Interventions with potential to improve the mental health and wellbeing of UK veterinary surgeons

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.

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 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.

Student Veterinarian Perceptions of Community-Based Primary Care Veterinary Clinics in Indigenous Communities in Southern Ontario, Canada

Community-based primary care veterinary clinics represent an opportunity to benefit multiple populations. Student veterinarians are afforded the opportunity to build technical and non-technical professional skills, while underserved communities are provided with access to companion animal care. The Ontario Veterinary College (OVC), as with many other veterinary colleges across Canada and the United States, has hosted community-based primary care veterinary clinics, including in local Indigenous communities. As these clinics continue and grow, it is critical to evaluate their operation to ensure that they align with community goals and values, adequately support student learning, and do not perpetuate racism and implicit bias. The objective of this study was to explore the perceptions of student veterinarians who had volunteered at community-based primary care veterinary clinics in First Nations communities in southern Ontario, Canada. We used an online survey that consisted of multiple choice and short answer questions focused on motivating factors for involvement, supports available before and during the clinics, exposure to Indigenous cultures, and the challenges and rewards associated with volunteering. Forty-one student veterinarians from OVC completed the survey in January 2020. Most students were motivated to volunteer to make a positive difference in the lives of people and animals and improve their clinical skills. In general, respondents felt adequately prepared for and supported during their experiences but did recommend additional pre-departure instructions on roles and responsibilities. Participants were ambivalent as to whether they had learned about Indigenous culture, with several strongly recommending more cultural sensitivity training. Most students found their experiences rewarding because of the gratitude expressed by clients and the feeling that they had made a difference. We reflect on the potential benefits and challenges of community-based primary care veterinary clinics in light of student responses.

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.

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

Background

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

Method

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

Results

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

Conclusions

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

Supplementary Information

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

Stress and strain among veterinarians: a scoping review

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

Comparison of resident and intern salaries with the current living wage as a quantitative estimate of financial strain among postgraduate veterinary trainees

OBJECTIVE

To compare resident and intern salaries with current regional living wages as a quantitative estimate of financial strain.

SAMPLE

152 residency programs and 141 internship programs listed with the Veterinary Internship and Residency Matching Program for the 2021-2022 training year.

PROCEDURES

Data were collected for program annual salary and location. Regional living wage for each location was determined with the Massachusetts Institute of Technology Living Wage Calculator, and annual salary was compared with living wage to estimate income surplus before and after taxes. Results for programs in academia and private practice were compared. Spearman correlation was used to determine whether program annual salary was significantly associated with regional living wage.

RESULTS

Mean ± SD income surplus before taxes was $7,786 ± 9,426 for clinical residency programs, $16,672 ± 5,105 for laboratory animal programs, and $5,829 ± 8,119 for internships. Academic residencies and internships offered salaries significantly lower than those offered in private practice, and income surpluses before and after taxes were significantly lower for academic programs than for private practice programs. There were weak and moderate, respectively, correlations between program annual salary and regional living wage for residency (r = 0.369) and internship (r = 0.570) programs.

CLINICAL RELEVANCE

Postgraduate training prolongs financial instability, and annual salaries generally do not meet the minimum income standard of a living wage. Financial stress has implications for mental health and diversity, and these findings invite deeper consideration of current remuneration practices for veterinary residents and interns.

The Human Aspect of Horse Care: How the COVID-19 Pandemic Impacted the Wellbeing of Equestrian Industry Stakeholders

During the lockdown phase of the COVID-19 pandemic, equestrian stakeholders faced a dilemma whereby they were required to balance caring for the welfare of horses with adapting to the restrictions imposed to protect public health. The present study investigated the impact of the pandemic on the wellbeing of a sample of industry stakeholders, including horse owners, equine veterinarians, farriers and welfare centre managers (n = 26) using a qualitative methodology. Findings from the interviews indicated that the mental health and wellbeing of veterinarians and horse owners was negatively affected by pandemic-related obstacles to communication and limitations to horse-owner interactions. However, this study also identified several positive outcomes for wellbeing during lockdown resulting from pro-social activities that were engaged with by horse owners to overcome social isolation, the separation of the community and loneliness. These findings provide accounts of ways in which those caring for horses might be challenged during national emergency scenarios, pointing to areas that would benefit from future mental health and wellbeing interventions.

Frequency, Stressfulness and Type of Ethically Challenging Situations Encountered by Veterinary Team Members During the COVID-19 Pandemic

Ethically challenging situations (ECS) are common in veterinary settings and can lead to moral stress. However, there is no published information about how a global pandemic affects the frequency and types of ECS encountered by veterinary team members. An online mixed methods survey was developed to determine the frequency, stressfulness and types of ECS experienced by veterinarians, animal health technicians and veterinary nurses since the advent of the global COVID-19 pandemic in March 2020. Responses from 540 veterinary team members from 22 countries were analyzed. With the advent of the COVID-19 pandemic, the median frequency of ECS encountered by respondents increased from several times per month to several times per week (Spearman Rank Correlation 0.619, P < 0.0001). The most common ECS (encountered at least several times per week) were: challenging decisions about how to proceed when clients have limited finances (64.4%), conflict between personal well-being and professional role (64.3%), conflict between the interests of clients and the interests of their animals (59.6%). These were followed by challenging decisions about what counts as an essential veterinary service (48.1%); conflict between well-being of family/household members and professional role (46.3%); and challenging decisions about whether to perform non-contact veterinary visits (46.3%). The most stressful ECS (reported to be very or maximally stressful) were: conflicts between the interests of clients and the interests of their animals (50.2%), other (42.9%), conflicts between the interests of my employer and my own interests (42.5%), challenging decisions about how to proceed when clients have limited finances (39.4%), conflict between personal well-being and professional role (38.0%), and conflict between well-being of family/household members and professional role (33.6%). Thematic analysis of free-text responses revealed biosecurity, client financial limitations, animal welfare, working conditions, and client relations as prominent themes. This is, to the best of our knowledge, the first study to describe the impacts of the pandemic on ECS experienced by veterinary teams globally. It identifies an increase in the frequency of ECS associated with the COVID-19 pandemic, and a number of stressors unique to the pandemic. We identified a number of resources and strategies that may help veterinary team members navigate ethical challenges that may emerge in their daily work, as well as in the context of global crises.

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

OBJECTIVE

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

SAMPLE

1,130 veterinarians in clinical practice across Canada.

PROCEDURES

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

RESULTS

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

CONCLUSIONS AND CLINICAL RELEVANCE

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

Occupational stress and coping strategies in experienced Australian veterinarians

BACKGROUND

Veterinarians have been identified as being at particularly high risk of stress in the workplace, this predisposes them to anxiety, depression and suicide. Previous quantitative studies have identified causes of stress and common coping strategies used by veterinarians. The current research aimed to gain a deeper understanding of the experience of veterinarian stress and ways of coping using qualitative methods.

METHOD

Twelve practicing small animal veterinarians in Australia were recruited. They took part individually in semi-structured research interviews. Interpretative phenomenological analysis (IPA) was used to design the study and to analyse the transcripts.

RESULTS

Analyses of the interview data identified an overarching theme: spending less time working in clinical settings and four main themes: Preoccupation, self-doubt, conflicting responsibilities (between care of the animal, the human client and financial demands of the business) and insufficient support.

CONCLUSION

The results give a deeper understanding of sources of stress and the difficulties experienced in coping. These findings can help explain why veterinarians are leaving the profession or reducing their work hours, as well as emphasize the importance of continuing education of veterinarians on self-care and coping with stress, help with resolving ethical dilemmas, and working as a team.

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

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

Characteristics associated with negative attitudes toward mental illness among US veterinarians

OBJECTIVE

To explore associations between demographic, occupational, and mental health characteristics and negative attitudes toward mental illness among veterinarians.

DESIGN

Cross-sectional survey.

SAMPLE

9,522 veterinarians employed in the United States.

PROCEDURES

Data from a previously conducted voluntary, anonymous, web-based survey were used. Negative attitude was defined as slight or strong disagreement with 2 statements: "Treatment can help people with mental illness lead normal lives" (treatment effectiveness) and "People are generally caring and sympathetic to people with mental illness" (social support). Multivariable logistic regression was used to identify variables associated with negative attitudes.

RESULTS

Of the 9,522 respondents, 6,585 (69.2%) were female, 4,523 (47.5%) were 40 to 59 years old, 291 (3.1%) had a negative attitude toward treatment effectiveness, and 4,504 (47.3%) had a negative attitude toward social support. After adjusting for other variables, negative attitude toward treatment effectiveness was significantly more likely in males, those with 10 to 19 (vs 1 to 9) years of practice experience, solo practitioners, those in government (vs "other") practice, those with evidence of serious psychological distress, and those reporting suicidal ideation after veterinary school and significantly less likely in those receiving mental health treatment. A negative attitude toward social support was significantly less likely in males and significantly more likely in 40 to 59 (vs 20 to 39) year olds, childless respondents, solo practitioners, those without membership in a veterinary association, those with evidence of serious psychological distress, those reporting depression during or after veterinary school, and those reporting suicidal ideation after veterinary school.

CONCLUSIONS AND CLINICAL RELEVANCE

Characteristics such as age, sex, practice setting, and mental illness history might be useful to consider when targeting interventions to support and educate veterinarians about mental illness.

The Complex Relationship Between Veterinarian Mental Health and Client Satisfaction

A relatively high risk of poor mental health has been described among Canadian veterinarians, but no published studies have explored the impact that veterinarian mental health may have on veterinary clients and patients. In order to investigate the association between veterinarian mental health and veterinary client satisfaction, veterinarians were randomly sampled and recruited throughout southwestern Ontario, Canada, from November, 2017, through January, 2019. Sixty participating veterinarians completed an enrollment survey that included psychometric scales measuring resilience, perceived stress, anxiety, depression, emotional distress, emotional exhaustion, depersonalization, personal accomplishment, burnout, secondary traumatic stress, and compassion satisfaction. Nine hundred and ninety-five companion animal clients of these veterinarians were recruited in-clinic over 2–3 days and completed a post-appointment survey including the Client Satisfaction Questionnaire. The associations between clients' satisfaction scores (as the outcome variable) and each of the veterinarians' mental health measures (as the explanatory variables) were assessed using separate, multilevel, multivariable linear regression models. The associations between client satisfaction and veterinarian mental health measures were non-linear and complex; in several of the models, relatively higher client satisfaction was unexpectedly associated with poor veterinarian mental health states, while lower client satisfaction was associated with mental health scores suggesting wellness. Given that client satisfaction may impact client adherence to medical recommendations, client loyalty, and business income, the association with veterinarian mental health may have broad implications and warrants further investigation.

Development and validation of a Burden Transfer Inventory for predicting veterinarian stress related to client behavior

OBJECTIVE To develop and validate a Burden Transfer Inventory (BTI) of stressful client behaviors and to evaluate whether those behaviors are associated with client caregiver burden and contribute to veterinarian stress and burnout. DESIGN 3-stage cross-sectional psychometric validation study. SAMPLE 1,151 small animal veterinarians and 372 dog and cat owners. PROCEDURES During stage 1, a pool of 34 items representing stressful client behaviors was created through open-ended surveys of practicing veterinarians and 3 phases of pilot testing. During stage 2, 1,151 veterinarians recruited through the Veterinary Information Network completed a survey including those behavior items and validated measures of stress and burnout. Completed surveys were randomly assigned to either a measure development or validation database for factor and item analyses. Data were then combined to determine whether the BTI was correlated with measures of stress and burnout. During stage 3, owners of dogs and cats with a serious illness completed an online survey to assess how frequently they engaged in each BTI item as well as a validated measure of caregiver burden. RESULTS For dog and cat owners, there was a significant positive correlation between caregiver burden and the frequency that those owners reported engaging in BTI items. The frequency that veterinarians reported encountering BTI items was positively correlated with measures of stress and burnout, which suggested burden transfer from owners to veterinarians. The extent to which veterinarians reported being bothered by BTI items was a more robust predictor of stress and burnout than the frequency with which those items occurred. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated the BTI can be used to understand how client behaviors associated with caregiver burden affect veterinarian stress and burnout. The BTI may be useful to identify specific stressors affecting individual veterinarians and how they react to those stressors.

Current insights in veterinarians' psychological wellbeing

This article outlines some of the key prevalence studies regarding the psychological health of veterinarians, and highlights the reasons for distress, with factors such as workload, financial issues, long working hours, challenging interactions, unexpected outcomes, euthanasia and fear of complaints or making mistakes being commonly cited. During the last decade, many ways to improve veterinarians' wellbeing have been suggested, including both individual and organisational strategies. However, what appears to be lacking is a body of intervention research to test the effectiveness of these strategies.This article outlines some of the types of psychological distress which have been reported in veterinarians, and emphasises key issues such as the impact of practitioners' help-seeking behaviour and moral and ethical dilemmas. Some wellbeing interventions from overseas studies are highlighted, with a focus on strategies that can be adopted by organisations as well as individuals. The review includes several recommendations to improve the psychological wellbeing of veterinarians such as using multi-disciplinary clinician wellbeing models to structure interventions, the possibilities of mindful self-compassion practices, and the regular use of peer support and reflective groups. It concludes that implementation and robust evaluation of wellbeing initiatives in the New Zealand veterinary population are urgently needed.

Meaningful work and well-being: a study of the positive side of veterinary work

OBJECTIVES

Mental health is a growing concern in many healthcare professions, including veterinary medicine, as research suggests that veterinarians report higher levels of distress, burnout and suicidal ideation than other healthcare occupations and the general public. A recent literature review found that about twice as many articles published on veterinary wellness refer to the negative aspects of mental health (eg, stress and depression) compared with the positive aspects of well-being. Little attention has been devoted to examining the positive aspects of veterinarians' work, and few models have been developed to explain their well-being. This paper empirically assesses a veterinary model of work-derived well-being based on the theory of eudaimonia. Eudaimonic well-being reflects having fulfilling work that contributes to the greater good. Three core clusters of job characteristics are hypothesised relevant to veterinarian well-being that include: actualising self, helping others (animals or people) and a sense of belonging (to team or profession). In addition, meaningful work is proposed as the mechanism through which situational job characteristics may exert a positive influence on well-being.

METHODS

Survey data from 376 veterinarians in clinical practice were analysed using path analysis.

DISCUSSION

Meaningful work is important in understanding the well-being of veterinarians. Job characteristics (self-actualising work, helping animals and people and a sense of belonging) contribute to a sense of meaningful work, which in turn is related to eudaimonic well-being. Excessive job demands (work overload, financial demands and physical health risks) appear less relevant in understanding meaningful work but are clearly important in having negative consequences for veterinarians' well-being.While strategies that cultivate meaningful work may be effective in nurturing veterinarians' well being, several limitations of this study should be noted. First, due to the cross-sectional data, definitive statements about the causal ordering of variables cannot be made. Second, the data were derived from a single source such that monomethod bias may be an issue. Third, the data rely on self-report measures and the responses may be influenced by social desirability or response biases. Lastly, while the sample may be representative of the veterinarians throughout a large geographic area in Canada, it may not represent the work arrangements of veterinarians in other countries.

CONCLUSIONS

The significance of these findings is that they may shift research attention from focusing on the harmful, demanding aspects of veterinary work to better understanding the deeply meaningful aspects that improve veterinarians' well-being. In addition, the results may stimulate consideration of strategies that move beyond individual-level interventions that focus on veterinarians adopting better coping strategies and becoming more resilient. This may lead to adopting organisational and occupational-level strategies that can involve promoting more positive and supportive workplace cultures and developing more professional resources for promoting wellness and meaning in the profession of veterinary medicine.

Being Nice Is Not Enough-Exploring Relationship-Centered Veterinary Care With Structural Equation Modeling. A Quantitative Study on German Pet Owners' Perception

During the last years, the philosophy of relationship-centered care gained increasing attention in veterinary medicine. Relationship-centered care is based on a joint venture between pet owner and veterinarians and therefore offers the opportunity to satisfy the pet owners' need for participation in medical decision-making and to provide the best care for the patient. Although research on relationship-centered care in the veterinary consultation is still limited, the available findings suggest that the characteristics of relationship-centered care reflect the pet owners' expectations on satisfactory veterinary care. In this study a quantitative survey was conducted among German pet owners that collected information regarding their perception of the veterinarians' communication during the last appointments. Questionnaires were available online and paper-based. Data were analyzed using exploratory factor analysis and structural equation modeling using SAS. First aim of the study was to explore structural equation modeling (SEM) as an opportunity to evaluate quantitative data in the field of research on relationship-centered care. Further, SEM was used to evaluate associations between the implementation of different characteristics of relationship-centered care in the veterinary practice (empathic communication, partnership-building) and latent outcome variables regarding the pet owners (pet owners' need for further information, consultation of competing health care providers). N = 1,270 valid questionnaires were completed. Participants owned small companion animals (55.6%), horses (7.6%), or both (36.9%) within the last 2 years. Results of SEM suggest that partnership-centered and empathic communication decreased the pet owners' needs for further information (e.g., from online sources) and their need to consult alternative health providers (e.g., homeopaths). Especially addressing the pet owners' worries and fears, discussing pros and cons of diagnostic and therapeutic options as well as providing the required amount of information were shown to be large influence factors within the model. Therefore, veterinarians are recommended to implement the concept of partnership-centered care in their daily practice, for it may increase pet owners' loyalty and satisfaction. Results may motivate future research in this field. Further development of the proposed model assumptions may enable valuable progress in the field of quantitative research on relationship-centered care.

Caregiver burden in owners of a sick companion animal: a cross-sectional observational study

Much recent work has focused on occupational stress in veterinary medicine, although little is known about the possible contribution of client-based factors. Clients providing care for a companion animal with protracted illness are likely to experience 'caregiver burden' and reduced psychosocial functioning, which may ultimately lead to increased veterinarian stress. This cross-sectional observational study assessed caregiver burden and psychosocial function in 238 owners of a dog or cat, comparing owners of an animal with chronic or terminal diseases (n=119) with healthy controls blindly matched for owner age/sex and animal species (n=119). Results showed greater burden, stress and symptoms of depression/anxiety, as well as poorer quality of life, in owners of companion animals with chronic or terminal disease (p<0.001 for all). Higher burden was correlated with reduced psychosocial function (p<0.001 for all). Owners of a sick companion animal exhibit elevated caregiver burden, which is linked to poorer psychosocial functioning. This knowledge may help veterinarians understand and more effectively handle client distress in the context of managing the challenges of sick companion animal caregiving. Future work is needed to determine whether clients with this presentation impact veterinarian stress and how burden in this population might be reduced.

The Impact of a Brief Embedded Mindfulness-Based Program for Veterinary Students

Veterinary medical students, like other university students, are likely to experience elevated levels of stress, anxiety, and depression over the course of their studies. Mindfulness-based interventions have previously been effective for university students in reducing stress, depression, and anxiety. In this study, a mindfulness-based intervention was embedded in a core (compulsory) unit of a veterinary science course, in part with the aim of improving student well-being. Preliminary results suggest that, despite the mindfulness intervention, overall symptoms of stress, depression, and anxiety among participants (n=64) increased between the start and end of the semester. However, further analysis showed that most of this longitudinal increase was attributable to individuals who scored above the normal range (i.e., at least mild level of symptoms) in one or more measures at the beginning of the semester. Within this subset, individuals who regularly engaged in mindfulness practice once a week or more throughout the semester reported significantly lower depression and anxiety symptoms than those who practiced less than once a week (i.e., who had long periods without practice). Results suggest that engaging regularly in mindfulness practice potentially acted as a protective factor for students already experiencing at least a mild range of symptoms of anxiety and depression at the beginning of the semester. While not all veterinary students may derive significant benefit immediately, providing access to an embedded mindfulness program early in their program may facilitate the development of adaptive coping mechanisms, which may be engaged to increase resilience across their academic and professional life.

Zoonotic disease risk perceptions in the British veterinary profession

In human and veterinary medicine, reducing the risk of occupationally-acquired infections relies on effective infection prevention and control practices (IPCs). In veterinary medicine, zoonoses present a risk to practitioners, yet little is known about how these risks are understood and how this translates into health protective behaviour. This study aimed to explore risk perceptions within the British veterinary profession and identify motivators and barriers to compliance with IPCs. A cross-sectional study was conducted using veterinary practices registered with the Royal College of Veterinary Surgeons. Here we demonstrate that compliance with IPCs is influenced by more than just knowledge and experience, and understanding of risk is complex and multifactorial. Out of 252 respondents, the majority were not concerned about the risk of zoonoses (57.5%); however, a considerable proportion (34.9%) was. Overall, 44.0% of respondents reported contracting a confirmed or suspected zoonoses, most frequently dermatophytosis (58.6%). In veterinary professionals who had previous experience of managing zoonotic cases, time or financial constraints and a concern for adverse animal reactions were not perceived as barriers to use of personal protective equipment (PPE). For those working in large animal practice, the most significant motivator for using PPE was concerns over liability. When assessing responses to a range of different “infection control attitudes”, veterinary nurses tended to have a more positive perspective, compared with veterinary surgeons. Our results demonstrate that IPCs are not always adhered to, and factors influencing motivators and barriers to compliance are not simply based on knowledge and experience. Educating veterinary professionals may help improve compliance to a certain extent, however increased knowledge does not necessarily equate to an increase in risk-mitigating behaviour. This highlights that the construction of risk is complex and circumstance-specific and to get a real grasp on compliance with IPCs, this construction needs to be explored in more depth.

Survey of occupational hazards in Minnesota veterinary practices in 2012

OBJECTIVE

To identify the scope of occupational hazards encountered by veterinary personnel and compare hazard exposures between veterinarians and technicians working in small and large animal practices.

DESIGN

Cross-sectional survey.

POPULATION

Licensed veterinarians and veterinary staff in Minnesota.

PROCEDURES

A survey of Minnesota veterinary personnel was conducted between February 1 and December 1, 2012. Adult veterinary personnel working in clinical practice for > 12 months were eligible to participate. Information was collected on various workplace hazards as well as on workplace safety culture.

RESULTS

831 eligible people responded, representing approximately 10% of Minnesota veterinary personnel. A greater proportion of veterinarians (93%; 368/394) reported having received preexposure rabies vaccinations than did veterinary technicians (54%; 198/365). During their career, 226 (27%) respondents had acquired at least 1 zoonotic infection and 636 (77%) had been injured by a needle or other sharps. Recapping of needles was reported by 87% of respondents; the most common reason reported by veterinarians (41%; 142/345) and veterinary technicians (71%; 238/333) was being trained to do so at school or work. Recent feelings of depression were reported by 204 (25%) respondents. A greater proportion of technicians (42%; 155/365) than veterinarians (21%; 81/394) indicated working in an environment in which employees experienced some form of workplace abuse.

CONCLUSIONS AND CLINICAL RELEVANCE

Veterinary personnel in Minnesota were exposed to several work-related hazards. Practice staff should assess workplace hazards, implement controls, and incorporate instruction on occupational health into employee training.

The role of veterinary team effectiveness in job satisfaction and burnout in companion animal veterinary clinics

OBJECTIVE

To determine the role of veterinary team effectiveness regarding job satisfaction and burnout in companion animal veterinary practice.

DESIGN

Cross-sectional observational study.

SAMPLE

48 companion animal veterinary health-care teams.

PROCEDURES

274 team members participated in an online survey. Overall job satisfaction was evaluated with a 1-item measure, and the 3 dimensions of burnout (exhaustion, cynicism, and professional efficacy) were measured with the Maslach Burnout Inventory-General Survey. Team effectiveness was assessed with a survey developed for this study. Demographic and team effectiveness factors (coordinated team environment, toxic team environment, team engagement, and individual engagement) associated with job satisfaction and burnout were evaluated.

RESULTS

Overall mean job satisfaction score was 5.46 of 7 (median, 6.00); veterinary technicians and kennel attendants had the lowest scores. According to the Maslach survey results, 22.4% of participants were in the high-risk category for exhaustion, 23.2% were in the high-risk category for cynicism, and 9.3% were in the high-risk category for professional efficacy. A coordinated team environment was associated with increased professional efficacy and decreased cynicism. A toxic team environment was negatively associated with job satisfaction and positively associated with exhaustion and cynicism. Individual engagement was positively associated with job satisfaction and professional efficacy and negatively associated with exhaustion and cynicism.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested the effectiveness of a veterinary team can significantly influence individual team members' job satisfaction and burnout. Practices should pay specific attention to the effectiveness with which their veterinary team operates.

Career identity in the veterinary profession

This research investigates vet and vet nurse career identity through the qualitative methodology of narrative enquiry. It derives learning and understanding from these empirical data to assist the veterinary profession to adjust to the changing industry landscape. Through a case series of 20 vets and vet nurses' career stories, this paper seeks understanding about career identity and its impact on individuals and organisations in the light of industry consolidation. Findings suggest that career is central to identity for many veterinary professionals who tend to have a strong sense of self; this is particularly evident around self as learner and technically competent, teacher and educator, ethical and moral and dedicated and resilient. Consequently, mismatches between 'who I am' and 'what I do' tend not to lead to identity customisation (to fit self into role or organisation) but to the search for alternative, more identity-compatible employment. This study offers a valuable insight for employers, veterinary professionals and universities. It suggests that businesses can gain competitive advantage and employees achieve validation and enrichment by working towards organisational and individual identity congruence and that teaching veterinary professionals with contemporary business in mind may develop graduates with a more sustainable identity.