veterinarians were recruited. The participants were predominantly female (n = 15, 88%). Seven participants (41%) reported personal experience of problem drinking. Four main themes were identified: a normalised culture of drinking, the impact of drinking on mental health and suicide risk, perceptions and attitudes towards problem drinking, and impacts of formal intervention. Drinking to cope was normalised and widespread among veterinarians. Problem drinking was reported to negatively impact mental health and provoke high self-stigma. Both alcohol-related stigma and fear of involvement from the Royal College of Veterinary Surgeons (RCVS) were barriers to help-seeking.

LIMITATIONS

No other veterinary professionals or participants with lived experience of RCVS investigation for problem drinking were included.

CONCLUSION

Alcohol-related stigma and fear of RCVS involvement reduce veterinary help-seeking for problem drinking, which may have a negative effect on veterinarians' mental health.

Predictors of suicidal ideation in Italian veterinarians

Suicide represents a significant problem for healthcare professionals such as veterinarians. Previous studies showed that contextual and individual risk factors can contribute to suicidality among veterinarians. In the present study, self-report measures on exposure to animal euthanasia, substance abuse, reflective functioning, and suicidal ideation were administered to 1556 Italian veterinarians aged 24-74 years old. Structural equation modelling revealed that failures in reflective functioning and substance abuse were associated with suicidal ideation. Prevention programs focusing on improving reflective functioning and decreasing substance abuse might reduce suicide risk among veterinarians.

Suicide Risk in Veterinary Professionals in Portugal: Prevalence of Psychological Symptoms, Burnout, and Compassion Fatigue

Mental health problems and suicide risk among veterinarians and veterinary nurses are well documented in the literature. Data on veterinary assistants have been overlooked, however. In addition, information on Portuguese veterinary professionals is lacking. An online sample of 833 Portuguese veterinary professionals (443 veterinarians, 287 nurses, and 103 assistants) completed self-report questionnaires about suicide risk and mental health between December 2022 and March 2023. Descriptive analysis revealed that 3.5% of respondents attempted suicide during their lifetime; 17.2% experienced extremely severe depression and suicidal ideation; 17.8% and 27.0% experienced extremely severe stress and anxiety, respectively; and 27.4% and 27.7% reported burnout and compassion fatigue, respectively. Multiple linear regression analysis revealed that professionals with a history of mental illness history; with current clinical symptoms of depression, anxiety, and stress; and working more than 40 hours per week experienced greater levels of burnout, compassion fatigue, and suicide ideation. Other variables such as being a woman, being a veterinary assistant, and disagreeing with motives for euthanasia also predicted some mental health problems. Mental health problems in the Portuguese veterinary professionals are a major health concern. These professionals are at higher risk for suicide, and clinical implications and guidelines are discussed.

Stress factors in veterinary medicine-a cross-sectional study among veterinary students and practicing vets in Austria

Background

Although the issue of high mental health burden among veterinarians is well-documented in previous studies, little is known about the specific occupational stress factors associated with mental health issues. Therefore, the aims of this study were twofold: (1) to assess occupational stress factors within the veterinary profession, with a particular emphasis on comparing the expectations of veterinary students with the experiences of practicing veterinarians and (2) to link the experienced stress with mental health indicators in veterinarians.

Methods

All registered veterinarians and veterinary-medicine students in Austria were invited to participate in a cross-sectional online survey. The data collection took place during the winter of 2022/2023 and included standardized questionnaires on mental well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), stress (PSS-4), and insomnia (ISI-2). Additionally, participants were asked about various estimated (students) or experienced (vets) occupational stress factors, which were to be rated on a 5-point Likert scale ranging from "not at all" to "very strongly". An open question invited respondents to identify in free text further experienced/anticipated sources of work-related stressors in veterinary practice.

Results

A total of 430 students and 440 veterinarians participated in the study. The results of a repeated measures analysis of variance (ANOVA) indicate that the burden of bureaucracy is perceived as less stressful by students than experienced by veterinarians, all other areas are perceived as more stressful by students than by veterinarians. In veterinarians, bureaucracy is experienced as the most burdensome, followed by animal suffering, and communication with animal owners. Further analysis of possible associations between the extent of perceived stressors and indicators of mental health shows that while bureaucracy is the most burdensome, it has the smallest correlation with mental health indicators. On the other hand, financial concerns, which are not ranked among the main stressors, have the strongest correlation with impaired mental health.

Conclusion

The results suggest that financial security for veterinarians is crucial to safeguard their mental health. The training of veterinary medicine students and practicing veterinarians in the areas of administration, time management, handling animal suffering, and communication with animal owners might be beneficial in reducing their job-related stressors.

'All I do is fight fires': Qualitative exploration of UK veterinarians' attitudes towards and experiences of pre-purchase consultations regarding brachycephalic dogs

BACKGROUND

Demand for brachycephalic dogs has dramatically increased over the past decade, despite growing evidence of strong associations between brachycephaly and severe, chronic disease. Positive post-purchase attitudes of owners towards brachycephalic dogs are highly intractable, facilitated by normalisation of breed-related disease and strong dog-owner bonds. Veterinarian-led pre-purchase consultations (PPCs) have been promoted as an opportunity to influence acquisition decisions regarding brachycephalic dogs.

METHODS

Using reflexive thematic analysis, this qualitative study investigated veterinarians' attitudes towards, and experiences of, engaging in PPCs for brachycephalic dogs.

RESULTS

Veterinarians described significant structural barriers, such as lack of time and staff, and perceptual barriers, such as perceived futility, negative outcomes of PPCs and public distrust in the profession, that combine to inhibit many veterinarians from offering or delivering brachycephalic PPCs. Some of these barriers are intractable at an individual-veterinarian level and lead to moral distress due to conflicts between veterinarians' responsibilities to animal welfare versus clients' and business needs, with resultant censorship of authentic views on brachycephalic ownership compromising professional integrity and autonomy.

LIMITATIONS

Wider views and/or experiences may exist outside of the sampled population.

CONCLUSION

Stronger veterinary leadership, including from the RCVS, BVA and veterinary corporates, is now urgently required to build profession-wide solutions that overcome the barriers identified to create public-facing consensus and innovative solutions to the 'brachycephalic crisis'.

Dog owner mental health is associated with dog behavioural problems, dog care and dog-facilitated social interaction: a prospective cohort study

Despite numerous qualitative and cross-sectional studies investigating how dog-related factors may impact owners' well-being, empirical studies to test these causal effects are lacking. This prospective cohort study examined the correlation and potential causal effect of 17 dog-related factors with six well-being outcomes (depression, anxiety, loneliness, suicidal ideation, hedonic well-being and eudaimonic well-being) in dog owners. Over a four-week period, 709 adult dog owners reported their weekly well-being and occurrence of each dog-related factor (e.g. how many times they ran with their dogs). A random intercept cross-lagged panel model (RI-CLPM) with significance threshold set at 0.001 was used. Six factors correlated with poorer owner well-being (i.e. aggressive dog behaviour, fearful dog behaviour, poor dog health, failure to provide for the dog, lack of control over the dog, and dog presence). Only 'friendly conversation with others due to the dog' correlated with better well-being. Purposeful reductions in the frequency of dog behavioural and health-related issues are likely to improve owner well-being, as well as greater consistency in dog care (i.e. provide for the dog) and more engagement in friendly dog-facilitated social interactions. No potential causal effects were significant. Further studies investigating causal relationships are essential to improve people's well-being through dog ownership.

Well-being of veterinarians in rural and urban areas

Introduction

The field of veterinary medicine is characterized by a variety of challenging working conditions. The alarmingly low mental well-being of veterinarians has been examined from various perspectives. However, the influence of work location on the well-being of veterinary professionals has scarcely been investigated. The aim of the study was therefore to analyze the well-being of German veterinarians and to determine whether there is a correlation between well-being and work location.

Methods

As part of a cross-sectional study, 999 veterinary professionals answered questions regarding their work location (self-designed questions) and well-being (WHO-Five Well-being Index, WHO-5). A differentiation was made according to work location: urban cities (population > 100,000), medium/small cities (population < 100,000 inhabitants), and rural areas.

Results

Overall, the surveyed veterinarians had low well-being (ranging from 56.8% in rural areas to 61.3% in medium/small towns). The results of the general linear model indicated a significant difference in the WHO total score among veterinarians from different work locations (p < 0.001). However, when sex, age, type of employment, and field of specialization were included in the analysis, no significant between-subject effects were found.

Conclusion

According to the results, work location does not seem to have a significant influence on the well-being of veterinarians and therefore may be of lower priority in the development and implementation of interventions. However, further investigation of work-related predictors of the mental health of veterinarians is recommended, as the results indicate a low well-being among these professionals.

Cross-sectional survey of sleep, fatigue and mental health in veterinary anaesthesia personnel

OBJECTIVE

To evaluate the sleep quality, prevalence of fatigue and depressive symptoms in veterinary anaesthesia personnel.

STUDY DESIGN

Anonymous online voluntary survey.

METHODS

Sleep quality, fatigue, depressive symptoms and self-perceived burnout were scored using the Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Patient Health Questionnaire-9 (PHQ-9) and single-item burnout measure, respectively. Demographic data and questions about work-related fatigue, out-of-hours duty, transport and rest periods were included. PSQI, FSS and PHQ-9 scores were compared using Spearman rank correlation tests.

RESULTS

Responses from 393 participants were obtained from an estimated population of 1374 including diplomates of the American and European Colleges of Veterinary An(a)esthesia and Analgesia (43.9%), residency-trained veterinarians (15.6%), residents-in-training (13.8%) and veterinary technicians and nurses (12.0%), from 32 countries. Most were employed in clinical university teaching hospitals (54.2%) or clinical private practice (41.5%). PSQI scores > 5 were reported by 71.2% of respondents, with 52.4% reporting insufficient sleep to meet their job demands. Many showed high or borderline fatigue (56.4%), and 74.7% reported mistakes due to work-related fatigue. Major depressive symptoms (PHQ-9 score ≥ 10) were found in 42.7%, with 19.2% reporting they had thought about suicide or self-harm in the previous 2 weeks. Over half (54.8%) met the criteria for burnout and more veterinary nurses and technicians suffered from burnout than other roles, with 79.6% of this group affected (p < 0.001). Scores for PSQI and FSS [r (388) = 0.40, p < 0.001]; PSQI and PHQ-9 [r (389) = 0.23, p < 0.001]; and FSS and PHQ-9 [r (387) = 0.24, p < 0.001] were all positively correlated.

CONCLUSIONS AND CLINICAL RELEVANCE

This survey demonstrates a high prevalence of poor sleep, fatigue, depressive symptoms and burnout in veterinary anaesthesia personnel, and more should be done to improve the health of those in the profession.

Moral distress in rural veterinarians as an outcome of the Mycoplasma bovis incursion in southern New Zealand

AIMS

To gain insight into the world of rural veterinarians during the Mycoplasma bovis incursion within southern Aotearoa New Zealand by exploring their experiences during the incursion, and to understand the consequences, positive and negative, of these experiences.

METHODS

A qualitative social science research methodology, guided by the philosophical paradigm of pragmatism, was used to collect data from an information-rich sample (n = 6) of rural veterinarians from Otago and Southland. Interview and focus group techniques were used, both guided by a semi-structured interview guide. Veterinarians were asked a range of questions, including their role within the incursion; whether their involvement had any positive or negative impact for them; and their experience of conflicting demands. Analysis of the narrative data collected was guided by Braun and Clarke's approach to reflexive thematic analysis.

RESULTS AND FINDINGS

All six participants approached agreed to participate. Analysis of the data provided an understanding of the trauma they experienced during the incursion. An overarching theme of psychological distress was underpinned by four sub-themes, with epistemic injustice and bearing witness the two sub-themes reported to be associated with the greatest experience of psychological distress. These, along with the other two identified stressors, led to the experience of moral distress, with moral residue and moral injury also experienced by some participants.

CONCLUSIONS

Eradication programmes for exotic diseases in production animals inevitably have an impact on rural veterinarians, in their role working closely with farmers. Potentially, these impacts could be positive, recognising and utilising veterinarians' experience, skills and knowledge base. This study, however, illustrates the significant negative impacts for some rural veterinarians exposed to the recent M. bovis eradication programme in New Zealand, including experiences of moral distress and moral injury. Consequently, this eradication programme resulted in increased stress for study participants. There is a need to consider how the system addresses future exotic disease incursions to better incorporate and utilise the knowledge and skills of the expert workforce of rural veterinarians and to minimise the negative impacts on them.

CLINICAL RELEVANCE

To date, the experience of moral distress by rural veterinarians during exotic disease incursions has been under-reported globally and unexplored in New Zealand. The findings from this study contribute further insights to the existing limited literature and provide guidance on how to reduce the adverse experiences on rural veterinarians during future incursions.

ABBREVIATIONS

MPI: Ministry for Primary Industries; PITS: Perpetration-induced traumatic stress; PTSD: Post-traumatic stress disorder.

Veterinary professional identity: Conceptual analysis and location in a practice theory framework

Professional, social, and cultural issues and phenomena of veterinary practice are now established areas of commentary and interest in research, education, professional publications and even in the mainstream media. Despite the availability of theoretically informed literature in diverse relevant domains and disciplines including professional practice, workplace learning, and medical sociology and anthropology, commentary and research on veterinary practice issues and phenomena remains dominated by clinician-educators and clinician-policymakers. Reflecting the clinical disciplinary traditions, there is a resulting over-representation of individualistic, positivist perspectives and under-theorized research studies. In this paper we provide an interdisciplinary theoretical framework for veterinary practice and veterinary professional identity grounded in a practice theory perspective. We begin by arguing for the need for such a framework by scoping veterinary practice in its contemporary social context. We go on to provide a sociocultural framing of veterinary practice, underlining the mutual constitution of individuals and the social world through participation in practices and taking into consideration important concepts including knowledge, institutions, ethics, and embodiment. We assert the importance of professional identity as a core phenomenon of veterinary practice, constituted by making meaning of professional practice experiences, especially through narrative and dialogue. This practice theory framework for veterinary practice and veterinary professional identity development provides rich opportunities for understanding, researching, and enacting diverse activities and phenomena, especially learning, development and change within and beyond formal educational settings.

A qualitative study exploring the perceived effects of veterinarians' mental health on provision of care

Introduction

Veterinary medicine is a rewarding, yet demanding profession with a myriad of occupational stressors that can impact the mental health of veterinarians. Stress, mental health outcomes, and associated risk factors amongst veterinarians have been well-researched. Much less research has investigated how high stress and/or poor mental health can impact veterinarians' provision of care.

Methods

One-on-one research interviews were conducted with 25 veterinarians at a Canadian veterinary conference in July 2016 and verbatim transcripts were produced from the audio recordings. The research team collaboratively analyzed the interviews using thematic analysis.

Results

Five themes described the perceived impacts of high stress and/or poor mental health: perceived negative impacts on interactions with (1) co-workers and (2) clients; (3) reduced concentration; (4) difficulty in decision making; and (5) reduced quality of care.

Discussion

These results highlight the perceived impacts of self-reported high stress and/or poor mental health on veterinary team dynamics, the potential to impact case outcomes, and possibly endanger patient safety. Interventions to help mitigate the impacts of high stress and poor mental health are discussed.

Mental health in the veterinary profession: an individual or organisational focus?

The veterinary profession is experiencing a shortage of veterinarians, with attrition recognised as a substantial contributor. Research has also indicated increased levels of mental ill health and alarming suicide rates in practitioners. The primary aim of this study was to investigate the impact of eleven modifiable workplace factors on mental health outcomes, job appreciation and intention to leave the veterinary profession. The second aim was to ascertain whether workplace factors influence mental health outcomes after controlling for individual resilience. An online survey was completed by 73 practising Australian veterinarians. Unfavourable workplace factors correlated with adverse outcomes including depression, stress, reduced job appreciation and increased likelihood of leaving both the role and the profession. Workplace factors remained linked with the outcomes of job appreciation, depression and stress whilst controlling for practitioner resilience. Job appreciation was a significant predictor of intention to leave both the current role and the profession. Via multiple linear regression, two categories were identified as associated with improved psychological outcomes and job appreciation. These were workplace factors that represent breaks from workload and control or decision latitude in the workplace. Whilst resilience represents a key area for intervention, workplace factors potentially represent an easier-to-modify area for intervention.

Perceptions of the impact of the RCVS Certificate in Advanced Veterinary Practice on the careers of its graduates

BACKGROUND

This study aimed to investigate the perceived effect of the RCVS Certificate in Advanced Veterinary Practice (CertAVP) on its graduates, with respect to career advancement, professional practice and contentment with work in the veterinary industry.

METHODS

A cross-sectional online survey of CertAVP graduates was performed, utilising descriptive analysis of Likert scales, logistic regression of demographic variable associations with key outcomes and free-text analysis.

RESULTS

The majority (89%) of the 103 respondents felt that the CertAVP led to improvements in professional practice, 56% felt it had helped advance their career and 55% stated it had improved their contentment with work in the veterinary industry. The CertAVP was perceived to improve evidence-based practice, clinical governance, intellectual satisfaction and encourage lifelong learning, but was not perceived to improve work-life balance.

LIMITATION

Due to potential response bias, this study may not represent the wider population.

CONCLUSION

Despite respondents reporting career advancement, this was only reflected in mentorship and managing more complex cases; respondents neither felt that the CertAVP resulted in promotion, a pay rise or new leadership roles, nor did it afford greater flexibility in their working schedule.

Professional quality of life among Spanish veterinarians

BACKGROUND

In Spain, the perceived professional quality of life among veterinarians has not been explored.

METHODS

Veterinarians were invited to complete an online questionnaire in which they answered the Professional Quality of Life scale, the Medical Outcomes Study Social Support Survey and the Warwick-Edinburgh Mental Well-Being Scale. Participants were asked whether they were receiving psychological therapy or were taking anxiolytics, hypnotics or antidepressant medication. Alcohol consumption was measured using the Alcohol Use Disorders Identification Test and nicotine dependence was assessed using the Fagerström test; participants were asked whether they took illegal drugs.

RESULTS

The study sample comprised a total of 602 veterinarians, most of whom reported average levels of compassion satisfaction, secondary stress trauma and burnout. Emotional support and mental wellbeing influenced participants' professional quality of life. The percentage of veterinarians in psychological therapy and/or taking anxiolytics was higher than in the general population.

CONCLUSIONS

A considerable number of clinical veterinarians in Spain may be suffering from work-related stress. Our study identifies salary, emotional support and mental wellbeing as important factors that affect the professional quality of life. Interventions to improve veterinary clinicians' professional quality of life should therefore focus on these factors.

"The Damage Happens … You Just Try Not to Dwell on It": Experiences of Discrimination by Gender and Sexual Minority Veterinary Professionals and Students in the US and the UK

Data collected in a 2016 survey of veterinary students and professionals from the United States and the United Kingdom who identified as lesbian, gay, bisexual, transgender, queer, questioning, and asexual (LGBTQ+) indicated that 34.5% (152/440) had experienced difficulties related to their sexual orientation or gender identity at school or work. This study's objective was to examine narrative responses collected in the 2016 survey and utilize content analysis to explore the research questions: What are the concerns of the LGBTQ+ veterinary population, and how do they attempt to resolve difficulties at work and school? To address these questions, we developed two taxonomies that cataloged (a) the difficulties reported by veterinary professionals and students in the 2016 survey sample and (b) the outcomes of their attempts to resolve these difficulties. The themes related to difficulties that occurred most frequently were exposure to homophobic or transphobic language (n = 69; 45.4%), outness/staying in the closet (45, 29.6%), and negative emotional outcomes (32, 21.2%). The most common themes that described the outcomes of their attempts to resolve those difficulties were unresolved (n = 41, 27.0%), changed jobs or graduated (22, 14.5%), and found self-acceptance of acceptance from others (21, 13.8%). Our findings can inform the efforts of schools and colleges of veterinary medicine, professional organizations, and workplaces in targeting improvements to support LGBTQ+ students and professionals and the development of measures tailored to this population.

Depression, suicidal ideation and suicide risk in German veterinary medical students compared to the German general population

Background

Various studies from different countries indicated that veterinarians have a significantly increased risk of depression, suicidal ideation and of death by suicide. For German veterinarians a recent study has demonstrated a three times higher rate for depression, two times higher rate for suicidal ideation and a five times higher suicide risk compared to the German general population. For veterinary students, recent studies in the US and UK indicated higher mental distress. To date, empirical studies on depression, suicidal ideation and suicide risk among veterinary students in Germany were lacking so far. This study investigates depression, suicidal ideation and suicide risk of veterinary students in Germany.

Methods

913 German veterinary students (14.3% response rate, 90.7% women, mean age 23.6 years) between 18 and 46 years were included and compared with representative German general population samples from 2007 (N = 1097, 55.4% women, mean age 33.9) and 2015 (N = 1033, 56.1% women, mean age 32.8) of the same age range using the depression module of the Patient Health Questionnaire (PHQ-9) and Suicide Behaviors questionnaire-Revised (SBQ-R). The general population samples were collected with the assistance of a demographic consulting company.

Results

The prevalence of depression among German veterinary students was 45.9% (compared to 3.2% in the general population), suicidal ideation was 19.9% (compared to 4.5% in the general population) and suicide risk was 24.0% (compared to 6.6% in the general population).

Conclusion

In this study, German veterinary students have a 22.1 times higher risk to be screened positive for depression, a 4 times higher risk for reporting current suicidal ideation and they are 4.2 times more likely to have an increased suicide risk compared with the general population in Germany of the same age range.

Professional help-seeking behaviour for mental health problems among veterinarians in Norway: a nationwide, cross-sectional study (The NORVET study)

Background

Veterinarians have a relatively high prevalence of mental health problems; however, research on professional help-seeking is limited. The main purpose of the present study was to investigate the prevalence of mental health problems and professional help-seeking behaviour for such problems, and the independent factors associated with help-seeking behaviour among veterinarians in Norway.

Method

This cross-sectional study included all veterinarians in Norway (response rate 75%, 70% women). Logistic regression was used to calculate odds ratios (OR) for professional help-seeking for mental health problems. Analyses were controlled for socio-demographic, individual (personality trait reality weakness, SCL-5, attitudes toward mental illness), and work-related factors (work field, job stress).

Results

The prevalence of self-reported mental health problems in need of treatment was 30% (746/2494), significantly higher among women than men (36% vs. 15%). Fifty-four percent had sought professional help, women significantly more often (56%) than men (41%). Among veterinarians with serious suicidal thoughts, 50% (69/139) had sought help. Veterinarians most frequently related mental health problems to work problems (47%), women significantly more often (49%) than men (34%). Factors significantly associated with help-seeking were being female, OR = 2.11 (95% CI: 1.24–3.60), working with production animals, OR = 0.35 (0.13–0.98), public administration, OR = 2.27 (1.15–4.45), academia/research, OR = 4.78 (1.99–11.47) or ‘other’ fields, OR = 2.79 (1.23–6.32), and attitudes toward mental illness, OR = 1.32 (1.03–1.68).

Conclusions

Thirty percent of veterinarians in Norway reported mental health problems in need of treatment, and only half of them had sought professional help. A low degree of help-seeking was also seen among those with serious suicidal thoughts. Being female, positive attitudes toward treatment of mental illness, working in public administration, academia/research and ‘other’ field were associated with more help-seeking, while working in production animal practice was associated with less help-seeking. Interventions to increase help-seeking behaviour for mental health problems among veterinarians are warranted.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13710-y.

Stress and strain among veterinarians: a scoping review

The aim of this review is to systematically review studies on work-related stress that may affect the mental health of veterinarians. Studies have indicated a high prevalence of various risk factors for mental disorders among practicing veterinarians. In addition to a high risk of suicide, there is increasing evidence of burnout and depression. A scoping review was conducted using the PubMed, MEDLINE, Scopus, Cochrane Library, Web of Science, PubPsych and PSYNDEX databases. Twenty-one studies (plus seven studies with nonstandardized questionnaires) published between 2000 and 2021 were found that presented data on the effect of workload on the mental wellbeing of veterinarians. All of the included studies indicate a high prevalence of psychological stressors in veterinary practice. The risks of burnout, anxiety and depressive disorders are higher in this occupational group than in the general population and other occupational groups. Subjectively, female veterinarians perceive their psychological workload to be higher than that of their male counterparts. Working hours and ethical dilemmas stand out as major sources of stress. There is a need to improve overall psychological wellbeing of veterinarians. Organizational support services and developing personal strategies for coping with work-related stress can prove helpful.

Female veterinarians' experiences with human clients: the link to burnout and depression

Purpose

Previous research studies have noted that veterinarians are up to four times more likely to die by suicide than the general population. Studies have indicated possible catalysts for this increased risk, including exposure to euthanasia, depression, burnout, compassion fatigue, occupational stress, work–life imbalance and anxiety. With female veterinarians reporting higher rates of mental health issues and the fact that the ratio of female to male veterinarians is almost 2:1, the study focused on the female veterinarian population. Few research studies have been conducted to examine stressors directly related to human factors. The present study aims to examine the path to depression and burnout as it relates to positive versus negative interactions with human clients (owners of animal patients).

Design/methodology/approach

The study recruited 222 female veterinarians online (average age = 36.89). The participants completed three scales measuring (1) burnout; (2) depression, anxiety and stress; and (3) positive and negative experiences with human clients.

Findings

Using the structural equation modeling (SEM), the results showed contrasting patterns of positive versus negative client-related experience in relation to burnout and depression. Positive client experience showed a direct path to the lower levels of depression and client-related burnout while negative client experience revealed a non-direct path to depression but a direct path to more specific burnout such as client-related and work-related burnout.

Originality/value

Results of the study offered insight into the unique contribution of client-related experience in burnout and depression as positive versus negative client experience took on differential paths to depression and burnout.

Predictors of Professional Quality of Life in Veterinary Professionals

Working in the veterinary profession can be both stressful and rewarding. High workloads, long work hours, emotionally charged interactions with clients, and exposure to animal suffering and participation in euthanasia place many at risk of compassion fatigue, which then threatens their professional quality of life (ProQOL). Despite this risk, many veterinary professionals choose to stay within the profession. This study explores personal and organizational factors predicting compassion satisfaction (CS), burnout, and secondary traumatic stress (STS) in veterinary professionals, and the extent to which these aspects of ProQOL are linked with intentions to leave the profession. Regression results show that personal factors accounted for 31.1% of the variance in CS, 45.3% in burnout, and 33.8% in STS. Organizational factors significantly accounted for 33.3% of the variance in CS, 47.9% in burnout, and 32.7% in STS. Together, ProQOL accounted for 28.9% and 16.0% of the variance in intentions to leave one's current role and to leave the profession altogether, respectively. These results suggest that both personal and organizational factors play a role in veterinary professionals' ProQOL and highlight the importance of promoting CS and managing burnout and STS for the purpose of fostering veterinary staff well-being and retention.

A taxonomy of occupational and organisational stressors and protectors of mental health reported by veterinary professionals in Australasia

AIM

To develop a taxonomy of positive and negative occupational and organisational factors reported that impact the mental health of veterinary professionals.

METHODS

Veterinary professionals working in Australasia were surveyed between February and June of 2021. The survey comprised two questions related to participants' perceptions of the positive and negative aspects of their job role that impact their mental health and wellbeing. Reflexive thematic analysis was employed to analyse the responses and generate two taxonomies of occupational and organisation stressors and protectors reported by participants.

RESULTS

Fifty-three responses from veterinary professionals were analysed. The final stressor taxonomy generated contained 9 overarching themes and 36 subthemes. The most common of these were negative work conditions, challenging relationships with clients, and adverse events and patient outcomes. The taxonomy of protectors contained 11 overarching themes and 32 subthemes, with the most common including fulfillment and satisfaction, positive work conditions, and relationships with colleagues.

CONCLUSION

This study is the first to examine both positive and negative factors in the veterinary industry reported by veterinary professionals in Australasia. The results highlighted stressors that can be addressed on both an individual and organisational level to promote the mental and health well-being of professionals working in the animal care industry.

Mental Health Impact of Mass Depopulation of Swine on Veterinarians During COVID-19 Infrastructure Breakdown

This study was designed to assess the mental health of swine veterinarians involved with mass depopulation events related to COVID-19 and compare them to swine veterinarians not involved in mass depopulation. Additionally, we assessed the well being, quality of life, psychological distress, burnout, and resilience in veterinarians who conducted depopulation events and the potential impact of depopulation methods on these factors. Finally, we identified coping methods utilized by swine veterinarians for improved well being. The study involved the distribution of an anonymous online survey, available December 2020 to January 2021, to swine veterinarians practicing in the United States. A total of 134 responses were analyzed. Stress related to the depopulation effort was predominantly an outcome of two factors: ethics of care (people and pigs) and perception of others (public, colleagues, family, friends, neighbors). Depopulation involvement was associated with burnout (p = 0.001). The depopulation method utilized significantly impacted depopulation distress (p = 0.007), perception of others (p < 0.001), and burnout (p < 0.001). Nearly one-third (29%) of all participants reported moderate levels of burnout. Based on these results, the call to action is to enhance the availability and visibility of existing mental health services and take necessary steps to destigmatize mental health. Additionally, it is critical to support the development of mental health programs for swine veterinarians through education, training, research, and transparent communication.

Veterinary house officer perceptions of dimensions of well-being during postgraduate training

OBJECTIVE

To describe veterinary house officers’ perceptions of dimensions of well-being during postgraduate training and to identify potential areas for targeted intervention.

SAMPLE

303 house officers.

PROCEDURES

A 62-item questionnaire was generated by use of an online platform and sent to house officers at participating institutions in October 2020. Responses were analyzed for trends and associations between selected variables.

RESULTS

239 residents, 45 rotating interns, and 19 specialty interns responded to the survey. The majority of house officers felt that their training program negatively interfered with their exercise habits, diet, and social engagement. House officers reported engaging in exercise significantly less during times of clinical responsibility, averaging 1.6 exercise sessions/wk (SD ± 0.8) on clinical duty and 2.4 exercise sessions/wk (SD ± 0.9) when not on clinical duty (P < 0.001). Ninety-four percent of respondents reported experiencing some degree of anxiety regarding their physical health, and 95% of house officers reported feeling some degree of anxiety regarding their current financial situation. Overall, 47% reported that their work-life balance was unsustainable for > 1 year; there was no association between specialty and sustainability of work-life balance. Most house officers were satisfied with their current training program, level of clinical responsibility, and mentorship.

CLINICAL RELEVANCE

Veterinary house officers demonstrated a poor balance between the demands of postgraduate training and maintenance of personal health. Thoughtful interventions are needed to support the well-being of veterinary house officers.

Supportive relations in a feminized occupation: How male and female veterinarians compare

Several traditionally male-dominated professions, including law and medicine, have experienced an influx of women over the last 30 years. We extend research on gender equality in the professions, which has often examined segmentation and stratification, by examining the integration of men and women into a traditionally male-dominated profession in terms of the emotional and instrumental support they receive from colleagues. We examine veterinary medicine as a case study because interestingly this profession has seen the most dramatic growth in the representation of women over the last 30 years - more than law or medicine. We also explore whether traditional masculine control tasks (clinic ownership and autonomy) and traditional female care tasks (animal care and client interactions) are related to integration. We analyze survey data from 384 Canadian veterinarians. Findings show that practice ownership and challenging client interactions are associated with reduced support for women, but not for men. In contrast, directly caring for animals is associated with more support for men, but this is not the case for women. We discuss the implications of differential levels of social support for the integration of women into traditionally male-dominated professions.

Are They Ready? Trials, Tribulations, and Professional Skills Vital for New Veterinary Graduate Success

Stress and burnout levels are high among young veterinarians with the transition to practice being particularly challenging. This qualitative study aimed to capture and document the new graduate veterinary experience within the United States and which professional skills are most important for success during the transition to practice. The researchers sought to better understand this challenging transition period and provide insight for veterinary educators who are tasked with preparing new veterinary graduates for day 1 practice readiness. To gain a deeper understanding of the new graduate experience, a focus group was conducted with six veterinarians who recently graduated from four different U.S. veterinary colleges. Several themes arose regarding their experiences in the transition to practice including setbacks and adaptations, self-sufficiency and self-doubt, changing clientele and ethical dilemmas, leadership and conflict, and good vs. bad mentorship. Self-care, conflict management, and client communication were perceived as the most important professional skills for success in the transition to practice. New graduate veterinarians reported that they were least prepared for working with clients with financial constraints and managing conflict. Drawing from this qualitative data, the researchers propose several topics that could be incorporated into professional skills curriculum to further enhance day 1 preparedness of new veterinary graduates to promote well-being in the transition to practice.

Prevalence and individual and work-related factors associated with suicidal thoughts and behaviours among veterinarians in Norway: a cross-sectional, nationwide survey-based study (the NORVET study)

OBJECTIVES

Several studies have shown increased suicide rates among veterinarians. We investigated the self-reported prevalence of suicidal thoughts and behaviours and contributing and independent factors associated with suicidal thoughts and behaviours among veterinarians in Norway.

DESIGN

Cross-sectional, nationwide survey.

PARTICIPANTS

2596 veterinarians in Norway (response rate: 75%).

MAIN OUTCOME MEASURE

Paykel's five-item questionnaire.

RESULTS

In total, 27% (n=682/2567) of veterinarians in Norway felt that life was not worth living during the last year, 5% (n=139/2562) had serious suicidal thoughts, and 0.2% (n=6/2537) had attempted suicide. Female veterinarians reported significantly higher prevalence of suicidal feelings and thoughts than males. For serious suicidal thoughts, women had nearly twice the prevalence as their male colleagues (6.2% (n=108/1754) vs 3.6% (n=28/766), χ²: 6.5, p=0.011). Independent factors associated with serious suicidal thoughts were being single (OR 1.76, 95% CI 1.13 to 2.72, p<0.05), negative life events (OR=1.43, 95% CI 1.22 to 1.68, p<0.001) and the presence of mental distress (OR 2.75, 95% CI 2.14 to 3.52, p<0.001). The veterinarians related their serious suicidal thoughts to work and personal problems, and a lesser degree to family, social and other problems. Nearly twice as many women (53%, n=57/108) as men (28%, n=7/25) reported work problems as the most important contributing factor to their serious suicidal thoughts (χ²: 4.99, p=0.03). 4% (n=6/139) reported work problems as the only factor of importance.

CONCLUSIONS

Veterinarians in Norway have relatively high prevalence of suicidal feelings and thoughts, including serious suicidal thoughts. In multivariable analyses, the individual factors were more important than work-related ones, while work problems were the most reported contributing factor to serious suicidal thoughts by the veterinarians themselves. The role of gender and specific work-related factors should be further investigated to better understand the complexity of suicidal behaviour among veterinarians.

Experiences and impact of moral injury in U.K. veterinary professional wellbeing

BACKGROUND

Veterinary professionals (VPs) are often exposed to distressing and ethically challenging events in their line of work, yet little is known about whether they may experience moral injury and the impact potentially morally injurious events (PMIEs) may have on their wellbeing. This cross-sectional study aimed to examine the association between PMIEs and the mental health outcomes of U.K. VPs.

METHOD

Assessments of PMIE exposure and self-report measures of common mental disorders were administered using an anonymous online questionnaire to 90 U.K. VPs between December 2020 and May 2021.

RESULTS

Exposure to PMIEs was reported by almost all VPs (89.0%), with acts of omission most frequently reported. Experiences of PMIEs were significantly associated with symptoms of PTSD (p < 0.01) and experiencing a betrayal event was significantly associated with PTSD symptoms (p<0.05). However, there was no significant association found between PMIE exposure and alcohol misuse or CMD (p > 0.05).

CONCLUSIONS

This study provides some of the first evidence that experiences of moral injury are significantly associated with adverse mental health outcomes in U.K. VPs. Future work is needed to design effective pathways for prevention and intervention for VPs exposed to highly challenging events.

HIGHLIGHTS

U.K. veterinary professionals were found to experience moral injury.Experiences of moral injury were significantly associated with symptoms of PTSD.

Employability as a Guiding Outcome in Veterinary Education: Findings of the VetSet2Go Project

This paper presents a mini-review of employability as a guiding outcome in veterinary education-its conceptualisation, utility, core elements and dimensions, and pedagogical approaches-through a summary of the findings of a major international project with the same aims (the VetSet2Go project). Guided by a conception of the successful veterinary professional as one capable of navigating and sustainably balancing the (sometimes competing) needs and expectations of multiple stakeholders, the project integrated multiple sources of evidence to derive an employability framework representing the dimensions and capabilities most important to veterinary professional success. This framework provides a useful complement to those based in narrower views of competency and professionalism. One notable difference is its added emphasis on broad success outcomes of satisfaction and sustainability as well as task-oriented efficacy, thus inserting "the self" as a major stakeholder and bringing attention to resilience and sustainable well-being. The framework contains 18 key capabilities consistently identified as important to employability in the veterinary context, aligned to five broad, overlapping domains: veterinary capabilities (task-oriented work performance), effective relationships (approaches to others), professional commitment (approaches to work and the broader professional "mission"), psychological resources (approaches to self), plus a central process of reflective self-awareness and identity formation. A summary of evidence supporting these is presented, as well as recommendations for situating, developing, and accessing these as learning outcomes within veterinary curricula. Though developed within the specific context of veterinarian transition-to-practise, this framework would be readily adaptable to other professions, particularly in other health disciplines.

High Psychosocial Work Demands, Decreased Well-Being, and Perceived Well-Being Needs Within Veterinary Academia During the COVID-19 Pandemic

Higher psychosocial work demands in veterinary and academic professions are associated with decreased occupational, physical, and mental well-being. COVID-19 introduced far-reaching challenges that may have increased the psychosocial work demands for these populations, thereby impacting individual- and institutional-level well-being. Our objective was to investigate the psychosocial work demands, health and well-being, and perceived needs of faculty, staff, residents and interns at the Ontario Veterinary College, in Ontario, Canada, during COVID-19. A total of 157 respondents completed a questionnaire between November 2020 and January 2021, that included the Third Version of the Copenhagen Psychosocial Questionnaire (COPSOQ-III) and open-text questions on perceived needs for well-being. Results showed that COPSOQ-III dimensions of quantitative demands, recognition, sense of community, burnout, stress, and depressive symptoms, were significantly worse in our study population than the Canadian norm. Quantitative and emotional demands, health and well-being (including depressive symptoms, stress, cognitive stress, somatic stress, and burnout), and work-life conflict were also reported to have worsened since the COVID-19 restrictions for most respondents. Females and caregivers had higher odds of experiencing increased work demands, and decreased health and well-being, compared to males and non-caregivers. However, male caregivers experienced worsened supervisor relations, compared to female caregivers. Social capital also worsened for clinical and part-time employees, compared to full-time and non-clinical employees. Respondents identified increased workload support, community-building, recognition of employees' capacities and personal needs, flexible work schedules, and consistent communication, as strategies to increase well-being during COVID-19 and generally. Overall, our findings suggest that COVID-19 has increased occupational demands, work-life conflicts, and decreased well-being in veterinary academia. Institutional-level interventions are discussed and recommended to aid individual and institutional well-being.

What Impacts Perceived Stress among Canadian Farmers? A Mixed-Methods Analysis

Globally, farmers report high levels of occupational stress. The purpose of this study was to identify and explore factors associated with perceived stress among Canadian farmers. A sequential explanatory mixed-methods design was used. An online cross-sectional national survey of Canadian farmers (n = 1132) was conducted in 2015-2016 to collect data on mental health, demographic, lifestyle, and farming characteristics; stress was measured using the Perceived Stress Scale. A multivariable linear regression model was used to investigate the factors associated with perceived stress score. Qualitative interviews (n = 75) were conducted in 2017-2018 with farmers and agricultural sector workers in Ontario, Canada, to explore the lived experience of stress. The qualitative interview data were analyzed via thematic analysis and then used to explain and provide depth to the quantitative results. Financial stress (highest category-a lot: (B = 2.30; CI: 1.59, 3.00)), woman gender (B = 0.55; CI: 0.12, 0.99), pig farming (B = 1.07; CI: 0.45, 1.69), and perceived lack of support from family (B = 1.18; CI: 0.39, 1.98) and industry (B = 1.15; CI: 0.16-2.14) were positively associated with higher perceived stress scores, as were depression and anxiety (as part of an interaction). Resilience had a small negative association with perceived stress (B = -0.04; CI: -0.06, -0.03). Results from the qualitative analysis showed that the uncertainty around financial stress increased perceived stress. Women farmers described the unique demands and challenges they face that contributed to their overall stress. Results from this study can inform the development of mental health resources and research aimed at decreasing stress among Canadian farmers.

Behavioral health and sleep problems among US Army veterinarians and veterinary technicians participating in the Millennium Cohort Study

OBJECTIVE

To determine the prevalences and relative odds of mental health problems, suicidal ideation, psychotropic medication use, problem drinking, trouble sleeping, and lack of social support among veterinarians and veterinary technicians, compared with other medical professionals, in the US Army.

SAMPLE

7,744 US Army personnel (957 officers [101 veterinarians and 856 physicians and dentists] and 6,787 enlisted personnel [334 veterinary technicians and 6,453 medics]) participating in the Millennium Cohort Study.

PROCEDURES

Eligible participants completed ≥ 1 survey while serving as an Army veterinarian, veterinary technician, physician, general dentist, or medic. Analysis methods including multivariable logistic regression adjusted for covariates and stratified by pay grade were used to investigate associations between each health-care occupation and outcomes of interest.

RESULTS

Veterinarians had higher reported prevalences of mental health problems, trouble sleeping, and lack of social support than did nontrauma physicians, trauma physicians, or dentists. On multivariable analysis, veterinarians had higher odds of mental health problems, trouble sleeping, and lack of social support, compared with physicians and dentists combined; odds for these outcomes were also higher for veterinarians, compared with various individual reference groups. Veterinary technicians had lower reported prevalence and lower odds of psychotropic medication use, compared with medics.

CONCLUSIONS AND CLINICAL RELEVANCE

Further examination of Army policies and organizational structures related to veterinarians may be warranted, along with the development of policies and interventions designed to improve mental health, sleep quality, and social support among military veterinarians.

Association of demographic, career, and lifestyle factors with resilience and association of resilience with mental health outcomes in veterinarians in Canada

OBJECTIVE

To investigate the association of demographic, career, and lifestyle factors with resilience and the association of resilience with mental health outcomes in Canadian veterinarians.

SAMPLE

1,130 veterinarians in clinical practice across Canada.

PROCEDURES

An online questionnaire was used to collect participant data and included 5 validated psychometric scales to evaluate resilience (through the Connor-Davidson Resilience Scale [CD-RISC]), perceived stress (through the Perceived Stress Scale), emotional distress (through the Hospital Anxiety and Depression Scale), burnout (through the Maslach Burnout Inventory), and secondary traumatic stress (through the Professional Quality of Life Scale). A multivariable linear regression model was used to investigate associations between CD-RISC scores and demographic, career, and lifestyle characteristics. Univariable linear regression models were used to assess the relationship between resilience scores and other mental health outcomes.

RESULTS

The strongest positive association was between CD-RISC score and overall health. The level of satisfaction with support from friends and workplace resources had positive associations with the CD-RISC score. The presence of mental illness had the strongest negative association with the CD-RISC score. Being married, working in a small animal practice, or having an associate role were negatively associated with the CD-RISC score. The CD-RISC score had negative associations with scores for perceived stress, anxiety, depression, burnout, and secondary traumatic stress.

CONCLUSIONS AND CLINICAL RELEVANCE

Models provided evidence for the role of resilience in protecting against negative mental health outcomes in veterinarians. Both personal and workplace factors were associated with resilience, presenting opportunities for intervention at each of these levels.

Sources of pleasure in veterinary work: A qualitative study

BACKGROUND

Despite the rise in positive psychology within organisational settings, less is known about the positive factors associated with veterinary work and veterinarian well-being. This qualitative study investigated sources of pleasure for veterinarians.

METHOD

A subset of archival data from a larger study on veterinary well-being was analysed. The current study was based on data from 273 veterinarians responding to a Ten Statements Test (TST) and demographic questions. In the TST, participants provided up to 10 responses to the prompt, 'I derive pleasure in my work as a veterinarian when…'.

RESULTS

Using the job demands-resources model as a framework, a total of 2536 responses were manually coded into themes relating to resources (positive responses) or demands (responses indicating a negative factor). In order of frequency, job resources are related to professional expertise (22%), positive outcomes (20%), job characteristics (19%), relationships (16%), recognition (10%), helping (7%) and personal resources (3%). Top job demands are related to stress and fatigue (17%) and poor work-life balance (16%).

CONCLUSION

The results suggest that there are an abundance of positive factors in veterinary work associated with feelings of pleasure, which may support veterinarian well-being.

Students' Engagement in and Perceptions of Blended Learning in a Clinical Module in a Veterinary Degree Program

Blended learning has received much interest in higher education as a way to increase learning efficiency and effectiveness. By combining face-to-face teaching with technology-enhanced learning through online resources, students can manage their own learning. Blended methods are of particular interest in professional degree programs such as veterinary medicine in which students need the flexibility to undertake intra- and extramural activities to develop the range of competencies required to achieve professional qualification. Yet how veterinary students engage with blended learning activities and whether they perceive the approach as beneficial is unclear. We evaluated blended learning through review of student feedback on a 4-week clinical module in a veterinary degree program. The module combined face-to-face sessions with online resources. Feedback was collected by means of a structured online questionnaire at the end of the module and log data collected as part of a routine teaching audit. The features of blended learning that support and detract from students' learning experience were explored using quantitative and qualitative methods. Students perceived a benefit from aspects of face-to-face teaching and technology-enhanced learning resources. Face-to-face teaching was appreciated for practical activities, whereas online resources were considered effective for facilitating module organization and allowing flexible access to learning materials. The blended approach was particularly appreciated for clinical skills in which students valued a combination of visual resources and practical activities. Although we identified several limitations with online resources that need to be addressed when constructing blended courses, blended learning shows potential to enhance student-led learning in clinical courses.

A survey of negative mental health outcomes, workplace and school climate, and identity disclosure for lesbian, gay, bisexual, transgender, queer, questioning, and asexual veterinary professionals and students in the United States and United Kingdom

OBJECTIVE

To compare the prevalence of negative mental health outcomes among lesbian, gay, bisexual, transgender, queer, questioning, and asexual (LGBTQ+) veterinary professionals and students with the prevalence reported in a previous study of veterinarians; compare LGBTQ+ veterinary professionals and students in regard to access to LGBTQ+ policies and resources, workplace or school climate, and identity disclosure; and examine whether these variables were associated with mental health (eg, psychological distress) or work- and school-related (eg, emotional labor) outcomes.

SAMPLE

440 LGBTQ+ veterinary professionals and students in the United States and United Kingdom.

PROCEDURES

Between July and December 2016, a web-based questionnaire was distributed through email messages to members of LGBTQ+ veterinary groups and announcements at general veterinary and LGBTQ+-focused conferences and in newsletters.

RESULTS

Nonheterosexual cis men, nonheterosexual cis women, and transgender and nonbinary individuals all had higher lifetime prevalences of suicidal ideation and attempted suicide, compared with previously reported prevalences for male and female veterinarians in general. Professionals reported more welcoming climates than did students (eg, lower frequency of exposure to homophobic language and more supportive environments) and greater identity disclosure; however, students reported greater access to institutional resources and policies. Climate variables had a more robust relationship with negative outcomes than did access to LGBTQ+ policies or identity disclosure variables.

CONCLUSIONS AND CLINICAL RELEVANCE

Comparatively high rates of suicidal ideation and suicide attempts among LGBTQ+ professionals and students and the relationship between climate variables and negative mental health outcomes suggested enhanced efforts are needed to improve the climates in veterinary workplaces and colleges.

Is veterinary work more than satisfying? A critical review of the literature

Despite the rise of positive psychology in recent times, research continues to emphasise the risks and negative outcomes associated with veterinary work. Understanding these challenges and risks is imperative in helping those affected and preventing or limiting exposure for future veterinarians. However, it is vital that positive factors associated with their well-being are concomitantly addressed. Drawing on an organisational psychology perspective and associated theories, this review critically analyses the literature on veterinary well-being, job satisfaction and the role of positive emotions at work. This perspective prompts a call to researchers to investigate the positive aspects of veterinary work and offers many suggestions for future research and associated implications. Drawing on an extensive evidence base of research pertaining to positive emotions and well-being in veterinarians, the development, implementation and validation of workplace interventions should follow. The veterinary profession is a highly rewarding one and a focus on pleasure in veterinary work and ways to encourage this, will only help veterinarians flourish and help to promote the profession in the way it deserves.

Veterinary Interventions to Improve Neonatal Survival on British Beef and Sheep Farms: A Qualitative Study

Neonatal lamb and calf deaths are a major issue in UK agriculture. Consistent mortality rates over several decades, despite scientific advances, indicate that socioeconomic factors must also be understood and addressed for effective veterinary service delivery to improve lamb and calf survival. This qualitative study utilised semi-structured interviews with vets and farmers to explore the on-farm mechanisms and social context, with a particular focus on the role of the vet, to manage and reduce neonatal losses in beef calves and lambs on British farms. Data were analysed using a realist evaluation framework to assess how the mechanisms and context for veterinary service delivery influence survival as the outcome of interest. A lack of a clear outcome definition of neonatal mortality, and the financial, social and emotional impact of losses on both vets and farmers, are barriers to recording of losses and standardisation of acceptable mortality levels at a population level. Despite this, there appears to be an individual threshold on each farm at which losses become perceived as problematic, and veterinary involvement shifts from preventive to reactive mechanisms for service delivery. The veterinarian-farmer relationship is central to efforts to maximise survival, but the social and economic capital available to farmers influences the quality of this relationship. Health inequalities are well-recognised as an issue in human healthcare and the findings indicate that similar inequalities exist in livestock health systems.

The relationship between resilience, anxiety and depression among patients with mild symptoms of COVID-19 in China: A cross-sectional study

AIMS AND OBJECTIVES

To explore the role of resilience in anxiety and depression and to clarify their relationships among patients with mild symptoms of coronavirus disease 2019 (COVID-19) in Wuhan, China.

BACKGROUND

The outbreak of COVID-19 has negatively affected some individuals, but resilience plays a decisive role in the response of individuals under pressure and can help them deal with pressure more effectively.

DESIGN

The cross-sectional descriptive correlational survey was reported in line with the STROBE guidelines.

SUBJECT AND SETTING

In total, 296 patients from FangCang Hospital in Wuhan, Hubei, China, with mild symptoms of COVID-19 were recruited.

METHODS

Participants were recruited through convenience sampling. The data collected included their demographic information, the Connor-Davidson Resilience Scale and Hospital Anxiety and Depression Scale.

RESULTS

A small number of patients in this study had above threshold anxiety (subthreshold anxiety and major anxiety) and depression (subthreshold depression and major depression). The mean total resilience score of the participants was slightly below the normal level of ordinary Chinese adults. Resilience was inversely associated with and was a protective factor for both anxiety and depression in our samples. Risk factors for anxiety include being female and having colleagues with COVID-19, while a risk factor for depression was having family members with COVID-19.

CONCLUSIONS

This study shows that after taking the general demographics into consideration, higher levels of resilience were associated with lower anxiety and depression among mild COVID-19 patients in Wuhan, China.

RELEVANCE TO CLINICAL PRACTICE

Health professionals, especially clinical nurses, need to be aware of the psychological status of COVID-19 patients and promote resilience to improve their mental health.

Burnout, Reasons for Living and Dehumanisation among Italian Penitentiary Police Officers

The literature on burnout syndrome among Penitentiary Police Officers (PPOs) is still rather scarce, and there are no analyses on the protective factors that can prevent these workers from the dangerous effect of burnout, with respect to the weakening of the reasons for living and de-humanization. This study aimed to examine the relationships between burnout, protective factors against weakening of the reasons for living and not desiring to die and the role of de-humanisation, utilising the Maslach Burnout Inventory (MBI); the Reasons for Living Inventory (RFL); the Testoni Death Representation Scale (TDRS); and the Human Traits Attribution Scale (HTAS), involving 86 PPOs in a North Italy prison. Results showed the presence of a high level of burnout in the group of participants. In addition, dehumanization of prisoners, which is considered a factor that could help in managing other health professional stress situations, does not reduce the level of burnout.

Stress, anxiety, depression, and resilience in Canadian farmers

PURPOSE

To estimate the prevalence of stress, anxiety, depression, and resilience amongst Canadian farmers.

METHODS

An online cross-sectional survey using validated psychometric scales [Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale] conducted with farmers in Canada between September 2015 and February 2016.

RESULTS

1132 farmers participated in the study. The average PSS score was 18.9. Approximately 57% and 33% of participants were classified as possible and probable cases for anxiety, respectively; the respective proportions for depression were 34% and 15%. The average resilience score was 71.1. Scores for stress, anxiety, and depression were higher, and resilience lower, than reported normative data. Females scored less favorably on all mental health outcomes studied, highlighting important gender disparities.

CONCLUSIONS

These results highlight a significant public health concern amongst farmers, and illustrate a critical need for research and interventions related to farmer mental health. These findings are important for policymakers, physicians, and public and mental health service providers, and can help to inform decision-making, policy recommendations, resource allocation, and development and delivery of training programs for farmers.

Suicide among veterinarians in the United States from 1979 through 2015

OBJECTIVE To assess proportionate mortality ratios (PMRs) for suicide among male and female US veterinarians from 1979 through 2015. DESIGN PMR study. SAMPLE Death records for 11,620 veterinarians. PROCEDURES Information for veterinarians who died during 1979 through 2015 was obtained from AVMA obituary and life insurance databases and submitted to a centralized database of US death records to obtain underlying causes of death. Decedent data that met records-matching criteria were imported into a software program for calculation of PMRs for suicide stratified by sex and indirectly standardized for age, race, and 5-year calendar period with 95% confidence intervals. RESULTS 398 deaths resulted from suicide; 326 (82%) decedents were male, 72 (18%) were female, and most (298 [75%]) were ≤ 65 years of age. The PMRs for suicide for all veterinarian decedents (2.1 and 3.5 for males and females, respectively), those in clinical positions (2.2 and 3.4 for males and females, respectively), and those in nonclinical positions (1.8 and 5.0 for males and females, respectively) were significantly higher than for the general US population. Among female veterinarians, the percentage of deaths by suicide was stable from 2000 until the end of the study, but the number of such deaths subjectively increased with each 5-year period. CONCLUSIONS AND CLINICAL RELEVANCE Results of the study indicated that PMRs for suicide of female as well as male veterinarians were higher than for the general population. These data may help to inform stakeholders in the creation and implementation of suicide prevention strategies designed for veterinarians.