Experiences of veterinarians in clinical behavior practice: A mixed-methods study

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.

Dog Owners’ Perspectives on Canine Heart Disease in Klang Valley, Malaysia

Simple Summary

Heart disease is a common chronic illness among dogs that often requires long-term treatment. This study investigated owners’ awareness and knowledge about canine heart disease, followed by their intention to treat with respect to the Theory of Planned Behavior. The attitude, subjective norm, and perceived behavioral control (PBC) in predicting dog owners’ intention to treat canine heart disease, with empathy as moderator, was analyzed. The majority of dog owners have a high awareness of the disease denoted by their ability to identify 5 to 8 out of 12 common clinical signs. Although seeking treatment is a common effort by dog owners, the cost was the barrier that curtailed their intention. If dog owners improve their attitudes, receive support from spouses and other family members, and increase their confidence in managing their pets, this can increase the pursuance of heart disease treatment. Owners with low empathic concern can be motivated to treat by cultivating perceived behavioral control. Therefore, continuous education may improve owners’ preconceived ability to provide care, and veterinarians may play an essential role in encouraging treatment in dogs diagnosed with heart disease.

Abstract

Canine heart disease often requires long-term treatment, which involves a continuous commitment from the dog owners. In addition to investigating their awareness and knowledge, the Theory of Planned Behavior was applied to also analyze attitude, subjective norm, and perceived behavioral control (PBC) of the dog owners, with empathic concern as a moderator in predicting intention to treat canine heart disease. Through a convenience sampling approach, 261 respondents, who were clients of University Veterinary Hospital, Universiti Putra Malaysia (UVH-UPM), with experience in owning or caring for dogs, were recruited. While the majority of the respondents (83.5%) claimed that they were aware of canine heart disease, most respondents (45.6%) could only identify 5 to 8 (Fair) out of 12 of the salient clinical signs. Most dog owners (92.3%) were willing to seek treatment if the pet dogs were affected, although the intent is deterred by cost (39.5%). In this study, attitude, subjective norms, and perceived behavioral control were significant predictors for the intention to treat. Dog owners with low empathic concern can be motivated to treat affected dogs by cultivating perceived behavioral control. Therefore, continual education may improve dog owners’ preconceived ability to provide care, and veterinarians may play an important role to encourage treatment in dogs diagnosed with heart disease.

"It's Like a Kick in the Teeth": The Emergence of Novel Predictors of Burnout in Frontline Workers During Covid-19

The context of Covid-19 has offered an unusual cultural landscape for examining how workers view their own position relative to others, and how individuals respond to prolonged exposure to workplace stress across different sectors and cultures. Through our recent work tracking the well-being of frontline workers in the UK and Ireland (the CV19 Heroes project), we have uncovered additional psychological factors that have not been accounted for in previous models of occupational stress or burnout. In recent months, frontline workers have worked to protect the community from the threat of SARS-CoV-2 and, simultaneously, have evaluated their perceptions of collective efforts of others as either congruent or incongruent with collective goals (e.g., lowered mortality and morbidity): we call this novel aspect solidarity appraisal. These frontline workers have been hailed as heroes, which we argue has led to the creation of an implicit psychological contract (the hero contract) between frontline workers and the public. Here, the heroes are willing to "go above and beyond" for the greater good, with the expectation that we (the public) do our part by adhering to public health guidelines. Where frontline workers perceive incongruence between the words and actions of others in working toward collective goals this drives negative affect and subsequent burnout. In this perspective article, we evaluate the cultural context of the pandemic in the UK and Ireland and suggest important socio-cultural factors that contribute to perceptions of solidarity, and how this may relate to burnout and worker welfare during and beyond the pandemic context.

Owner Personality, Owner-Dog Attachment, and Canine Demographics Influence Treatment Outcomes in Canine Behavioral Medicine Cases

Human and canine parameters can affect the development of canine behavior problems, although their influence on the dog's response to veterinary behavioral treatment remains unclear. This study aimed to investigate the possible associations between canine behavior following clinical intervention and canine demographic characteristics, owner personality and owner-dog attachment. The study included 131 dog-owner dyads who attended a veterinary behavioral service. Owners completed the C-BARQ at baseline, 3-months and 6-months, and the 10 Item Personality Inventory and Lexington Attachment to Pet Scale at baseline. Data were analyzed for the effect of clinical intervention on C-BARQ subscale scores using mixed effect models. Binary logistic regression models were used to analyze the association between behavior change and canine and owner parameters. Within 6-months of veterinary consultation, trainability increased (coefficient 0.03, p = 0.01) and chasing (coefficient −0.04, p = 0.02), separation-related behavior (coefficient −0.04, p = 0.01) and energy level (coefficient −0.04, p = 0.05) decreased. Treatment outcomes were associated with both canine and owner variables. Canine behavior at baseline was the most consistent predictor of behavior change with less desirable baseline behavior associated with greater odds of decreased problem behavior at three- and 6-months post-consultation across most C-BARQ subscales. Canine age and weight; owner conscientiousness, extraversion and openness; and owner-dog attachment were also associated with treatment outcomes for some behavioral categories. These findings could be used by veterinarians to formulate more accurate prognoses and provide owners with targeted advice to reduce the influence of background factors on the dog's response to clinical behavioral intervention.

An integrated review of the role of communication in veterinary clinical practice

Background

There is a growing interest in exploring the nature of communication in veterinary medicine and understanding how veterinary practitioners communicate with their clients and other professionals. This is the first integrative review of literature on veterinary communication. Applying the PRISMA model, the PubMed, PsychInfo and ERIC databases were searched using keywords such as ‘veterinary’, ‘vet’, ‘communication’ and ‘interaction’ for related articles published between 1 January 2000 and 31 December 2018.

Results

Keyword searching through the databases yielded 1572 related studies. Only 48 of these studies were included in our analysis after an in-depth review by two independent reviewers using the critical appraisal skills Programme frameworks with high inter-rater reliability (Cohen’s kappa coefficient κ > 0.8). The existing body of research on veterinary communication can be classified into three major areas: (a) client–veterinarian communication, (b) cross-disciplinary communication in a professional veterinarian team and (c) training of veterinary communication skills. This review details the complexity and heterogeneity of agenda in the field of veterinary communication. The included studies indicate that veterinary practitioners are not equipped with specific communication skills to address different agendas in veterinary communication. The veterinary curriculum should include a component on communication training that can help veterinary students acquire necessary communication skills that allow them to effectively communicate with clients and other professionals

Conclusion

This review detailed the complexity of agendas in the field of veterinary communication. The results indicate that veterinary practitioners can further benefit from training on specific communication skills that address the agendas found in veterinary communication research. Furthermore, the veterinary curriculum should include a component on communication training that equips veterinary students with the necessary communication skills that allow them to effectively communicate with different stakeholders such as clients and colleagues with and across the field of veterinary science.

Evaluation of team effectiveness and personal empathy for associations with professional quality of life and job satisfaction in companion animal practice personnel

OBJECTIVE

To examine variables of veterinary team effectiveness and personal empathy for associations with professional quality of life (ie, compassion satisfaction, burnout, and secondary traumatic stress) and job satisfaction in companion animal practice personnel.

DESIGN

Cross-sectional survey.

SAMPLE

Data from 232 surveys completed by personnel from 10 companion animal veterinary practices in 2 regions of the United States between April 7 and December 20, 2016.

PROCEDURES

Online surveys were used to collect practice-level data (eg, practice type, setting, and staffing) and individual-level data (eg, demographics, job position, and years in the position and profession). Instruments used in developing the surveys included the Team Effectiveness Instrument, Davis Interpersonal Reactivity Index, Professional Quality of Life Scale, and a measure for job satisfaction. Data were evaluated for associations with professional quality of life and job satisfaction.

RESULTS

Individual engagement was positively associated with job satisfaction, negatively associated with secondary traumatic stress, and moderated by levels of personal distress for compassion satisfaction and burnout. Toxic team environment was positively associated with burnout and negatively associated with job satisfaction. Empathetic concern and personal distress were both positively associated with secondary traumatic stress. Empathetic concern was moderated by team engagement for compassion satisfaction.

CONCLUSIONS AND CLINCAL RELEVANCE

Results indicated that variables influencing professional quality of life and job satisfaction were multimodal and included aspects of team effectiveness and empathy; therefore, workplace strategies that enhance individual and team engagement and mitigate toxic team environments could potentially improve professional quality of life and job satisfaction in veterinary personnel.

Development and Application of the Lincoln Adherence Instrument Record for Assessing Client Adherence to Advice in Dog Behavior Consultations and Success

Adherence to the advice of medical practitioners is critical to successful treatment outcomes and has been much researched in human health, but is less well studied in the veterinary and clinical animal behavior fields. Given that the management of behavior problems often requires substantial change in established client behavior, it is likely that adherence is a substantive issue affecting success. However, little is known about the relationships between relevant factors, and there is no established way of assessing these. Therefore, the aim of this study was to develop an instrument for coding factors likely to impinge on pet owner adherence to behavior advice and validate its utility through the identification of the factors appearing to relate most closely to a successful treatment outcome in a sample population from our clinic. Potential factors affecting adherence were identified from human health and animal behavior studies, and a survey instrument developed with items matched to these factors. Forty-two dog owners who had attended the University of Lincoln Animal Behavior Clinic over a 2-year period provided data used in the analysis. The assessment of treatment outcome success by clients and clinicians was correlated, but clinicians tended to overestimate success by half a point on a 5-point scale. Eleven items relating to adherence were found to correlate with client ratings of treatment success in a univariate analysis, with three of these remaining in an ordinal logistic regression model. These three related to trust in the advice given by the clinician, concern over distress caused to the pet in the longer term and the perceived recommendation of treatment measures that had failed. By further examining the relationship between all of these factors in a hierarchical cluster analysis, we were able to postulate ways in which we might be able to improve client adherence and thus treatment success. This provides a model for the application of the instrument in any veterinary behavior practice wishing to use client feedback to rationalize areas of the consultation which might be improved.

Factors related to work and life satisfaction of veterinary practitioners in Germany

Objectives

Veterinary practitioners’ working situation is both challenging and changing. They have higher levels of work-related stress and suicide risk than the general population. The proportion of women is increasing, and in Germany especially women and employed veterinarians are reported to be less satisfied than comparable subgroups of the general population. In this study we identified key factors associated with work and life satisfaction among veterinary practitioners in Germany.

Design

Questionnaire-based cross-sectional survey.

Setting

All veterinary practitioners registered in Germany in 2016.

Participants

There were 2549 respondents, of whom 1930 met the inclusion criteria for further analysis. They had a median age of 37 and the majority of respondents were women (79.3 per cent). Almost two-thirds (63.8 per cent) worked as employed veterinarian.

Primary outcomes

Importance of different job characteristics measured in 5-point Likert items, work satisfaction measured on a 5-point Likert item and life satisfaction measured in 11-point Likert items.

Secondary outcomes

Facets such as satisfaction with leisure time, family life, health and standard of living, information on working conditions such as working time, income, as well as year of birth and other demographic data.

Results

A ‘good working atmosphere’ was the most relevant job characteristic for all veterinary practitioners. Work satisfaction of employed practitioners is closely linked to satisfaction with their colleagues. This link is less pronounced for self-employed practitioners. A ‘reasonable salary’ was the second and ‘holidays and leisure time’ was the third most important job characteristics for employed practitioners. A ‘good working atmosphere’ and ‘family friendly arrangements’ were statistically significantly more important for women than for men, while a ‘reasonable salary’ was more important for men.

Conclusions

Our results indicate strong associations between levels of work satisfaction and various work-related factors in subgroups of veterinary practitioners in Germany that reduce life satisfaction. The strength of some associations differs between men and women, as well as between self-employed and employed veterinarians. Outgoing students should be better prepared for the challenging working conditions that they face in veterinary practice. Salary levels should be improved and the working conditions adapted to the respective subgroups in order to increase work and life satisfaction.