Veterinary surgeons and suicide: a structured review of possible influences on increased risk

Life satisfaction, psychological distress, compassion satisfaction and resilience: when the pleasure of helping others protects veterinary staff from emotional suffering

INTRODUCTION

Individuals working in veterinary field suffer significantly from mental health problems, and research has extensively focused on psychological and work-related predictors of psychological distress. This study intended to approach psychological distress through a positive lens by investigating the predictive role of life satisfaction on psychological distress in veterinary staff, and the mediating effect of compassion satisfaction, resilience and perceived social support.

METHODOLOGY

A total of 868 veterinary staff (i.e. veterinarians, veterinary nurses, veterinary assistants and veterinary administrative staff) completed a web-survey assessing life satisfaction, psychological distress, compassion satisfaction, resilience, and social support.

RESULTS

Life satisfaction negatively predicts psychological distress, and compassion satisfaction and resilience showed a mediation effect on the relationship between life satisfaction and psychological distress, with compassion satisfaction explaining 59% and resilience 6.4% of the effect of life satisfaction on psychological distress.

CONCLUSION

Current data support the role of life satisfaction as a protective dimension on psychological distress within a broader sample population of veterinary staff in Portugal, highlighting the role of compassion satisfaction and resilience in contributing in minimising distress among veterinary staff.

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.

Empathy and mental health in veterinary medicine

In veterinary medicine, the relationship between empathy and mental health presents a complex and important aspect of professional well-being. Veterinarians are frequently exposed to numerous work-related stressors and are therefore more likely to experience mental health disorders and commit suicide. Due to the specific nature of the profession, veterinarians deal with negative patient outcomes, inform owners of unfavourable news, handle heavy workloads, and professional isolation. Psychological stress is a result of all these factors coming together, and it can lead to anxiety, depression, burnout, and even frequently reported suicide. Animal euthanasia has been recognised as a unique professional risk factor that can have harmful psychological effects on veterinary professionals.This paper explores the role of empathy in the mental health of veterinarians and other veterinary staff, and how this might contribute to their vulnerability to psychological stress and suicidal ideation. Empathy plays an important role in interpersonal interactions, while also influencing human-animal relationships, which adds a whole new level of complexity to the doctor-patient dynamic in this field. Veterinarians are responsible for providing compassionate care for both the animals they treat and their owners. They must manage the emotionally demanding work while preserving their mental health by balancing between providing empathetic care and sustaining their own emotional boundaries. To alleviate the negative effects of psychological stress, veterinary professionals require interventions such as peer support groups, stress management training, and mental health support programmes.

Overcommitment, Work-Related Behavior, and Cognitive and Emotional Irritation in Veterinarians: A Comparison of Different Veterinary Working Fields

Mental health is a serious problem among veterinarians. The aim of this study was to analyze work-related behaviors and experience (AVEM), overcommitment (OC), and cognitive and emotional irritation (IS) in different veterinary working fields. The survey included 724 German veterinarians (average age 41.0 ± 9.72 years). Validated questionnaires were used to assess overcommitment, work-related behavior and experience patterns (health-promoting pattern G or S; health-hazardous risk pattern A or B), and irritation in several working fields. A correlation analysis and a multivariate test were performed. Increased OC was observed in 35.8% of veterinarians (mixed animals vs. inspectors, p = 0.042; small vs. mixed animals, p = 0.001). A total of 66% of veterinarians exhibited AVEM risk pattern A or B. There was no significant association of AVEM risk patterns and veterinary specialty. Only the AVEM dimension "tendency toward resignation in the face of failure" differed among working fields (p = 0.04). Regardless of direct animal contact, German veterinarians showed increased psychological stress. Inadequate compensation and prolonged stress are significant factors that can lead to burnout or depression. These risks should be considered in the context of occupational healthcare.

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.

Understanding psychological outcomes following exposure to potentially morally injurious events in animal care: development of the Moral Distress-Posttraumatic Growth Scale for Veterinary Professionals

AIMS

To generate a taxonomy of potentially morally injurious events (PMIE) encountered in veterinary care and develop an instrument to measure moral distress and posttraumatic growth following exposure to PMIE in the veterinary population.

METHODS

Development and preliminary evaluation of the Moral Distress-Posttraumatic Growth Scale for Veterinary Professionals (MD-PTG-VP) employed data from veterinary professionals (veterinarians, veterinary nurses, veterinary technicians) from Australia and New Zealand across three phases: (1) item generation, (2) content validation, and (3) construct validation. In Phase 1 respondents (n = 46) were asked whether they had experienced any of six PMIE and to identify any PMIE not listed that they had experienced. In Phase 2 a different group of respondents (n = 11) assessed a list of 10 PMIE for relevance, clarity and appropriateness. In Phase 3 the final instrument was tested with a third group of respondents (n = 104) who also completed the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT), a measure of posttraumatic stress, and the Stress-Related Growth Scale-Short Form (SRGS-SF) a measure of perceived posttraumatic growth. Spearman's correlation coefficients were calculated between respondent scores on each of the MD-PTG-VP subscales, the SPRINT, and the SRGS-SF to assess construct validity.

RESULTS

A 10-item taxonomy of PMIE encountered in veterinary care was generated in Phase 1. Items were deemed relevant, clear and appropriate by veterinary professionals in Phase 2. These were included in the developed instrument which measures frequency and impact of exposure to 10 PMIE, yielding three subscale scores (exposure frequency, moral distress, and posttraumatic growth). Assessment of construct validity by measuring correlation with SPRINT and SRGS-SF indicated satisfactory validity.

CONCLUSIONS

The MD-PTG-VP provides an informative tool that can be employed to examine professionals' mental health and wellbeing following exposure to PMIE frequently encountered in animal care. Further evaluation is required to ascertain population norms and confirm score cut-offs that reflect clinical presentation.

CLINICAL RELEVANCE

Once fully validated this instrument may be useful to quantify the frequency and intensity of positive and negative aspects of PMIE exposure on veterinary professionals so that accurate population comparisons can be made and changes measured over time.

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.

Suicide rates among health-care professionals in Norway 1980-2021

BACKGROUND

Suicide rates have been high in several health-care professions. Suicide rates were described in physicians, dentists, veterinarians, psychologists, pharmacists, nurses, as well as theologians, other graduates and the general population in Norway.

METHODS

Data on educational attainment were linked to data on suicide and all-cause mortality from 1980 to 2021. Suicide rates were reported per 100,000 person-years. The total number of person-years included in the study was 66.4 and 67.2 million for males and females, respectively.

RESULTS

Between 1980 and 2021, male veterinarians (35.9, 95 % CI 19.3-52.4), physicians (25.7, 21.3-30.2) and nurses (22.2, 16.6-27.7) had higher suicide rates compared others with higher education (11.7, 10.7-12.7). For females, this was the case for psychologists (15.0, 8.2-21.7) and nurses (9.3, 8.3-10.3), vs. others with higher education (5.1, 4.2-6.0). Suicide rates declined over the four decades for most groups. For physicians, suicide rates declined and approached the suicide rate of others with higher education. Suicide rates among physicians increased with age, with physicians over 60 years having twice as high suicide rates compared to others with higher education.

LIMITATIONS

The study included only educational status, not current occupation or employment status. This is a descriptive study, with some known risk factors for suicide not accounted for.

CONCLUSIONS

Suicide rates for physicians declined over time, but not for nurses. From 2010 to 2021, nurses of both genders was the only group with higher suicide rates compared to other graduates. The increased suicide rates among veterinarians, nurses, female psychologists and elderly physicians are concerning.

Prevalence of mental health symptoms in Austrian veterinarians and examination of influencing factors

Although previous studies point to a high mental health burden in veterinarians, little is known about mental health in Austrian veterinarians as well as potential underlying factors of poor mental health. We assessed mental health in Austrian veterinarians, compared it to the mental health of the general population, and explored potential risk factors for poor mental health in veterinarians. A total of n = 440 veterinarians (72.0% women; mean age: 44.53 ± 11.25 years) took part in an online survey in 2022 in which validated screening tools for symptoms of depression (PHQ-9), anxiety (GAD-7), sleep disorders (ISI-2), perceived stress (PSS-4), and alcohol abuse (CAGE) were applied. Multivariable logistic regression revealed higher adjusted odds for exceeding cut-offs for clinically relevant depressive, anxiety, and insomnia symptoms in veterinarians (1.35-2.70) compared to the general population. Mental health symptoms in veterinarians were associated with female gender, physical inactivity, higher smartphone usage, higher working hours, less professional experience, and working with pets. In conclusion, it appears that veterinarians encounter mental health challenges that are more pronounced than those experienced in the general population. The teaching of strategies to improve mental hygiene as part of the curricula of veterinary education and targeted training and mentoring of employers and their team should be implemented to improve mental health in the veterinary profession.

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.

Combining sentiment analysis and text mining with content analysis of farm vet interviews on mental wellbeing in livestock practice

BACKGROUND

The aim of the How Farm Vets Cope project was to co-design, with farm veterinary surgeons, a set of web-based resources to help them and others deal with the different situations that they can face. As part of the wider project, participants were recruited for one-to-one semi-structured phone interviews. These interviews focused on elements of job satisfaction and how the participants coped during periods of poor mental wellbeing or with setbacks and failure.

METHODS

Transcripts of these interviews were analysed using both quantitative methods of sentiment analysis and text mining, including term frequency/inverse document frequency and rapid automated keyword extraction, and qualitative content analysis. The twin aims of the analysis were identifying the important themes discussed by the participants and comparing the results of the two methods to see what differences, if any, arose.

RESULTS

Analysis using the afinn and nrc sentiment lexicons identified emotional themes of anticipation and trust. Rapid automated keyword extraction highlighted issues around age of vets and support, whilst using term frequency/inverse document frequency allowed for individual themes, such as religion, not present across all responses, to be identified. Content analysis supported these findings, pinpointing examples of trust around relationships with farmers and more experienced vets, along with some examples of the difference good support networks can make, particularly to younger vets.

FINDINGS

This work has confirmed previous results in identifying the themes of trust, communication and support to be integral to the experience of practicing farm veterinary surgeons. Younger or less experienced vets recognised themselves as benefiting from further support and signposting, leading to a discussion around the preparation of veterinary students for entry into a farm animal vet practice. The two different approaches taken showed very good agreement in their results. The quantitative approaches can be scaled to allow a larger number of interviews to be utilised in studies whilst still allowing the important qualitative results to be identified.

Suicidality in Veterinarians: Trends at Different Career Stages and a Test of the Interpersonal Theory of Suicide

OBJECTIVE

The aim of this study was to investigate sex differences in suicide ideation and attempt at different career stages and test hypotheses derived from the Interpersonal Theory of Suicide (IPTS) in a sample of veterinarians.

METHOD

The sample of currently practicing veterinarians used for this study (N = 10,319) was derived from a larger sample. Participants completed an online self-report questionnaire.

RESULTS

As predicted, women generally had a higher prevalence of suicide ideation and attempt across career stages, except men and women showed similar rates of suicide attempt after veterinary school. Contrary to hypotheses, no interaction effects between IPTS variables were observed. However, perceived burdensomeness, thwarted belongingness, and hopelessness exhibited the main effects of suicide ideation, and there were main effects of perceived burdensomeness and hopelessness on suicide attempt. Compared with perceived burdensomeness and thwarted belongingness, hopelessness had a relatively more robust relationship with suicide ideation. We also found a significant relationship between fearlessness about death and suicide attempt, but no relationship between self-reported pain tolerance and suicide attempt.

CONCLUSIONS

Some of our findings were consistent with the IPTS while others were not. Future research would benefit from a longitudinal examination of suicidality in veterinarians.

Physical stress and musculoskeletal complaints of veterinarians - A narrative review

INTRODUCTION

Veterinarians have high physical workloads. The aim of this narrative review is to evaluate the literature on typical physical workloads, such as lifting/carrying and forced position (during surgery) and predictors of injuries. The health complaints of veterinarians were also examined.

METHODS

Diverse databases were used. Prevalence rates of total workloads (also including surgery), health complaints, musculoskeletal discomfort, and predictors of injury, musculoskeletal disorders, and precaution awareness were examined.

RESULTS

Thirteen studies were included. The most prevalent injury was animal attacks (9%-84%). Working in large and mixed practice types were predictors of injuries or musculoskeletal disorders (e.g., shoulder, lower back, head/neck) compared to other types of practice.

CONCLUSION

The study findings presented here clearly show a high need for intervention to minimize and prevent occupational risks. Ergonomic working conditions and occupational safety training can reduce the risk of musculoskeletal disorders.

Veterinarian-Chasing A Dream Job? A Comparative Survey on Wellbeing and Stress Levels among European Veterinarians between 2018 and 2023

Whilst recognizing the abundantly positive aspects within the different domains of the veterinary profession, the challenging socio-economic and cultural working climate has been identified as a source of veterinary mental wellbeing issues. This mixed methods study provides an overview of the mental state of veterinarians across Europe via two cross-sectional surveys in 2018/2019 (n = 14,559 veterinarians) and in 2022/2023 (n = 12,393 veterinarians). Mental wellbeing was assessed using 3 indicators: self-reported stress levels, the need for medical leave due to reduced mental wellbeing (22% and 23%, resp., in 2018/2019 and 2022/2023) and the seven-question Warwick-Edinburgh Mental Wellbeing Scale (2018/2019: 25, 2022/2023: 24.8). In both surveys, important differences were spotlighted between countries, but early-career veterinarians and female veterinarians were most at risk of decreased mental wellbeing all over Europe for all indicators. In conclusion, stress levels and need for medical leave due to reduced mental wellbeing remained at comparatively high levels across the two surveys and standardized mental wellbeing scores remained equally low. Notwithstanding the increased attention given to veterinary wellbeing in the last decade, our results underline that major efforts remain necessary, by creating more supportive and attractive workplaces that prioritize wellbeing, a good work/life balance, and providing job satisfaction.

Euthanasia of animals - association with veterinarians' suicidal thoughts and attitudes towards assisted dying in humans: a nationwide cross-sectional survey (the NORVET study)

BACKGROUND

Veterinarians are an occupational group with an increased suicide risk. Euthanasing animals may influence both veterinarians' views on assisted dying in humans and their suicide risk. We investigated (I) attitudes towards assisted dying, (II) whether the field of work and the frequency of euthanasing animals were associated with positive attitudes towards human euthanasia, and (III) whether frequently euthanasing animals was associated with serious suicidal thoughts.

METHODS

We conducted a nationwide cross-sectional study among veterinarians in Norway (response rate: 75%). Logistic regression models were used to calculate the odds ratios for both positive attitudes towards human euthanasia and serious suicidal thoughts. The analyses were adjusted for socio-demographic and work-related factors.

RESULTS

Fifty-five percent of the veterinarians agreed that euthanasia should be permitted for humans with a fatal disease and short life expectancy. Working with companion animals was independently associated with positive attitudes towards human euthanasia (OR = 1.66 (95% CI: 1.23-2.23)), while veterinarians' frequency of euthanasing animals was not. Frequency of euthanasing animals was independently associated with serious suicidal thoughts, OR = 2.56 (95% CI: 1.35-4.87).

CONCLUSIONS

Veterinarians' attitudes towards assisted dying in humans did not differ from those of the general population. Veterinarians' frequency of euthanasing animals was not associated with positive attitudes towards euthanasia in humans. However, veterinarians working in companion animal practices were more likely to have positive attitudes towards euthanasia in humans. Moreover, euthanising animals five times or more a week was associated with serious suicidal thoughts. We need more research to infer about causality in these findings.

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.

Solutions-Based Approach to Urban Cat Management-Case Studies of a One Welfare Approach to Urban Cat Management

Urban free-roaming cats create concern about their impacts on wildlife and human health, leading to the use of trap-adopt-kill methods to manage these populations. This method is ineffective at decreasing the free-roaming cat population and has a negative impact on cat caregivers' well-being. Using semi-structured interviews, this study explored the relationship that semi-owners (people who feed cats but do not perceive ownership) and owners of multiple cats have with the cats they care for, and the social and psychological impacts of an alternative assistive-centered approach to urban cat management. This approach to semi-owned and owned cats provided free sterilization and preventative healthcare. Our findings demonstrate that the caregivers had a strong emotional bond with the cats they cared for. The caregivers also experienced a positive impact on their quality of life, and indicated an improvement in the cats' welfare after having the cats sterilized through this program. Additionally, the cat caregivers indicated that they had a negative view of agencies, such as the municipal council. It is recommended that an assistive-centered approach to urban cat management be prioritized by local councils and welfare agencies to improve caregivers' quality of life and psychological well-being, whilst also improving cat welfare. The implementation of this assistive-centered management approach could improve the relationship between communities and the agencies involved, leading to the continuous reporting of free-roaming cats for sterilization. This assistive-centered approach has the potential to reduce the free-roaming cat population, their effects on wildlife, nuisance complaints, and council impoundments, and is aligned with the One Welfare philosophy.

When the Going Gets Challenging-Motivational Theories as a Driver for Workplace Health Promotion, Employees Well-Being and Quality of Life

Being characterized by high numbers of physical and mental health issues, the veterinary sector faces some negative peculiarities compared to other professions. To evaluate and possibly improve employees' well-being and to reward according to individual motivation, managing staff and the profession in general must understand every individual's motivation. Defining the motivation of veterinary professionals in a multidisciplinary way can be the first step in increasing the well-being of employees. To assemble current theories of work motivation and adapt and extend them to serve the veterinary profession, basic knowledge of the classical general psychological motivational theories and work motivational theories is inevitable. The authors aimed to illustrate the different motivational theories' key aspects and historical evolution to provide veterinary personnel with broad knowledge. In addition, the availability of already existing literature should be evaluated. A scoping review was performed. Methodological, empirical, review, and theoretical articles were evaluated. Only a minority of the studies (1.3%) evaluated motivational theories in veterinary health care. This reflects that there is a need for research in this field. Still, it is illustrated that the veterinarian profession would benefit from the implementation of general psychological as well as motivational work theories.

Determining Hopelessness Levels and Related Factors in Veterinary Students

This study addresses the level of hopelessness experienced by last-year students at a faculty of veterinary medicine. Moreover, it identifies the factors behind this emotion. A face-to-face questionnaire was administered to 238 last-year students from 2017 to 2021. The questionnaire included questions about sociodemographic and other characteristics, along with the Beck Hopelessness Scale. Data analysis included descriptive statistics, factor analysis, and chi-square tests. The findings suggested that nearly 60% of the respondents experienced hopelessness. The analysis also revealed a significant relation between hopelessness levels and variables such as year, gender, expected time of first employment, and psychological status. The results suggested that the current state of mental health is worrying for the veterinary faculty students and therefore for the future veterinarians. For this reason, it can be argued that steps to be taken towards a solution in the veterinary education periods are required.

Relationships between diversity demographics, psychological distress, and suicidal thinking in the veterinary profession: a nationwide cross-sectional study during COVID-19

Purpose

This study aimed to determine the relationship between demographic diversity and veterinary professionals regarding their psychological distress and suicidal experiences. This study also aimed to determine what demographic factors were associated with psychological distress and suicidal experiences for veterinary professionals.

Methods

This study used a cross-sectional web-based questionnaire to assess the prevalence of diversity, psychological distress, and suicidality in individuals over 18 working in the veterinary field within the United States. The study received 2,482 responses resulting in 2,208 responses that were included in the analysis. Descriptive statistics were performed to identify the categories with the highest rates of psychological distress, suicidal thoughts, and suicidal behaviors. Binomial logistic regressions were conducted to identify the strongest statistical predictors of psychological distress (Kessler-6-K6), suicidal thinking and suicide behaviors.

Results

Of the 2,208 respondents included in the analysis, 888 (41%) were experiencing serious psychological distress and 381 (17.3%) had considered suicide in the past 12 months. Results of the binomial regressions indicate gender, social class, age, and disability status were the strongest predictors of psychological distress. When controlling for psychological distress, the strongest predictors of suicidal thinking were sexual orientation, marital status, and professional role.

Implications

Limited research has been done to explore the relationship between demographic diversity of veterinary professionals and psychological distress, suicidal thoughts, and suicidal behaviors specifically. These results shed light on multiple demographic factors that promote and attenuate mental health, as well as the importance of asking respondents their demographic identities in veterinary medicine research. This research attempts to identify these mental health factors without collapsing categories with small sample sizes, which does cause a limitation in statistical power, yet also demonstrates how to increase inclusivity in research.

An anthropologist's voice in a veterinarian's noise: gearing up for new cultural realities

Over the past three decades, the veterinary profession has faced a cultural shift towards postspeciesism that requires a reassessment of the foundations of the existing distinctions between human and non-human animals proclaimed by the speciesism paradigm, which represents institutionalized discrimination against species and recognizes only the subjectivity of humans. Based on ethnographic observations in anthropological fieldwork and using speciesism/postspeciesism distinction, we aimed to explain the main causes of small animal practitioners' work-related stress and apply humanistic knowledge to recommend ways to alleviate the negative effects of the work environment. The explanatory model of disease, illness, and sickness, the example of the concept of family, and the circumstances of the feminization of the veterinary profession are discussed to illustrate the divergence between speciesist naturalistic veterinary knowledge and the postspeciesist cultural framework and its consequences. By failing to accommodate the changing values towards animals and by failing to challenge the anthropocentric hierarchy of values, the speciesist rationale of the veterinary profession contributes to many of the problems faced by practicing veterinarians. The incorporation of a modern moral-philosophical mindset towards animals may not even be possible because veterinary science is subject to a paradigm that is irreversibly tied to institutional discrimination against species and defies reflection on veterinary science itself. However, the veterinary profession has a privileged position in establishing an alternative ontological thinking and an alternative conception of "animal life." Anthropological knowledge was applied to anticipate further intervention of social and cultural sciences in the problems of small animal practitioners. Rather than further diversifying and increasing expectations towards veterinarians by expecting them to acquire additional skills, we propose another practitioner who can support, mediate, and enhance veterinary performance - the cultural anthropologist. With their deep knowledge of cultural differences and social dynamics, they can collaborate with veterinarians to act as a liaison between cultures, paradigms, and species.

A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors

Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.

Understanding Job Satisfaction and Occupational Stressors of Distinctive Roles in Zoos and Aquariums

For professionals caring for humans or non-human animals, many joys are to be found in working towards what an individual believes to be their calling, especially as they contribute to purposeful, meaningful work consistent with and intrinsic to their own values and beliefs. However, there can be downfalls. Empathic strain, conflict between co-workers, dissatisfaction with upper management, lack of opportunities to make positive changes, limited or no access to level and experience-appropriate professional development, and other stressors are all risks carried by organisations concerned with animal welfare. In the present study, a survey on job satisfaction and workplace stressors was completed by 311 zoo and aquarium professionals working in a range of roles from junior animal care staff to curator. Respondent profiles were created using Multiple Correspondence Analysis (MCA) and four distinct clusters were identified through Hierarchical Clustering on Principal Components (HCPC), highlighting common themes in different levels of experience and in job roles regarding stressors, satisfaction, and feelings about their work and workplaces. Overall, many zoo professionals were concerned with lacking the ability to feel empowered to do their best for animal welfare, and they described a link between the staff welfare and their perceptions of the welfare of the animals they cared for. Through identifying and understanding where organisations can better support their staff it is possible to target and reduce the number of common stressors faced by zoo professionals, leading to increased staff retention, higher job satisfaction, and an improved ability to perform at their best for animal welfare.

Links between pet ownership and exercise on the mental health of veterinary professionals

Background

Connections between the effects of pet ownership and exercise on mental health have previously been demonstrated in different populations. However, little is known about the potential effects of pet ownership and exercise on the mental health of veterinary professionals. Since these individuals have a high prevalence of poor mental health and suicide, while they deal with pets professionally, we investigated the impact of pet ownership, exercise and different types of pet ownership on this demographic group.

Method

Veterinary professionals over 18 years old answered an online questionnaire about pet ownership, exercise, mental health (including anxiety, depression and suicidal ideation) and mental health correlates. Regression models were used to identify variables significantly related to mental health outcomes.

Results

Of 1087 respondents, pet owners were more depressed than non-owners, while anxiety or suicidal ideation was not associated with pet ownership. Dog and horse owners were psychologically healthier (less anxiety, less suicidal ideation) than non-owners of these species. Veterinary professionals who ran regularly had lower anxiety and depression. Those who walked regularly and spent less time sitting experienced fewer depression symptoms.

Conclusions

Running, walking and avoiding prolonged sitting might protect the mental health of veterinary professionals. The type of pet owned may be an important factor in the relationship between pet ownership and mental health; however, generally, pet ownership was associated with worse mental health outcomes in this demographic group. Future studies should determine the causal nature of these relationships.

Suicide in veterinary medicine: A literature review

Veterinarians are commonly exposed to occupational stressors, including excessive workload and financial constraints. These stressors can lead to psychological distress, which typically results in mental health disorders such as depression, anxiety, and burnout and can even culminate in suicide attempts or suicide deaths. Risk factors associated with poor mental health and high rates of suicide in veterinary practitioners include continuous exposure to challenging scenarios, such as interpersonal conflicts, performing euthanasia, and easy access to lethal means of suicide, such as opioids and anesthetics. The previous studies highlight the urgent need for a better understanding of predisposing factors, mental health-related improvements in the professional environment, and the subsequent establishment of primary mental health-related care policies. Effective ways to promote mental health and prevent suicide may include social support, resilience, developing coping skills, promoting a healthy work environment, and discouraging perfectionist behaviors. This review aimed to summarize findings in studies that have investigated mental health and suicide in veterinarians and veterinary students and highlight measures that could be implemented as options for mental health promotion and suicide prevention.

Trends in Animal Shelter Management, Adoption, and Animal Death in Taiwan from 2012 to 2020

This current study investigated the trends in public animal shelter intakes and outcomes and the workload of shelter veterinarians in Taiwan from 2012 to 2020 and reports spatial, temporal, and socioeconomic factors associated with these trends. Information about the public animal shelter management of dogs and cats from all counties of Taiwan between 2012 and 2020 was acquired from the National Animal Shelter Management System of the Council of Agriculture Executive Yuan in Taiwan. Ridge regression followed by multivariable linear regression was conducted to examine the risk factors for animal intakes, outcomes, the number of adopted animals, and the estimated veterinary workload in public animal shelters. The intakes and outcomes of shelter animals significantly decreased over time. Euthanasia, which was performed in the shelters, was positively associated with shelter animal intakes and outcomes as it resulted in animal outcomes and thus facilitated the flow of animals in the shelters. Adoption and trap-neuter-vaccination-return, in replacement of euthanasia, became the main reasons for animal outcomes, and with every increase in human fertility rate, the monthly number of adopted animals over the number of animals entering shelters increased by 1.10% (95% CI: 0.21 to 2.00). The veterinary workload in the shelters of two counties exceeded what is regulated by law (i.e., 100 animals per veterinarian) in 2018 and increased to six counties in 2020. This current study reported important trends in the management of public animal shelters in Taiwan, the increasing workload of shelter veterinarians, and factors associated with these trends. It built the epidemiological foundation for future research on methods of improving shelter management and work conditions for shelter staff.

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.

Ethical and Practical Considerations Associated with Companion Animal Euthanasia

The reality that euthanasia in veterinary practice can end animal suffering but can also be used in circumstances that do not serve an animal's interest, can be a benefit for animals, and a burden for veterinary professionals, respectively. This essay addresses ethical and practical concerns associated with companion animal euthanasia, including defining euthanasia, why and when euthanasia should be performed, applying euthanasia in practice, contemporary methods, aftercare of deceased animals, and the consequences of euthanasia and dysthanasia for animals, animal owners, and veterinary professionals. We contend that an intention-based definition of euthanasia should be strictly applied in veterinary practice and that practitioners view euthanasia decisions as requests that can (and in some cases should) be declined, rather than as mandates.

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.

Intra-professional stress-demonstrating veterinarian identity in Hong Kong

OBJECTIVE

Little is known about the contributing factors of mental health among veterinarians in Hong Kong. This qualitative study aimed to examine potential contributing factors that lead to their stress and poor mental health.

PROCEDURES

Potential participants were screened and recruited using purposive and snowball sampling to maximise variations. Semi-structured interviews were conducted between December 2020 and April 2021. The data collection and analysis adopted the constructivist grounded theory's three-stage coding process and were thematically coded and analysed.

RESULTS

Eighteen veterinarians took part in the study. Intra-professional stress was classified by stressors from individual veterinarians, expectations of their workplace, and shared values among the profession. Participants expected themselves to exhibit professionalism when under low-quality workplace leadership with restrictions from the profession's institutional regulations and resources. The urbanised culture and cyberbullying phenomenon in Hong Kong contributed significantly to the stress and impacted their mental well-being.

CONCLUSION AND RELEVANCE

The quality of communication and the feasibility of meeting expectations were overarching concepts associated with intra-professional stressors. While this paper focuses on stressors residing within the veterinary community, veterinarians' responses to expectations of the animal-health enthusiast community were equally influential. This study enabled an international comparison of the profession's distress from non-Anglosphere, urbanised city, and will shed light on the development of future research and practice to improve the mental health of veterinarians, which directly influences the well-being of the animals and their owners in Hong Kong.

Variations in psychological disorders, suicidality, and help-seeking behaviour among college students from different academic disciplines

BACKGROUND

Elevated levels of suicidality, ADHD, mental ill-health and substance disorders are reported among college students globally, yet few receive treatment. Some faculties and courses appear to have more at-risk students than others. The current study aimed to determine if students commencing college in different academic disciplines were at a heightened risk for psychopathology, substance use disorders and suicidal behaviour, and examined variations in help-seeking behaviour.

MATERIALS AND METHODS

The study utilised data collected from 1,829 first-year undergraduate students as part of the Student Psychological Intervention Trial (SPIT) which commenced in September 2019 across four Ulster University campuses in Northern Ireland and an Institute of Technology, in the North-West of Ireland. The SPIT study is part of the World Mental Health International College Student Initiative (WMH-ICS) which uses the WMH-CIDI to identify 12-month and lifetime disorders.

RESULTS

Students from Life and Health Sciences reported the lowest rates of a range of psychological problems in the year prior to commencing college, while participants studying Arts and Humanities displayed the highest levels (e.g. depression 20.6%; social anxiety 38.8%). However, within faculty variations were found. For example, psychology students reported high rates, while nursing students reported low rates. Variations in help seeking behaviour were also revealed, with male students less likely to seek help.

CONCLUSIONS

Detecting specific cohorts at risk of psychological disorders and suicidality is challenging. This study revealed that some academic disciplines have more vulnerable students than others, with many reluctant to seek help for their problems. It is important for educators to be aware of such issues and for colleges to provide information and support to students at risk. Tailored interventions and prevention strategies may be beneficial to address the needs of students from different disciplines.

A Preliminary Assessment of Compassion Fatigue in Chimpanzee Caregivers

Compassion fatigue is defined as "traumatization of helpers through their efforts at helping others". It has negative effects on clinicians including reduced satisfaction with work, fatigue, irritability, dread of going to work, and lack of joy in life. It is correlated with patients' decreased satisfaction with care. Compassion fatigue occurs in a variety of helping professions including educators, social workers, mental health clinicians, and it also appears in nonhuman animal care workers. This study surveyed caregivers of chimpanzees using the ProQOL-V to assess the prevalence of compassion fatigue among this group. Compassion satisfaction is higher than many other types of animal care workers. Conversely, this group shows moderate levels of burnout and secondary traumatic stress; higher levels than other types of animal care workers and many medical professions. While compassion fatigue has an effect on the caregiver's experience, it has potential to affect animal welfare. Caregivers are an integral part of the chimpanzee social network. Compassion fatigue affects the caregiver's attitude, this could in turn affect the relationship and degrade the experience of care for captive chimpanzees. Compassion fatigue can be mitigated with professional development, mindfulness training, interrelationships among staff, and specialized training. This preliminary assessment indicates the work ahead is educating caregivers about compassion fatigue and implementing procedures in sanctuaries to mitigate burnout and secondary traumatic stress.

Authentic Conversations about Self-Care with Fourth-Year Veterinary Medical Students

Expanding literature on well-being within veterinary medicine has been instrumental in recognizing the prevalence of psychological distress among students and practitioners and promoting awareness and advocacy for well-being within teaching institutions, professional associations, and the workplace. However, greater focus on distress has also been critiqued for overemphasizing illness and reactive interventions, and a call has been made for more balanced conversations about veterinary well-being, with focus on strengths and proactive interventions. This Best Practices article highlights a proactive, strengths-focused intervention, aimed at increasing fourth-year students' awareness of self-care while in training and in their transition to the profession. Authentic conversations about self-care is a required part of clinical training at Kansas State University College of Veterinary Medicine. All students attend a private meeting with a behavioral scientist, engaging in an authentic conversation about their experience of stress and coping strategies. Current practices in providing stress management interventions are restricted to pre-clinical training. Authentic conversations about self-care are presented here as an alternative to current practices, which the authors argue are not adequately addressing students' needs during clinical training and the transition to the profession. Potential implications of providing self-care interventions during the clinical year of training include greater student engagement, increasing awareness, and self-efficacy as students make efforts to maintain well-being both in training and in the professional realm.

Identification and assessment of stress and associated stressors among veterinary students in India using a cross-sectional questionnaire survey

Background

Veterinary education, is a rigorous professional training program, which exposes students to significant academic and non-academic pressures. The identification of stressors and stress levels among veterinary students mighty help the designing and implementation of coping strategies to protect the students' mental health.

Methods

A 44-item based cross-sectional questionnaire survey was prepared and disseminated among veterinary students in India to identify the stressors responsible, measure the amount of stress, and relate stress to characteristics like gender, degree year, and family income. A total of n = 611 veterinary students across 14 states including 27 colleges/universities participated in the study. The collected data was evaluated for sampling adequacy, construct validity, and reliability using a set of statistical tests.

Results

The analysis revealed high sampling adequacy with a KMO value of 0.957 and a highly significant anti-image correlation (p < 0.001). The principal component analysis generated six factors or subscales which effectively explained 51.98% of the variance in the data, depicting high construct validity. The Cronbach's alpha value of 0.957 revealed high internal consistency for the questionnaire. Analysis revealed more than 94% of pupils under stress, with levels ranging from moderate to severe. Academic-related stressor (95.58%) was the leading cause of overall stress in the present study followed by inter- and intrapersonal and career related-stressors (93.12%) and exams and evaluation-related stressor (90.99%). In comparison to male students, female students reported significantly higher levels of overall stress, academic stress, and intrapersonal and interpersonal stress (p < 0.001) using Chi-square. The students from lower-income families experienced significantly higher overall stress as well as stress due to family responsibilities (p < 0.001). The first-year undergraduate students reported significantly higher (p < 0.001) stress due to family responsibilities-related stressors whereas second-year students due to social activities-related stressors. The hierarchal regression model predicted that gender, family income, academic-related stressors, inter- and intrapersonal and career-related stressors, and social activities-related stressors can be employed to evaluate overall stress among students, as they ensured the maximum variance in the data (p < 0.001).

Conclusions

To the best of our knowledge, this is the first Indian study to identify stressors, quantify associated stress and predict major attributes to be targeted in future studies for veterinary students.

Barriers to mental health help-seeking in veterinary professionals working in Australia and New Zealand: A preliminary cross-sectional analysis

Despite higher reported rates of mental ill-health than the general population, professionals working in the animal care industry have low reported rates of help-seeking behavior. Potential factors involved in veterinary professionals' reluctance to seek help include stigma toward mental ill-health, practical barriers to accessing supports, and a cultural normalization of symptoms in the industry. This preliminary study sought to explore these factors in a sample of veterinarians, veterinary nurses, and veterinary technicians and examine effects of gender, years' experience, and practice location. A total of 408 veterinary professionals working in Australia and New Zealand completed an online survey between June and December 2021 measuring perceived stigma, practical barriers to mental health help-seeking, perceptions of normalized psychopathology and sickness presenteeism. Results indicated moderate levels of both perceived stigma and barriers to mental health help-seeking. Interestingly, psycho/pathology (e.g., burnout, fatigue, and sickness presenteeism) was perceived to be a normalized aspect of the profession by majority of respondents. Although no effect of gender or geographic location were observed, stage of career did have an effect on findings. Early career veterinary professionals were identified as more vulnerable to perceived stigma and barriers to care. The practical and research implications of the findings are discussed and include the need for mental health to be more centrally incorporated into the veterinary curriculum and professional development. Also discussed is an agenda for future research aimed at improving the mental health and wellbeing of professionals working in the animal care industry.

Reducing occupational distress in veterinary medicine personnel with acceptance and commitment training: a pilot study

AIMS

To determine whether an educational programme targeting the reaction of veterinary personnel to difficult client interactions reduced burden transfer, stress and burnout in veterinary staff.

METHODS

Employees of three small-animal veterinary hospitals in the south-western United States of America were recruited and randomised to intervention (educational programme; n = 16) or control (no intervention; n = 18) groups. Participants of this randomised, parallel arms trial completed pre-programme assessment including the Burden Transfer Inventory (BTI), Perceived Stress Scale, and Copenhagen Burnout Inventory. Assessment was followed by two, group-format educational sessions, based on acceptance and commitment training, tailored to reducing reactivity to difficult veterinary client interactions (intervention group only). After training was completed, both groups were assessed using the same measures and the intervention participants provided use and acceptability ratings.

RESULTS

Intervention participants rated the programme as useful and appropriate, and reported that programme techniques were used a median of 43 (min 9, max 68) times during the 2 weeks prior to retesting. Relative to pre-programme scores, median post-programme scores for reaction (subscore of BTI) to difficult client interactions decreased in the intervention group (33 vs. 54; p = 0.047), but not in the control group (51 vs. 59; p = 0.210). Changes in median scores for stress and burnout from pre- to post-programme were non-significant for both groups.

CONCLUSIONS

This pilot and feasibility trial showed high rates of acceptability and use by participants, as well as promising reductions in burden transfer. A larger scale clinical trial with follow-up at extended time points is needed to more fully examine the efficacy of this novel programme.

CLINICAL RELEVANCE

Preliminary findings suggest this programme may be a useful approach to reducing occupational distress for individuals working in veterinary practice.

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.

Benefits of practice ownership among US private practice veterinarians extend to professional quality of life

Objective

To estimate the effects of practice ownership on wellbeing of US private practice veterinarians.

Sample

1,217 practice owners and 1,414 associate veterinarians (ie, nonowners) who participated in the 2021 AVMA Census of Veterinarians and Practice Owners Survey.

Procedures

A professional quality of life instrument was used to measure compassion satisfaction (CS; a positive attribute), burnout (BO), and secondary traumatic stress (STS) in practice owners and nonowners both as scores and as score categories (low, moderate, and high CS, BO, and STS). For hypothesis tests, propensity score matching was used, with owners (n = 595) matched to nonowners (595) on several demographic and employment factors.

Results

Owners had significantly (P < .001) higher CS scores (mean ± SE, 34.1 ± 0.3) and lower BO scores (26.1 ± 0.3) than nonowners (32.8 ± 0.3 and 26.9 ± 0.3, respectively), but STS scores were comparable between groups (27.4 ± 0.3 and 27.5 ± 0.3; P = .55). The prevalence of low CS scores and high BO scores was significantly (P < .001) higher for nonowners versus owners (53.8% vs 42.7% and 51.6% vs 46.4%, respectively). Both owners and nonowners had a high prevalence of high STS scores (81.8% and 83.2%, respectively; P = .53).

Clinical Relevance

Results suggested that practice ownership confers a benefit to private practice veterinarians in terms of CS and BO, but not STS. The prevalence of poor CS, BO, and STS scores was higher than reported previously for 2016 to 2018, suggesting an impact of the COVID-19 pandemic. The high prevalence of high STS scores in both groups warrants attention and action to protect the welfare of the veterinary workforce and support optimal patient care.

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.

An acceptance and commitment training program reduces burden transfer, stress, and burnout among veterinary healthcare teams

OBJECTIVE

To determine whether an acceptance and commitment training (ACT) program targeting reactions to difficult client interactions would reduce burden transfer, stress, and burnout among veterinary healthcare teams.

SAMPLE

Small animal veterinary hospital employees randomly assigned to participate in an ACT program (intervention group; n = 72) or to not undergo the training program (control group; 71).

PROCEDURES

The study was designed as a randomized, controlled, parallel-arms trial. All participants completed prestudy assessments of burden transfer, stress, and burnout. The ACT program consisted of 3 small-group–format educational sessions tailored to reducing reactivity to difficult veterinary client interactions; sessions were delivered via video teleconference. At the end of the educational sessions (posttest) and 1 month later (1-month follow-up), assessments of burden transfer, stress, and burnout were repeated, and participants in the intervention group provided ratings of program helpfulness and frequency of use for techniques taught in the program.

RESULTS

Participants receiving the program rated it as helpful and reported frequent use of program techniques. Relative to the control group, the intervention group showed significantly reduced burden transfer, stress, work-related burnout, and client-related burnout after completing the educational sessions. These improvements were maintained at the 1-month follow-up.

CLINICAL RELEVANCE

Findings support the usefulness of this program in reducing occupational distress in veterinary medicine. Future work is needed to examine whether it is similarly effective in formats that could be more broadly disseminated (eg, asynchronous, self-paced, independent learning).

Relation between occupation, gender dominance in the occupation and workplace and suicide in Sweden: a longitudinal study

OBJECTIVES

To describe the association between occupations and suicide, and to explore the effect of gender dominance in the occupation and in the workplace on the risk of suicide.

DESIGN

Register-based cohort study.

PARTICIPANTS

3 318 050 workers in Sweden in 2005 and followed up until 2010. Exclusion criteria for the study were: missing information in the occupational codes, yearly income of <100 Swedish krona, missing information of the employer, death or migration, and registered occupational code reported from more than 5 years ago.

OUTCOME

Suicides occurring during 2006-2010 identified in the cause of death register by the International Classification of Diagnoses-10 codes X60-84 and Y10-34.

RESULTS

Occupations with increased suicide were life science and health professionals (OR: 2.8, 95% CI: 1.50 to 5.26) among women. In men, these were metal, machinery and related workers (OR: 1.5, 95% CI: 1.09 to 2.05) and personal and protective service workers (OR: 1.59, 95% CI: 1.14 to 2.22). In terms of gender dominance in the occupation, borderline associations with increased suicide risk were found for men in both male-dominated (OR: 1.32, 95% CI: 0.98 to 1.79) and female-dominated (OR: 1.37, 95% CI: 0.99 to 1.91) occupations. For women, borderline increased risk of suicide was found in female-dominated occupations (OR: 1.51, 95% CI: 0.95 to 2.40). Finally, men showed a borderline increased risk of suicide in female-dominated workplaces (OR: 1.31, 95% CI: 0.94 to 1.81).

CONCLUSIONS

This study found that women in the 'life science and health professionals' group and men in the 'metal, machinery and related workers' as well as 'personal and protective service workers' groups have increased incidence of suicide also when adjusting for sociodemographic characteristics, precariousness of the employment relationship, spells of unemployment, previous mental disorders and suicide attempts. Moreover, gender dominance at workplace and occupation seems to be associated with the risk of suicide among men. The results of our study are novel and are worth exploring in future qualitative studies.

'We're gonna end up scared to do anything': A qualitative exploration of how client complaints are experienced by UK veterinary practitioners

BACKGROUND

UK veterinary practitioners are reported to be fearful of client complaints, but their experiences have not been formally captured. Understanding how complaints impact veterinary practitioners is key to mitigating detrimental consequences.

METHODS

A qualitative exploration of how UK veterinary practitioners experience and respond to adverse events was conducted. Data were collected via focus groups and interviews, which were transcribed and simultaneously analysed. Coding and theme development were inductive rather than restricted by preconceived theories.

RESULTS

Twelve focus groups and 15 individual interviews took place. One theme identified focused on the impact of client complaints. Practitioners experienced unintentional distraction and disengagement from clinical work, as well as employing defensive strategies as a direct result of complaints. The vexatious nature of some complainants was highlighted, along with concerns about practice and regulatory complaint management, lack of appropriate support, discriminatory behaviours and the influence of 'trial by media'.

CONCLUSIONS

Client complaints present a threat to practitioner mental health and workforce sustainability, as well as having implications for patient safety. Mitigating these effects is a complex and multifaceted undertaking, but fairness, transparency and timeliness of practice and regulatory complaint investigation must be prioritised, along with provision of tailored support for those facing complaints.

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.

Medical errors: Experiences, attitudes and perspectives of incoming and outgoing final-year veterinary students in the USA

BACKGROUND

Medical errors have an impact on veterinary patient safety. Studies in human medicine suggest that students can help prevent medical errors. However, there are no studies that address the role of veterinary students in patient safety.

METHODS

An electronic survey was distributed to incoming final-year (IFY) and outgoing final-year (OFY) students at the Washington State University College of Veterinary Medicine. Response data were compared between class year groups with a Fisher's exact test and Mann-Whitney U test.

RESULTS

The response rate was 26.8% (70/261). Most respondents (85.7%) reported being present during a medical error, and 60% reported causing a medical error. The OFY group indicated lower agreement with documenting an error in the patient record and whether all errors should be disclosed. The IFY group felt more distress surrounding potential errors and sequential career implications. Compared with the IFY group, the OFY group agreed more that errors occur frequently in veterinary medicine and disagreed more that hospital staffing is adequate to ensure patient safety. Open responses recognised a need for communication training and identified that the OFY group regarded errors more actionably, whereas the IFY group viewed errors more emotionally.

CONCLUSION

Most veterinary students will experience medical errors prior to graduation, but some lack clarity around appropriate disclosure and documentation. Additional training on medical errors and error disclosure should be provided to veterinary students.

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.

Opportunities for Expanding Access to Veterinary Care: Lessons From COVID-19

The COVID-19 pandemic impacted people and professions around the world, including veterinary medicine. The epidemiology of SARS-CoV-2 broadened the definition of vulnerability in human populations, and the virus' economic impacts exacerbated well-established financial barriers to providing equal access to medical care. The objective of this study was to explore how the pandemic was impacting access to companion animal care in the months March-September of 2020, with a focus on traditionally vulnerable as well as newly vulnerable populations. Additionally, this study sought to identify areas on which the veterinary profession can focus in order to help increase access to veterinary care, including the veterinary school curriculum, continuing education, and telemedicine. We conducted surveys and interviews with animal owners (n = 1009), veterinarians and clinic staff (n = 516), and access to veterinary care organizations (n = 17). Collectively, these responses highlighted how the COVID-19 pandemic created new, and amplified existing, issues with accessing and providing veterinary care. Three critical themes arose; (1) opportunities for further learning for the veterinary profession; including curricula around telemedicine, financially resilient business models and understanding health disparities and vulnerable populations; (2) a need for a network of collaboration and communication across veterinary clinics and access to care organizations and (3) future preparedness for health, economic or other crises response. Overall, the pandemic emphasized the complexity of access to care, as well as the role of veterinarians in public health. This information can be used to develop strategies to aid in increased access to veterinary care now and in the face of future disasters.

Lecture Capture: Friend or Foe?

Lecture capture (LC)-a recording of the live lecture provided as a supplementary resource-is accepted as a standard provision in UK higher education. Previous research has shown it to be very popular with students, although there have been conflicting findings in terms of its impact on attendance and attainment, and suggestions that student engagement with this resource varies depending on their own preferences and approaches. The aim of the present study was to determine the impact of LC on students in a wider sense, encompassing pedagogic and pastoral aspects of student development. This mixed-methods study analyzed focus group and questionnaire data from first- and second-year veterinary students at one UK university. Results demonstrated the student belief that LC is important for learning and well-being but highlighted the facilitation of passive and surface learning that this resource offers. More worryingly, this study identified a group of students for whom this resource may be particularly unhelpful. This group, relied excessively upon LC for learning, felt overwhelmed by their workload despite working fewer hours, and subsequently achieved poorer exam results. A key theme in this negative relationship appeared to be low self-efficacy. The findings enable educators to consider how resources are provided and to encourage implementing mechanisms to help students make better choices, and take control of their learning.